NHS Capital Spending

Gregory Campbell Excerpts

Wednesday 4th March 2026 Westminster Hall

[Bobby Dean]

I agree with the hon. Gentleman, and I am sure that, like me, he hears constituents say that they do not want to attend their local A&E because they do not trust that they will be seen in time. I am sure that the figures he is describing are an undercount of the people who should be in there. Like me, he will have received emails about corridor care for some time. I had hoped that corridor care was a peak crisis moment and that it would subside, but it has become the norm and that is extremely worrying. It is not acceptable for patients, it is not fair on staff, and it is not a sustainable way to run our NHS.

If the Government are to reconsider which schemes should be in which waves of the new hospital programme, let me assure the Minister that my local trust is ready to go. Plans have been drawn up, land has been secured, and teams can move at pace. We need this, we want this, and we are ready. If that is not possible, but other pots of capital to be reallocated still remain, I make a separate plea: extend St Helier’s emergency department now. That is a smaller ask than delivering a whole new building, but it will make a big difference. The only thing more full than the corridors at my local hospital right now is my inbox, which is filling up with constituents describing their traumatic experiences.

St Helier hospital emergency department sees around 250 patients a day, with routine overcrowding leading to the trust being placed into national oversight measures. Kirsty, one of my constituents, was left anxiously waiting for her 83-year-old mum to be seen, witnessing elderly patients crying, vomiting, screaming and walking around in severe pain in the corridors. The father-in-law of Muhammad, another constituent, waited over 13 hours only to return home without seeing a doctor at all. Others have shared deeply personal details of their stories; their conditions were explained to them alongside countless others in the same corridor. It is undignified, unjust and unsafe.

The trust has come up with a plan. It believes that it can redesign the existing estate, creating a new urgent treatment centre and expanding the same-day emergency care service. By doing so, it would dramatically increase the number of patients it can see. The urgent treatment centre would be able to handle up to 30% of patients—up from 14%—and SDEC could get to 20%, up from 8%. That would prevent unnecessary overnight stays, free up hospital beds, speed up ambulance transfers, and reduce delays for patients needing hospital admission. The plan would also address £15 million of the trust’s ageing estates backlog. It is immediately deliverable; the trust believes that work can begin as early as autumn 2026. It would make an incredible difference, so I ask the Minister to make use of any influence she has over the matter to help the proposal get over the line.

Before I conclude, let me raise one further point about NHS capital expenditure that I suspect will not make me popular, but that I believe is right. The Government have tentatively re-entered the world of public-private partnership models with their announcement of neighbourhood health centres late last year. We all know how disastrous that model of financing was in the past, with the long-term costs to the taxpayer far outweighing the short-term benefits. Britain was among the first in the world to pilot such a scheme, and it failed fast.

It must be said, however, that other nations have learnt the lessons of our failures and successfully delivered social infrastructure at scale, on budget and on time. Indeed, I believe that is one of the reasons why we have fallen behind so badly. As a member of the Treasury Committee, I recently guested on a Public Accounts Committee inquiry into PPP, which concluded that if we get procurement, contract management, and the risk allocation of projects right, then we can massively accelerate the delivery of infrastructure in our country in a way that delivers real value for money for the taxpayer.

[Mr Gregory Campbell (East Londonderry) (DUP)]

I congratulate the hon. Member on securing the debate. To summarise what he is saying, we need to better spend the money that is currently being deployed in the NHS. Does he agree that this has to be the underpinning feature going forward? More and more money has been poured into the NHS; we all think it is a fantastic organisation and praise those who work in it, but we need to spend that money better and modernise the monolith that is the NHS.

[Bobby Dean]

I agree with the hon. Gentleman, who hits on one of the central points of this debate. We can continue to pour money into the operational side of the NHS, but if we do not get the capital expenditure right and improve the equipment, systems and buildings, we will always be pouring good money after bad.

I know that PPP is fraught with political risk, particularly for a Labour Government who are scarred by what happened in the past, but I urge them to look at the National Audit Office’s report and the experience of others internationally. They should also listen to the NHS Confederation, which is pushing them to go further and experiment with different financial models for delivering the infrastructure that we need at scale.

NHS capital has been insufficient, uncertain and inflexible for far too long. The new Government have good intentions to improve on all three, but now is the first moment at which we can start to look at their delivery. After what I have outlined today, I would like to put several questions to the Minister. Will she update us on the current level of capital underspend under this Government? Where in the system is the underspend occurring, and what is being done about it? Will the Government allow trusts to carry forward any unspent capital to future years? Will that exist beyond the current spending review period? What assessment has the Department made of the delivery of the new hospital programme, and will any schemes be reconsidered for movement between the waves? Will the Minister outline whether the Government plan to reform the capital allocation system to allow multi-year planning and reinvestment of trust surpluses permanently?

The NHS cannot function without modern, safe and efficient infrastructure. No Government can deliver improvements in performance or productivity without addressing the capital crisis at the heart of our system. I urge the Minister to use this moment to reset the capital regime and put it on a footing that prioritises long-term investment, accelerates delivery and gives patients and staff the facilities they need and deserve.