Health Infrastructure Plan

With your permission, Mr Speaker, I wish to make a statement on the health infrastructure plan announcement.

Our health is the nation’s biggest asset, and the NHS is the Government’s top domestic priority. We are backing our commitment to our NHS with record levels of funding. As part of this, today I am pleased to update the House on the biggest, boldest hospital-building programme in a generation. Through our new health infra- structure plan we are supporting more than 40 hospital- building projects across the country, with six getting the go-ahead immediately—HIP 1. That includes £2.7 billion of investment that gives those six hospitals the funding to press ahead with their plans now, alongside last Friday’s investment in technology to ensure that no CT scanner is more than 10 years old.

The six hospital trusts are Barts Health NHS Trust, Epsom and St Helier University Hospitals NHS Trust, West Hertfordshire Hospitals NHS Trust, Princess Alexandra Hospital NHS Trust, University Hospitals of Leicester NHS Trust and Leeds Teaching Hospitals NHS Trust. Under HIP 2, a further 21 schemes have been given the go-ahead with £100 million seed funding to go to the next stage of developing their plans, subject to business case development. This £2.8 billion capital investment follows on from August’s £850 million for new upgrades, which included, for example, a £72.3 million investment in the Greater Manchester Mental Health NHS Foundation Trust. All of this, of course, comes on top of the £33.9 billion cash increase in funding for the day-to-day running of our NHS.

This announcement represents another part of our long-term, strategic investment in the future of the NHS, properly funded and properly planned, to ensure our world-class healthcare staff have world-class facilities to deliver cutting-edge care and to meet the changing needs and rising demand that the NHS will face in the 2020s and beyond. Capital spend on NHS infrastructure is fundamental to high-quality patient care, from well-designed facilities that promote quicker recovery to staff being better able to care for patients using the equipment and technology that they need. It is also essential to the long-term sustainability of the NHS’s ability to meet healthcare need, unlocking efficiencies and helping to manage demand. The investment we are making in our buildings, our technology and our equipment is vitally important in itself, but it is most important because it gives our fantastic NHS staff the tools they need to do the job.

Our staff are at the heart of the NHS, which is why we have invested in the NHS’s workforce. Our interim NHS people plan has set out immediate actions that we will take to reduce vacancies and secure the staff we need for the future—including addressing pensions tax concerns, increasing university clinical placements by over 5,000 more and bolstering the workforce. But it is only right that we invest in the buildings they work in, and in which they provide first-class care for patients. For too long, Governments of all parties have taken a piecemeal and unco-ordinated approach to NHS buildings and infrastructure.

The health infrastructure plan will change that. In the future, every new hospital built or upgraded must deliver our priorities for the NHS, and happen on time and in a planned way, not the current stop-start that we see.

But NHS infrastructure is more than just large hospitals. Pivotal to the delivery of more personalised, preventive healthcare in the NHS long-term plan is more community and primary care away from hospitals. That requires investment in the right buildings and facilities across the board, where staff can utilise technology such as genomics and artificial intelligence to deliver better care and empower people better to manage their own health.

This is only the beginning. The full shape of the investment programme, including wider NHS infrastructure, digital infrastructure, and wider capital investments that support the economy and health system will be confirmed when the Department receives a multi-year capital settlement at the next capital review.

This is a long-term, strategic investment in the future of our NHS, properly funded and properly planned, to ensure that our world-class healthcare staff have world-class facilities to deliver care and meet changing needs and rising demand, so that the NHS can face the 2020s and beyond with confidence.

I welcome the Minister to his place and thank him for advance sight of his statement. I know him to be a decent man—we have worked together on many joint Leicester and Leicestershire campaigns—and I consider him a friend, but I am afraid that we have to hold him and his Government robustly to account. What was announced yesterday was not in fact 40 guaranteed new hospitals but six hospital reconfigurations. It was also not the biggest hospital rebuilding programme in history, because that happened under the last Labour Government.

Of course, I welcome investment in Leicester Royal Infirmary—it is a big investment and to have won it shows what an effective Member of Parliament I am—but will the Minister be clear that that also means a downgrade of Leicester General Hospital, with services closing, including maternity services, and a loss of beds? Will he also tell us what happened with the Epsom and St Helier reconfiguration? Will he confirm that that means moving from two acute services to one in a part of London where accident and emergency pressures are increasing? Will he tell us today whether, across these reconfigurations, the end result will be more beds or fewer?

We know that the NHS is facing a repair bill of £6 billion after years of capital cuts under this Conservative Government, but the Government have so far refused to publish the capital allowances for between next year and 2025. Will the Minister guarantee that the £2.7 billion allocated will be additional to the capital baseline, and will he undertake to publish the NHS departmental expenditure limits on capital spending so that we can be reassured, rather than our assuming that this is all smoke and mirrors?

The Minister has also invited 21 other trusts to make use of a £100 million fund to prepare plans for future upgrades, yet he has just admitted that that will be subject to “business case review”. Is not the truth that the Minister and the Secretary of State cannot give any cast-iron guarantee that each and every one of these hospitals will be upgraded between 2025 and 2030, because not a penny piece of extra investment has been allocated to the programme for 2025 to 2030?

Finally, how were the 21 trusts chosen? In our mental health hospitals, 1,000 patients are forced to stay in quite dire old-style dormitory wards—the Minister might have seen the ones at the Leicestershire Partnership NHS Trust, for example—yet not a single mental health trust is on the list of 21 produced yesterday. Does that not show yet again that this Government neglect mental health services and some of the most vulnerable patients in the land?

I will at least start by expressing gratitude to the hon. Gentleman for his kind words at the beginning of his remarks. As he says, we work closely together in our city and county, although I suspect that that spirit of co-operation might not extend across these Dispatch Boxes. None the less, it is a pleasure to stand opposite him. Although I would not agree with his characterisation of where the money has gone, is he, on the basis of that characterisation, suggesting that his own seat is a marginal constituency?

I find it extraordinary that the shadow Secretary of State takes opposition to a new level by opposing investment in our NHS, trying to cavil and challenge it. He will forgive me if I do not take his specific questions in the same order as he asked them, but I will run through as many of them as I can recall or as I noted down.

On mental health, I have to say that I find it very difficult to take lessons from the hon. Gentleman when this Government have invested huge additional sums in mental health care. As I mentioned in my opening remarks, we have allocated capital for Greater Manchester Mental Health NHS Foundation Trust—the announcement was made earlier this summer—and for Mersey Care NHS Foundation Trust, so I think the hon. Gentleman is perhaps being a little unfair in suggesting there is no investment in mental health from this Government.

This is an ambitious programme, but unlike the last Labour Government, we will not leave hospitals saddled with masses of private finance initiative debt. That programme was massively expanded under the Labour Government he served as a special adviser. Perhaps he should welcome this Government’s approach, which is to give hospitals the funding they need to deliver without saddling them with debt.

We have made it clear that the hospitals named in HIP 1 have the funding to go ahead, including the hospitals that serve his constituency and mine. I am a little surprised to hear the hon. Gentleman challenge the notion that anyone bidding for huge sums of public money should have to go through a business case. Surely when we are spending public money, it is reasonable of us to make sure it delivers value for money and better outcomes for patients. I know the Labour party does not pay much attention to value for money, but my party and this Government do. We are focused on patient outcomes and delivering investment in our NHS. We can say proudly that, with this raft of announcements, the extra £33 billion and the announcements made already, we truly are the party of the NHS.

I very much welcome the allocation of £450 million to Royal Cornwall Hospitals NHS Trust. We are keen to work with the Department. Local NHS leaders are eager to work on producing a good business plan that meets the needs of patients and staff in Cornwall. When will the seed funding enabling them to develop those plans be available? If all goes as well, as I am sure it will, we will be able to start building those new facilities in 2025.

I know that my hon. Friend’s local hospital trust and her constituents have no greater champion in this place than her. She is right to highlight the allocation to Royal Cornwall Hospitals NHS Trust. The seed funding was announced yesterday and is there now, so we hope that the trust will get to work using that money to develop plans to improve services at local hospitals.

I am grateful to the Minister for advance sight of his statement.

UK Government decisions on pension costs and funding already result in a shortfall of £48.4 million for the NHS in Scotland, which comes on top of the UK Government making wider budget reductions in health funding for Scotland of £42 million compared with their previously claimed level of consequentials. Scotland now faces a shortfall of £90 million for its health services as a result of UK Government decisions. Now that the UK Government have apparently opened the spending taps, will they pay back the moneys due to Scotland, or will we continue to be short-changed? When will the full Barnett consequentials of this new investment be published?

In total, the Tories’ decade of austerity has cumulatively cut the Scottish block grant by more than £12 billion in real terms. With the economy already faltering, the Chancellor’s predecessor warned that a destructive no-deal Brexit could inflict a £90 billion hit on the Exchequer and suggested that no new money would be available. How then can the Minister guarantee that this money will come to the NHS?

I will not stray into the politics of the NHS in Scotland. The hon. Gentleman asks specifically about Barnett consequentials. I can confirm that they will apply, and if it would be helpful I will write to him with details.

As my hon. Friend might guess, I am delighted by the announcement about Epsom and St Helier University Hospitals NHS Trust, which will find favour with hon. Members on both sides of the House. We have been talking about it for a long time, and this is the first genuine movement.

I have a tiny, slightly off-the-wall additional request. As my hon. Friend is aware, I have a declared interest in dentistry, which means that every time the word “health” comes up, I get prodded in the back by my colleagues. In most western nations, 60%, 70% or 80% of the public water supply is fluoridated. It is a proven caries prevention. Would he include in his plans the infrastructure to greatly expand the fluoridation of our water supply? It would bring benefits in terms of prevention and, in due course, cost.

As he said, my hon. Friend showed some dexterity in asking that question, but I am happy to reassure him. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), is looking at this matter, and I am sure that she will be happy to discuss it with him further.

I would always welcome more money for our NHS, but as always the devil is in the detail. The “Shaping a healthier future” programme proposed the closure of four A&Es in north-west London, at a cost of £76 million, but just six months ago the Health Secretary stood at that Dispatch Box to declare the scheme scrapped. The author of that scheme, Daniel Elkeles, is now the chief executive at St Helier, where he is plotting to use these latest funds to reduce two A&Es to one—away from those most in need—which would place intolerable pressure on nearby St George’s. Does the Minister not see a pattern here?

I always think it a little unfair in this House to name or attack individuals where they do not have the ability to answer back. The Government have made it clear that the announcement today and yesterday is about putting more money into our NHS, which will improve services for the hon. Lady’s constituents and for those across the capital and indeed the country.

Northern Lincolnshire and Goole NHS Foundation Trust faces some particular challenges in delivering across two district hospitals and the community hospital to a relatively small population but one that has a big and complicated geography. Goole Hospital, for example, is still operating on a coal-fired boiler. I will write to the Minister following this, of course, but can he look at the particular requests we have with regard to the backlog of works at the trust?

My hon. Friend is quite right to highlight that in certain parts of the country, including his constituency, geography can present a challenge for the delivery of services. I look forward to his letter and will be very happy to respond and to look into the matter with him.

With a £1.3 billion maintenance backlog, Imperial College Healthcare NHS Trust, which includes St Mary’s, which serves my constituency, faces the largest challenges in the country and has been waiting for years for the approval to go ahead with the St Mary’s development. In recent years, we have seen the Grafton ward closed because of significant structural concerns, with the loss of 32 beds; a ceiling collapse in Thistlewayte ward; the Paterson centre flooded; and floods, electrical issues and drainage issues commonplace across the whole estate. Can the Minister guarantee me that today’s announcement will mean no repeat of these sorts of problems in St Mary’s in the coming months, and how does he feel it will be better served by the £200 million deficit the trust has and the £120 million deficit in our local clinical commissioning groups?

As the hon. Lady will recall, many years ago, when I had more hair and it was not so grey, I sat on Westminster City Council, and St Mary’s was an issue back then that we discussed on various occasions. She is right to highlight it, but I would have expected her to very much welcome the inclusion of Imperial and St Mary’s in the announcement of seed funding to develop their proposals and get the investment they need.

We are rather pleased in Winchester at today’s announcement and with our place within it. My constituents do not care about the political knockabout in this House. They love their hospital and are really pleased that it is going to be invested in. Will the Minister confirm how the seed funding process will work in the immediate term—we are in wave 2, but we are keen to get cracking so that we are ready—and will he also confirm that this is a huge vote of confidence in the Royal Hampshire County Hospital in Winchester, not just from the Government, but from the NHS as well?

I know that, since my hon. Friend was first elected to this House, he has made health and the NHS his No. 1 priority. He served with distinction as a Minister in the Department and continues to champion his constituents’ interests in this respect. On the seed funding, we have made the announcement and are keen to get the money to those trusts as swiftly as possible so they can work with us to develop their plans. I agree entirely that its inclusion in this list is a vote of confidence from us and the NHS in the work his local hospital is doing.