Hospitals

I inform the House that I have selected the amendment in the name of the Prime Minister.

I beg to move,

That this House regrets the appalling state of repair of NHS hospitals across the country; notes that the NHS maintenance backlog rose to £13.8 billion in 2023-24; further notes the sustained pattern of cannibalising NHS capital budgets to keep day-to-day services running; condemns the previous Government’s record of starved repair budgets and exploding maintenance backlogs, which made sewage leaks, cracked walls, crumbling ceilings and sinking floors commonplace; further condemns the previous Government for launching the New Hospital Programme with no realistic plan to fund or deliver it; further regrets that almost half of the selected hospitals are now not set to begin construction until after 2030; calls on the Government to reverse the delay to the New Hospital Programme and create a crumbling hospitals taskforce to bring construction dates forward; and further calls on the Government to end the vicious cycle of false economies and rising repair backlogs by putting hospitals across the country on a path towards sustainable funding.

The appalling state of our hospital buildings is a national scandal. Everybody in this country should be in control of their own lives and health, which means everybody getting the care they need when and where they need it, but that can never be realised while so many patients are treating in grossly inadequate settings. From Shropshire to Cornwall, Cambridgeshire, Watford and Devon, patients are losing their dignity because of decisions taken by the Conservatives, and the Labour Government’s failure to rectify them.

The Conservatives’ record is one of starved repair budgets, serious leaks, crumbling ceilings and bucket-strewn wards. It is an outrage that millions of people are waiting for treatment, yet overcrowded hospitals have had to close operating theatres because they are no longer fit for use. Patients and hospital staff deserve the dignity of safe, modern and clean environments, but instead the previous Government shamefully chose to raid the repair budget to plug the gap in day-to-day costs, as our hospitals fell apart, and the new Government, who were elected on what increasingly looks like false hope, are pursuing a false economy in delaying the desperately needed new hospital programme.

As with so much of their agenda, the Government promised so much but are delivering so little and betraying those who put their faith in the Labour party. Farmers who were fed up with the Tories taking them for granted have been hit with a tax grab on their families’ futures. Employers, who were promised growth and no new taxes, have been whacked with a national insurance increase. Patients, who were promised new hospitals, have had them taken away.

I was with the hon. Lady almost up until that point. I congratulate her on opening the debate. It is absolutely true that the new hospital programme did not deliver new hospitals and was unfunded under the Tories. However, it is being funded now under Labour. Money is being invested in my local hospitals, in the Imperial College Healthcare NHS trust, and it is preparing for major rebuilds. Will she perhaps give the new Government a little credit for what they have done, and correctly identify the shambles that we were left with?

The hon. Member will be aware that there were not 40 new hospitals—they were not all hospitals and there were not 40 of them. The issue here is that the start dates for work on many hospitals that need urgent rebuilding have been pushed back into the 2030s, long beyond the life of this Parliament. The people who are served by those hospitals were promised new facilities and have not had them. That is devastating for those communities.

If the Conservative approach was contemptible, Labour’s approach has been to procrastinate. The cost to the NHS of papering over the cracks and keeping hospitals running past their natural lifespan is enormous. That is why the Government must reverse the delay to the new hospital programme at once and urgently deliver the new hospitals that patients have long been promised.

I wonder if the hon. Member can explain to me how spending £22 billion extra on the national health service this year can in any way be described as procrastination.

It is important to recognise that the additional investment in the NHS amounts to about £10 billion a year—according to Office for Budget Responsibility numbers, which I am sure the hon. Gentleman has looked at—because of the cost of national insurance hikes and of compensating other public sector employers for those hikes. The £22 billion figure is somewhat misleading. The point that we are making is that it is a false economy to keep those buildings going, to keep repairing a crumbling estate, to keep patching up and putting a sticking plaster on those problems. Those buildings need to be demolished and rebuilt, so that approach is a false economy. It would be much better to build new buildings up front and save on future repair costs. We need to ensure that no one is treated in broken, uncomfortable and unsafe facilities. Repairing and replacing crumbling, substandard hospitals is not only vital for delivering better care and treating-more patients, but crucial for rebuilding the economy after years of Conservative economic vandalism.

How much would all this cost? In my county of Shropshire, the cost of the maintenance backlog across all sites has reached about £75 million. I am sure that everyone here would agree that £75 million is a lot of money—indeed, it is so much that it is the total amount of Government capital investment for hospices this year—but in terms of hospital maintenance it is a drop in the ocean. Torbay hospital needs more than £50 million to clear the backlog, Watford hospital has a backlog of £63 million, and Hull royal infirmary requires an eye-watering £70 million. Across England, the figure is a colossal £13.8 billion—and that is just to bring our existing hospital estate to the minimum standard.

The hon. Member is right that a huge amount of money needs to be spent. A lot of that goes back to the fact that, as Lord Darzi tells us, £37 billion less was spent on hospital buildings in the 2010s than was necessary. Will she remind me who was in government for the for half of the 2010s?

The hon. Gentleman will be aware that, when one comes into government and has to clean up the mess left behind by the previous Government, one has to make difficult choices. It is the job of the Opposition to point out where they would make those choices or take different options. We would invest to save money in the long run, rather than fritter money away on a repair bill for buildings that need to be demolished. It is not sensible to pour good money after bad when the right thing to do is invest in a new fit-for-purpose and modern estate that does not have endless and extortionate maintenance requirements.

I will make some progress.

At North Devon district hospital, the ducting of the ventilation system that serves the operating theatres has not been changed since it was installed in 1979, and cannot be replaced because of ceiling height and asbestos. As a result, all operating theatres have been non-compliant with NHS England buildings guidance since 2007. The good people of Devon clearly need a new hospital, and they were promised that they would have one by 2030, only for the Labour Government to take it away and decide that the change those people need will not be delivered for another decade.

Even hospitals with comparatively few maintenance problems, such as the Royal Shrewsbury hospital, which serves my constituents and has a £35 million backlog, are clearly a long way short of being up to standard. I will not go into detail again about the catalogue of issues in Shropshire—the ambulance delays and station closures, the waiting times for check-ups, scans and surgeries, or the substandard state of cancer care—but they all combine to put huge pressure on hospitals, where staff and buildings are straining under the load.

I commend the hon. Lady and the Liberal Democrats for securing this debate. One issue that they have not mentioned in their motion is car parking at hospitals, which is an ongoing problem for disabled people and patients who miss or delay their appointments as a result of a lack of spaces. Does she agree that car parking is central to addressing the issues that she is setting out?

Car parking is a real problem, particularly where public transport is poor—it plagues my constituents—and when it is unrealistically expensive for people who need to use hospital facilities. I thank the hon. Member for that point.

The NHS crisis impacts on patient outcomes. My constituent Emma was left in the “fit to sit” area for 48 hours despite having been diagnosed with suspected sepsis, 96-year-old Mary waited outside in an ambulance for 11 hours, and 82-year-old Paula spent 24 hours on a trolley in a corridor. That is the reality in hospitals up and down the country. I think we all agree that that is a disgrace and it must be rectified.

Will the hon. Lady give way?

I will make some progress.

One of the main reasons those problems have not been rectified is successive delays from successive Governments. Shropshire is, again, a prime example. This is not related to the new hospital programme, but none the less, £312 million was granted for the hospital transformation programme in Shropshire back in 2018. Seven years later, while the country has been through five Prime Ministers and eight different Health Secretaries, Shropshire is still waiting for that transformation to take place. Opposition from both the Labour and Conservative councils that serve the area, along with the ridiculously lengthy process that capital expenditure has to go through to be signed off, means that desperately needed improvements have been horribly delayed as construction costs rise. As a result, the original plans have been scaled back and their value diminished.

My hon. Friend mentions the inordinate delays that occur with regard to applications for capital funds. I have watched with horror as my local hospital trust in West Hertfordshire has had to submit business case after business case while watching the costs rack up. Does she agree that one way to spend the allocated money more efficiently would be by devolving those budgets to local hospital trusts, rather than having a centralised programme that drives up the costs?

I could not agree more. That is exactly the situation we saw in Shropshire. Once again, the people who will suffer are the patients.

Last year, less than £900 million of the £13.8 billion required to eradicate the repair backlog for hospitals was invested—just 6.5%. It does not take an accountant to work out that at that rate, it will take 15 years to clear the current backlog, let alone the further deterioration of the crumbling buildings. Investment in eradicating the repair backlog fell sharply from £1.4 billion in 2021 to £895 million in 2023-24—a fall of 37%. I am afraid that, just like their approach to fixing social care, the Government’s continued lack of imagination and ambition is leaving our NHS less productive and less stable, which risks leaving millions languishing on NHS waiting lists.

I will give way to the hon. Member for Chelsea and Fulham (Ben Coleman) because he has tried to intervene before.