New Hospitals

Lord Kamall Excerpts

Thursday 18th November 2021 Lords Chamber

[Baroness Walmsley]

To ask Her Majesty’s Government what progress they have made towards their commitment of building 40 new hospitals.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

The Government committed in October 2020 to build 40 new hospitals by 2030. We have confirmed an initial £3.7 billion to support these schemes for the first four years of the 10-year programme. This, together with eight previously announced schemes, will mean that we will have 48 new hospitals by the end of the decade. Six of the 48 new hospitals are currently in construction, including the first of the 40 new hospital schemes, and one scheme is now complete.

[Baroness Walmsley (LD)]

My Lords, as the Minister said, eight NHS capital schemes already under way when the promise was made were added to the Prime Minister’s pledge for 40 new hospitals by 2030, but now their cost overruns will have to be paid for out of the original pot of money. Can the Minister say how many of the originally promised 40 will now have to be postponed and how many are really new?

[Lord Kamall (Con)]

The Government have said that we will deliver 40 new hospitals by 2030 and in October 2020 we published the full list of the 40. This includes eight schemes that were announced by previous Governments but are to be delivered this decade and 32 new hospitals. We have also confirmed that we will identify further new hospital schemes, the process for which is ongoing, with a final decision to be made in spring 2022. This means that 48 hospitals in total are to be delivered over the decade.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I have here the New Hospitals Programme Communications Playbook, which the noble Lord’s department has put out and which makes it clear that if you build a new wing of a hospital, that counts as a new hospital. What is worse is that NHS bodies are being instructed to lie and propagandise on behalf of the Government. Will he withdraw this disgraceful communication?

[Lord Kamall (Con)]

I hope that the noble Lord will recognise that whenever a new project is started and there is a decision to build a new hospital in a community, it surely makes sense to look at whether there is space on existing sites. Otherwise, if we start criticising new hospitals on existing sites, there may be a perverse disincentive for a hospital to say, “Well, let’s build elsewhere”. when there is a perfectly good site. It is important, whatever you call it, whatever the semantics, to recognise that we are building modern, digital, sustainable hospitals for the future.

[Lord Bethell (Con)]

My Lords, we very much welcome the investment in physical buildings, but the modernisation of the NHS also depends on digital infrastructure and training. Will the Minister please tell us what steps he is taking towards a programme of technological improvements that are needed to modernise the NHS?

[Lord Kamall (Con)]

I thank my noble friend for the question—I have picked up many of the things that he started when he was in post. One of the great things about being the Minister for Technology, Innovation and Life Sciences is having a real ability to drive through digitisation of the health service, making sure that we have a modern health service that is fit for the future, so that if you are a patient in one part of the country and something happens to you, all your information is available elsewhere for the clinicians at the time and you get the best possible care. That is something that we should be celebrating.

[Lord Jones of Cheltenham (LD) [V]]

My Lords, one of the principles of managing taxpayers’ money is to take account of the revenue implications of a capital budget. In view of the projected increases in building costs, is the Minister confident that the new hospitals programme managers understand this? What is being done to recruit the necessary doctors, nurses, technicians and maintenance staff for these new and existing hospitals?

[Lord Kamall (Con)]

One thing that is exciting about the new hospitals is that we are going to transform the way in which we deliver new healthcare infrastructure. First, it will be sustainable, with net-zero carbon across the NHS. Digital transformation is key, making use of the latest technology, so no longer will we have microscope slides couriered between sites, but we can instantly see a digital image and assess it using AI. There will be standardised design and modern methods of construction and new hospitals will be integrated with local health and care systems. This is a project for a health system that is fit for the future.

[Lord Lancaster of Kimbolton (Con)]

Many of these new hospitals will be built in existing centres of population. My concern, though, is for areas of high projected population growth, such as the Oxford-Cambridge arc, where we always seem to be playing catch-up when it comes to medical facilities. Can my noble friend simply reassure me that the principles of “I before E”—infrastructure before expansion—will be applied when choosing where these hospitals will be?

[Lord Kamall (Con)]

I assure my noble friend that, in deciding where to build a hospital, among the things that the NHS and others look at are the needs in the community, existing infrastructure and making sure that we can build hospitals that are fit for the future, that are digital, that are transformative, but are led by clinicians as opposed to construction experts.

[Lord Mann (Non-Afl)]

The Minister said, just a moment ago, “whatever you call it”. When David Cameron was Prime Minister, he gave a pledge on district general hospitals and the definition of hospitals became important. Many of us said that, in order to be defined as a hospital, it had to incorporate 24-hour accident and emergency. What is the Minister’s definition of a hospital and is the pledge from David Cameron on district general hospitals current?

[Lord Kamall (Con)]

Each of the building projects will be a new hospital that will deliver brand-new, state-of-the-art facilities. One thing that we must be careful of is that if we say, “Well, you can’t call that a new hospital, even though it is a new facility, because it’s on an existing site”, we do not create perverse incentives, where the local NHS or the local ICS says, “We mustn’t build it there, because we will be accused of not having a new hospital”. Surely what we should be focusing on is outcomes, not inputs, and the fact that we are delivering modern, digital hospitals for the future.

[Baroness Thornton (Lab)]

My Lords, leaving aside the dubious and overinflated claims of 40 new hospitals, many of which are, in reality, upgrades—as welcome as they are—I and others in the House raised with the Minister’s predecessor but one in 2019 that there was an alarming repairs and infrastructure crisis, which was then in the region of £3 billion. Could the Minister explain to the House which part and how much of the new hospitals programme will address the immediate and urgent matter of crumbling wards, sewer leaks in wards and old and dodgy kit?

[Lord Kamall (Con)]

The noble Baroness will recognise that we need not only to build new hospitals but to upgrade existing infrastructure and this is all part of the capital programme. The decisions on individual hospitals and upgrades will be taken in local communities in consultation with clinicians and local ICSs.

[Lord Balfe (Con)]

My Lords, will the Minister avoid getting caught in a numbers game? We need an adequate number of beds in a good geographical spread to deal with the needs of the whole population. I hope that he will see this as part of an integrated expansion of the health service and that we will not get tied up with the numbers, as we did years ago—how many hospitals, how many this, how many that. We need an improved health service. This is a vital part of it, but it is only a part.

[Lord Kamall (Con)]

I completely agree with the sentiments expressed by my noble friend. Surely what we should focus on is output; surely what we need is the best healthcare system across the country. We need up-to-date healthcare with the best information from patients to make sure that we can diagnose and give them appropriate treatment, working with the very latest technology such as artificial intelligence to spot patterns, to make sure that we can also build in prevention when we look at tackling health issues in the future. I welcome my noble friend saying that we have to focus on output—modern digital infrastructure and modern digital hospitals fit for the future.

[Baroness Brinton (LD) [V]]

My Lords, my local hospital, Watford General, is on the list of 40 so-called new hospitals, although the plans have been in place and supported cross-party for close to two decades, and its infrastructure is failing. Despite a clear promise of funds by the Prime Minister during a visit to the hospital in October 2019, the trust is yet to be allocated funding from the Treasury and it remains a pathfinder. I want a clear outcome. When will funding be confirmed and granted?

[Lord Kamall (Con)]

On the point about the noble Baroness’s local hospital, I am afraid that I am not aware of where she is situated geographically, but I can tell her that six of the 48 hospitals are already under construction and one is now completed. I hope that the noble Baroness will write to me on the hospital that she referred to so that I can give her an answer.

[Lord Foulkes of Cumnock (Lab Co-op)]

My Lords, will the Minister stop waffling and put on record an answer to the question asked by the noble Lord, Lord Mann, saying precisely what he means by a “new hospital”? I tell him not to waffle back.

[Lord Kamall (Con)]

I thank the noble Lord for his advice just before I was about to answer. Whatever you call it—and we can debate semantics—the important thing is surely that we build new hospitals and upgrade existing infrastructure. Surely we should celebrate the fact that we are building 48 new state-of-the-art hospitals—

[Noble Lords]

You are not.

[Lord Kamall (Con)]

We should not celebrate building new hospitals? Well, there we are. We should celebrate the fact that we are building new hospitals to give patients the best possible care, aided by digital technology and making sure that they are sustainable.