PARLIAMENTARY DEBATE
Health Infrastructure Plan - 30 September 2019 (Commons/Commons Chamber)
Debate Detail
Our health is the nation’s biggest asset, and the NHS is the Government’s top domestic priority. We are backing our commitment to our NHS with record levels of funding. As part of this, today I am pleased to update the House on the biggest, boldest hospital-building programme in a generation. Through our new health infra- structure plan we are supporting more than 40 hospital- building projects across the country, with six getting the go-ahead immediately—HIP 1. That includes £2.7 billion of investment that gives those six hospitals the funding to press ahead with their plans now, alongside last Friday’s investment in technology to ensure that no CT scanner is more than 10 years old.
The six hospital trusts are Barts Health NHS Trust, Epsom and St Helier University Hospitals NHS Trust, West Hertfordshire Hospitals NHS Trust, Princess Alexandra Hospital NHS Trust, University Hospitals of Leicester NHS Trust and Leeds Teaching Hospitals NHS Trust. Under HIP 2, a further 21 schemes have been given the go-ahead with £100 million seed funding to go to the next stage of developing their plans, subject to business case development. This £2.8 billion capital investment follows on from August’s £850 million for new upgrades, which included, for example, a £72.3 million investment in the Greater Manchester Mental Health NHS Foundation Trust. All of this, of course, comes on top of the £33.9 billion cash increase in funding for the day-to-day running of our NHS.
This announcement represents another part of our long-term, strategic investment in the future of the NHS, properly funded and properly planned, to ensure our world-class healthcare staff have world-class facilities to deliver cutting-edge care and to meet the changing needs and rising demand that the NHS will face in the 2020s and beyond. Capital spend on NHS infrastructure is fundamental to high-quality patient care, from well-designed facilities that promote quicker recovery to staff being better able to care for patients using the equipment and technology that they need. It is also essential to the long-term sustainability of the NHS’s ability to meet healthcare need, unlocking efficiencies and helping to manage demand. The investment we are making in our buildings, our technology and our equipment is vitally important in itself, but it is most important because it gives our fantastic NHS staff the tools they need to do the job.
Our staff are at the heart of the NHS, which is why we have invested in the NHS’s workforce. Our interim NHS people plan has set out immediate actions that we will take to reduce vacancies and secure the staff we need for the future—including addressing pensions tax concerns, increasing university clinical placements by over 5,000 more and bolstering the workforce. But it is only right that we invest in the buildings they work in, and in which they provide first-class care for patients. For too long, Governments of all parties have taken a piecemeal and unco-ordinated approach to NHS buildings and infrastructure.
The health infrastructure plan will change that. In the future, every new hospital built or upgraded must deliver our priorities for the NHS, and happen on time and in a planned way, not the current stop-start that we see.
But NHS infrastructure is more than just large hospitals. Pivotal to the delivery of more personalised, preventive healthcare in the NHS long-term plan is more community and primary care away from hospitals. That requires investment in the right buildings and facilities across the board, where staff can utilise technology such as genomics and artificial intelligence to deliver better care and empower people better to manage their own health.
This is only the beginning. The full shape of the investment programme, including wider NHS infrastructure, digital infrastructure, and wider capital investments that support the economy and health system will be confirmed when the Department receives a multi-year capital settlement at the next capital review.
This is a long-term, strategic investment in the future of our NHS, properly funded and properly planned, to ensure that our world-class healthcare staff have world-class facilities to deliver care and meet changing needs and rising demand, so that the NHS can face the 2020s and beyond with confidence.
Of course, I welcome investment in Leicester Royal Infirmary—it is a big investment and to have won it shows what an effective Member of Parliament I am—but will the Minister be clear that that also means a downgrade of Leicester General Hospital, with services closing, including maternity services, and a loss of beds? Will he also tell us what happened with the Epsom and St Helier reconfiguration? Will he confirm that that means moving from two acute services to one in a part of London where accident and emergency pressures are increasing? Will he tell us today whether, across these reconfigurations, the end result will be more beds or fewer?
We know that the NHS is facing a repair bill of £6 billion after years of capital cuts under this Conservative Government, but the Government have so far refused to publish the capital allowances for between next year and 2025. Will the Minister guarantee that the £2.7 billion allocated will be additional to the capital baseline, and will he undertake to publish the NHS departmental expenditure limits on capital spending so that we can be reassured, rather than our assuming that this is all smoke and mirrors?
The Minister has also invited 21 other trusts to make use of a £100 million fund to prepare plans for future upgrades, yet he has just admitted that that will be subject to “business case review”. Is not the truth that the Minister and the Secretary of State cannot give any cast-iron guarantee that each and every one of these hospitals will be upgraded between 2025 and 2030, because not a penny piece of extra investment has been allocated to the programme for 2025 to 2030?
Finally, how were the 21 trusts chosen? In our mental health hospitals, 1,000 patients are forced to stay in quite dire old-style dormitory wards—the Minister might have seen the ones at the Leicestershire Partnership NHS Trust, for example—yet not a single mental health trust is on the list of 21 produced yesterday. Does that not show yet again that this Government neglect mental health services and some of the most vulnerable patients in the land?
What is on this list, Mr Speaker? I will tell you. We have: Hastings and Eastbourne—marginal constituencies; Winchester—a marginal constituency; Plymouth—a marginal constituency; Reading—a marginal constituency; Truro—a marginal constituency; Torbay—a marginal constituency; Barrow—a marginal constituency; and Uxbridge—a marginal constituency. What a spooky coincidence it is that all these marginal constituencies are on the list. This is not a serious plan. It is a wing and a prayer ahead of a general election. The Prime Minister over-spins, under-delivers and is not straight with people—the truth is that you cannot trust the Tories with the NHS.
I find it extraordinary that the shadow Secretary of State takes opposition to a new level by opposing investment in our NHS, trying to cavil and challenge it. He will forgive me if I do not take his specific questions in the same order as he asked them, but I will run through as many of them as I can recall or as I noted down.
On mental health, I have to say that I find it very difficult to take lessons from the hon. Gentleman when this Government have invested huge additional sums in mental health care. As I mentioned in my opening remarks, we have allocated capital for Greater Manchester Mental Health NHS Foundation Trust—the announcement was made earlier this summer—and for Mersey Care NHS Foundation Trust, so I think the hon. Gentleman is perhaps being a little unfair in suggesting there is no investment in mental health from this Government.
This is an ambitious programme, but unlike the last Labour Government, we will not leave hospitals saddled with masses of private finance initiative debt. That programme was massively expanded under the Labour Government he served as a special adviser. Perhaps he should welcome this Government’s approach, which is to give hospitals the funding they need to deliver without saddling them with debt.
We have made it clear that the hospitals named in HIP 1 have the funding to go ahead, including the hospitals that serve his constituency and mine. I am a little surprised to hear the hon. Gentleman challenge the notion that anyone bidding for huge sums of public money should have to go through a business case. Surely when we are spending public money, it is reasonable of us to make sure it delivers value for money and better outcomes for patients. I know the Labour party does not pay much attention to value for money, but my party and this Government do. We are focused on patient outcomes and delivering investment in our NHS. We can say proudly that, with this raft of announcements, the extra £33 billion and the announcements made already, we truly are the party of the NHS.
UK Government decisions on pension costs and funding already result in a shortfall of £48.4 million for the NHS in Scotland, which comes on top of the UK Government making wider budget reductions in health funding for Scotland of £42 million compared with their previously claimed level of consequentials. Scotland now faces a shortfall of £90 million for its health services as a result of UK Government decisions. Now that the UK Government have apparently opened the spending taps, will they pay back the moneys due to Scotland, or will we continue to be short-changed? When will the full Barnett consequentials of this new investment be published?
In total, the Tories’ decade of austerity has cumulatively cut the Scottish block grant by more than £12 billion in real terms. With the economy already faltering, the Chancellor’s predecessor warned that a destructive no-deal Brexit could inflict a £90 billion hit on the Exchequer and suggested that no new money would be available. How then can the Minister guarantee that this money will come to the NHS?
I have a tiny, slightly off-the-wall additional request. As my hon. Friend is aware, I have a declared interest in dentistry, which means that every time the word “health” comes up, I get prodded in the back by my colleagues. In most western nations, 60%, 70% or 80% of the public water supply is fluoridated. It is a proven caries prevention. Would he include in his plans the infrastructure to greatly expand the fluoridation of our water supply? It would bring benefits in terms of prevention and, in due course, cost.
Every day, our NHS staff go above and beyond everyone’s expectations in whatever buildings, to make sure that they deliver first-class care for all our constituents and, indeed, for us all. I will happily write to my right hon. Friend setting out the process in more detail. I believe that my predecessor in this role was due to visit on the day on which he was reshuffled, so I very much look forward to taking up that invitation if it is extended and coming to see my right hon. Friend.
The NHS is a devolved matter in Greater Manchester, but NHS financial technicalities are holding back the redevelopment of the wonderful Wythenshawe Hospital in my constituency. Will the Minister meet me to discuss those technicalities?
With this plan, we are also looking to deliver a step change in how we deal with capital in the NHS, which is also hugely important. Instead of stop-start investment, we are looking for a rolling programme of investment to make sure we get those facilities up to standard in order to reduce the day-to-day spend on repairs. I will happily talk to my right hon. Friend about what we can do to ensure that we go through due process as swiftly as possible so that her hospital trust can get on with it.
The hon. Lady raises a specific point, and it would be wrong to suggest that this Government are not investing in mental health services. However, if she wishes to discuss the specifics of her constituency and of the needs in Yorkshire, I would be happy to meet her.
“The impact of low levels of funding over seven years has been longer and more impactful than when funding was squeezed by the Mrs Thatcher Government. More investment is required to increase staff training and in turn employ more qualified health staff.”
We know that hospitals in towns are often not funded to the same level as hospitals in cities, so could the Minister give me the number of hospitals in towns that are not in marginal seats which are having extra hospitals and funding? Will he meet me to discuss extra funding for Dewsbury’s hospital?
“these piecemeal announcements are not the same as having a proper, multi-year capital funding plan.”
So could the Minister clarify by what criteria these schemes have been selected, and what are his spending plans for the long term to repair our crumbling NHS?
When constituents get in touch with me frustrated with NHS wait times, it is invariably about the wait for mental health services, and some of the most difficult conversations I have had to have as a constituency MP have been with parents who have lost children to suicide or eating disorders, so why is the Government’s announcement today so silent on mental health issues, particularly regarding CAMHS?
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