Hospitals

Sean Woodcock Excerpts

Wednesday 23rd April 2025 Commons Chamber

[Layla Moran (Oxford West and Abingdon) (LD)]

Lord Darzi’s independent investigation clearly set out the impact that “capital starvation” has had on the NHS in recent years, and the importance of capital spending to fixing the health service. The report highlighted substantial shortfalls in capital investment, combined with a tendency to raid capital budgets to cover in-year spending deficits, so I welcome today’s Liberal Democrat motion, which allows Parliament to highlight how important these issues are to the public. This is the second Liberal Democrat Opposition day, and it is the second time we have debated health and social care. It is because it is a priority for the country that it is a priority for us.

The Health and Social Care Committee has taken a keen interest in the new hospital programme. We have challenged the Government to maintain their capital spending and not fall into the traps of the past, when capital spending was redirected to fund day-to-day spending, so I was pleased to receive confirmation from the Department, and now from the Dispatch Box, that the Chancellor’s changes to the fiscal rules will stop future raids on the capital budget, or CDEL, to fund the day-to-day spending budget, or RDEL. That is hugely welcome. However, although the protection of capital budgets is reassuring, I remain concerned about the lack of transparency around how the funding is allocated by the Treasury.

The charge levelled at the Government is that funding is being funnelled into acute care to tackle waiting lists, at the expense of funding primary care, infrastructure and care in the community. Clearly, on current commitments, we will not see capital funding that is sufficient to meet anything close to the unfunded promises made by the Tories in 2020. Nevertheless, the principle of investing in our hospital infrastructure is good; money will be saved in the long run on maintenance and emergency repairs, as well as providing a better quality of care.

In the policy paper on the plan for implementing the new hospital programme, the Government stated that funding will reach only £3 billion in the early 2030s due to

“other key priorities in health spending, such as funding to enable the Secretary of State’s 3 shifts”.

That is good, but we need transparency around how decisions were made and which projects were chosen. In January, the Secretary of State provided the criteria by which the schemes were scored and funding was allocated, such as site constraints and maturity of planning permission, but it is disappointing that, as I understand it—I am willing to be corrected—the review was conducted without the involvement of the trust teams responsible for delivering the rebuilding programmes. As of last month, no trust with a new hospital programme scheme has been provided with the full details of how it scored specifically against the criteria.

The Health and Social Care Committee has asked how the Department is prioritising schemes and has not received a clear answer, so my question is very simple: in the interests of transparency, will the Secretary of State publish, for every single new hospital programme scheme that was subject to last year’s review, the details and findings of the Department’s assessment of them against each of the criteria that were published alongside his statement in the House of Commons on 20 January 2025? It is the very least that the schemes that felt deprioritised deserve, and we are hearing many examples of those from Members of different parties. I choose to believe that this outcome is inadvertent but, frankly, it just looks a bit shady. We have seen it happen before with the levelling-up money under the previous Government. The Public Accounts Committee, on which I know many Members have served, as have I, has a motto: sunlight is the best disinfectant. If the Government will not publish the detailed assessment, the Minister needs to explain why.

My local area, like so many others, has been affected by this issue. Last year I visited the John Radcliffe hospital, which serves much of Oxfordshire, and I saw at first hand how its capacity to deliver care is being severely constrained by the size and condition of the physical estate. We went to visit the old site of the neonatal intensive care unit, which had to be moved because the staff were worried about the ceiling literally coming down on sick children and on incubators. It was atrocious.

The John Radcliffe hospital wants to be world-leading. It is a specialist tertiary care hospital, which means it is able to perform very specialist surgery, and it wants a new building to do that in. When it put to the Government a bid for £28 million, it was rejected. Instead, it has gone out to seek private financing, and it will now cost the trust £46 million to deliver the exact same building. Would it not have made sense for the Government to allow the trust to borrow from the Government to build it, and then to pay the money back from its own reserves over time? Think what it could have done with that £18 million.

[Sean Woodcock (Banbury) (Lab)]

I know the John Radcliffe hospital, which serves some of my constituents. The hon. Lady has made a powerful case about the amount of money that has potentially been lost through this process. Would she, however, reflect on the role played by her party, particularly the right hon. Member for Kingston and Surbiton (Ed Davey), and the amount of money wasted on the disastrous top-down reorganisation of the NHS under the coalition Government?

[Layla Moran]

I have to say that that was quite a segue. We are focusing on the capital estate. We all know that there were problems with the Lansley reform. In fact, I welcome the fact that it is being unravelled, and I was pretty vocal about it at the time.

The savings the John Radcliffe could have realised might have been spent on hospital at home services and other ways to divert people away from coming into A&E in the first place.

Across the wider Oxford university hospitals NHS foundation trust, £100 million of backlog is deemed as high or significant risk. Pausing or delaying plans to rebuild hospitals is a false economy, and hospitals around the country, including the John Radcliffe, are overspending on maintenance as a result. That is not limited to our hospitals; we are also seeing it in GP practices, many of which date from well before 1948. I will declare an interest in that my own surgery—the Summertown health centre—is one of those practices. It is doing incredibly well, despite working out of a very old Victorian building. It is desperate for a new site, and it was deemed one of the top priorities for the ICB. I note that the Minister mentioned a figure of £102 million, but, frankly, that does not touch the sides.

As in the case of the John Radcliffe, the Summertown health centre is now going out to seek private finance, which it will find a way to pay back slowly over time. The Exchequer would not even have to lay out this money in advance, and even with inflation, the amount it would get back is less than what the health centre has to pay to do this with private finance. I ask the Government to think about this innovatively. It is not the same as the PFI. It is the Government using their own borrowing rules to allow investment in vital public services, and it makes no sense that they cannot do it.

When it comes to mental health services, we have the incredible Warneford hospital in Oxfordshire, and Warneford Park in Oxford will provide a new cutting-edge mental health hospital surrounded by a research and innovation hub. Groundbreaking research is planned on understanding brain health and discovering new drug therapies and new forms of treatment. This is a great vision, but it will cost £500 million. We do have private benefactors, including local businesses, willing to feed into it, but where is the funding pot for mental health trusts? They were excluded from the new hospital programme, and it is not at all clear where that kind of money may be found.

--- Later in debate ---

[Sean Woodcock (Banbury) (Lab)]

For years, my constituents in Banbury have lived with the consequences of a health system that has been allowed to fall apart bit by bit, service by service. Our mental health services, especially for children and adolescents, are severely under-resourced. Families are waiting far too long for help, even in the most serious cases. Our maternity unit in Banbury was downgraded under the Conservatives, so those having complex or emergency births have to travel to Oxford or Warwick, with all the risk that that brings, especially when delays are caused by our inadequate transport infrastructure. There is no overnight surgery or day-care surgery available locally, and patients fall through the cracks because of poorly co-ordinated services between Oxfordshire, Warwickshire and Northamptonshire.

Under the Conservatives, and with the support of the Liberal Democrats in coalition, money was diverted away from vital health services into a disastrous and unnecessary reorganisation of our national health service. The result is what we are seeing now: fragmented care, overstretched services and communities like Banbury being left behind. My constituents are not going to be pleased by Governments making promises that they cannot keep and when they have no realistic plan or funds to deliver them.

[Helen Morgan]

Multiple Government Members have made that point, but surely they can see that promising to build a hospital in a decade’s time when they may not be in power is a meaningless promise.

[Sean Woodcock]

I suggest that our decade of national renewal will ensure that the hospitals that we have promised will be delivered. I am confident about that because things are changing. The new hospital programme has been put back on a firm footing, with every project backed by real funding and a realistic plan, which is equally important.

Crucially, this Government are not stopping there. Labour’s 10-year health plan is about improving how the whole system works with patients. That means better co-ordination between GPs, hospitals, mental health services and social care, and ensuring that wherever people live, even if that is on the border between counties, which is an issue close to the hearts of people in my constituents, they are not passed from one part of the system to another without support. It also means doing more locally, with more care available close to home, so fewer people have to travel longer distances to get basic treatment, and earlier invention, so that problems are picked up before they become emergencies.

We have already seen progress. We have cut waiting lists by over 200,000, delivered over 3 million extra appointments, recruited more GPs and invested £26 million in mental health crisis centres to alleviate the pressures on A&E services. Some £2 billion will be spent on technology and digital improvements to increase productivity and ensure patients are seen faster. We are starting to turn things around and doing so in a way that puts patients first, without making undeliverable, unrealistic promises that damage trust in politics and the power of politics under our democratic system. For too long, people in Banbury have been left wondering if their NHS would be there when they needed it. After 14 years, they can see that help is finally on the way. With this Labour Government, things are changing practically and with purpose.