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.
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.
My hon. Friend is making a strong case for Leighton, and he will know that, as a former Member for his constituency, I was able to work with that hospital very closely. All four of my children were born at Leighton Hospital, which sits in my constituency, and I also spent a week working in that hospital and cannot praise its staff highly enough. I hope that this building programme will give those staff the environment they deserve in order to provide the healthcare we know they can deliver, which is world class.
My hon. Friend is absolutely right, and what he has said is typical of people who live in the area, who have also experienced their children being born at that hospital and receiving excellent care there.
Speaking as a neighbouring constituency MP whose family has also made great and beneficial use of Leighton over many years, I strongly support my hon. Friend’s campaign for additional resources and support for Leighton. I very much respect him for that effective campaign, which I know has strong support across our constituencies.
My hon. Friend has spoken about the number of people who seek services from Leighton at the present time. Does he agree that that number is not going to diminish: it is going to increase, due to the additional numbers of houses that are being built in our areas? I note, for example, Northwich, where there is a huge amount of house building on the former ICI site, Middlewich in my constituency and Sandbach. Altogether, in recent years, thousands of new houses have been built for people who will want to look for support from Leighton.
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 lifespan, but that is the reality.
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.
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 ageing 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 lifespan 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 lifespan and address that now.
My hon. Friend has been extremely generous with his time. Will he also confirm that this project, if delivered, would save more than £400 million in backlog maintenance, as well as helping to free up a lot of the community care, which at the moment is under extreme pressure because of the lack of beds available at Leighton and in the surrounding area?
My hon. Friend makes an excellent point. This is actually about saving money in the long term given the unavoidable costs at the existing site.
Of course, building the hospital will provide jobs and opportunities for local people, with apprentices at South Cheshire College and others well placed to take advantage in the parts of Crewe where employment and salaries are still not where we would want them to be. I know that the plans have the full support of my hon. Friends for Congleton and for Eddisbury. Leighton’s bid is also supported by both Cheshire West and Cheshire East, as our local authorities, and the Cheshire clinical commissioning group. There is also cross-party support with the hon. Member for Weaver Vale (Mike Amesbury).
The chair of our newly formed Crewe Town Board, Doug Kinsman, has been keen that the whole board support the proposal, and the rest of the board have seen how important Leighton is to Crewe, both economically and in improving the health and wellbeing of Crewe residents. Importantly, we have the support of those residents. So far, more than 1,000 people have signed our petition supporting the hospital in its efforts to make it into the final eight. The residents include Betty Church, whose daughter was born in the hospital the year it opened, 1972, and Steve Burnham, who explained that not only were three members of his family born there, but his mum worked there for 40 years.
I asked residents to tell me about their experiences and share why they were supporting the campaign. Janice Butler wrote:
“My husband, elderly mother-in-law and father-in-law have all received fantastic help and treatment here. The hospital serves a huge population now and help to improve and upgrade its facilities is desperately needed and has been for many years. Despite the huge pressures, we have experienced excellent help here.”
9:44 am
Sir Mike Penning (Hemel Hempstead) (Con)
It is a pleasure to serve under your chairmanship, Mr Sharma, as was alluded to by my hon. Friend the Member for Crewe and Nantwich (Dr Mullan). This debate is enormously important. Hospitals are often the heart of our communities. The staff in our hospitals, whatever job they do, do a fantastic job, and it is right and proper that we pay tribute to them. But the environment that they work in is also vital to them.
To give a little history lesson from Hemel Hempstead and South West Hertfordshire, which is my part of the world, we had three hospitals—three acute hospitals—until just over 20 years ago when St Albans was closed as an acute hospital. The promise was made at the time that the emergency facility would be picked up by Hemel Hempstead and partly by Watford. That promise was made and then, sadly, Hemel Hempstead was closed—I am not going to get into party politics, but it was by the previous Administration—and we fought tooth and nail, as most constituency MPs would, to save it. Now we have partly elective surgery for non-emergency care at St Albans and I have a clinic—there is no other way I can describe it—at Hemel hospital. Three quarters, if not more, of my hospital is boarded up or vandalised on a site worth hundreds of thousands or millions of pounds.
I was thrilled—absolutely thrilled—when the Prime Minister announced at the general hospital in Watford, which is the only acute hospital we have left in our part of the world, that we were in the top six to get a brand-new hospital. That thrilled us not because we wanted suddenly to bring back our hospital—we understand the restrictions on doing so and what a modern hospital needs to provide for a community—but within hours of the Prime Minister announcing that we were in the top six and that there was the funding, unlike what it sounds as though the management did in my hon. Friend’s constituency, the management ruled out a new hospital on a greenfield site.
As for many of my colleagues, the population in my part of the world on the edge of London is booming. We have a thriving economy, and we have more jobs than we actually have people to fill them, even after the pandemic. The population is growing massively, and I have 20,000 homes coming to my own constituency in the next 15 years. The logic of not building a new hospital on an available greenfield site is confusing to everybody, especially to those who know that Watford hospital is a Victorian hospital next to the Watford Football Club ground in the middle of a Victorian town. All we have been offered is a refurbishment of Watford and a running down even more of the Hemel site.
What fascinates me is that the West Hertfordshire Hospitals NHS Trust seems to be completely unaccountable to the politicians who are giving it the money to look after care in our constituencies. I know that the Health and Care Bill going through Parliament at the moment is going to address that going forwards, but it does not address the historical problem going backwards. The trust spent millions of pounds proving that we cannot have a new hospital on a greenfield site, rather than actually spending some of its consultancy money proving that we could have it on a greenfield site.
It is a pleasure to serve under your chairmanship, Mr Sharma. I congratulate my hon. Friend the Member for Crewe and Nantwich (Dr Mullan) on securing this important debate on the new hospitals building programme. I warmly welcome the Government’s commitment to 48 new hospitals and the funding that was included in the spending review.
My local hospital, the Queen Elizabeth Hospital in King’s Lynn, serves 300,000 people across Norfolk, Cambridgeshire and Lincolnshire, and is in dire need of modernisation. QEH is one of the best-buy hospitals that have proved to be anything but. It is more than a decade beyond its planned lifespan and has real issues with planks of reinforced autoclaved aerated concrete—RAAC—that are structurally deficient.
The Standing Committee on Structural Safety issued an alert regarding RAAC planks two years ago, having first warned in 1999 of problems with them. That warning came after the collapse of a school roof. As much as 80% of QEH’s decaying and ageing estate is RAAC-planked; it is the most propped hospital in the country, which is nothing to boast about, with more than 200 props supporting the cracking roof in more than 50 areas across the hospital. The trust’s risk register has a red rating, with a direct risk to life and safety of patients, visitors and staff, due to the potential catastrophic failure of the roof structure. The critical care unit had to close for two weeks earlier this year as a result, while mitigation measures were put in place.
Although the trust is managing that risk, and the £20 million provided by the Department of Health and Social Care and the Minister for some of the most immediate issues is very welcome, the funding is but a sticking-plaster for the problem. The Minister knows he has an invitation to come and look at the modular endoscopy unit that is being constructed to allow the decant and fixing of fail-safes. As well as the very real structural issues, the layout of the hospital does not meet modern care pathways. There are too few consulting rooms, there is poor co-location of services and there are wards less than half the size of national guidance. That impacts on both patient experience and infection control.
It is a pleasure to serve under your chairmanship, Mr Sharma. I congratulate my hon. Friend the Member for Crewe and Nantwich (Dr Mullan) on securing this important debate. I am glad to speak once again in this place about my campaign for a new Airedale hospital in my constituency. I have raised the subject in Westminster and met the Minister on several occasions.
To set the scene about why we need a new, rebuilt Airedale hospital, similarly to the case that has just been made, my hospital suffers immensely from aerated concrete. The hospital opened in the 1970s, construction having started in the 1960s. Although the hospital’s original life expectancy was 30 years, we are now in its 51st year. The 1960s design sadly leaves a huge legacy of structural failings. Some 83% of the hospital is constructed from aerated concrete, which is in the roof, floors and ceilings. In total there are 50,000 aerated concrete panels in the hospital—five times more than any other hospital affected by that issue.
Aerated concrete is not the only unfortunate hangover from 1960s hospital design. The Airedale is also the largest flat-roofed hospital of any NHS asset in the country and, given that my constituency has some of the wettest weather in the UK, that leads to severe leakage. Unfortunately, the Airedale has more recorded leaks than any other hospital in the UK. Since being elected I have made several visits to the hospital, including up to the roof, where I have seen these issues for myself. I have also been shown parts of the hospital that are closed to the public to mitigate the risks from the aerated concrete and the flat roof.
Aerated concrete panels, such as those found in Airedale hospital, are prone to fail when deflections are recorded between 50 mm and 90 mm. More and more panels are constantly getting to this risk deflection. To put it bluntly, if swift action is not taken then the possibility of a collapse within the structure of the Airedale will constantly rise. We only need look back to 2019, when a school roof unfortunately collapsed because it had been constructed from aerated concrete. Such a collapse would be unthinkable, which is why we need to take swift action.
10:00 am
Jill Mortimer (Hartlepool) (Con)
It is a pleasure to serve under your chairmanship, Mr Sharma. I thank my hon. Friend the Member for Crewe and Nantwich (Dr Mullan) for securing the debate.
The coronavirus pandemic has thrown health inequalities in this country into stark relief. Those living in the poorest constituencies of England and Wales have been twice as likely to die from the virus as those in more prosperous constituencies. Figures from the Office for National Statistics covering March to May 2020 show that those living in the poorest 10% of England, which includes my constituency of Hartlepool, died at a rate of 128.3 per 100,000, whereas in the wealthiest 10% the rate was 58.8 per 100,000.
Any death in any part of the country is a tragedy, but such grotesque levels of health inequality cannot be allowed to continue in the world’s fifth-richest country. That is why I fully support the bid by the North Tees and Hartlepool NHS Foundation Trust for a new hospital by 2030 to replace the current North Tees hospital in Stockton—another hospital crumbling with concrete cancer that has outlived its lifespan, and facing huge remedial costs.
The replacement hospital must be built in an equitable location for all residents north of the Tees, and I have a site available in my constituency—one of the most deprived areas of the UK, where health inequalities have been most apparent. The number of people suffering from a range of health problems is consistently higher in Hartlepool than the England average. Those include cancer, depression, asthma, obesity, heart disease and high blood pressure. As a result, life expectancy in Hartlepool is significantly and regrettably below the national average. If the Government are serious about tackling health inequality in the UK, they must start in Hartlepool.
Despite the sheer scale of deprivation and health inequality in my constituency, healthcare services in Hartlepool have not been expanding over the past decade, but shrinking. My constituents are often required to travel to the currently crumbling North Tees hospital in Stockton for urgent or specialist treatment. For example, owing to the lack of a doctor-led maternity ward in Hartlepool, mothers-to-be in my constituency must travel 20 miles in labour to the nearest hospital if there are potential complications, which, sadly, commonly occur with the prevailing underlying health conditions in my community. During the birth of their baby, mothers have to undertake that terrible journey to a hospital that is crumbling. A child’s first experience of this world should not be health inequality.
I appreciate that the coronavirus pandemic has placed unprecedented pressures on healthcare services in this country and I welcome the record levels of investment that the Government are injecting into the NHS to tackle waiting lists and treatment backlogs, but I fear that will not be enough to reverse decades of neglect and indifference on the part of my predecessors. Only a new hospital can do that. Levelling up must mean more than simple investment in transport and general infrastructure. Levelling up life expectancy across the country should be a priority. Plans must be put in place now to abolish health inequality in the UK and to ensure that our ability to live a good and decent life is not determined by an arbitrary postcode lottery.
10:04 am
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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 lifespan 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 to remove 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.
Susan Marsh wrote:
“I started work at Leighton in 1972 and worked there for 35 years. Since retiring I have been a patient there numerous times. It has changed in the care it delivers since my day, both numbers and treatments. With a new build it will be able to continue to grow along with the population in the area, which will be badly needed.”
I will finish with what a current staff member said about Leighton, both as somewhere to work and as somewhere their family received treatment. Sophie Morris has shared her perspective from what must have been a difficult time in her life, which makes her words even more powerful. She wrote:
“I have worked at Leighton A&E for 6 years now and over that time the demand on the hospital has increased massively. Our last few summers have been busier than most winters. Shortly after starting as a nurse in A&E, my husband became ill. We found out he had terminal throat cancer when I was 7 months pregnant. From beginning to end we had fantastic support and care from all over the hospital.
I think it says a lot about the place and the fabric that is the staff who work there, that I could carry on working in a place that holds so many raw memories. As a body of staff we work so hard to look after the people who come to us for help, now we need some help so that we can provide the care that is demanded of us. Now we need some help so that we can provide the care that is demanded of us.”
I could not have put it better myself.
I know that the Minister will hear the case for investment in many other sites. He will need to consider all the applications carefully. I will work with residents to campaign for this much-needed investment, whatever the outcome of this opportunity, but I hope that I have left him in no doubt today that the case for Leighton to be included is a strong one and there is a whole community of people who want to see it succeed.
My constituents had been campaigning to save the Hemel hospital long before I was around, and there is cross-party support in our part of the world for saying, “Watford is not the right place, and it is not a new hospital. It is a refurbished hospital in completely the wrong place. Please see sense.” I fully understand that Watford constituents are worried they might lose their hospital, but they will not lose it because nothing is going to close until the new one opens. However, we have already lost ours, and the largest town in Hertfordshire has a clinic, with proposals for no intermediate care beds whatsoever and with pathology being taken away as we speak.
The point I want to make to the Minister is that, when we look at the bids that come in, we have to be careful that trusts have done what they were supposed to do, which is to look at the best possible options for the community they are supposed to serve, in the same way that we are serving them, rather than be blindfolded by the situation. In my case, the trust seems fixated with one site in the middle of a town and next to a football stadium, which by anybody’s logic would seem to be ludicrous.
I wish Watford every success—they may well stay up again this season. I am not a Watford fan, although most of my constituents are. I am sad to say I am a Spurs supporter, and that comes with a lot of problems, as we know. However, when Watford play at home, there is a massive knock-on effect on the hospital next door. Believe it or not the trust gives up some of its parking spaces to the football club, which is an historical agreement.
I can give an instance of when an ambulance was turned away from the route it would normally take into the hospital because Watford were playing at home. I am not blaming Watford and I am not blaming the police for this; it is just a logistical problem. The ambulance was turned away and sent on a different route as the road was closed because of the home game. I said to the police officer in charge, “If one of your officers had been injured, what would you have done? Would you have allowed that ambulance through?” He said, “Of course, we would have done.” The guy in the back of the ambulance that was trying to get to hospital had had a heart attack; fortunately he survived.
That is the sort of illogical thinking that is going on in some of the trusts, though clearly not in that of my hon. Friend the Member for Crewe and Nantwich. In my trust, its unaccountability to do what is right for the people it serves seems to be blindfolded. I politely ask the Minister, as he knows I have been pushing on this for more years than I can remember, please do not trust the management of my trust to give the full information. We want a new hospital on a greenfield site. I have letters showing that there is £590 million available for that, but not for refurbishment.
In short, the hospital needs to be replaced. There is a once in a generation opportunity to fix this and a compelling case for QEH to be one of the new eight schemes for which the Government are currently holding a competition. The Queen Elizabeth Trust has submitted an expression of interest for a single-phase new build that will meet current and future demand, with many thousands of homes planned in the area. The need is strong; QEH covers areas of deprivation, with poor health outcomes, and is in the Government’s priority areas for levelling up.
The plans put forward by the trust will eliminate RAAC from the hospital, but it is not just about replacing defective buildings. It is also an opportunity to transform and modernise local healthcare, integrating primary, community, mental health, acute, social care and third sectors in a health and wellbeing village. It will also promote sustainability, using modern methods of construction and net zero principles, incorporating the digital-first approach.
The project is well advanced and highly deliverable, with a strategic outline case well developed. It is backed by 4,000 staff at the hospital, and more than 15,000 people have signed a petition in support. The borough and county councils are on board, as are the regional NHS and at least seven right hon. and hon. Members whose constituents are served by the Queen Elizabeth. An acute hospital is essential in the area and the plans would deliver major improvements in care, patient outcomes and staff experience. An alternative multi-phased plan has also been submitted, although that would not deliver the same benefits or value for money.
Now is the opportunity to deliver a new hospital and support the trust’s strategy to be rated “good”, then “outstanding”, and to be the best rural district general hospital in the country. The Department of Health and Social Care has already committed to the removal of RAAC from the estate, and its risk will only continue to worsen. By including QEH in the new hospital programme, the inevitable need for replacement will become a funded programme, rather than an unplanned demand repeatedly requiring emergency capital funding. The people of North West Norfolk and beyond deserve nothing less.
The Airedale trust has informed me that if it were to experience a closure, even a temporary one, then 45,000 referrals to treatment, 60,000 diagnostic tests, including MRI scans and ultrasound therapy treatments, and 2,000 maternity deliveries would be affected. That cannot arise and I cannot stress how important it is that it is avoided. I firmly believe that that can only be done by delivering a new Airedale hospital.
The catchment area for Airedale hospital covers a huge rural area. I have the full support of my right hon. Friend the Member for Skipton and Ripon (Julian Smith) and my hon. Friends the Members for Pendle (Andrew Stephenson) and for Shipley (Philip Davies), all of whose constituents use the Airedale hospital alongside mine. We also have to look at the wider area. The local authority has proposed plans for 3,000 new houses to be built in my area alone, which will add pressure on existing hospital services.
It is fantastic that the Government have announced that there will be a further eight new hospitals, on top of the 40 already announced. I was proud to see that in September the Airedale trust submitted its bid for one of those final places. It is an ambitious bid, detailed and affordable. The plans are convenient, in that they will not disrupt the current workings of the Airedale and are following a fully strategic outlined case.
A full appraisal recommended that the most cost-effective and future-proofed solution would be a new Airedale hospital on the grounds already owned by the trust. Indeed, the trust owns 43 acres of land and can build a new hospital while keeping existing operations until a transfer to the new build. The plans have a strong environmental case and outline the Airedale trust’s vision to be Europe’s first carbon-neutral and fully digitally enabled hospital, with the capability to generate renewable energy on site.
May I once again request a visit to Airedale hospital by my hon. Friend the Minister? I want to raise again the urgency of the case, as I did last week in the main Chamber to the Prime Minister. The Airedale needs and deserves a rebuild, and I will continue to do everything that I can to stand up for my constituents and press the case.