New Hospital Programme

Karin Smyth Excerpts

Wednesday 22nd January 2025 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairship, Dr Huq. I congratulate the hon. Member for Bexhill and Battle (Dr Mullan) on securing a debate on this important matter. I commend his timing in getting this debate two days after an announcement that nobody else knew about. If he were a Labour MP, there would be howls of “Fix!”

There has been a lot of back and forth, but I want to confirm that we pledged to support this programme, and we are supporting it. That is what Monday was about—let us be in no doubt about that. I was part of the largest capital programme in the NHS when I served as a non-executive director under the last Labour Government; this will be the next largest capital programme, delivered under this Labour Government.

As Lord Darzi noted in his investigation, the hospitals that we rely on are deteriorating after the NHS suffered years of under-investment. This Government inherited a programme to deliver new hospitals that was unfunded beyond March 2025 and was repeatedly delayed, with no credible delivery plan.

[Chris Vince]

I thank the Minister for the Secretary of State’s statement on Monday, in which £1.5 billion of Government funding was dedicated to Princess Alexandra hospital. At my local hospital in Harlow, it is not just an issue of funding: in fact, the land was not purchased and the business plan was not completed. The idea that the hospital would be completed by 2030 was a pipe dream, was it not?

[Karin Smyth]

I thank my hon. Friend; I am happy to take interventions, but I need to finish by half-past 4, so I am conscious of time. He is absolutely right, and I will come on to his point.

We need to be very clear and honest with people about what was ready and about the different stages of these programmes, which we are very keen to do. Staff and patients deserve better. That is why the Secretary of State asked officials to review the programme and put it on a firm footing with sustainable funding so that all the projects can be delivered.

I thank the hon. Member for Bexhill and Battle for his service to the NHS and his experience. I agree that it is appalling for staff. We all understand that he and I disagree in our political analysis, but he made some really well-informed points about models of care and future models of care, all of which we need to take into account in the delivery of this programme and other parts of the capital programme—and we will.

As the Secretary of State announced to the House on Monday, we now have a realistic plan to deliver the programme. I am pleased that we can be honest with people as we start a new chapter setting out a new commitment to deliver these hospitals, which are so important to all our constituents, that is realistic and backed with funding. We have worked closely with the Treasury to secure five-year waves of investment, backed by £15 billion of investment over consecutive waves, averaging £3 billion a year. This will ensure a balanced portfolio of schemes at different development stages being delivered now and into the future.

The new delivery plan sets out the order and the waves of investment in which each new hospital will be constructed. Hospitals included in a wave will begin construction, while forthcoming schemes will be undertaking pre-construction work to prepare planning permission and secure business cases. With this approach, we can ensure that schemes are ready to be built as soon as possible. A list of the schemes in each wave has been published on gov.uk and in the plan for implementation.

For reference, I will briefly outline the timeline for delivery. [Interruption.] Actually, I think we have seen all the waves, and the hon. Gentleman wants us to move on to Bexhill and East Sussex.

[Mr Mohindra]

For Watford general hospital, we have a window between 2032 and 2034. Given the certainty that the Minister is trying to give to the programme and to the rest of the country, what assurances and assumptions has she made for that two-year window? How can she assure me and my constituents that there will be no further delays?

[Karin Smyth]

I will pick up that point. Wave 3, which is what the hon. Member for Bexhill and Battle has secured this debate on, includes schemes that were always part of a post-2030 plan. We now have the confirmed dates. The East Sussex new hospital scheme for East Sussex healthcare trust includes, as the hon. Gentleman says, new buildings and refurbishments at Eastbourne district general hospital, Conquest hospital and Bexhill community hospital. The scheme is in wave 3 of the delivery plan, and construction will commence between 2037 and 2039. We understand that this is disappointing news to some people who were expecting and were told that their hospital would be built earlier, but we can assure them that there is now a credible and funded plan for delivery—no more false promises. Our priority now is to get on and deliver these new hospitals for the benefit of the staff and patients who so vitally need them.

We understand the importance of these schemes to local communities and the need to invest in health infrastructure. We will continue to engage with trusts—including Watford, which the hon. Member for South West Hertfordshire (Mr Mohindra) mentioned—over the next few years to establish whether there are any other activities that can be progressed during the spending review. We will be in discussions with all those trusts to understand mitigations in the meantime. That was the source of many questions that came up in the many meetings that I held with hon. Members yesterday. I understand that all these hospitals are critical—they would not be on the list if there were not a major problem with them—so we need to talk to the trusts about how we manage the process in the meantime.

I acknowledge that this will be a difficult time for the core teams and all the people who have been working on these schemes, many of which will be stood down. Their expertise and knowledge is extraordinarily valuable. I know that the programme teams will make efforts to ensure that expertise is retained where possible and used to develop the wider programme.

The trust is currently developing its strategic outline case, as per the business case process set out in His Majesty’s Treasury’s Green Book. Following the review and approval of the SOC, the next step will be the development, review and agreement of the outline and full business case. I understand that many areas, including Bexhill, have plans for housing to accommodate a growing population. My Department will work closely with integrated care boards and the Ministry of Housing, Communities and Local Government to ensure that those communities have the health provision that they need.

Beyond establishing a credible programme, we are taking steps to restore people’s trust through honesty and transparency. We will be setting out further information for each scheme shortly, to ensure a more open way of working and collaborative programme delivery.

Yesterday, I held meetings with Members of Parliament from all waves of the process to give them the opportunity to ask more detailed questions about their individual schemes, and to give them the clarity that their constituents deserve. Letters have also been issued to the trusts. That was a very successful way of working; I certainly learned a lot about the individual schemes. Members of Parliament of all parties came to talk about their schemes. I gave a commitment that I would continue to talk to colleagues about them. I absolutely offer the same to the hon. Member for Bexhill and Battle. I will work with Members’ trusts to understand the detail on the ground.

[Ben Maguire (North Cornwall) (LD)]

I warmly welcome the news, on which I congratulate the Minister, that the women and children’s hospital at Treliske and the emergency care hospital at Derriford are in wave 1. However, some of my North Cornwall constituents rely on the crumbling North Devon district hospital, which is potentially 15 years from a rebuild. We are talking about mitigations, so please will the Minister meet me to discuss how we can expand care at the community hospitals in Bodmin, Launceston and Bude, which are all at least one hour from their closest district hospitals?

[Karin Smyth]

I thank the hon. Gentleman for his intervention. We had a good discussion yesterday about North Devon; I understand the rurality of that location, as it is fairly close to my Bristol constituency. Obviously, however we manage it, there are a lot of schemes represented by a lot of MPs. I am open to suggestions about how we go forward. I hope hon. Members feel that we have tried to give as much information as we can to them and the trusts in the announcement and the meetings yesterday. That is the spirit in which we will continue.

[Danny Beales (Uxbridge and South Ruislip) (Lab)]

I welcome the spirit of openness and transparency that the new leadership of the programme has demonstrated. Previously, and frustratingly, residents in Hillingdon were—to be frank—led up the garden path. We were left with all but an IOU note for £750 million for a new hospital. The revenue funding for the new hospital ran out this year. We were pleased to see it renewed, and to be in wave 1; a significant capital investment of more than £1 billion has been committed to.

This is complicated: it is hard to deliver projects at this scale. With the best will in the world, if another £20 billion were to appear, despite the Conservative party opposing any methods that would raise money, the construction sector would struggle to build all these hospitals at once. Is it not the case that it is challenging to deliver this project at scale? Will the spirit of openness and transparency continue?

[Karin Smyth]

I thank my hon. Friend for his continued campaigning on behalf of the residents of Hillingdon; I used to be one of them. Talking to people is really important, and we have learned a lot from it. In case I have not outlined this enough, let me be clear that all our constituents who are on the programme are in severe need. The programme has looked at clinical need and deliverability. We understand how difficult these choices are, so I thank my hon. Friend for that intervention.

[Helena Dollimore]

I welcome the Labour Government’s confirmation of funding, which will help the Conquest hospital in Hastings, part of the East Sussex Healthcare trust, and other hospitals that my constituents use. It comes alongside the Chancellor’s announcement of a big package of support in the Budget, with record investment in our NHS to provide more appointments to clear the backlog left by the Conservatives.

[Karin Smyth]

I thank my hon. Friend for her intervention, which highlights the point that the hon. Member for Bexhill and Battle raised about other capital plans and programmes to help his constituents and others over the coming years.

In conclusion, I thank the hon. Gentleman for raising this issue.

[Clive Jones]

rose—

[Dr Mullan]

rose—

[Karin Smyth]

If the hon. Member for Bexhill and Battle, whose timing is superb, wants to make an extra point, I will give him the courtesy of a chance to come back in.

[Dr Mullan]

In the last hour, I have had a communication from the trust explaining that, with the delay, the extra cost may be in the hundreds of millions. I would be grateful to take up the Minister’s offer of some time, as well as to talk to MPs who use those services, to see how we can help the trust to access that funding.

[Karin Smyth]

I thank the hon. Gentleman for that intervention. We learned a lot yesterday from the expert team from the new hospital programme; I thank them for their incredible work in getting to this point. Those colleagues who could make the meetings yesterday found that the team’s knowledge about every single programme was phenomenal. I have yet to ask the team a question about any scheme to which they do not know the answer—I give hon. Members that confident assurance. The team includes colleagues from both NHS England and the Department.

When I went to an assurance meeting a few weeks ago, I learned that the relationship between the central control of the programme and the trusts, how we get the schemes delivered for everyone’s constituents, and the value of parliamentarians talking to me—everyone has stopped me in the corridors to raise these issues—are all very valuable. That is a good function of parliamentarians. That is the spirit in which we want to continue.

Our commitment is to deliver these hospitals, including the Eastbourne district general, Conquest hospital and Bexhill community hospital schemes, and I am pleased to say that we have an affordable, deliverable plan to do so. It will be difficult, but I look forward to working with the hon. Member for Bexhill and Battle and other colleagues.

[Mr Mohindra]

It is very gracious of the Minister to allow me to intervene again. In the interests of full transparency, can she assure us that if the development of the new hospitals gets delayed, all MPs will be informed, not just those in the relevant constituency? Work on Watford general is meant to begin between 2032 and 2034. Will the Government communicate any further delays as quickly as possible? That will certainly be critical to our constituents.

[Karin Smyth]

We absolutely will. This is one of the advantages of the waves: we recognise, and everybody knows, that there are sometimes unavoidable delays to schemes, perhaps to do with the sites, but the advantage of the pre-construction work and our knowledge of the sites is that most of that should be built into the programme and the timing. But life happens.

One of the central issues for the programme is capacity in the construction arena, as well as across the country, in terms of developing primary estate to get these things done. The advantage of the waves is that they give us flexibility if things move, as they inevitably will—that is life. We very much want to keep up relationships with local trusts and inform them. That will be difficult, as my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) says, but that is the spirit in which we want to continue. I give him and other colleagues that absolute commitment.

Question put and agreed to.