The Department of Health and Social Care (DHSC) has insisted it remains committed to delivering 40 new hospitals in England by 2030 after an influential group of MPs said they had "no confidence" that the Government will meet the deadline.
In a highly critical report, the Public Accounts Committee (PAC) said it was extremely concerned at the "worryingly slow" progress made in the 3 years since the New Hospital Programme (NHP) was created.
The committee, which scrutinises whether Government spending offers value for money, also accused ministers of "raiding" budgets for capital projects to cover day-to-day health service spending, which had left the NHS estate facing a record maintenance backlog.
Flagship Hospital Building Commitment
In 2020 the Government committed to build 40 new hospitals by 2030, at a cost of £3.7 billion, as well as completing eight schemes that were already in construction or pending final approval. The NHP was 'reset' in May this year to include rebuilding five hospitals that were built using reinforced autoclaved aerated concrete (RAAC), which had become structurally unsound.
As a result of the reprioritisation, as well as the rising cost of construction materials, the DHSC said that up to eight of the schemes were being rescheduled for delivery later than 2030.
In its report, the PAC warned, "with a very large number of hospitals planned to be in construction simultaneously in the last years of the decade, we have no confidence that even the reduced target of 32 new hospitals is achievable by 2030".
The PAC also warned of a risk that future hospitals, which are being built to a standardised design known as Hospital 2.0, are at risk of being too small. "There appears to be insufficient funding for DHSC to build all the hospitals it plans, and to an adequate size, by 2030," MPs concluded.
The committee called on the DHSC to urgently examine how the NHP can deliver "some tangible results for patients", and to take swifter action to tackle the problem of RAAC in hospital buildings.
Crumbling NHS Infrastructure
The committee noted that the NHS had a record maintenance backlog of £10.2 billion in 2021-2022, which it said had been exacerbated by ministers diverting £4.3 billion of NHS capital funding from planned capital spending to cover day-to-day costs between 2014-2015 and 2018-2019.
Dame Meg Hillier MP, chair of the PAC, said: "The physical edifice that is the NHS is quite literally crumbling before our eyes. There was nothing inevitable about this heart-breaking crisis. It can be laid squarely at the door of the decision to raid budgets reserved for maintenance and investment in favour of day-to-day spending."
She added: "Quite aside from the fact that the planned new hospitals risk being too small for future purposes, funding does not even appear to be in place to construct them in time, all underpinned by failures of basic record-keeping and fresh and urgent concerns over RAAC."
Commenting on the report, Miriam Deakin, director of policy and strategy at NHS Providers, called on government ministers to "heed warnings that planned hospitals may be too small for future health and care needs". She said: "Too many NHS buildings and facilities are quite simply falling to bits. Mental health, hospital, community, and ambulance services lack money for critical capital projects needed to give patients 21st century care in modern settings."
"Thankfully, the NHP will help some trusts to remove substantial, critical risks from their estate. The MPs rightly highlight the NHS' £10 billion-plus and growing 'to-do' list of repairs, the cost of trying to patch up creaking infrastructure and out-of-date facilities. And with more unsafe old reinforced autoclaved aerated concrete found on more NHS sites, the picture is getting worse."
In an emailed comment, a spokesperson for the DHSC said: "We are committed to delivering 40 new hospitals by 2030, expected to be backed by over £20 billion of investment and additional clinical projects."
"Three hospitals open to patients, another two opening shortly, and a further sixteen in construction or have early construction activity underway to prepare sites. Our innovative ‘Hospital 2.0’ approach will enable us to build high quality hospitals more quickly.
"With better value for money for the taxpayer, new hospitals will feature single bedrooms which can reduce length of stay, improve infection control, and boost use of bed capacity."