Asked by
To ask His Majesty’s Government what assessment they have made of
(1) the backlog of the maintenance of NHS buildings, and (2) the
impact of the backlog on the capacity of the NHS to deliver
services.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care () (Con)
The NHS publishes the annual Estates Returns Information
Collection, which provides a detailed breakdown of backlog
maintenance. Patient and staff safety is our top priority. While
individual NHS organisations are responsible for their estates,
we recognise that backlog maintenance can have a significant
impact on NHS services. That is why £12 billion in operational
capital will be provided to the NHS over the next three years for
trusts to maintain and improve the estate.
(Lab)
My Lords, last month, NHS Digital reported that the maintenance
backlog had increased by 11% from last year to over £10 billion,
with more than half of it posing a high or significant risk to
safety or the delivery of healthcare. So does the Minister agree
that, if more facilities, operating theatres and buildings had
been properly maintained, they could have been used to provide
care and reduce waiting times? Having allowed the maintenance
backlog to double over the past 12 years, will the Government now
fix this?
(Con)
I agree that it is an area of key priority; that is why the spend
in this year as reported by NHS trusts has gone up by 57%—an
increase to £1.4 billion. So we recognise that this needs to be
worked on, but I put it in the context of an overall £10 billion
capital programme, including a new hospital build. We very much
recognise that making sure we have excellent facilities is key to
success in the NHS.
(Con)
My Lords, what has become of the great hospital building
programme that Mr promised in the 2019
Conservative election manifesto?
(Con)
I am very pleased to say that the hospital programme is very much
a feature. We are already working on five hospitals, which are in
the process of being delivered. The programme for the 40
hospitals is very much in progress, and we see it as a real
opportunity for the UK to take a lead, as we are looking at using
a whole new series of modern methods of construction, which we
believe will be world leading in this space.
(CB)
My Lords, the Minister will no doubt be aware that for a long
time it has been the practice of the NHS to rob Peter to pay Paul
by appropriating capital budget to supplement revenue deficits.
That really needs to stop, as it has led to a massive deficit in
estate maintenance across the NHS. Care is being delivered in
dilapidated surroundings across the system. That means that this
building programme really matters—it is not a question of leaping
forward but of making good long-term neglect. So I express to the
Minister that if, as a result of the financial review, we find
the programme being either delayed or cut, that would be deeply
unsatisfactory.
(Con)
I agree on the importance of that; as the noble Lord says, often
these are easy savings to make, but they are not the right ones.
I assure the House that it is a key priority of mine that even
such things as operational maintenance, which sounds very unsexy,
are a key element in all this. As I say, that is why we have seen
a 57% increase in the past year. At £10 billion a year, I hope we
all agree that this is a good plan, albeit that there is a lot
that needs to be done.
(Con)
My Lords, the Public Accounts Committee has stated that £8.6
billion was lost by the DWP last year in overpayments to benefit
claimants and fraud. That is £8.6 billion that could be used to
maintain the NHS estates. Can my noble friend the Minister say
what the Government are doing to ensure that not only are the
inefficiencies cut in the NHS, but efficiencies are made within
the wider government departments?
(Con)
Thank you. I am sure the whole House will agree the need for
efficiencies to make sure every pound is well spent. I have a
little knowledge in the DWP space. Although it falls outside my
responsibilities now, I was the lead NED there and I know that
the team worked very hard during the pandemic to make sure that
universal credit reached people quickly, and as a result they did
not proceed with as many checks as they would do normally. It was
deliberate policy to make sure money was paid quickly to those
who needed it. At the same time, they absolutely understand that
they need now to get on top of it and it is key to their action
because, as my noble friend says, the more money we can free up
in other departments, the more we can focus it on the front line
where we really need it.
(Lab)
My Lords, I recognise that the noble Lord is new in post and the
Secretary of State is sort of new, having been in and out and
then back again. But the backlog in repairs is mirrored by the
exponential increase in waiting lists. Has this something to do
with the atrophy that now exists in the health service due to the
changes brought in by , which have led not to the
integration of services but the integration of bureaucracy?
(Con)
I can assure the noble Lord that bureaucracy is not the aim of
the game and that getting money to the front line is the
priority. We have record levels of investment in this area. We
are currently devoting about 12% of GDP to health spending, which
sits alongside the highest in the world. That is not to say we do
not have to make sure every penny of that is spent effectively
and, where possible, on the front line rather than on back office
and bureaucracy.
(LD)
My Lords, the key test of any organisation with a backlog of
maintenance is whether it sustains that expenditure when it is
under financial pressure. So will the Government commit that the
extra money they have budgeted for maintenance in the health
service will be maintained in real terms when inflation is
running at 10%?
(Con)
We understand the importance of the programme, as I mentioned,
and, in terms of the finances of the country, we have people in
high positions who know its importance in the health debate. So
the noble Lord can rest assured that it is top of our agenda, and
we will be fighting hard to make sure that the capital programme
is given the priority it needs.
(CB)
My Lords, would the Minister like to visit Masham GP surgery,
where I live? He will find it is a GP surgery that needs
updating. It was turned down, and one of the doctors left and
went to Canada. It is now totally unsuitable for a growing
population, for both patients and the staff working there.
(Con)
I do recognise the importance of primary care. We know that a lot
of the people who turn up to A&E would be better served in
the primary care system, so making sure we have good facilities
in this place is vital, and again it is something that is part of
our agenda. There was an excellent report in this space recently,
and it is something we are working towards—so, yes, GP surgeries
are very much an important part of this £10 billion
programme.
(Con)
My Lords, in response to an earlier question about the hospital
building programme, my noble friend the Minister mentioned the
modern construction techniques of hospitals. I wonder whether he
could enlighten the House on some of the leading technology
methods we are looking at when it comes to the new hospital
programme.
(Con)
Absolutely; I look forward to sharing this with the House in a
lot more detail shortly. This is a real opportunity to create a
world-leadership position. The idea behind it is to have a
standardised approach to building hospitals—hospitals 2.0, as I
like to call them—where we look as much as possible to have
standard processes, procedures and components, so that we can
build them quicker, cheaper and more efficiently, and get
economies of scale from doing that. I believe that it will not
only pioneer the way we build hospitals in this country but give
us an opportunity to be a pioneer worldwide and create a major
export industry.
(Lab)
My Lords, I believe that Prime Minister Johnson promised 40 new
hospitals, but the Minister has mentioned five—what has happened
to the other 35?
(Con)
The other 35—I will happily read them out if the noble Lord
wishes—are very much part of the programme, and extensive work
and business plans are being performed. I visited one myself,
Watford General Hospital, just the other day to go through the
plans, so the noble Lord can rest assured that the other 35 are
very much still part of the programme.
