Kettering General Hospital

Philip Hollobone Excerpts

Wednesday 2nd February 2022 Westminster Hall

[Derek Twigg (in the Chair)]

Before we begin, I remind Members to observe social distancing and wear masks. I will call Philip Hollobone to move the motion and then the Minister to respond. There will not be an opportunity for the Member in charge to wind up. That is the convention for 30-minute debates, as I know the Member is well aware.

[Mr Philip Hollobone (Kettering) (Con)]

I beg to move,

That this House has considered the redevelopment of Kettering General Hospital.

It is a delight to see you in the Chair, Mr Twigg.

I thank Mr Speaker for granting me this debate, and I welcome the Hospitals Minister to his place. I also welcome my hon. Friend the Member for Northampton South (Andrew Lewer), who is kindly here to support the calls for the redevelopment of Kettering General Hospital. I thank the very hard-working, dedicated and loyal workforce at Kettering General Hospital for all they do to address the healthcare needs of the local population across Northamptonshire, particularly north Northamptonshire—in particular, Simon Weldon, the group chief executive, and Polly Grimmett, the director of strategy at Kettering hospital.

The Hospitals Minister knows Kettering hospital well and has always been extremely attentive and courteous to the healthcare needs of the local population in Kettering and beyond. He kindly visited the hospital on 7 October 2019, and he has responded to Adjournment and Westminster Hall debates on the hospital on 23 October 2019, 8 June 2021 and 10 September 2021. We have had regular meetings with him, most recently on 17 January this year.

I welcome the Government’s unprecedented investment in the NHS as a whole, and their commitment to the national hospital building programme. It has resulted in commitments to Kettering hospital of £46 million for an on-site urgent care hub, £350 million in health infrastructure plan 2 funding for 2025-30 and a write-off in 2020 of all the hospital’s £167 million trust debt. That is a total investment package for the hospital of a staggering £563 million, which is the biggest ever investment in Kettering General Hospital.

Kettering hospital is 125 years old this year. It has been on the same site ever since its inception in 1897. It is a much-loved local hospital that I hope will have a bright future. Let me reassure the Minister that I am not asking for more money. I welcome his recent decision that the two funding streams—the £46 million for the urgent care hub and the £350 million HIP2 funding—be meshed together, so that a synthesis of investment can be provided to the hospital. I have said this to the Minister before, and I repeat it today: promises are one thing, but delivery is quite another, and we now need the cash. The hospital needs the £46 million in cash so that works can continue.

In announcing the award of £46 million for the new urgent care hub in the debate on 23 October 2019, the Minister himself said:

“My officials and NHS England will be in touch with the trust to discuss further details, in order to ensure that funds are released and that work starts on the project as swiftly as possible. I am conscious of the urgency that my hon. Friend the Member for Kettering highlighted.”—[Official Report, 23 October 2019; Vol. 666, c. 30WH.]

I welcomed those words, but that was over two years ago. While we have been promised £46 million, the hospital has not yet received the cash.

My first main ask is for the imminent provision to KGH of the £46 million sustainability and transformation partnership wave 4b funding, which was first pledged in the debate here in October 2019, so that the initial enabling works for the redevelopment of the hospital can continue to 2023-24. Secondly, I reinvite the Minister to visit Kettering hospital. He has kindly visited before and has promised to visit again. I hope that that visit will take place soon.

Thirdly, can we have confirmation that the NHS’s new hospitals programme team will approve, and give feedback on, the hospital’s strategic outline case for its redevelopment, which was submitted early last year, so that the hospital can develop the next stage—an outline business case—in May 2022? Fourthly, can the Minister confirm that he will look favourably on Kettering hospital’s eligibility for £53 million of slippage from other more complicated and larger hospital development schemes—such slippage will inevitably occur across the redevelopment of 40 hospitals—so that work can continue on the Kettering site all the way through to the 2025 to 2030 HIP2 period?

The hospital is straining at the leash to get the redevelopment project under way. Initial work has already commenced, but the hospital must go through various approval processes to fulfil the NHS’s investment requirements. Essentially, there is a three-stage business case approval process: a strategic outline case, an outline business case and a final business case.

The hospital submitted its SOC early last year, but it has not yet received feedback from the new hospitals programme team to inform the outline business case, which it is keen to submit in May this year. Once the OBC is achieved, feedback is required for the final business case. The big risk is that these various business case approval processes are extended too long, which will mean that substantial development on site will be held up.

The second risk is that the hospital needs the cash from the £46 million to allow the initial enabling work to continue. That work covers things such as the reprovisioning of car parking, clinical and office spaces to create construction space for the redevelopment itself, as well as road and utility diversions and site clearance. Without the cash from the £46 million, the risk is that those enabling works will have to stop, and that would be of extreme concern to local people.

The third risk is that the trust does not receive any slippage money from the other 40 hospital building programmes around the country. The Kettering scheme is relatively small, compared with some of the very large hospitals being rebuilt, but it is flexible. It can respond extremely well to receiving any slippage money from those other projects.

[Andrew Lewer (Northampton South) (Con)]

My hon. Friend is giving a remarkably impressive run-through of some of the complex bureaucracy and procedures. I want to pick up on his point about integration. Does he agree that Northampton General Hospital and Kettering General Hospital working together more efficiently provides some promising opportunities? While I cannot join him in saying that I will not ask the Minister for more money, because Northampton General Hospital is in the next stage of needing this sort of funding, I join him in asking the Minister to come and look at Northampton General Hospital and Kettering General Hospital as soon as possible.

[Mr Hollobone]

I thank my hon. Friend for his helpful intervention. How about this as a constructive suggestion? Would it not be wonderful if, on visiting Kettering, the Minister was able to call in at Northampton on the way? We are only 18 miles apart. Northampton and Kettering hospitals work together under the same NHS trust umbrella, and there is a lot of close working between the two hospitals. I recognise the need for more investment in Northampton hospital as well. I congratulate my hon. Friend on all his work for his constituents, which I know is hugely appreciated.

The risk is that, if Kettering hospital is not allowed to begin work on its full business case approval process this summer, the hospital will miss its 2023 target date for substantial construction on the site. The hospital continues to work towards a timetable that sees construction start on site in 2023. This is an accelerated timeline, because the hospital is eager to go on what is a relatively low-risk project. The hospital does not need to do any land deals; it owns all the land. There is strong local support among health system partners and planners. The hospital is keen to use repeatable designs from other hospital projects that have worked well elsewhere.

Can we have feedback from the new hospital programme team on the business case and designs for the hospital, so that the hospital can incorporate national thinking on programme priorities such as digital, net zero carbon and modern methods of construction? Can we have, as early as possible, the selection by the new hospital programme team of an appointed construction partner to work with the trust on developing the final scheme details, and can the hospital have the funding to cover the fees associated with this stage of the design? The risk is that, unless this support from the new hospital programme team is forthcoming, work on the hospital’s main scheme may have to come to a stop, with key resource being stood down and reassigned. I am sure the Minister wants to avoid that.

It is welcome news that the trust has received confirmation that the £46 million can be combined with the £350 million, so that it is a united programme. However, at present, there is no process in place to allow the hospital to start accessing these funds once existing programme budgets run out in March this year. Unless the trust is able to access these funds this year, early enabling work required to prepare the site for construction in 2023 will not be completed and the main build will not be possible on time.

One thing that keeps the chief executive awake at night is the power plant at Kettering hospital: £25 million of the money required for enabling work relates to the need for a new energy centre on site to replace the temporary plant and life-expired distribution system. This is an immediate risk to patient safety due to ongoing shutdowns caused by testing and repair work. If the Minister were kind enough to agree to visit the hospital, I am sure the trust would want to show him the power plant, which is in urgent need of attention. If we get the £46 million, the scheme can progress, enabling works can continue and the hospital will be on track for early construction work beginning in 2023.

I reiterate that Kettering hospital is a much-loved local hospital. It serves all the residents of Kettering, Wellingborough, Corby and others, sometimes including patients form Northampton. We live in one of the fastest-growing areas in the country. Corby has the country’s highest birth rate, and Kettering hospital expects a 21% increase in the number of over-80s in the local area in the next five years alone. The area has committed to at least 35,000 new houses over the next 10 years. The local population is set to rise by some 84,000, to almost 400,000 people. The A&E now sees up to 300 patients every single day in a department that is sized to safely see just 110. Over the next 10 years, the hospital expects the number of A&E attendances to increase by 30,000, up from 100,000; that is the equivalent of almost 80 extra patients every day.

The A&E is full. It was constructed in 1994 to cope with just 45,000 attendances each year. By 2045, 170,000 attendances are expected. Seventy per cent. of the buildings on the main site are more than 30 years old, and there is a maintenance backlog of £42 million. Sixty per cent. of the hospital estate is rated as either poor or bad. Local people know that this investment is needed. The Government have also accepted that the investment is needed. What we need now is the cash to make sure that the works can start on time in 2023.

[The Minister for Health (Edward Argar)]

It is a pleasure to serve under your chairmanship, Mr Twigg. I congratulate my hon. Friend the Member for Kettering (Mr Hollobone) on securing this debate. By my tally, this is the fourth debate I have responded to that he has secured on the future of Kettering General Hospital and its redevelopment. That fact reflects his commitment to this issue on behalf of his constituents, and his typically courteous but tenacious approach to the matter. I will put on record, as they are unable to be here, the work done by my hon. Friends the Members for Wellingborough (Mr Bone) and for Corby (Tom Pursglove) in this respect. I welcome the intervention from my hon. Friend the Member for Northampton South (Andrew Lewer).

The topic is not a new one for this House to discuss, but it is an extremely important one. I hope that I might move matters a little bit further forward in this debate for my hon. Friend the Member for Kettering. It was a pleasure to meet him, my hon. Friends the Members for Wellingborough and for Corby and Simon Weldon on 17 January to discuss Kettering General Hospital and receive an update on its plans. I join my hon. Friend the Member for Kettering in paying tribute to Simon and all of the team at Kettering General Hospital and at Northampton General Hospital for the work they have done, not only in the past two years, but day in, day out every year, to support the local community and provide first-class care.

My hon. Friend the Member for Kettering made, as ever, a generous offer to visit Kettering General Hospital with him. It was a pleasure to do so in 2019, when he gave me a very warm welcome in Kettering. I also take his suggestion of visiting Northampton at the same time. Without setting a specific date, my aim is to try to visit him during the February recess—I will discuss this with him. It is not a long haul for me from my constituency in Leicestershire to his in Kettering or Northampton, so that is what I will hope to do, subject to that working for the trust. Ministers are often surplus to operational requirements in a busy trust at busy times, but I suspect that Simon will welcome me to explain what progress he has made. That is my commitment to my hon. Friend.

As my hon. Friend set out, Kettering General Hospital is part of the broader foundation trust, and continues to work closely with the central programme team in taking forward the rebuild of Kettering General as a new hospital for his community. It is part of the broader programme to build 40 new hospitals by 2030. On 13 January, Natalie Forrest, who is the senior responsible owner for the new hospital programme, and officials attended a virtual meeting with the chief executive and staff from Kettering General to discuss progress and provide an update on the scheme in the context of the programme. As my hon. Friend knows, Kettering General Hospital NHS Foundation Trust has received £4.4 million of funding to develop its plans for the rebuilding of Kettering General Hospital. They were successful in securing funding back in 2019, at that stage for a new urgent care hub, which would transform the provision of urgent and critical care in the area. I know that officials are in discussion with the chief executive of the hospital trust regarding the trust’s plans for enabling works on the Kettering General Hospital site and have set out what will be required for these proposals to be assessed as quickly as possible, once business cases are received from the trust, which is in line with what my hon. Friend would expect of appropriate processes for spending public money.

I will provide a little background. The Department wrote to the chief executive on 16 June last year to confirm that, at his request, the urgent care hub and new hospital programme schemes could be brought together as a single pot of money, to maximise the benefits that local people could derive.

Essentially, my hon. Friend asked why things have not progressed since 2019. That is largely because the trust changed its plans. That money was ringfenced for an urgent treatment centre. We had discussions about that with the trust and accepted its proposal to merge the two pots of money. That then necessitated their coming forward with proposals about how they would spend that money as part of the enabling works for a broader scheme. If changes are made, it is right that those changes are justified, in the context of the appropriate stewardship of public money.

The hub and the new hospital that are to be built both share a set of common enabling works, which have been factored into the new hospital development plans. As a result, the trust is incorporating the urgent care hub delivery into that broader plan. It means that the hub will now be part of the first stage of the building of the new hospital, enabling the more efficient use of resources to deliver better results.

In respect of the business case for that plan—I know that my hon. Friend is keen that there is progress on that as swiftly as possible—my officials have been in touch with the trust recently, most recently yesterday and before that on 26 or 27 January, asking the trust to put forward its proposals for those enabling works. We need those to progress the business case. My officials continue to nudge the trust gently, saying, “Please submit your proposals for that and the business case for it”. My commitment is that my officials will consider those proposals as swiftly as they can, once they have received them. As I understand it, given the scale of the enabling works, they would not need to go through the full internal approvals process, but the trust needs to submit a business case for that element.

The second element, which I know my hon. Friend and the trust are keen to see being advanced as swiftly as possible, is the new boiler room and power plant. Essentially, that would have to go through the full approvals process, but I understand that the board of the trust is due to meet in April to agree and finalise its proposal and business case on that work. As soon as it submits that, I can commit to my hon. Friend that—assuming that it is up to scratch, which I am sure it will be—it will go before the first joint investment committee of the Department following its submission, so that it can be considered as swiftly as possible.

At the moment, if I may put it this way, the ball is in the trust’s court, for it to send its proposal and business case over. However, my commitment is that as soon as the trust does so, I will task officials with considering them as swiftly as possible.

[Mr Hollobone]

I thank the Minister for his very helpful comments. I think that the ball, in part, may be in the trust’s court, but there is perhaps another ball with the new hospitals programme team. I say that because the hospital submitted its strategic outline case to the NHS a year ago and what the trust requires is feedback on that, to inform the development of its outline business case. So would the Minister be kind enough to look at that feedback?

[Edward Argar]

I am happy to look at that. The point I am making to my hon. Friend is that for the moneys that he and the trust wish to draw down from the £46 million, we do not have the business cases from the trust that would enable that work. I suspect that they will be winging their way to the Department pretty swiftly following this debate and as soon as they arrive we will look at them. Regarding the broader business case for the overall scheme, I will turn to that, if I may, in just a moment.

All the new hospitals that will be delivered as part of the programme, including Kettering, are required to work with the central team and, with the support of regional and local trust leadership, to design and deliver their hospitals in keeping with a consistent and standardised national approach. This collaborative approach is intended to help each trust to get the most from its available funding, while avoiding repetition of work and design, and ensuring that adherence to the principles, which my hon. Friend alluded to, of repeatable design, modern methods of construction and net carbon zero, is embedded from the outset, to maximise the potential benefits of the programmatic approach, as well, of course, as providing better value for money for the taxpayer.

All the projects that are part of that 40-hospital programme need to ensure that their approach is consistent with the programme, which that has been developed over the past year and has reached a greater level of maturity. Therefore, there will be individual conversations with trusts about where they align with the programme, or where they may need to adapt to meet that national approach.

My hon. Friend touched on the trust’s desire to go faster and begin the main project construction in 2023. In the spirit of openness, my only caveat to that is that, in the nature of funding through multiple spending review periods, it is not the case that a pot of money is earmarked for each programme and is just waiting to be drawn down; there is a profiling of moneys made available by the Treasury. I appreciate the trust’s eagerness to go faster, and I appreciate my hon. Friend’s clear steer that he believes it is capable of going further and faster, but we need to look at it in the context of all the other schemes and the availability and profile of moneys being made available. I just sound that slight note of caution, so I will not commit to a date, much though he tempts me to do so.

[Mr Hollobone]

I appreciate the Minister’s comments. I would just highlight that there are some very large new hospital programmes out there that will not be achieved on time. Kettering is a relatively small, flexible and modular scheme that is perfectly placed to pick up on any slippage from some of the larger schemes.

[Edward Argar]

I am grateful to my hon. Friend, because I was about to turn to his final ask, which was whether the Department would look favourably on Kettering’s scheme if there was slippage from other schemes in the course of the spending review period. Although I cannot prejudge in this place that Kettering will be top of the list, he makes a strong case. It is absolutely right that we look at schemes and have a list of schemes that we believe could fill the gap if moneys are not going to be spent in year. It is important that that contingency is built in, and my hon. Friend makes a strong case for Kettering to be one of the hospitals that is considered for acceleration if it is ready and the moneys become available. I will not prejudge the advice that I will be given by officials as to which schemes are most mature, but he makes his case clearly and forcefully on the Floor of the Chamber.

I am grateful to my hon. Friend not only for the opportunity to discuss and debate Kettering General Hospital, but for the opportunity to visit Kettering. On my last visit, I received a very warm welcome from him and the team at the hospital. In what I have said today, I hope I have ensured that I get an equally warm welcome when I come and see him this month. Like him, I am keen to see all these schemes progress, and I am keen to see the benefits that the schemes will realise.

In the context of Kettering General Hospital, my hon. Friend continues to be an incredibly powerful advocate for the interests of his constituents and those in the wider area of Northamptonshire who are served by the hospital. I look forward to continuing to work with him very closely in the future, as well as with the trust’s chief executive and team, other hon. Friends from Northamptonshire and my team in the Department, to help progress these very exciting and important plans, which will make a huge difference to his constituents’ lives in the years ahead.

Question put and agreed to.