Hospital Building Programme

Virendra Sharma Excerpts

Wednesday 3rd November 2021 Westminster Hall

[Mr Virendra Sharma (in the Chair)]

Before we begin, I remind Members that they are expected to wear face coverings. This is in line with current Government guidance and that of the House of Commons Commission. I also remind Members that they are asked by the House to have a covid lateral flow test twice a week if coming on to the parliamentary estate. That can be done either at the testing centre in the House, or at home. Please also give each other and members of staff space when seated, and when entering and leaving the room.

[Dr Kieran Mullan (Crewe and Nantwich) (Con)]

I beg to move,

That this House has considered the hospital building programme.

It is a pleasure to serve under your chairmanship, Mr Sharma. I welcome the chance to discuss the Government’s £3.7 billion hospital building programme, and particularly welcome the opportunity to make the case to the Minister for my local hospital, Leighton, to be included as one of the final eight sites chosen by the Government.

Leighton Hospital was built in the 1970s, and officially opened by the Queen in 1972. I have looked back at the pictures of her visit, and it made me think about just how long Her Majesty has been serving our nation in this way—visiting, before I was even born, the hospital that serves my constituents today. At that time, Leighton Hospital represented a huge change in how healthcare was provided in the area, going on to pick up the role of several smaller hospitals spread across the patch. Its importance and role have only grown since then, serving a population that has increased significantly and now stands at more than 300,000 people.

Whether it is the hip and knee replacements it carries out, the babies it helps deliver, the thousands of cancer screening tests and treatments it undertakes, the cataracts it repairs, or the urgent GP and accident and emergency care it provides, Leighton is at the heart of our local health services. In an ordinary year, Leighton provides around a quarter of a million out-patient appointments, carries out more than 30,000 operations and more than 200,000 diagnostic imaging tests, and has more than 90,000 visits to its emergency department. Of course, none of that would be possible without its fantastic staff: Leighton employs more than 4,500 staff, and that fantastic team of cleaners, porters, cooks, receptionists, healthcare assistants, physiotherapists, occupational therapists, nurses, doctors, volunteers and many others is what turns a building into a hospital.

Those staff can be proud of their achievements in the battle against covid. Not only have they cared for covid patients, but they have also vaccinated 47,000 people under the leadership of their director of pharmacy, Karen Thomas. I had the absolute pleasure of volunteering alongside the staff during the first lockdown. I was quite uncomfortable with the media attention on me for doing this for only a short period of time, when those staff do it day in, day out without any fuss or attention.

As I have seen again and again during my time working in the NHS, its staff have an enormous amount of dedication, often going above and beyond, and are perhaps too accustomed to working in departments and environments that make doing a really good job more difficult than it should be. That is why, although we are talking about buildings today, it is important to highlight that—as others have said—we will only be able to make the most of new facilities if we are able to carry on with the success we have had so far in recruiting more staff.

--- Later in debate ---

[Justin Madders]

I will reflect on the right hon. Gentleman’s comments. That leads on to another point I wanted to raise with the Minister: we are aware that the economy is currently in something of a flux in a whole range of sectors, in terms of finding the right people and the right skills, and construction is not immune to that. Do the plans include any wiggle room to take account of the fact that the cost of labour and materials is unfortunately going up quite rapidly at the moment?

NHS Providers said that

“there are still significant questions on whether the NHS will be able to meet the government's manifesto pledge to upgrade 70 hospitals and build 40 new ones given the lack of clear, long term, funding commitments beyond 2024/25.”

It also said that it awaits

“confirmation of the money that will be available to providers to tackle the £9.2bn maintenance backlog that has built up.”

The Minister will know that that has shot up in recent years, leading to cancelled operations and a 23% increase in treatments being delayed or cancelled in the last year because of infrastructure failures, and yet we are hearing very little on what is being done about that. I think the hon. Member for Eddisbury mentioned something in the region of £400 million being identified as the maintenance backlog costs at Leighton Hospital alone. We have also heard from other Members on infrastructure issues causing difficulties in their own trusts.

These problems are not new; they are the result of a decade of underfunding on both capital and revenue, with the Health Foundation reporting that

“the UK is investing significantly less in health care capital as a share of GDP compared with most other similar European countries.”

Of course, we have also seen frequent revenue raids on capital in the last few years. If these plans are to be successful, those raids must stop. I hope the Minister will be able to guarantee that there will be no revenue raids on capital for this programme in the next decade. I would also be grateful if he could set out the Department’s plan to tackle the maintenance backlog.

A few moments ago, I mentioned the interplay between large infrastructure projects and other capital requirements at a system level, particularly around how we get capital investment into primary and community care. Taking my own patch, Ellesmere Port, which I know best, we have several GP premises in the town centre that are past their best—past their useful life, perhaps—they are not really suitable in these covid-conscious times. We are not short of more modern, available premises in the town centre, where there might even be greater potential for integration with other services

However, these projects take time and money, and some decision must be taken at a system level to prioritise them. I think that would be an important step forward for improving access in my community and dealing with some of the health inequalities we have talked about. I recognise that sometimes it is a fact of life that the bigger players—the acute trusts—will always be higher profile than individual practices for attracting funds and investment. In many ways, this is an echo of the debate that the Minister and I have had in recent weeks on the Health and Care Bill Committee. I mention it again because, particularly with capital investment, there is a danger that primary and community services will struggle to have their voices heard against some of the bigger players in an extremely large integrated care system.

I will end with a few comments from stakeholders regarding the Chancellor’s statement last week. The King’s Fund said that

“the real game changer would have been clear funding for a workforce plan. Chronic workforce shortages across the health and care system heap further pressure on overstretched staff who are exhausted from the pandemic. Yet despite pledges, promises and manifesto commitments, the government has failed to use this Spending Review to answer the question of how it will chart a path out of the staffing crisis by setting out the funding for a multi-year workforce strategy.”

The Health Foundation said that

“new money for technology and buildings, although vital, is of limited value without additional staff. A workforce plan backed by investment in training are critical and we await details of both so that the NHS’s recovery can be secured.”

The Nuffield Trust said:

“It is striking that there is a lack of strategic workforce investment alongside this boost in funding for facilities. Staffing is recognised as the number one issue for the sustainability of the health service. Recovery from the pandemic not only rests on investment but on hard-working staff as well.”

Finally, the NHS Confederation said that

“to ensure the extra money delivers for the public, a strong and supported NHS workforce is needed. This is why training and increasing the supply of doctors, nurses and other health and care professionals is so important at a time when public polling recognizes that staffing is the biggest problem facing the NHS.”

While we welcome the investment in new buildings, we hope that none end up being a white elephant, because the elephant in the room is that we could find ourselves in the remarkable position by 2030 that brand new hospitals, extensions, or refurbishments are delivered, but are not fully operational because of a failure over the preceding decade to tackle the workforce crisis. That is here and now, and it needs to be tackled in the short, medium and long term. That is the final plea I make to the Minister: these investments are welcome, but we must ensure that we have a plan so that these buildings are fully staffed when they are up and running.

[Mr Virendra Sharma (in the Chair)]

Before I ask the Minister to contribute, I will just say that I will be joining that long queue very soon to lobby for Ealing Hospital’s future, but not this morning.