New Hospitals

Baroness Laing of Elderslie Excerpts

Thursday 25th May 2023 Commons Chamber

[The Secretary of State for Health and Social Care (Steve Barclay)]

It is like a two-for-one offer.

With permission, Madam Deputy Speaker, I will make a statement on the new hospital programme.

As we celebrate 75 years of the NHS this summer, we must continue to set up its success for the 75 years to come. At the heart of this is our new hospital programme, the biggest hospital building programme in a generation, which will help us to deliver on our manifesto commitment to build 40 new hospitals by 2030. Today, I reconfirm to the House our commitment for 40 new hospitals to be built by 2030.

We made our manifesto commitment in 2019, and in 2020 we listed 40 schemes as part of the new hospital programme. Since we formally launched the schemes, we have learned more about the use of reinforced autoclaved aerated concrete, more commonly known as RAAC. RAAC is a lightweight form of concrete that, between the mid-1950s and the mid-1980s, was commonly used in the construction of a number of public buildings, including hospitals—often on roofs and occasionally in walls and floors.

We now know that RAAC has a limited lifespan, with difficult and dangerous consequences for the people who rely on or work in those hospitals. I know this has caused considerable concern to colleagues in this House, to NHS staff in those hospitals and to constituents who are treated in them.

We remain committed to eradicating RAAC from the wider NHS estate. As part of the spending review allocation up to 2024-25, we allocated £685 million in immediate support to the affected trusts, but in some cases we must go much further. Seven hospitals in England were constructed, either wholly or in major part, with RAAC, and an independent assessment shows they are not safe to operate beyond 2030. Two of the hospitals are already part of the new hospital programme, namely the West Suffolk Hospital and James Paget University Hospital. The five remaining hospitals have submitted expressions of interest to join the programme but are not yet part of it. Those are Airedale General Hospital in Keighley, Queen Elizabeth Hospital in King’s Lynn, Hinchingbrooke Hospital near Huntingdon, Mid Cheshire’s Leighton Hospital, and Frimley Park Hospital in Surrey.

We accept in full the independent assessment that these hospitals are not safe to operate beyond 2030. Today, I confirm to the House that we will expand our new hospital programme to include those five further hospitals built with significant amounts of RAAC. With the two RAAC hospitals already in the programme, the seven RAAC hospitals will be rebuilt completely using a standardised design known as Hospital 2.0, with the aim of completing all seven by 2030. I can confirm to the House today that these new hospitals will be fully funded.

I want to take a moment to thank all those who have campaigned so tirelessly for new hospitals to be built to replace the existing RAAC hospitals, including my hon. Friends the Members for Keighley (Robbie Moore) and for Shipley (Philip Davies), who have championed Airedale vociferously; my right hon. Friend the Member for Surrey Heath (Michael Gove), who has campaigned so strongly for Frimley; my hon. Friend the Member for Huntingdon (Mr Djanogly), who lobbied hard for Hinchingbrooke; my hon. and learned Friend the Member for Eddisbury (Edward Timpson) and my hon. Friend the Member for Crewe and Nantwich (Dr Mullan), who led the campaign on Leighton Hospital; and my hon. Friend the Member for North West Norfolk (James Wild), my hon. Friend the Member for North Norfolk (Duncan Baker), who is my Parliamentary Private Secretary, and my right hon. Friend the Member for South West Norfolk (Elizabeth Truss), who all campaigned so assiduously for the hospital in King’s Lynn.

Taken together, the new hospital programme represents a huge commitment to strengthening the NHS estate. Since 2020, we have committed to invest £3.7 billion by the financial year 2024-25, and we expect the total investment to now be more than £20 billion for the programme as a whole. Resolving the uncertainty over the RAAC hospitals, which today’s announcement achieves, in turn allows much-needed clarity for the rest of the new hospital programme. The programme has been divided into cohorts 1 to 4, and construction in cohort 1 has already started. Cohort 1 contains eight schemes. Two hospitals are already open to patients, with the new Louisa Martindale Building at the Royal Sussex County Hospital in Brighton due to open later this year. Work at Moorfields Eye Hospital is due to start imminently, having cleared its final business case.

Cohort 2 comprises 10 schemes. The following schemes will now be ready to proceed, in line with plans set out by the respective trusts: the National Rehabilitation Centre; Derriford emergency care hospital in Plymouth; Cambridge Cancer Research Hospital; Dorset County Hospital in Dorchester; and St Ann’s Hospital, Christchurch Hospital, the Royal Bournemouth Hospital and Poole Hospital, all of which are in Dorset. A further two schemes within cohort 2, Shotley Bridge Community Hospital and the women and children’s hospital in Cornwall, will also be approved to proceed, but in line with the standardised design elements we are promoting through Hospital 2.0, on which I will set out further details in a moment. As such, with the uncertainty that surrounded the RAAC hospitals now addressed, all the cohort 2 schemes can proceed, and they will be fully funded.

The cohort 3 schemes include major hospital new builds at Sutton, Whipps Cross, Hillingdon, Watford, Harlow, Leeds and Leicester. Today’s announcement confirms that those schemes will now proceed and be fully funded. They will be constructed using the Hospital 2.0 standardised approach. It is worth reminding the House of the merits of using that methodology. First, although longer will be taken on the initial design, the current approach of each scheme constructing its own bespoke design has meant that the average time from design to completion of a major hospital has been about 11 and a half years. By embracing modern methods of construction, we will massively speed up the construction phase and, in addition, accelerate Treasury and other government assurance processes. There has been much debate to date on when hospitals start, but the more important issue is when schemes are completed. A standardised modular design has been shown to work in other sectors—for example, when building schools and prisons—and is widespread across the private sector.

Today’s announcement confirms that all cohort 3 schemes can now proceed. In turn, enabling works that had been held up due to the uncertainty about the RAAC hospitals can now progress. I pay tribute to right hon. and hon. Members who have campaigned strongly for the cohort 3 hospitals to proceed. They include my right hon. Friends the Members for Uxbridge and South Ruislip (Boris Johnson), for Chingford and Woodford Green (Sir Iain Duncan Smith), for Harlow (Robert Halfon) and for Epping Forest (Dame Eleanor Laing), and my hon. Friend the Member for Hertford and Stortford (Julie Marson). I know that not all of them can raise points during this statement, but the latter three have all championed Harlow and its case. I also pay tribute to my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn), to name just some of those who have raised these issues. [Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order.

[Steve Barclay]

Opposition Members have asked for the update and called for the programme, but they do not want to hear about it when the announcement is being made.

Turning to the hospitals in cohort 4, two of the schemes —West Suffolk Hospital and James Paget University Hospital—are RAAC hospitals. As I touched on a moment ago, they have been confirmed as part of the seven RAAC schemes. They will therefore be funded for completion by 2030. Four more hospitals in cohort 4 remain on track for completion by 2030: Milton Keynes University Hospital, Kettering General Hospital, Musgrove Park Hospital in Taunton and Torbay Hospital. Again, I pay tribute to the Members for those constituencies, including my hon. Friends the Members for Milton Keynes South (Iain Stewart), for Milton Keynes North (Ben Everitt), for Kettering (Mr Hollobone), for Taunton Deane (Rebecca Pow) and for Torbay (Kevin Foster).

The remaining seven hospitals within that cohort will also proceed as part of the new hospital programme. The work will start on those schemes over the next two years, but they will be part of a rolling programme where not all work will be completed by 2030. That is a reflection of the disruption that two years of the covid pandemic caused, as well as the pressure from construction inflation.

Some work within cohort 4 will start next year. That includes a new surgical hub at Eastbourne, alongside the discharge lounge already under construction. We will discuss key worker accommodation on the site with the trust, as part of engagement with the local housing association. At Charing Cross Hospital in Hammersmith, work will begin on temporary ward capacity to enable the floor-by-floor refurbishment to proceed. In Nottingham, work will begin on a new surgical hub and three new operating theatres will begin as part of the wider redesign, taking forward the Ockenden report recommendations. In Lancashire, a new surgical hub will be opened at the Royal Preston Hospital, which is due to be completed this year. We will reconfigure services across two trusts. I am sure that one of those sites will be of interest to Mr Speaker, as it is expected to be near Chorley. We are in active discussion with the Royal Berkshire Hospital, given the problems with the existing site, which had already made a 2030 completion date very stretching. In addition, we are building three new mental health hospitals in the Surrey and Borders, Derbyshire and Mersey Care areas.

Turning to Devon, I pay tribute to my hon. Friend the Member for North Devon (Selaine Saxby) and my right hon. and learned Friend the Member for Torridge and West Devon (Sir Geoffrey Cox), who have secured new community diagnostics centres at North Devon. The discharge hub there is near completion, and we will take forward discussions with the trust and the local housing association on key worker accommodation over the next two years, as the first part of the North Devon new hospital build. We will discuss the original refurbishment proposal alongside the new build Hospital 2.0 option.

In summary, the cohort schemes will all proceed, but the commitment to completion by 2030 applies to the 40 schemes set out today, which meets our manifesto commitment to build 40 hospitals by 2030.

Finally, let me set out the merits of the Hospital 2.0 approach. Building new hospitals in this way has clear advantages. Construction experts estimate that with modular design, the efficiency saving will be in the region of 25% per square foot. That is essential in addressing the pressure of construction inflation and unlocking the additional schemes that are being absorbed as a result of the RAAC announcement.

There is one key risk to today’s announcement: the plan announced by the Labour party. As we speed things up, it is determined to grind them to a halt. The plan Labour set out on Monday said:

“as a first step, before we commit to any more money, we’d make an assessment of all NHS capital projects to make sure money is getting allocated efficiently”.

So the risk to these schemes is from those on the Benches opposite.

Today’s announcement confirms more than £20 billion of investment for the NHS estate. It confirms that all seven RAAC hospitals, which NHS leaders have called on the Government to prioritise, will be prioritised, with complete rebuilds using modern methods of construction. It allows all cohort 2 schemes to proceed once business cases have been agreed, and modular build will be used for two of those schemes. It gives trusts the certainty to begin enabling works on major schemes in cohort 3 and a package of early work for schemes in cohort 4, two of which will be accelerated as part of the RAAC programme.

In 2019 we committed to the biggest hospital building programme in a generation, and today we confirm the funding to build 40 hospitals by 2030. I commend this statement to the House.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the shadow Secretary of State.

--- Later in debate ---

[Steve Barclay]

It is a very strange approach to complain about Members coming to the Chamber. The hon. Gentleman almost sinks his own point with his opening gambit. We are here because of the campaigning of Conservative Members for new hospitals. That is why, when they see that there is a statement on new hospitals as part of that campaign, it is no surprise that they are in the Chamber. It is pretty odd to complain about Members coming to the Chamber because they are interested in what is happening in their own constituencies.

It is equally strange for the Opposition to appear to be complaining about a plan that they have been calling for over recent weeks. The shadow Secretary of State has repeatedly said that he wants to see the new hospitals programme plan. We have set that out in the statement today, to which he says he is concerned that we only have a plan. A plan on the Government side beats no plan on the Opposition side.

The hon. Gentleman also seems, slightly oddly, not to welcome a commitment to over £20 billion of investment in the NHS estate. He seems to have an objection to me giving a commitment to address the issues of RAAC hospitals, which NHS leaders themselves have said should be prioritised and which independent reports have said create a risk beyond 2030, and coming to the Chamber after discussions with Treasury colleagues and others across Government to confirm that we now have funding to address the seven RAAC hospitals that he has called for action on.

The shadow Secretary of State then seems to have an objection about speed, yet the whole thrust of my statement was about how we are changing our methodology through the use of modern methods of construction, learning from what has been done in the education sector, the justice sector and the private sector about delivering construction schemes at pace. That gives more confidence on cost; it stops local chief executives changing the specifications once designs are under way; it allows things to be built more quickly; it allows us to benefit from technology, with construction in factories as opposed to more conventional construction; and it allows us to deliver schemes more quickly.

It is for that reason that Conservative Members campaigned so strongly for it, none more so than my right hon. Friend the Member for Pendle (Andrew Stephenson), who has been an assiduous champion of the case for Airedale General Hospital. As the statement sets out, we are committed to addressing the RAAC hospitals, and fixing them has in turn unblocked something that was causing delay to the programme for the enabling works for cohort 3, in particular.

Cohort 2, where schemes are well advanced, will also now be able to proceed. We also updated the House on the more bespoke approach being taken to some of cohort 4. The shadow Secretary of State is right to talk about a sense of jeopardy, because those on the Opposition Front Bench have said they want to pause, review and stop the schemes we will be proceeding with. That is the real risk to the new hospitals programme. We have a new approach. We have a clear plan. It is the Labour party that wants to stop it.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the Chair of the Health and Social Care Committee.

[Steve Brine (Winchester) (Con)]

I am grateful for the statement; the Select Committee will want to have a good look at it, and we will start when the Secretary of State comes to see us next month. At the last election, I promised my constituents significant investment in Winchester Hospital. That is already happening, and now with early work in cohort 4 we have the promise of the elective hub to scale the orthopaedic list. Can the Secretary of State be clear with my constituents that, as the new Hampshire hospital comes together as part of the wider cohort 4, it will be for clinicians to make the clinical case on what safe and sustainable services look like in the long term for those people?

--- Later in debate ---

[Steve Barclay]

St Mary’s is part of three aspects of the Imperial NHS trust: there is the work at Charing Cross in Hammersmith, where we are building the temporary ward to unblock the refurbishment, which will be floor by floor, and the work in Hammersmith with the cardiac—[Interruption.] The hon. Member for Hammersmith (Andy Slaughter) may want to chunter, but I am trying to explain the investment we are placing into the constituencies, so we have funding going into—[Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. I have asked the hon. Gentleman politely to stop shouting. I hope he will do so.

[Steve Barclay]

Thank you, Madam Deputy Speaker. We recognise the importance of the Imperial bid; that is why we are starting to build the temporary ward capacity at Charing Cross and the first phase of work is under way on the cardiac elective recovery hub, to bring cardiac work on to the Hammersmith site. On St Mary’s Hospital, we have already put in some initial funding to explore the new site with Transport for London and Network Rail. That will go into the rolling programme, of which St Mary’s will be part, alongside the redesign that is needed, taking on board the changes at Charing Cross and Hammersmith.