PARLIAMENTARY DEBATE
New Hospital Programme - 22 January 2025 (Commons/Westminster Hall)

I will call Dr Kieran Mullan to move the motion, and then I will call the Minister to respond. As is the convention with these 30-minute wonders, there will not be an opportunity for the Member in charge to wind up.

I beg to move,

That this House has considered the New Hospital Programme.

It is a pleasure to serve under your chairmanship, Dr Huq, for a debate that is very timely in the light of the statement of the Secretary of State for Health and Social Care this week. My remarks will focus on three hospitals that serve my constituency as part of the East Sussex healthcare NHS trust: Eastbourne district general hospital and Conquest hospital, which are situated outside my constituency but are major secondary care providers for my constituents, and Bexhill community hospital.

As part of the new hospital programme announced by the previous Government, Eastbourne district general hospital is due to be entirely rebuilt, and Conquest hospital is set to be reorganised and the structure improved to ensure that it is fit for the future. Alongside creating additional in-patient wards and improved parking facilities, the plans include expanding the emergency departments at Eastbourne and Conquest, improving access to cardiology and ophthalmology services, and redeveloping out-patient theatres, endoscopy and diagnostic services.

Plans to upgrade Bexhill community hospital are also included in the programme, equipping it to deliver more services locally. Currently, only 53% of space in the hospital is allocated to clinical space. Once that work is complete, that will increase to 70%. To reflect increasing demand for care, the plans will also increase the number of hospital beds by 13%, the number of single rooms as a proportion of hospital space from 18% to 70%, and the number of out-patient consulting rooms by 28%.

Having worked in the NHS as a doctor in A&E for a number of years before becoming an MP, I know the difficulties that can arise from working in buildings that are in need of improvement. The physical infrastructure of the building is outside the control of frontline staff, so they often have to do whatever it takes to make it work, but it would be better if they did not have to. I think the Minister would agree that despite those circumstances, our healthcare staff work tirelessly, and we owe it to them to deliver better infrastructure.

Whatever the new Government may say, progress on the new hospital programme was being made under the previous Government, despite the challenges presented by the pandemic and the inflationary pressures on construction costs as a result of the war in Ukraine. The programme was incredibly ambitious but remained a significant commitment to investment in hospital infrastructure.

During the 2024 general election, the Labour party committed to delivering the new hospital programme. Candidates up and down the country made pledges to deliver on the programme, but this week, the Health Secretary broke that pledge at the Dispatch Box by moving the goalposts, as a result of which many constituents in Bexhill and Battle will not see the benefits of the programme until 2039 at the earliest.

I declare my interest as a governor of the Royal Berkshire hospital, and that a family member has shares in a medical company. My constituents are heartbroken by the Government’s decision to push the start date of the Royal Berks’s construction to 2037, which will disappoint patients and staff. The hon. Member must recognise the role that his party played in creating that situation, so does he agree that his party needs to reflect on its part in the delayed new hospital programme, and will he apologise for it?

It is a 30-minute debate, and I want to be generous in letting hon. Members make short points in support of their hospitals, but I do not want to allow it to degenerate into a highly political back and forth. As I was saying, the Government pledged to do it and they did not.

Will the hon. Gentleman give way?

In a moment.

Will my hon. Friend give way?

I will.

I congratulate my hon. Friend on securing this timely debate. As he will know, Dean Russell, the former Member of Parliament for Watford, was a keen advocate for Watford general hospital. He continued to make sure that we progressed the project for that hospital, which has a real impact on my constituency of South West Hertfordshire. Does my hon. Friend share my disappointment that Watford general is now not likely to get spades in the ground until 2032 at the earliest? Furthermore, some of the figures being bandied about are concerning. I know that the Minister has uploaded draft costs, but £1.5 billion to £2 billion seems a bit high for what was initially proposed.

I share that disappointment, which relates to some of the remarks that I will go on to make about how those costs will go up with the delays, because of the inflationary pressures globally.

To address the concerns about our role in the process, I remind the Minister that the Chancellor was specifically asked during the election campaign about commitments that were being made on tax and spend. She was also asked whether those commitments would have to change when Labour was in government, because of the fiscal challenges that she had not known about—

I will not give way yet.

Yet that is exactly what the Government have done again and again, breaking not only that pledge but a series of pledges they made during the election—that they would not say in government that they had been forced into a particular situation. That was the Chancellor’s specific pledge. It was clear from the Secretary of State’s statement this week that the Government intend to continue making the issue a political football.

I will reiterate the important context behind the challenges that we are seeing in NHS capital backlogs. When we came into Government in 2010, £1 in every £4 being spent by the Government was borrowed, which was clearly unsustainable. If the Labour party thinks that its current economic inheritance presents challenges for public spending, let me remind it of what we inherited. Unemployment was higher; inflation was higher; the deficit, or the black hole as Labour Members like to call it, was higher; and economic growth was lower. Even in that context, however, we prioritised NHS spending.

I thank the hon. Member, my constituency neighbour, for giving way and I congratulate him on securing this debate. We both care deeply about our three local hospitals and I, too, pay tribute to the work of our amazing NHS staff. Recently, I was at one of those local hospitals with a family member and I will be there again next week.

Does the hon. Member agree, however, that when Labour came into office, it was confronted with the fact that the Conservative Government had not budgeted for the new hospital that they had promised for our community, and that the money for it had run out in April? If the Conservative Government had been serious about committing to the new hospital programme, they should have budgeted for it. The new Labour Government have provided that funding and put in place a realistic and honest framework for our communities that sets out when we will get that work done.

Governments make choices. I have just laid out the economic situation that we inherited, which was worse than the one Labour has inherited, and yet we prioritised NHS spending. Nobody forced Labour to give above-inflation pay increases to a number of public sector workers and enormous pay increases to train drivers, or to make a significant but unwise investment in the green investment plan.

Will the hon. Member give way?

I do not have to let anybody intervene, but I will let you intervene to make a point about your hospitals. If there continues to be a back-and-forth, I will not let anybody intervene—this is my speech and I will make my points.

Order. We have had the word “you” a few times, which refers to me as the Chair.

There is not time for a continual back-and-forth in a 30-minute debate, so I will make some more progress.

When it comes to comparing the record of the NHS, the performance of the NHS under Labour in Wales, across many of the metrics that Labour Members have criticised us for, is actually worse than the record of the NHS elsewhere. That is because across England, Scotland and Wales—this is why I hope we can come to some agreement—we not only had the pandemic but face an increasing demographic challenge.

The SNP, Labour and the Conservatives, in the three areas in which we respectively have responsibility for health, are seeing considerable challenges that all of us are struggling to manage, as the Labour party will now struggle to manage them. As was the case when Labour was last in office, capital spending is often deprioritised when budgets are challenged, and decisions are made that might make sense in the short term but that also create long-term pressures.

The issue that we are debating is nothing new. Members from both sides of the House agree that our hospitals need modernisation, with 42% of the NHS estate having been built before 1985 and 14% of the estate pre-dating the NHS.

I will give way to the hon. Member for Camborne and Redruth (Perran Moon), who stood up first.

I thank the hon. Member for giving way. I appreciate that he does not want this debate to be political, but so far it has been all about politics. If we want to have a debate about the state of the NHS and how we transform it, it must be a level debate.

In Cornwall, we have one general hospital, but we are very fortunate that it is in the first phase of the programme because it is a women and children’s unit, which we have a desperate need for. It was originally promised by the former Prime Minister, Boris Johnson, more than 10 years ago, but nothing came to fruition. We have been waiting a long, long time for it.

I fully accept that government is about choices. We have had to deal with—whatever we want to say; however we want to position it—a number of different challenges since we came into government—

Order. The Clerk is frowning at me, because this is a bit long for an intervention.

Does the hon. Member agree that we now have a coherent programme—however long it is for—to implement those changes?

That remains to be seen; we will have to see what the Office for Budget Responsibility says in March about the planned public expenditure limits.

To be clear about taking interventions, I am very happy to debate things, but this is a 30-minute debate in which the primary focus is on the person who secured the debate. The Minister will get a chance to make those repeated points, so I will not let anyone else make another intervention. I was happy to let people make interventions, because I am keen for you all to champion your local hospitals, but if you are not willing to play ball with me—

Order. Avoid the word “you”—that is one to steer clear of.

I apologise. If Members are not willing to go along with that courtesy, I am afraid that I will not continue to take interventions. I have tried to be fair and decent.

I hope that the Minister will at least be shorter on rhetoric and longer on the details of what will actually happen than the Secretary of State was. That brings me back to my local hospital and what happens next. Shortly after the election, I attended a briefing with East Sussex healthcare trust, which I am proud to say has made incredible improvements over the past 10 years. Despite being in what it described as a challenging financial position, it has reversed its special measures and improved standards across the board.

The hospitals under the trust are crucial parts of our local healthcare services in East Sussex and have served the community for decades. Each year, they carry out over 160,000 emergency attendances, 56,000 planned surgeries and 438,000 out-patient appointments. It is also important to remember that those hospitals are not just healthcare providers but job creators, employing around 8,700 people locally.

However, East Sussex healthcare trust was clear that the remedial works due under the new hospital programme could not be delivered soon enough. When the programme was announced in 2019, the trust estimated that the total backlog rectification cost throughout all its hospitals was over £300 million. Its critical infrastructure risk was the 10th highest in England, and was estimated to represent around £64 million of the £300 million total required to resolve the backlog. If left untouched, it is estimated that that figure will rise to £220 million over 10 years.

Given the disappointing decision to delay the major infrastructure investment that would have addressed the situation, what is the plan now? How will the Government now ensure that those sites can continue to function effectively? I am grateful to the Minister for her time in our previous interactions, but I ask her to explain in detail how the Government are going to manage those issues. The trust is now working at pace to try to develop a better understanding of the impact of the decision and the possible mitigations. What support is being put in place by the Department and NHS England to assist hospitals in that work?

Tackling the colossal backlog of repairs is not enough to equip such hospitals for the 21st century. The way that we deliver care has drastically changed since they were built. A new hospital is not just a new building; it is more than just bricks and mortar. It is about rethinking traditional and outdated models of care to reflect the changing needs of patients. Hospitals in East Sussex have been assessed as having a digital maturity level of zero. That must be addressed if the Government’s ambition of a digital revolution is to be realised. The layout of the hospitals is simply not designed for modern healthcare, with far too few single rooms to meet demand, which leaves hospitals poorly equipped to effectively control infection and unable to offer patients privacy and dignity when they need it most.

Those issues are more pronounced when we enter the winter months, with the UK Health Security Agency reporting a sharp increase in the number of patients admitted to hospital for flu and other respiratory diseases. As the Health Secretary mentioned last week, there are 5,100 people in hospital with flu, which is more than three times the number at this point last year. That is only compounded by the UK’s ageing population, which is often described correctly as a demographic time bomb, as in the next 25 years the number of people older than 85 will double to 2.6 million. In East Sussex alone, the population is expected to increase by 14%, with significant growth in the over-70s demographic. As that comes to pass, healthcare needs will become more complex and the demand for services will continue to grow.

I have been working with a number of GP practices in my constituency to help bring to fruition their plans to move to larger, more modern premises. As such, I am encouraged by the Government’s £889 million of extra funding for general practice. From that work, I know that a significant barrier to those projects being delivered is the rising cost of construction. I was informed by Rother district council that construction costs on its joint projects have increased by approximately 40% since 2020.

Those issues underscore how critical the rebuilds are to East Sussex healthcare trust, as well as others across the country, to deliver the best healthcare outcomes for patients and future-proof our NHS. Although financial prudence is essential, the Health Secretary’s delays only escalate construction costs and deepen the strain on our healthcare system. Investment now will save money and lives in the long term. Instead, the Labour Government have delayed plans—admittedly ambitious plans—and kicked the can down the road. The decision to delay schemes in East Sussex will have consequences for patient care, NHS staff and public trust.

Without urgent interim funding to address those issues, patient safety and care standards will be at risk. I call on the Minister to secure dedicated resources to tackle the new challenges in maintenance and capital spending created by the Government’s decision, and ensure that hospitals can continue to serve the community safely and effectively while we wait for the new promised facilities to materialise. Delay must not mean deterioration, and I urge the Government to act now to protect both patients and NHS staff.

It is a pleasure to serve under your chairship, Dr Huq. I congratulate the hon. Member for Bexhill and Battle (Dr Mullan) on securing a debate on this important matter. I commend his timing in getting this debate two days after an announcement that nobody else knew about. If he were a Labour MP, there would be howls of “Fix!”

There has been a lot of back and forth, but I want to confirm that we pledged to support this programme, and we are supporting it. That is what Monday was about—let us be in no doubt about that. I was part of the largest capital programme in the NHS when I served as a non-executive director under the last Labour Government; this will be the next largest capital programme, delivered under this Labour Government.

As Lord Darzi noted in his investigation, the hospitals that we rely on are deteriorating after the NHS suffered years of under-investment. This Government inherited a programme to deliver new hospitals that was unfunded beyond March 2025 and was repeatedly delayed, with no credible delivery plan.

I thank my hon. Friend; I am happy to take interventions, but I need to finish by half-past 4, so I am conscious of time. He is absolutely right, and I will come on to his point.

We need to be very clear and honest with people about what was ready and about the different stages of these programmes, which we are very keen to do. Staff and patients deserve better. That is why the Secretary of State asked officials to review the programme and put it on a firm footing with sustainable funding so that all the projects can be delivered.

I thank the hon. Member for Bexhill and Battle for his service to the NHS and his experience. I agree that it is appalling for staff. We all understand that he and I disagree in our political analysis, but he made some really well-informed points about models of care and future models of care, all of which we need to take into account in the delivery of this programme and other parts of the capital programme—and we will.

As the Secretary of State announced to the House on Monday, we now have a realistic plan to deliver the programme. I am pleased that we can be honest with people as we start a new chapter setting out a new commitment to deliver these hospitals, which are so important to all our constituents, that is realistic and backed with funding. We have worked closely with the Treasury to secure five-year waves of investment, backed by £15 billion of investment over consecutive waves, averaging £3 billion a year. This will ensure a balanced portfolio of schemes at different development stages being delivered now and into the future.

The new delivery plan sets out the order and the waves of investment in which each new hospital will be constructed. Hospitals included in a wave will begin construction, while forthcoming schemes will be undertaking pre-construction work to prepare planning permission and secure business cases. With this approach, we can ensure that schemes are ready to be built as soon as possible. A list of the schemes in each wave has been published on gov.uk and in the plan for implementation.

For reference, I will briefly outline the timeline for delivery. [Interruption.] Actually, I think we have seen all the waves, and the hon. Gentleman wants us to move on to Bexhill and East Sussex.

For Watford general hospital, we have a window between 2032 and 2034. Given the certainty that the Minister is trying to give to the programme and to the rest of the country, what assurances and assumptions has she made for that two-year window? How can she assure me and my constituents that there will be no further delays?

I will pick up that point. Wave 3, which is what the hon. Member for Bexhill and Battle has secured this debate on, includes schemes that were always part of a post-2030 plan. We now have the confirmed dates. The East Sussex new hospital scheme for East Sussex healthcare trust includes, as the hon. Gentleman says, new buildings and refurbishments at Eastbourne district general hospital, Conquest hospital and Bexhill community hospital. The scheme is in wave 3 of the delivery plan, and construction will commence between 2037 and 2039. We understand that this is disappointing news to some people who were expecting and were told that their hospital would be built earlier, but we can assure them that there is now a credible and funded plan for delivery—no more false promises. Our priority now is to get on and deliver these new hospitals for the benefit of the staff and patients who so vitally need them.

We understand the importance of these schemes to local communities and the need to invest in health infrastructure. We will continue to engage with trusts—including Watford, which the hon. Member for South West Hertfordshire (Mr Mohindra) mentioned—over the next few years to establish whether there are any other activities that can be progressed during the spending review. We will be in discussions with all those trusts to understand mitigations in the meantime. That was the source of many questions that came up in the many meetings that I held with hon. Members yesterday. I understand that all these hospitals are critical—they would not be on the list if there were not a major problem with them—so we need to talk to the trusts about how we manage the process in the meantime.

I acknowledge that this will be a difficult time for the core teams and all the people who have been working on these schemes, many of which will be stood down. Their expertise and knowledge is extraordinarily valuable. I know that the programme teams will make efforts to ensure that expertise is retained where possible and used to develop the wider programme.

The trust is currently developing its strategic outline case, as per the business case process set out in His Majesty’s Treasury’s Green Book. Following the review and approval of the SOC, the next step will be the development, review and agreement of the outline and full business case. I understand that many areas, including Bexhill, have plans for housing to accommodate a growing population. My Department will work closely with integrated care boards and the Ministry of Housing, Communities and Local Government to ensure that those communities have the health provision that they need.

Beyond establishing a credible programme, we are taking steps to restore people’s trust through honesty and transparency. We will be setting out further information for each scheme shortly, to ensure a more open way of working and collaborative programme delivery.

Yesterday, I held meetings with Members of Parliament from all waves of the process to give them the opportunity to ask more detailed questions about their individual schemes, and to give them the clarity that their constituents deserve. Letters have also been issued to the trusts. That was a very successful way of working; I certainly learned a lot about the individual schemes. Members of Parliament of all parties came to talk about their schemes. I gave a commitment that I would continue to talk to colleagues about them. I absolutely offer the same to the hon. Member for Bexhill and Battle. I will work with Members’ trusts to understand the detail on the ground.

I warmly welcome the news, on which I congratulate the Minister, that the women and children’s hospital at Treliske and the emergency care hospital at Derriford are in wave 1. However, some of my North Cornwall constituents rely on the crumbling North Devon district hospital, which is potentially 15 years from a rebuild. We are talking about mitigations, so please will the Minister meet me to discuss how we can expand care at the community hospitals in Bodmin, Launceston and Bude, which are all at least one hour from their closest district hospitals?

I thank the hon. Gentleman for his intervention. We had a good discussion yesterday about North Devon; I understand the rurality of that location, as it is fairly close to my Bristol constituency. Obviously, however we manage it, there are a lot of schemes represented by a lot of MPs. I am open to suggestions about how we go forward. I hope hon. Members feel that we have tried to give as much information as we can to them and the trusts in the announcement and the meetings yesterday. That is the spirit in which we will continue.

I welcome the spirit of openness and transparency that the new leadership of the programme has demonstrated. Previously, and frustratingly, residents in Hillingdon were—to be frank—led up the garden path. We were left with all but an IOU note for £750 million for a new hospital. The revenue funding for the new hospital ran out this year. We were pleased to see it renewed, and to be in wave 1; a significant capital investment of more than £1 billion has been committed to.

This is complicated: it is hard to deliver projects at this scale. With the best will in the world, if another £20 billion were to appear, despite the Conservative party opposing any methods that would raise money, the construction sector would struggle to build all these hospitals at once. Is it not the case that it is challenging to deliver this project at scale? Will the spirit of openness and transparency continue?

I thank my hon. Friend for his continued campaigning on behalf of the residents of Hillingdon; I used to be one of them. Talking to people is really important, and we have learned a lot from it. In case I have not outlined this enough, let me be clear that all our constituents who are on the programme are in severe need. The programme has looked at clinical need and deliverability. We understand how difficult these choices are, so I thank my hon. Friend for that intervention.

I welcome the Labour Government’s confirmation of funding, which will help the Conquest hospital in Hastings, part of the East Sussex Healthcare trust, and other hospitals that my constituents use. It comes alongside the Chancellor’s announcement of a big package of support in the Budget, with record investment in our NHS to provide more appointments to clear the backlog left by the Conservatives.

I thank my hon. Friend for her intervention, which highlights the point that the hon. Member for Bexhill and Battle raised about other capital plans and programmes to help his constituents and others over the coming years.

In conclusion, I thank the hon. Gentleman for raising this issue.

If the hon. Member for Bexhill and Battle, whose timing is superb, wants to make an extra point, I will give him the courtesy of a chance to come back in.

In the last hour, I have had a communication from the trust explaining that, with the delay, the extra cost may be in the hundreds of millions. I would be grateful to take up the Minister’s offer of some time, as well as to talk to MPs who use those services, to see how we can help the trust to access that funding.

I thank the hon. Gentleman for that intervention. We learned a lot yesterday from the expert team from the new hospital programme; I thank them for their incredible work in getting to this point. Those colleagues who could make the meetings yesterday found that the team’s knowledge about every single programme was phenomenal. I have yet to ask the team a question about any scheme to which they do not know the answer—I give hon. Members that confident assurance. The team includes colleagues from both NHS England and the Department.

When I went to an assurance meeting a few weeks ago, I learned that the relationship between the central control of the programme and the trusts, how we get the schemes delivered for everyone’s constituents, and the value of parliamentarians talking to me—everyone has stopped me in the corridors to raise these issues—are all very valuable. That is a good function of parliamentarians. That is the spirit in which we want to continue.

Our commitment is to deliver these hospitals, including the Eastbourne district general, Conquest hospital and Bexhill community hospital schemes, and I am pleased to say that we have an affordable, deliverable plan to do so. It will be difficult, but I look forward to working with the hon. Member for Bexhill and Battle and other colleagues.

It is very gracious of the Minister to allow me to intervene again. In the interests of full transparency, can she assure us that if the development of the new hospitals gets delayed, all MPs will be informed, not just those in the relevant constituency? Work on Watford general is meant to begin between 2032 and 2034. Will the Government communicate any further delays as quickly as possible? That will certainly be critical to our constituents.

We absolutely will. This is one of the advantages of the waves: we recognise, and everybody knows, that there are sometimes unavoidable delays to schemes, perhaps to do with the sites, but the advantage of the pre-construction work and our knowledge of the sites is that most of that should be built into the programme and the timing. But life happens.

One of the central issues for the programme is capacity in the construction arena, as well as across the country, in terms of developing primary estate to get these things done. The advantage of the waves is that they give us flexibility if things move, as they inevitably will—that is life. We very much want to keep up relationships with local trusts and inform them. That will be difficult, as my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) says, but that is the spirit in which we want to continue. I give him and other colleagues that absolute commitment.

Question put and agreed to.