New Hospital Programme and Imperial College Healthcare NHS Trust

I beg to move,

That this House has considered the New Hospital Programme and Imperial College Healthcare NHS Trust.

It is a pleasure to see you in the Chair this afternoon, Sir Mark. I understand that our proceedings may be interrupted for some time, but let us make a start. I am delighted to see my west London colleagues here—my hon. Friends the Members for Westminster North (Ms Buck), for Ealing Central and Acton (Dr Huq) and for Brentford and Isleworth (Ruth Cadbury)—and indeed the hon. Member for Cities of London and Westminster (Nickie Aiken), my hon. Friend the Member for Reading East (Matt Rodda), and, of course, the hon. Member for Strangford (Jim Shannon), without whom no debate would be complete, perhaps to remind us that although this is to some extent a local or regional issue, it has much wider implications.

To be clear, this debate is about one thing specifically: the defunding and removal from the 2030 new hospital programme of three major hospitals—Charing Cross, Hammersmith, and St Mary’s—all of which form part of the Imperial College Healthcare NHS Trust. They are teaching hospitals, major emergency and trauma hospitals, research hospitals, academic hospitals, tertiary hospitals—hospitals with a huge national and international reputation—but they are also local hospitals for my constituents and those of many other Members.

In the Secretary of State’s statement on the new hospital programme on 25 May, seven of the schemes that had previously been in the 40 hospitals scheme were removed from that programme with respect to completion by 2030—we must be careful in our words here. I need to deconstruct what has happened since that time, because there has been some misleading presentation of the facts. In order to clarify this, I sent some rather key questions to the Minister in advance of this debate.

Essentially, looking at the statement that was made, the Secretary of State said, in respect of those seven schemes:

“The work will start on those schemes over the next two years, but they will be part of a rolling programme where not all work will be completed by 2030.”—[Official Report, 25 May 2023; Vol. 733, c. 479.]

That is the key change, as far as we are concerned, in relation to that statement.

The questions that still sadly remain unanswered are these: what works will be done at each of the three hospitals before 2030? How much will the budget be for that, and will it come out of the £20 billion new hospitals by 2030 programme? What is the total budget for the rebuild schemes at each of the three hospitals? Is this secured funding, and when will it be allocated? By what date or dates will the works for each hospital be completed?

I have put together what I think are the answers—I have done my sleuthing—but I really need to hear it from the Minister’s own mouth, this afternoon if possible, or in a follow up if he needs to use that. I might also add a sort of meta-question to that: when will I receive a response to the email that I and my hon. Friend the Member for Westminster North sent to the Secretary of State on 28 May, which raised those same issues?

I understand that there is confusion associated with the new hospital programme—as would be true of any scheme that came in under the aegis of the former Member for Uxbridge and South Ruislip—about whether those were new hospitals or not. Almost a year ago, I asked the then Prime Minister about the new hospitals—the “new” hospital at Hammersmith that opened in 1902, and the “new” hospital at Charing Cross that opened in 1818—but I will not focus on that point today. This is about the funding and the timetabling of the scheme; frankly, the Minister can call them whatever he likes.

There have been a number of schemes moving in and out. At one stage there were going to be 48 new hospitals. I think 128 bids came in for the extra eight places and five were successful. We are told there is £20 billion, which sounds like a lot of money—it is a lot of money—but it is not the £32 billion to £35 billion that the Health Service Journal says would be needed to complete all the schemes that have at one time been put forward for the new hospital programme. Those are legitimate grievances, but I do not have time to deal with them all today. I have time only to deal with the one matter that I have already raised.

I need to give a little bit of background. As I have indicated, the hospitals have a long and illustrious history, going back more than two centuries in the case of Charing Cross. In 2012, an Orwellian programme called Shaping a Healthier Future, which had been the product of two years’ secret work by the consultants McKinsey, said that several A&Es should close, including the one at Hammersmith, and that Charing Cross should be demolished and replaced by primary care and treatment services on the site. It was the biggest closure programme in the history of the NHS.

Sadly, we did lose the A&E at Hammersmith in 2014, but after a herculean battle fought over seven years by community groups, such as Save Our Hospitals, and by Labour local authorities, particularly that in Hammersmith, that battle was won and Charing Cross had a reprieve and would go on being a major hospital. That happened in 2019.

It was rumoured that the money that would have been gained by selling most of the land at Charing Cross might have gone into the St Mary’s scheme, which, by common consent, is the hospital that most needs emergency work. But although the bill for essential repairs on the three hospitals is about £350 million—far and away the biggest repair bill of any hospitals in the country—if we want to make those hospitals fit for the 21st century, the actual cost, which I believe is accepted by Department of Health and Social Care officials, will be about 10 times that, between £3 billion and £4 billion. If that seems an unspecific figure—my hon. Friend the Member for Westminster North will say more about this—it is because it depends to some extent on what receipts can be received from land value and moneys at Charing Cross. It is a significant sum of money, but it is to make those essential and world-class hospitals fit for purpose for decades going forward, not just to patch them up.

It was always going to be difficult, and it was disappointing that the hospitals were in cohort 4 and would just squeak in by 2030—that is when the work would be completed. We would have a newly built hospital at St Mary’s and refurbished hospitals at Charing Cross and Hammersmith over that time. That is why it was so disappointing when they were moved out of that without any further future date being given.

What is at stake here? Because there has been so much information, I do not want to use my own words, but the words of the trust itself. In preparation for this debate today, it said:

“the main funding for our schemes has been pushed back beyond the original commitment of 2030 as other schemes have been added to the programme and prioritised. We had two schemes in the original list of 40 hospitals to be built by 2030: a complete rebuild of St Mary’s Hospital in Paddington; and extensive refurbishment and some new build at both Charing Cross Hospital and Hammersmith Hospital”—

confusingly, the Department of Health classifies the two hospitals of Hammersmith and Charing Cross as one scheme, but it certainly affects the two hospitals. The trust goes on:

“It is clearly very disappointing that we will not now be funded to complete these schemes before 2030.”

It also states that

“some funding to progress to final business case approval and to support enabling work”

should be provided, and

“we are awaiting a response in terms of a decision and a funding allocation.”

It then talks about the business plans that it is going to put forward. In rather more emotive but absolutely accurate language, it says:

“If we waited until 2030 to start building works at St Mary’s it would become impossible to patch up our oldest facilities, many of which house key clinical services. As the provider of London’s busiest major trauma centre and host of the NHS’s largest biomedical research centre, that would be hugely damaging for the health and healthcare of hundreds of thousands of people”.

That is the statement from the chief executive officer at Imperial, Professor Tim Orchard, and those words should resonate with the Minister.

I am aware that the Division bell will probably start ringing as soon as I stand up, but I am familiar with that quote from Tim Orchard. My hon. Friend is making a really powerful speech. I am familiar with all these hospitals, as are all my constituents. I was born at Queen Charlotte’s, my little sister was born at Hammersmith, and both my parents were under Charing Cross. I went to the Western Eye Hospital last year when I had shingles, and I have an auntie who has retired but was a consultant professor at St Mary’s.

Does my hon. Friend agree that it is really sad that, in the 75th year of the NHS, we are talking about crumbling estates and all these issues? The backlogs at these hospitals existed long before covid. The Government like to throw up that smokescreen and say, “It’s covid’s fault.” I have just written to Tim Orchard because a constituent told me that there is only one temporary scanner at Hammersmith at the moment. Is that not scandalous? Does my hon. Friend agree that, to paraphrase the Sex Pistols, who were formed on the Wormholt estate, which borders both our constituencies, this is the great NHS scandal?

I thank my hon. Friend for that contribution, and I entirely endorse what she said.

I want to deal briefly with the misinformation—I accept that it was wholly unintentional—in the Secretary of State’s statement, or rather in his responses to questions following his statement, because it is important. A ministerial correction was made following a point of order that I made arising out of that. In response to my hon. Friend the Member for Westminster North, the Health Secretary said:

“We recognise the importance of the Imperial bid; that is why we are starting to build the temporary ward capacity at Charing Cross and the first phase of work is under way on the cardiac elective recovery hub, to bring cardiac work on to the Hammersmith site.”—[Official Report, 25 May 2023; Vol. 733, c. 485.]

There are 47 words in that statement, and four errors had to be corrected in the ministerial correction. That may be an all-time record; I do not know. Some are more important than others. There are bids, not one bid. We are not starting to build; we will start to build at some time in the unspecified future. There is no cardiac elective recovery hub; there is a cardiac catheter lab. The idea that we are just moving cardiac services to the Hammersmith Hospital site would be a surprise, given that St Mary’s is a world-leading cardiac hospital at the moment.

I accept that mistakes happen, but there were other errors in that statement. It implied that works are under way, whereas it is common consent now that they have not yet started. The cardiac work is nothing to do with the new hospital programme; it is part of the ordinary work, as is the refurbishment of wards. The temporary ward at Charing Cross will be necessary, but not until the main funding for the floor-by-floor hospital renewal refurbishment is ready to go. Some greater clarity would be helpful on those very contentious matters.

Order. I remind Members to bob if they wish to be called in the debate. I now call Nickie Aiken.

Thank you, Sir Mark, it is a pleasure to serve under your chairmanship. I thank the hon. Member for Hammersmith (Andy Slaughter) for bringing forward the debate and for the points he has raised. As the Member of Parliament for the Cities of London and Westminster, I would like to focus my remarks specifically on St Mary’s Hospital in my constituency.

In September 2021, Imperial College Healthcare NHS Trust set out the need for a complete redevelopment of St Mary’s: a new 840-bed, research-led major trauma and acute teaching hospital, which would release around five acres of surplus land for wider site regeneration. As I know the Minister appreciates, that development is of huge—

Order. The sitting is to be suspended for multiple Divisions in the Chamber. We require approximately 15 minutes for each vote. There is an issue in that there may be more than four votes. I would imagine it could possibly be an hour before we come back. Those who have put in to speak should not worry, because there will be injury time.

Being the Member of Parliament for Cities of London and Westminster, I would like to focus my remarks specifically on St Mary’s Hospital, which is based in my constituency. Back in September 2021, Imperial College Healthcare NHS Trust set out the need for a complete redevelopment of St Mary’s Hospital, a new 840-bed research-led major trauma and acute teaching hospital, which would release around five acres of surplus land for wider site regeneration.

I know the Minister appreciates that the development is of huge importance to the wider London area and not just my constituency. After all, St Mary’s is the major acute hospital for north-west London, providing care across a range of specialities in London, in addition to its world-leading maternity centre and 24/7 A&E department. It played a significant role in the 7/7 bombings and other major incidents over the years. It is host to the NHS’s largest biomedical research centre and through its partnership with Imperial College London, the trust continues its long legacy of translating academic discovery into better care and treatment, including making a major contribution to the management of covid-19.

I welcome the Secretary of State for Health and Social Care’s recent confirmation of Government funding for the redevelopment of St Mary’s. Though the timescales have been altered, I appreciate that the full picture is more complex and I know that work continues to complete the majority of the redevelopment as near to the original timescales as possible. I also appreciate the complexities of the programme’s schedule for building works, so I am glad to hear from discussions with Ministers that they are committed to getting the enabling works started as soon as possible. To that end, I look forward to visiting St Mary’s with the Minister responsible, Lord Markham, and the Under-Secretary of State for Levelling Up, Housing and Communities, my hon. Friend the Member for Kensington (Felicity Buchan) to discuss the case for change and the redevelopment more widely.

I pay tribute to Lord Markham and to officials at the Department of Health and Social Care, as well as to the Minister and the Secretary of State, for their communication with the trust and me throughout the process. I am currently concerned about running key clinical services while we wait for building works to commence and specifically about services being patched up to keep patient care running. As it stands, key parts of the estate date back to 1845 and most of the facilities—even the most modern bits—are at least 70 years old. That is because St Mary’s has been developed piecemeal over the decades. I am sure anyone who has visited there will agree that, when walking through the site, it is clear that the hospital is a patchwork of buildings with complex patient pathways.

I am grateful for the opportunity to contribute to this debate, and I congratulate my hon. Friend the Member for Hammersmith (Andy Slaughter) on securing it. It is a pleasure to follow the hon. Member for Cities of London and Westminster (Nickie Aiken). St Mary’s Hospital, which I will mainly concentrate my remarks on, is located in her constituency but is the main hospital serving my constituents in north Westminster.

There is a feeling that this is déjà vu all over again. In April 2019, my hon. Friend the Member for Hammersmith and I spoke in a very similarly titled debate on the Imperial hospitals programme. I said:

“In January 2018, Imperial College Healthcare NHS Trust gained full planning permission for the first phase of the redevelopment of St. Mary’s”

as part of the overall redevelopment of the trust. I said that the

“failure to gain funding and approval from key stakeholders…is a key risk on the trust’s corporate risk register, because the conditions of St Mary’s Hospital have deteriorated so much…the structural issues in the hospital have become absolutely and imminently challenging.”—[Official Report, 24 April 2019; Vol. 658, c. 354WH.]

That case has intensified in the intervening years, as I will come to in a moment.

That was four years ago. A couple of weeks ago, we had the announcement that the main funding for the Imperial hospitals scheme has been pushed back beyond the start date of 2030. Other hospitals have been prioritised. Many of the 40 hospitals have received their commitment to proceed on the original timescale, but not St Mary’s or the Imperial hospitals. As the chief executive of the trust board said, that is very disappointing news.

The 40-hospital building programme was a key feature of the 2019 general election. Conservative candidates took advantage of the opportunity to pose outside St Mary’s Hospital and put the pictures on social media and in their campaign literature. One enthusiastically announced:

It is a real pleasure to speak in this debate, and I congratulate the hon. Member for Hammersmith (Andy Slaughter) on securing it on this issue. He is indeed a hardy, dedicated and assiduous MP. I say that in all honesty, because I think the good people of Hammersmith have an excellent MP, and they should be very proud of the efforts he makes on behalf of his people in the Chamber and Westminster Hall.

This debate is about the new hospital programme, which applies to the UK mainland. I have come along to add my support to the hon. Gentleman, as I do for many right hon. and hon. Members, here and in the main Chamber. That is my purpose for being here. I am also here to discuss the new hospital programme, which was announced at the 2019 Conservative manifesto launch and would have delivered 40 new hospitals in the UK by 2030. I understand the reasons for the delays—the covid pandemic has focused attention elsewhere and taken away much of the funding—but there is a real need, and hon. Members have made that case today on behalf of their constituents.

I also understand the position of the hon. Member for Hammersmith on the refurbishment works at Charing Cross and Hammersmith Hospitals. As MPs, we want the best of care, access and opportunities for our constituents, and delays to any work are often frustrating, so I understand the request very well, and support his position and his ongoing commitment to his constituents.

I am pleased to see the Minister in his place. He responded to the first debate in Westminster Hall this morning on cancer very well. If he answers hon. Members in the same way in this debate as he did in that one, they will be more than satisfied. With the support of the new hospital programme, Imperial College Healthcare NHS Trust is beginning the next phase of redevelopment planning work for its three main hospital sites, all of which are included in the 40 new hospitals that the Government have committed to building by 2030.

I will quickly give a Northern Ireland perspective: what is happening here is also happening back home. It is important that we all remember that the demands for hospital care and better hospitals are not just in London; they are across the whole of this great United Kingdom of Great Britain and Northern Ireland. Northern Ireland has around 3% of all hospitals, with 40 across the Province.

Order. Health is devolved in Northern Ireland, and the focus of this is very much on—

That is what I have done in my comments, Sir Mark. I just want to give you the example of Northern Ireland—

But it is not a speech about the Northern Ireland health service, surely.

I have every hope that the Department of Health and Social Care will be able to give us timely updates on hospitals in England. This is a discussion I always have with those in the devolved Assemblies. We must—I conclude with this—do our best for our constituents and ensure that the collective facilities are in place to serve their needs. I hope the work in the constituency of the hon. Member for Hammersmith will commence soon as some reassurance for his constituents. He put his case forward—the Minister, I am sure, will respond—and I support him in what he has requested.

It is a pleasure to serve under your chairmanship, Sir Mark. I thank the hon. Member for Hammersmith (Andy Slaughter) for his work in securing this debate, and I thank Members from across the House for their contributions. I support the points my hon. Friend made. He set out clearly in his speech a great deal of local need and hope for a solution to be found in his area, as have other Members. I would like to add my support to them and to highlight a similar issue at the Royal Berkshire Hospital in Reading, which serves both Reading and a very large part of the Royal County of Berkshire.

I start by paying tribute to NHS staff in our county and across the country. They are extremely hard working. They have been through the pandemic and many other great difficulties in recent years and they deserve our respect and support. This rebuilding programme is part of that. It is investing in the future of the country and in the health of our population.

The Royal Berkshire Hospital is one of 40 hospitals that were originally identified by the Government for rebuilding but, sadly, when the announcement was made by the Department of Health and Social Care recently, it was not mentioned. The public and hon. Members present can only imagine the stress that puts staff under, as well as the patients who are waiting for a resolution to many serious building problems in our area. I hope that the Minister will address that point.

Sadly, as my hon. Friend mentioned earlier, the hospital now risks potentially missing out, because if the Government’s plans and assumptions are correct, the pot of money available could run out in 2030 and, as of yet, there is no date for work to start at the Royal Berkshire Hospital.

The issues at the hospital are quite clear and are very similar to the ones in London and across the country. The old part of the hospital, the North Block, is 173 years old. The site is a patchwork of buildings from different dates since then, the A&E department is not suitable, and there is a £200 million backlog of repairs—all very similar to the situation my hon. Friend described for west London, which is obviously nearby. There are many other issues, and all of this affects the productivity of the hospital, the experience of patients and, to some extent, the morale of staff. A number of staff, many of whom I know, have contacted me over some months and years to express concerns about this issue, so I hope that today the Minister will be able to clarify the position for the 40 hospitals in London, Reading and many other areas around the country. I hope he will be able to reassure both patients and staff, and give the country the certainty it needs.

It is a pleasure to serve under your chairship, Sir Mark. I draw your attention to my revised entry in the Members’ Registry of Financial Interests: my spouse is chair of audit at the Imperial College Healthcare NHS Trust. I thank my hon. Friend the Member for Hammersmith (Andy Slaughter) for securing this important debate on the hammer blow that has been inflicted on west London—just one part of the funding and investment crisis being inflicted on the NHS by the Government.

Many of my constituents rely on services from the Imperial College Healthcare NHS Trust, and particularly the St Mary’s, Hammersmith and Charing Cross Hospitals. For constituents in the eastern third of my constituency, Charing Cross Hospital is their local general hospital, whereas for those across my constituency, some or all treatments could be at Charing Cross, Hammersmith or St Mary’s.

My hon. Friend powerfully laid out the case against the Government and the complete neglect they have shown over the past 10 years to those across west London who need NHS care and those who work in the NHS. The sad thing is that I am not even surprised, because this is what we have come to expect from a Conservative Government—things such as the promises made by the now former Member for Uxbridge and South Ruislip. He said there would be 40 new hospitals—that is a promise he drove into the ditch.

I expect that the Minister will make a valiant effort to shake the Etch A Sketch and pretend that the last four years did not actually happen, but patients and staff cannot pretend. Every delayed or inadequate repair or rebuild of any NHS buildings impacts on staff and patients. Leaking roofs, failing electrics, flooding sewage systems and structural faults put whole wards out of action. Operations have been cancelled, diagnostic units and pharmacies have suddenly closed, and much more. This all leads to delayed diagnostics, delayed treatment and delayed discharge.

The NHS backlog currently stands at over 7.3 million, and over 48,000 people in my constituency and the borough of Hounslow were waiting for treatment last year, including 50 who had been waiting over a year for an operation. Behind every single one of those cold numbers is a person whose life is put on hold or, worse, put at risk because of the delays to well-overdue investment. Examples of delay include people who are forced to go private, stroke victims waiting months for a physio, and a young man waiting over a year for an assessment for a broken hip. Behind every one of those stories is not just frustration, but a deeper anger—a righteous anger about just how bad the state of things is. How many of the delays that people are experiencing are made worse because of the failure to invest in the core infrastructure of NHS buildings? We should be clear that it is not the fault of NHS staff and boards. The Imperial trust has needed work to happen for years, and has been preparing and getting plans ready in the expectation that the Government’s promised support will arrive.

Order. Ruth, could you wind up?

In conclusion, my constituents, who already face record waiting lists, will face a longer wait and greater difficulty because of the Government’s decision to pause investment. The Government over-promise and under-deliver. The whole farce shows why, after 13 years in power, it is time for a change.

It is a pleasure to serve under your chairmanship, Sir Mark. It is good to see the Minister; the day after we were last opposite one another, he decided he would not continue after the next general election. I hope we have a good exchange today, and I wish him well.

I am pleased to be in the debate. I declare an interest in that I was born in the Chiswick branch of the old Hammersmith Hospital. The groundworks at Ealing were dug by my father and thousands of Irish labourers from across west London, and I used to visit that hospital as a child. My brother was born in Hillingdon. These places matter to local people.

We are here to discuss something called the new hospital programme, but what we quickly learned was that it was not new, they were not hospitals and there certainly were not 40 of them. It is an absolutely sorry saga, and as we have heard it is a hammer blow for people in west London. It is also a saga that is recognised across the country. Members should not just take my word for it; according to the National Audit Office, the NHS estate does not meet the demands of a modern health service. The growth in backlog maintenance risks harm to patients, and the need for capital is being consistently underestimated. Billions of pounds in capital have been diverted to cover inadequate revenue funding, and yet some capital cannot be used for technical reasons, so there are underspends. Assets are sold to fund day-to-day activities.

In July 2020, the Public Accounts Committee recommended a capital strategy and guidance, including expectations on how backlog maintenance costs will be addressed alongside other priorities. In October 2021, the NHS Confederation stated that NHS leaders had concerns about safety standards because they cannot sufficiently maintain their estate, enable positive digital innovations and reduce the elective backlog without further worsening health inequalities. It described a disjointed and opaque allocation system and unresolved issues about how integrated care systems will allocate and prioritise capital spend.

It is a pleasure to serve under your chairmanship, Sir Mark. How do I follow that speech by the hon. Member for Bristol South (Karin Smyth)? Well, first, I would like to congratulate the hon. Member for Hammersmith (Andy Slaughter) for bringing forward the debate. I also thank my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) and the hon. Members for Westminster North (Ms Buck), for Strangford (Jim Shannon), for Reading East (Matt Rodda) and for Brentford and Isleworth (Ruth Cadbury). Time is short, but I will try to answer as many points as possible.

The new hospital programme is the biggest hospital building programme in a generation, which will help us deliver on our manifesto commitment to build 40 new hospitals by 2030. The hon. Member for Hammersmith raised a number of specific questions. I am not responsible for the new hospital programme, because that matter sits with Lord Markham. Nevertheless, I will endeavour to answer as many of the hon. Gentleman’s questions as possible. Furthermore, I know that Lord Markham would be pleased to meet him and colleagues, and I will ensure the hon. Gentleman gets a response to his letter.

On 25 May, we announced that the Government remain committed to building 40 new hospitals by 2030, and the new hospital programme is expected to be backed by more than £20 billion in funding for hospital infrastructure. It is the biggest hospital building programme in a generation. Going forward, new schemes will be considered through a rolling programme of capital investment in hospital infrastructure.

Will the Minister give way?

Time is very short, and I ask that the hon. Gentleman to let me answer as many of the questions as I can. If there is time, I will give way.

The programme is part of a more sustainable and consistent approach to delivering state-of-the-art new hospitals and will mean further investment to upgrade NHS facilities across the country. Our announcement is hugely significant to all hospitals in the programme and it gives funding certainty for trusts to progress their schemes in line with revised indicative allocations, most of which are a significant uplift on previous allocations.

I now turn to the specific questions. The hon. Member for Hammersmith said that the debate is about the defunding of the trust. I want to be clear that the trust has been informed of a significantly larger indicative allocation for both schemes than was previously given in 2019. Far from being defunded, the funding envelope has increased significantly.

Furthermore, no schemes have been removed from the programme, as the hon. Gentleman suggested. It is one programme, with a small number of schemes that will now complete beyond 2030. If I might correct the hon. Gentleman, he said that the pot is £20 billion; to be clear, it is over £20 billion.

On Charing Cross, I believe that the hon. Gentleman said that the temporary ward or decant facility will not be necessary until the main construction starts on the tower. That is part of the enabling works that have been raised, which can and should be completed well in advance of the main construction, and therefore can be used as extra capacity should there be a gap between the works. It is the first phase of that floor-by-floor work.

I understand that the main construction itself has not been postponed to start after 2030. We have been clear that, as part of the rolling programme, we may move schemes forward and backward—that question was raised by the hon. Member for Westminster North—based on their readiness to progress. The reason the two Imperial schemes were already in cohort 4 and are now in the rolling programme is that their plans are at such an early stage of development. If they are ready to progress sooner—or indeed other schemes, as the hon. Lady suggested, encounter problems along the way—some schemes may move forward and others may move back. Having the enabling works and business case ready is vital, and I know that hon. Members will have those conversations with the trust.

I thank everybody who has contributed to the debate, and the Front Benchers for their contributions. I have a huge amount of respect for the Minister and genuinely wish him great success in his future career, wherever that may be, but he will not be surprised to hear that my constituents will not hear “early stage” and “fluidity” as comforting words. They had schemes for the completion of these major rebuilds of their hospitals by 2030 and assured funding. That is what we do not have, and however we dress it up, we are waiting in hospitals that are not fit for purpose. It is an insult not just to my constituents and patients but to the incredibly dedicated staff. Some of the best clinical staff in the world work in those hospitals, in frankly terrible conditions. That is why we need concrete answers. I will take up the offer of meeting the Lords Minister, but today’s Minister will not be surprised to hear that my hon. Friends and I will pursue this day by day and line by line until we have those assurances.

That this House has considered the New Hospital Programme and Imperial College Healthcare NHS Trust.