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Volume 55 Number 2, February 1, 2025 | ARCHIVE | HOME | JBCENTRE | SUBSCRIBE |
On Wednesday, January 29, at Prime Minister Questions this week, the Prime Minister was bombarded with angry questions from MPs about the NHS hospital repair and building programme. This has been deferred by governments in many cases for at least 10 years with some not starting construction for 14 years.
The so-called "New Hospital Programme" (NHP) was set up in 2020, when Boris Johnson declared, to much scepticism and derision, that 40 new hospitals were to be built in England by 2030. The Programme was also intended to transform how NHS healthcare infrastructure was to be built, including by standardising hospital design; it was heralded as the biggest hospital building programme in a generation and a dramatic shift in the way major healthcare projects are delivered. At the time, NHS Trusts had an estimated £6.5bn backlog of maintenance to restore their estates to a standard fit for purpose, and this figure has obviously increased tremendously since then. By 2023, the National Audit Office (NAO) was reporting that the NHP was experiencing "delays", and that maybe 32 of the initial 40 would be delivered by 2030.
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The present government has now confirmed that 18 hospitals will not begin construction until 2032 at the earliest under what is politely called a "revision" to the New Hospital Programme. To add insult to injury, the government has been spending more than £200 million on two private consultancy firms to review the previous government's hospital building plan that had failed to build, or fund beyond 2025, the 40 new hospitals it had promised during its term of office. The "New Hospital Programme: plan for implementation" [1] which was published on January 20 followed a review started when the Labour government took office and when they also put on hold existing hospital building programmes. Following the review by the private consultants, the NHP will now be subject to "5-year waves of investment. Delivery expectations may be subject to change depending on local and national factors and the programme reserves the right to adjust the delivery plan as schemes develop in the future."
Health Secretary Wes Streeting had the gall to say: "The New Hospital Programme we inherited was unfunded and undeliverable. Not a single new hospital was built in the past five years, and there was no credible funding plan to build forty in the next five years." That is to say, a clear need for essential investment in building and repairing hospitals, which the previous government recognised in words but completely denied in deeds, has been further kicked down the road by Starmer's government, under the hoax of balancing the books, denying the truth that it is a priority for a modern society to invest in health and social care. Rather than calling out the hypocrisy of the previous Conservative governments, Wes Streeting has become notorious for adopting the same rationale for refusing essential investment, and prioritising a privatising, pay-the-rich agenda and direction of the NHS.
Amongst the reaction reported, for example, by Healthcare Management, Siva Anandaciva, director of policy, partnerships and events at The King's Fund, warned: "Pausing or delaying plans to rebuild hospitals is ... very likely to be a false economy - many hospitals are already spending significant amounts of taxpayers funding trying to maintain sub-standard buildings - and they will have to keep doing so in the years to come." Matthew Taylor, chief executive of the NHS Confederation, said it was "very disappointing" and urged the government to consider the "bigger picture on capital" ahead of the Spending Review this spring.
The Public Accounts Committee for its part issued a report [2] diverting the blame to NHSE "officials" for the state of sustainability of the "NHS's financial position" which "continues to worsen, with local NHS systems overspending by some £1.4 billion in 2023-24, more than double the previous year, due to rising demand, failure to invest in the estate, inflation, and workforce issues."
Thus is the anti-social argument of "overspending" by the NHS utilised to deny resolving the NHS crisis in favour of the people and their health. Such is the incoherence of government and the cartel party system. Such a bankrupt system cannot take responsibility for fully funding the NHS and providing it with investment in NHS estate and workforce resources that guarantees a modern health service for all and accessible to all.
Essential Investments Put on Hold
Hospitals that were in the process of being built such as Whipps Cross University Hospital, north-east London, have been put on hold. This new hospital is according to the NHP now in "wave 2" and expecting a "construction start date" of "2032-2034" leaving Whipps Cross with a new car park but no new hospital and no guarantee that it will be built even according to the new government's NHP 10-year timetable.
A statement on St Mary's, Charing Cross, Hammersmith and Western Eye London [3], some of which estate is 180 years old, states that "successive governments have kicked the can down the road for far too long, leaving us with the task of running a group of major hospitals that have not been maintained". Professor Tim Orchard, chief executive of Imperial College Healthcare NHS Trust, said: "This is devastating news for our communities, our staff and patients, and for the whole of the capital's healthcare system. We understand that the Government's New Hospital Programme must be affordable but the simple truth is that St Mary's Hospital, in particular, will not last until the 2040s. We run London's busiest major trauma centre and care for more than a million patients a year."
Fighting to Safeguard the Future of the NHS
Whilst for health workers and people in the communities this is indeed devastating news, it is made even more devastating because of the realisation that the Labour government will spend billions on escalating NATO's war in Ukraine, supporting Israel in its genocidal war against the Palestinians and funding the extra runway in Heathrow that the people of London have continued to oppose. Working people realise the importance of fully funding the NHS and investing in the welfare and health of the people. They recognise that they must put their energy into continuing to discuss and plan their own resistance to cuts to their health services and privatisation of its services that the Labour government is continuing, or will try to impose. At the same time they wish to have the decision-making power to shape the type of health care service that is needed to meet the needs of all and what the NHS should be: a modern health service that health staff and the public at large have been fighting for over many years in order to safeguard the future of the NHS and the right of all to health care.
Notes
1. New Hospital Programme: plan for implementation
https://www.gov.uk/government/publications/new-hospital-programme-review-outcome/new-hospital-programme-plan-for-implementation#waves-of-delivery
2. NHS financial sustainability, Public Accounts Committee
https://publications.parliament.uk/pa/cm5901/cmselect/cmpubacc/350/report.html
3. Statement in response to New Hospital Programme announcement, January 22
2025
https://www.imperial.nhs.uk/about-us/news/statement-in-response-to-nhp-announcement