NHS Capital Spending

Matt Western Excerpts

Wednesday 4th March 2026 Westminster Hall

[Several hon. Members rose—]

[Matt Western (in the Chair)]

Order. I remind Members that they must bob if they wish to be called in the debate. I first call Gareth Thomas, who will be followed by Steve Darling.

[Gareth Thomas (Harrow West) (Lab/Co-op)]

The White House in Harrow, thanks to NHS capital money, will shortly become even better than its American namesake. I pay tribute to the hon. Member for Carshalton and Wallington (Bobby Dean) for the way in which he introduced the debate. I agree very much that levels of capital investment into the NHS do not get the attention that they deserve in this place. He is certainly right about the impact on NHS capital spending of the austerity over the previous 14 years of Conservative health administrations. He rightly referenced the shameful spectacle of Conversative Health Secretary after Conservative Health Secretary handing back capital moneys to the Treasury at the end of March. My hon. Friend the Minister will be pleased to know that I have a solution to that problem if she faces it this year.

The White House, which is located at Harrow college, close to Harrow-on-the-Hill station, is set to become one of Harrow’s neighbourhood care centres thanks to NHS capital. NHS capital is allowing the local NHS to convert the White House, which is part of the college at the moment, into a new, expanded GP surgery and care centre. It will offer two opportunities for students enrolled at the college to begin a career in health and social care. Crucially, it will create a hub for care services that can keep people out of hospital and, in particular, out of accident and emergency queues.

The White House is set to be one of a number of new neighbourhood care centres, including Belmont health centre, Alexandra Avenue health and social care in Rayner’s Lane in my constituency and the Pinn medical centre in Pinner. This planned expansion of primary care over the next two years, using NHS capital moneys, builds on a recent significant increase in the number of GP surgery appointments. The nightmare of having to get an appointment to see a GP once lines open at 8 am is beginning to ease, but much more progress still needs to be made. GP appointments in Harrow have increased substantially since July 2024. Just under 120,000 appointments took place that month, but by October last year the total number of appointments each month had risen to more than 145,000—a 22% increase. For face-to-face appointments in particular, there had been a 30% increase.

I welcome the difference that NHS capital allocated to Harrow will make for primary care in the coming years. The funding for GP Direct, a surgery currently based in west Harrow, to expand and offer more and better primary care services, and for a neighbourhood healthcare centre located at the Alexandra Avenue clinic, is set to make even more of a qualitative difference to primary care services in my constituency.

However, I hope to make the case to the Minister for the allocation of further NHS capital investment at Northwick Park hospital. Waiting lists are beginning to come down at Northwick Park, but, again, there is much more to do. To help maintain that progress, Northwick Park needs a new 36-bed critical care unit, with space for further expansion. A series of NHS and independent assessments of critical care across north-west London have identified a shortage of critical care beds, particularly on the Northwick Park site. The existing intensive care unit there has a series of problems that compromise the current delivery of critical care. It is not co-located with other key NHS services on site, such as the emergency department or operating theatres. It is outdated, noisy, cramped and unfit for purpose for patients and families facing critical illness—or, worse, potential end of life.

The trust has put together a proposal for a new UK-leading exemplar intensive care unit that provides additional critical care beds and a new CT scanner, which would embed modern standards of patient experience and family support. The proposal is for a 36-bed unit and allows for a potential future expansion for a further 24 critical care beds. The new unit that is immediately proposed allows for 30 of the 36 beds to replace existing critical care beds that are located in other parts of Northwick Park hospital, which will free up extra bed space and, in turn, help to alleviate pressures on other parts of the hospital, notably in accident and emergency. It will also play a useful role in helping to prevent the cancellation of elective operations.

The recommended bed occupancy for critical care beds is set at 85%, according to the National Institute for Health and Care Excellence. Northwick Park has been consistently above that level for some time. The hospital has one of the busiest A&E departments in the country, receiving an average of 90 ambulances a day, rising to 140 on its busiest days. Critical care admissions are also up by more than 16% since 2018-19, and more than 80% of admissions to the trust are at Northwick Park hospital. It is worth reflecting on the experience of covid. Northwick Park was the first hospital during the covid pandemic to declare a critical incident, as the number of intensive care beds simply ran out.

An expansion in critical care beds at Northwick Park needs funding. It needs funding to improve services now, but also to better prepare north-west London for future health emergencies. The bid for funding is strongly supported by the trust board and, I understand, by the local integrated care board as well. I hope that the Minister, her Health colleagues and the Treasury will support it, and that the Minister will commit to doing all she can to give it a strong push.

Work on cancer care services is also taking place in the London North West University NHS trust. Northwick Park already sees more than 50,000 people with suspected cancer each year, and diagnoses more than 3,000 cases. However, too many cancer cases have to be dealt with outside of our area, and the quality of the experience for those being treated for cancer could be significantly improved with further investment. I hope that the Minister will duly make sure that Northwick Park is flagged up early for further investment as part of the national cancer plan.

[Matt Western (in the Chair)]

I expect speeches to be around five minutes so that we can get everyone in. Please be respectful to colleagues.

[Steve Darling (Torbay) (LD)]

What a pleasure it is to serve under you as chairman, Mr Western. I congratulate my hon. Friend the Member for Carshalton and Wallington (Bobby Dean) on securing this important debate. Sorting out Torbay hospital, the hospital that serves my constituency as well as the constituents of my hon. Friends the Members for South Devon (Caroline Voaden) and for Newton Abbot (Martin Wrigley), is my No. 1 priority as the Member of Parliament for Torbay.

I knew that the hospital was in a difficult place prior to my election, but as I began to immerse myself in the challenges facing it, I was shocked. I was shocked by what was effectively wanton vandalism—corporate vandalism, even—undertaken by the previous Conservative Government by making promises that they just could not keep. The vandalism—the fact that they chose not to invest—made it much harder to invest in the longer term and actually made it more costly. It is that old proverb: a stitch in time saves nine.

In Torbay we face some massive challenges. We have seen more than 700 sewage leaks at our hospital. These sewage leaks do not just happen in the corridors; they happen in clinical areas and affect wards where patients are. There have to be deep cleans, and there are delays for patients in getting on to lists and, most importantly, delays in supporting people who need medical interventions.

We heard from my colleague, my hon. Friend the Member for Carshalton and Wallington, that delays are occurring because of poor ventilation, and we have heard about the impacts—indeed, there have been very significant impacts in Torbay hospital. However, approaching the hospital, someone might think that the seventh cavalry was coming over the horizon—the tower block is wrapped in scaffolding, so it must be being sorted. However, the reality is that the £1 million scaffolding is there purely to stop bits of the building falling off and braining staff and members of the public as they go past. Having to spend so much of our NHS money just maintaining a crumbling building is not good. The Torbay and South Devon NHS foundation trust has some bids in with the Minister around the challenges in the tower block; I am sure she is considering those at the moment and I hope she will look upon them kindly.

I also want to reflect on what works well in Torbay hospital. I recently visited and saw some really exciting changes. There are millions of pounds-worth of investment in the emergency department, for example, which is really welcome. The daytime operations area, where people come in for a short period in the hospital, is calm and businesslike, which is what we want during hospital visits, but that is very different from other parts of the hospital, particularly for those people who suffer from cancer, for whom the offer is chaotic and situated all over the estate. Cancer sufferers deserve a better experience.

We have seen investment in the endoscopy unit, and 90% of patients are being seen within five weeks, which is a massive improvement. However, looking at the estate of Torbay hospital as a whole, 85% of it is not up to standard. The £350 million investment supports only half of the hospital.

We have also seen a toxic change to the spending power of this capital programme. We have seen Brexit, we have seen the pandemic, which has impacted on the spending power of capital programmes, and we have seen the war in Ukraine, which has seen building prices spiral. Some of the management in the hospital field say that, since the pandemic, the spending power of capital programmes has halved, so can the Minister tell us how the Government have taken account of the fact that money is going only half as far as it did historically?

In conclusion, Torbay is one of the most deprived communities in the country and the NHS often picks up the rough end of that. Only recently, a director told me she has patients who believe that living to their 60s is a good span of life. I am sure the Minister agrees that is not the aspiration we should have for our communities. In the south-west we have seen a lack of capital investment, whether in our railways or NHS infrastructure. I hope the Minister will tell us how the Government are planning to invest in the NHS in the south-west and, as my hon. Friend the Member for Carshalton and Wallington asked, what innovation there is to bring forward that investment. Sadly, Torbay has been kicked into the long grass until the mid-2030s. The staff are our most important asset, and they deserve that investment much sooner.

[Matt Western (in the Chair)]

The next speaker will have five minutes. Thereafter, I am afraid I will have to drop to four minutes.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

It is a real pleasure to serve under your chairship, Mr Western. I thank the hon. Member for Carshalton and Wallington (Bobby Dean) for setting the scene incredibly well. Of course, I want to give a Northern Ireland perspective, but I want to put forward two areas where possible savings could be made, and I wonder whether the Minister has had a chance to look at that, collectively or individually.

The hon. Member for Carshalton and Wallington, who set the scene, had 1,000 petition signatures for this debate—well done to him for garnering that interest. Our hospitals are so important and their services are lifesaving, so in terms of our finances they are priority No. 1. It is absolutely no secret that NHS capital spending has a direct impact on patient flow, waiting times and staff morale, and also on the quality of care.

Each year, my colleagues and I listen to the Budget and assess how our block grant can benefit the people of Northern Ireland through our healthcare system. It is clear that we must invest heavily in our facilities as well as our day-to-day spending. In her spring Budget yesterday, I think the Chancellor said that an extra £380 million was coming to Northern Ireland in the block grant. That should hopefully go some way to helping balance the books.

Around two years ago in my constituency of Strangford, our minor injuries unit closed following the opening of an urgent care unit in Ulster hospital. It was one of the most modern acute hospital sites following more than £235 million in capital investment, including in the new emergency facilities, patient accommodation and surgical and research infrastructure. Rather than planning a completely new hospital, the Department of Health has focused on transforming the Ulster into the regional acute hub. That is the right strategy, aligned with wider NHS reconfiguration plans for Northern Ireland.

Furthermore, there are plans for a new maternity hospital at the Royal Victoria hospital in Belfast. That is one of Northern Ireland’s largest capital projects, with more than £100 million already invested. Further investment is also planned for the surgical hubs, elective facilities and rapid diagnostic centres. I am pleased that hospitals in Northern Ireland have witnessed increased capital investment but, in comparison to St Helier hospital, as the hon. Member for Carshalton and Wallington described, it is clear that some hospitals are still struggling drastically, and he underlined that point incredibly well. More needs to be done to ensure that they are fit for purpose.

I have two points on savings, which I put to the Health Minister back home, Mike Nesbitt. A level of middle management has been created, which is not always necessary. I am not saying that people should lose their jobs; I am just looking at how it can be done in a good way to ensure value for money. The second point is about agency staff. Back home—and I understand it is the same over here—agency staff are sometimes employed rather than full-time nurses. That is never cost-effective, because it is better to pay a nurse a good wage than it is to employ agency staff. Those are two thoughts that might be helpful.

NHS capital spending is not a luxury; it is a necessity. It is the foundation of safe buildings, modern equipment, efficient services and dignified patient care. Without sustained investment, we will continue to see rising waiting lists, staff burnout and crumbling infrastructure. The Minister is always very responsive, and we are glad to have her in her place. The hon. Member for Carshalton and Wallington is asking for the Government to commit to sustained strategic capital investment that will secure the future of our NHS and deliver the standard of care that patients and staff both deserve. Those two ideas to save money are worth looking at as well.

[Matt Western (in the Chair)]

I call Josh Taylor—sorry, I got that wrong; I call Luke Taylor.

--- Later in debate ---

[Luke Taylor]

I could not agree more with the hon. Member’s point. When the condition of an asset does not attract staff, particularly in more deprived areas, the challenges will be greater. Those compounding challenges are borne out visibly through the physical asset, and everything becomes much more difficult.

I should not have to be here making points about political faith and delivery—or the economic arguments that have been made by other Members—but I will make the important humane case, based on the experiences of my constituents. I recently did a health survey where residents wrote in and told me their stories. One of them was a woman whose husband spent 54 hours in A&E with sepsis, lying on a trolley in a room so small it could have been a broom cupboard. Another, who is in her late 80s, sat waiting on a chair for 10 hours after a suspected heart attack, while another woman, who was unable to sit on a chair because of her pain, had to lie on the floor crying and wait for several hours.

Almost half of those who responded to the survey said that they had waited for more than four hours in A&E at St Helier hospital. We have the NHS numbers, too: across the Epsom and St Helier trust, 18,600 people waited for more than 12 hours in 2025. That is sickening; it is an example of a system that is not working. “Sickening” is the right word: like thousands of people across Sutton, I am sick to the back teeth with the endless delays that have got us here.

There is another important angle. In almost every one of the stories I was told, there was nothing but deep appreciation for the dedicated staff on the estate, many of whom the respondents credit with saving their lives in spite of—not because of—the conditions that they find themselves in. How can we keep recruiting into the NHS or uphold its public image if these are the conditions that we are expecting staff to work in? This is normally the part of the speech where I talk about the Government’s awful inheritance from the Conservatives, but I do not feel like making that point any more, because the people of Sutton have had enough context-setting and this Government is almost two years old now.

I thank the Minister for her discussions of this topic with me and other colleagues. I feel that we are engaging openly and positively, and I want to make that very clear for the record, but I ask the Government to listen to the pleas of our constituents, and to please provide the money to expand our emergency department. At risk of returning to my point about trust, if we do not fix this, we risk a catastrophe in Sutton that might undermine the faith of my residents and the broader public in the entire model of the NHS.

My speech has been about expanding, refurbishing and fixing St Helier hospital, but there is the separate issue of the real and urgent need for the specialist emergency care hospital that our NHS and residents were promised by the previous Government. We need that too, and we need it quickly. The expansion of our A&E would complement the provision in Sutton, and it needs to be brought forward.

[Matt Western (in the Chair)]

I now call Josh Babarinde.