Hospital Building Programme

Mike Amesbury Excerpts

Wednesday 3rd November 2021 Westminster Hall

[Dr Mullan]

My hon. Friend is absolutely right. One of the great things about the plans for the new site is that they take into account those future projected increases in population. I do not know what we will do if the resources are not there to do that.

Going back to staffing, we have more nurses and doctors and more staff overall working in the NHS than ever before, but it remains a huge undertaking for the Government to continue to work on recruitment and retention to staff new facilities. I know a lot of the media and campaigning by Opposition parties has focused on pay. While it is important, my experience is that fixing staff shortages would be the priority for most staff. The obstacles for further recruitment will not simply be solved by higher pay; the challenges are more complicated than that.

Of course, buildings and facilities matter, but we have to remember that the material used to build Leighton was expected to last only 30 years. It might seem odd to us now to create a major public facility with that sort of life span, but that is the reality.

[Mike Amesbury (Weaver Vale) (Lab)]

The hon. Gentleman is a neighbouring MP. A reference was made to Northwich in my constituency. This proposal certainly has cross-party support. I support the hon. Gentleman and all Cheshire MPs in arguing this case with the Minister in front of us for much-needed investment in a first-class hospital facility in our patch.

[Dr Mullan]

It is great to get cross-party support to demonstrate to the Minister how important it is to all our local communities. I thank the hon. Gentleman for his support.

As I was saying, the building was not designed to last this long or to serve the size of population that it serves. My view is clear that we can be more efficient and do more in the community, but an aging population will have an ever-increasing demand for healthcare. We can delay the need for the most specialist hospital care in a population, but we can almost never remove it and stop the demand increasing overall.

How has Leighton managed this challenge over recent years? Rightly, it has benefited from major investment, as mentioned by my hon. Friend the Member for Eddisbury (Edward Timpson) who is working closely with me on this campaign alongside my hon. Friend the Member for Congleton (Fiona Bruce). I remember his excellent work in helping to secure funding for brand new theatres and a brand new ITU.

My first campaign after becoming the candidate for Crewe and Nantwich was to reverse the decision to turn down a request for an emergency department extension, which was ultimately funded in 2019. More recently, Leighton received £15 million to build a brand-new emergency department. As the Government understand the necessity, Leighton has had funding to tackle the parts of the original building that are simply not fit for use in the short term. However, there comes a point where the costs of one-off investments, accumulated maintenance and the need to replace the original building structures become a cost that cannot be borne by the ordinary capital spending, and when a whole new building becomes the best option financially and for patient care. That is where Leighton is at.

The life span of the original building is coming to an end. I suggest to the Department of Health and Social Care and the Treasury that they view the funding committed to the hospital building programme as a unique opportunity to look at estates that are winding down towards the end of their life span and address that now.

Under the leadership of the chief executive officer, James Sumner, Leighton has done an enormous amount of work for many months to develop its plans for a new hospital. The team sought expert advice on the life span of the current estate and, importantly, the cost of maintaining it and to keep the existing original buildings in use. I know the Minister will scrutinise the figures and see for himself the financial sense in the case that has been made. Independent analysis demonstrates that the ongoing refurbishment of the present failing infrastructure over the next 15 years will cost substantially more than projected new build costs.

Importantly, the plans are ambitious in ensuring better healthcare is delivered in a better environment for patients and staff. As well as providing the mentioned much-needed bed capacity to meet the projected demand later in the decade, the new facilities will deliver single rooms to improve privacy, dignity and infection control. The new layout will incorporate the latest design advice for supporting patients with conditions such as dementia.

The site as a whole will be reorganised some of the long journeys from key locations, such as the emergency department, to other parts of the hospital that have grown as a result of sporadic development to date. They will future proof the hospital with the most up-to-date digital infrastructure which is becoming increasingly important for delivering the best possible care and doing so efficiently. A new site will enable Leighton to play its part in the race to net zero with more energy efficient buildings and solar power and even, potentially, a geothermal heat source, which is a technology I am campaigning for the Government to support to get off the ground across the country.

The team at Leighton have a track record of delivering improved and innovative care to back up their pledges. For example, the trust recently received an award for its same-day emergency care programme, led by surgeons David Corless and Ali Kazem. I am sure that, with improved facilities, they will continue to find new and better ways to care for their patients.

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[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to see you in the Chair, Mr Sharma. I congratulate the hon. Member for Crewe and Nantwich (Dr Mullan) on securing the debate. As a fellow Cheshire Member, our paths will no doubt cross as we get involved in the megalithic integrated care system that covers our area, and it is good to see healthy representation from Cheshire Members, which shows the interest and passion that we have for improved health services in our area. He mentioned that he volunteered to use his medical skills on the frontline during the pandemic, and we thank him for his efforts, just as we thank everyone who contributed to the fight against covid, be it in the NHS, in social care or in any of the other many sectors that played their part. We recognise and value the commitment that was made by so many people over such a long period of time.

As the hon. Member for Crewe and Nantwich set out, hospitals are more than the buildings themselves. It is the staff who make hospitals, and he brought that to the fore in his comments. He said that the site of Leighton Hospital has exceeded its original lifespan—I think it is as old as I am, which is a concern. Hopefully, I will not be up for a rebuild any time soon. It was a common theme of contributions to the debate that a lot of the buildings in Members’ constituencies have reached the end of their natural lifespans. It would be useful to hear from the Minister whether any assessment has been made of how many hospital buildings, and buildings across the wider NHS, have already exceeded their original lifespans. The hon. Gentleman made a compelling case for why a new hospital needs to be built in Crewe, and he mentioned that the local population has grown considerably.

[Mike Amesbury]

I thank my hon. Friend and constituency neighbour for giving way. Of course, Leighton Hospital is part of the Mid Cheshire Hospitals NHS Foundation Trust, which also includes Victoria Infirmary in Northwich. This would be a real opportunity to capture investment across the campuses, which serve a number of our constituents, and I would certainly welcome my hon. Friend’s support on that. As a Cheshire MP, it would certainly be very welcome indeed.

[Justin Madders]

My hon. Friend probably needs to direct his pleas to the Minister more than me—at this stage, of course—but I would be delighted to visit the facility with him. I am sure that he will make a strong case for investment, as other Members have done. There is an issue with how the interplay works between some of the competing bids for what is obviously a very competitive process, which I will return to later. Like the hon. Member for Eddisbury (Edward Timpson), my hon. Friend the Member for Weaver Vale (Mike Amesbury) has shown that there is cross-party support for the case for a new hospital that was made by the hon. Member for Crewe and Nantwich, who also set out why this is good for patients. He talked about some of the issues around privacy, dignity and infection control, and he said that a new build gives us an opportunity to invest in modern digital infrastructure. Of course, he also mentioned important stuff to do with COP26 and the energy efficiency of a new build. Those were all well-made points.

We also heard from the right hon. Member for Hemel Hempstead (Sir Mike Penning), who made a persuasive and passionate case as to why the current plans need to be reconsidered. He made a very interesting point about the accountability of trusts. He is probably not aware that the Minister and I have been debating this issue in Committee for a number of weeks, and it is fair to say that we have differing views as to how accountable the current system is and whether it will actually change at all when the Health and Care Bill receives Royal Assent. There is an issue with how large trusts have their own priorities, which are not necessarily in tune with the rest of the wider population and healthcare system.

The hon. Member for North West Norfolk (James Wild) made a very strong case for the Queen Elizabeth Hospital in King’s Lynn; he highlighted the critical nature of the maintenance issues there, which are clearly having an effect on patient care now. The Minister will not be surprised to know that I will be referring to the maintenance backlog during my comments today. The hon. Member also set out very well how new builds can not only improve infection control, but enhance the patient experience. We should always remember that the patient journey is central to these things. A new hospital always has to have the interests of patients, and their perspective, at the heart of its plans.

The hon. Member for Keighley (Robbie Moore) made a strong case for why a new hospital is needed in Airedale. Again, it is a building that is past its original lifespan; it has critical infrastructure issues. Describing it as the “leakiest hospital is the UK” is not something the hon. Member will want to repeat for much longer. It shows again that many of these issues have been building up for some time.

I was very interested in what the hon. Member for Hartlepool (Jill Mortimer) said about health inequalities; it was an important point, and perhaps a broader one than some of the others that have been made. She is absolutely right that the pandemic has shone a light on the existing health inequalities in this country. I agree that if we are serious about levelling up, reducing health inequalities has to be central to any policy.

The right hon. Member for Basingstoke (Mrs Miller) made a compelling case about how investment is needed for her new hospital, and how the change and growth in local population has created additional demand. It is an important point that, because of the way that her town has built up, there is more demand from an increasingly ageing population.

All the Members have made very good cases today; if it was based on the commitment and passion of individual Members, the Minister’s job would be quite straightforward. However, I know there will be many other demands on the departmental budget. There is a serious point here. We need to have transparency on the criteria that will be applied when the decisions are made. It would be fair to say, if we look at levelling-up bids, there has been some consternation that the decisions are not always made on the merits of the case. It is important that the Department is crystal clear on why particular projects are getting the go-ahead, and why others may have to wait a little longer.

I am sure that the Minister would be disappointed if I did not make a reference to whether the Prime Minister’s claim to be building 48 new hospitals is in fact an accurate one. We take with a large pinch of salt the definitions from the Department’s playbook that the following count as a new hospital: they say this includes

“a new wing of an existing hospital (provided it contains a whole clinical service, such as maternity or children’s services).”

They also say this includes

“A major refurbishment and alteration of all but the building frame or main structure, delivering a significant extension to useful life which includes major or visible changes to the external structure.”

That may well be investment in buildings—which is of course welcome—but it stretches credibility to say that those are new hospitals. I will not repeat the whole debate again on whether those descriptions can be classed as new hospitals, except to say that the Minister will no doubt rely on his VAT notices to reach that figure of 48: we will rely on the good sense of the British public to judge whether a new hospital is indeed a new hospital. When we get to 2030, we will see how many new hospitals we actually have—although it is possible that both the Minister and I will have moved on by that point.

Let us return to the present day, move away from the headlines and the spin, and ask some specific questions about the programme. I will start with the cost issue. It is my understanding that the projects identified in phase 1 have been promised a total of £2.7 billion, although some reports suggest that a £400 million price cap is being applied to each scheme, even though some of the published plans for those schemes have exceeded that limit already. Could the Minister comment on whether there is in fact an upper cash limit on particular projects, and whether it is indeed £400 million?

Almost exactly a month ago, the Prime Minister made an announcement on round 2 of the health infrastructure plan, in which, incidentally, only three out of the 25 hospitals are in the whole of the north of England. I think that says something about the Government’s commitment to levelling up and bolsters the case made by the hon. Member for Crewe and Nantwich to push forward for a new building in Crewe. Could the Minister advise what period and how much of the total programme the £3.7 billion mentioned in that announcement covers? Could the Minister also advise if the £4.2 billion, announced in the spending review last week in relation to new hospitals, is the same money as the Prime Minister announced on 2 October or is in addition to that? If it is additional, what period does that £4.2 billion cover? We want a little clarity on how much has actually been allocated and the period that it covers. I am sure the Minister realises that, even if we add up all those figures, it would not be the total cost of all those projects moving forward to 2030.

We have had three separate announcements over the last year. I make that point because the foreword to the health infrastructure plan talks about ending the “piecemeal and uncoordinated approach”. We have an investment plan spanning a decade, but the necessary investment has been announced for only the first half of that decade, at best, to come out in dribs and drabs. I suggest that the Minister might need to read the foreword to the plan again to see whether the ambitions set out there are being met.

NHS Providers has said that the actual cost of the planned building projects would be around £20 billion, most of which will need to be found in the next few years. Even building an average-sized new hospital costs around £500 million, which rather puts the spotlight on the supposed £400 million cost limit I referred to earlier. I wonder if the Minister could put a total cost—

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[Mike Amesbury]

One such scheme, for which I and my hon. Friends the Members for Warrington North (Charlotte Nichols) and for Halton (Derek Twigg) and the hon. Member for Warrington South (Andy Carter) have been campaigning, is two campuses for Warrington and Halton trust. They seem to meet those criteria, so I look forward to an assessment and conclusion in the not too distant future.

[Edward Argar]

I am grateful to the hon. Gentleman, who quite rightly never misses an opportunity to champion his constituents’ interests.

Hon. Members will be aware that the interest around the country is significant. A significant number of expressions of interest have been submitted, so whittling them down will be a competitive and challenging process, but we undertake to be as clear and transparent about that as we can be. I suspect that, when the final list is announced, if I do not come to the House with a statement, the shadow Minister may well UQ me, to give colleagues an opportunity to say they are very pleased or to ask why their hospital is not on the list.

Let me turn to points made by other hon. and right hon. Members. My right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) will not be surprised that I will not be drawn on the specifics of the internal politics and the plans for his trust at this point. However, he quite rightly made the extremely important point that when trusts develop their plans and bring them forward, they need to carry the communities they serve with them and genuinely reflect on stakeholder input from elected Members and others, rather than—I am not saying that this is or is not the case with this trust—automatically having a preconceived idea of what the right answer is.

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[Mrs Miller]

rose—

[Mike Amesbury]

rose—

[Edward Argar]

Let me just finish this point before I take interventions from my right hon. Friend the Member for Basingstoke and then the hon. Member for Weaver Vale.

Our investment in new hospitals will also significantly reduce the backlog maintenance, because it will take out of the total a number of hospitals, some of which have been mentioned, that are being propped up day after day, with money being spent just to patch up and mend.

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[Edward Argar]

Let me take the hon. Member for Weaver Vale first, because I promised him that I would give way. I also want to leave a few minutes at the end for my hon. Friend the Member for Crewe and Nantwich to wind up.

[Mike Amesbury]

On the point about maintenance, several hospital buildings built in the 1970s have used Grenfell-style aluminium composite material cladding and high pressure laminate, so I assume that is part of the assessment criteria. Some have roof systems that are in a critical state.

[Edward Argar]

I am grateful to the hon. Gentleman, who raises a couple of points. Yes, roofs are a factor. In some cases—my hon. Friend the Member for Keighley talked about Airedale—there is a flat roof, which is vulnerable to heat and water, and aerated concrete planks, which is extremely challenging.

The hon. Gentleman mentioned cladding. I might be slightly out, but from memory I think that there are no hospitals with cladding in need of remediation. We put a programme in place following the Grenfell findings. Off the top of my head, I think every hospital trust has either had it removed or been assessed by the fire brigade as not having a risk. If I am wrong about that, I will of course write to him to correct the record.