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Department of Health and Social Care: Treasury Funding

Volume 664: debated on Wednesday 4 September 2019

Motion made, and Question proposed, That this House do now adjourn.—(Nigel Huddleston.)

It is a huge pleasure to see you, Madam Deputy Speaker, in the Chair this evening, not just because you are my constituency neighbour as the Member for Epping Forest, but because you have worked so hard alongside me to get a vital new hospital health campus in Harlow at the Princess Alexandra Hospital. I am hugely grateful to you for being here today. I am grateful to the Speaker for granting this debate, my fifth, on capital funding for the Health Department, particularly for new hospital projects. I strongly welcome the extra £34 billion that is going into the NHS over the next few years. The Government are rightly making the NHS a priority in their spending plan. In doing so, they are helping to create certainty for our hospitals, future-proofing them for the challenges ahead. However, this day-to-day funding does not account for bigger-scale capital funding projects, such as new hospitals. The Health Service Journal suggests that in the past two years NHS providers have requested about £8.7 billion of capital funding in more than 360 formal bids.

The Prime Minister’s announcement of an £850 million cash boost for 20 new hospital upgrades is a step in the right direction, but we risk a healthcare crisis in this country if we do not act quickly. Many of our hospitals in England were built in the 1960s and 1970s and, while our model of care has modernised, the infrastructure has fallen behind. Many of our NHS hospitals are no longer fit for the 21st century, sadly none more so than the Princess Alexandra Hospital NHS Trust in Harlow.

You will no doubt understand the frustration of our constituents, Madam Deputy Speaker, and those of our neighbours, particularly those who work at the Princess Alexandra, that our Harlow hospital was not included in the hospital upgrade programme announced by the Prime Minister. As well as the numerous letters and conversations with colleagues, I have raised on no fewer than 30 occasions during questions in the Chamber the need for a new hospital health campus to serve west Essex. I mentioned that this is my fifth debate. I have also tabled 11 Commons motions. I am pleased to see a number of right hon. and hon. Members here who have also championed the case for increased hospital funding. Six local MPs, including you, Madam Deputy Speaker, helped significantly in writing to the Health Secretary in May last year, pledging their support for a new hospital and acknowledging its importance to

“the vitality of community and also to the economy of the entire region.”

Our passion and determination for a new health campus is founded in the desperate situation that we find ourselves in.

Of course. It is impossible not to give way to the hon. Gentleman—my hon. Friend, I should say.

I did seek the right hon. Gentleman’s permission earlier today, before the Adjournment debate, to make an intervention. Does he not agree that it is tremendous to see the Government today, through the Chancellor’s statement, listening to need and allocating additional funding for other things, such as policing, Northern Ireland and education, as well as some £1 billion, I understand, for health and social care? However, we do need a standard increase in the block budget under the Barnett formula for Northern Ireland. I suggest that that needs to be ring-fenced to provide frontline services that are also underfunded and on which there has to be a focus. I fully support his request to the Government, because across the whole of the United Kingdom of Great Britain and Northern Ireland there are pressures on health and social care. It is important that everybody in the United Kingdom of Great Britain and Northern Ireland sees the benefits.

I thank my hon. Friend. He has attended every debate I have secured on the Princess Alexandra Hospital in Harlow. That shows that there is not just support across Essex and Hertfordshire, but from as far afield as his constituency of Strangford and across Northern Ireland. His question, in essence, is about important funding for devolution and fair funding across the board. I completely agree with him and I thank him again for coming, on this fifth occasion, to support my campaign for a new hospital in Harlow.

We need a new hospital for four substantive reasons. First, and there are no two ways about it, the hospital estate is falling down. It is crumbling around staff, patients and visitors, so much so that it is inhibiting the work of our hardworking NHS staff who brought the hospital out of special measures in 2018. The Health Secretary himself, having visited the hospital at the start of this year, stated in this Chamber that:

“the basement of Harlow hospital is in a worse state of disrepair than the basement of this building.”—[Official Report, 1 July 2019; Vol. 662, c. 941.]

That is saying something, Madam Deputy Speaker.

Given that the Palace of Westminster has been promised a £3 billion restoration, I ask the Minister: when will the Treasury prioritise the crumbling basement of our NHS hospital in Harlow? Whenever I visit Princess Alexandra Hospital—as a patient, visitor, or in my capacity as an MP—I am genuinely astounded by the quality of care and exceptional service that is delivered, as was the Health Secretary on his visit. Following a comprehensive tour, he said:

“I’m incredibly impressed with how much the staff are managing to do in the current facilities.”

My inbox, however, is filled with the anxieties of constituents about the pressure on A&E and the condition of the estate. The doctors, nurses and specialists are working in extremely tight spaces, in an immensely pressurised environment. Staff simply cannot be expected to make service improvements, nor to meet NHS waiting time guidelines. I ask the Minister: how can we expect our NHS staff to deliver the high standards that we demand when they do not have the physical space, bed capacity or modern equipment to carry out their jobs?

In no other working environment would we expect as much in the 21st century. The remarkable hospital staff —everyone from the cleaners, porters, ancillary staff, nurses, doctors and consultants to the management team, led by a very special chief executive, Lance McCarthy —have progressed in leaps and bounds. I am particularly grateful to the chief executive for his decision to keep domestic services in-house, protecting the jobs and livelihoods of many Harlow residents.

In July, I was delighted to welcome Kathy Gibbs into Westminster for the NHS parliamentary awards. She was a finalist for the lifetime achievement award after dedicating her entire career to Princess Alexandra Hospital in Harlow. The neonatal unit has received a number of accolades for its dedicated care and has recently been shortlisted as a finalist to receive the Bliss neonatal excellence team award. Should the Minister wish to see at first hand the brilliant work that is done in the busy maternity ward, I encourage him to catch up with the latest series of W Channel’s documentary following TV personality Emma Willis as she joined our Harlow hospital team to train as a maternity care assistant.

All across the hospital, there is a collective effort to raise standards. The entire catering team at the hospital’s restaurant were celebrating recently, having again been awarded a five-star food hygiene rating from environmental health officers. Despite the challenges that they face, Princess Alexandra NHS staff are making progress beyond expectations. In the light of their hard work and proven capabilities, does the Minister agree that our NHS staff are some of the most deserving of a new hospital and place of work that is fit for purpose? They have shown us what they can do in an outdated, difficult working environment—just imagine what they could achieve if they were given the tools to succeed.

Our population is growing at an extraordinary rate, placing enormous strain on local healthcare resources. Our hospital, and town, was built in the 1950s to serve a population of approximately 90,000. Since then, Harlow has seen considerable change, going from strength to strength. We have a thriving enterprise hub—Kao Park—which is home to a state-of-the-art data centre and international businesses such as Pearson and Raytheon, offering unparalleled employment opportunities to thousands of residents. Thousands of new housing developments are under construction to accommodate our fast-growing population and help first-time buyers to get on the ladder of opportunity.

Yet, with this extraordinary population growth, there is unbearable pressure on staff at the Princess Alexandra. Our hospital is struggling to cope with healthcare demands from around 350,000 people, exacerbated by the closure of nearby A&E units at Chase Farm Hospital and the Queen Elizabeth II Hospital. We have one of the busiest A&E units in the country and this trajectory of growth is only set to continue. Soon, Harlow will become home to Public Health England, and we have the chance to become the public health science capital of the world, offering employment to hundreds of people and bringing in many new residents. The near completion of junction 7A on the M11 will improve accessibility to our town, encouraging investment and prospects for business expansion. Given this faster-than-average population growth, does my hon. Friend the Minister agree that we cannot expect our NHS staff to bear the brunt of such demand without giving them the proper resource—a new health campus—to do so?

It is not only about numbers. The third challenge that Harlow faces has been caused by out-of-area placements into large-scale, commercial-to-residential conversions. Permitted development rights legislation has been a disaster for our town. Many of the families placed in temporary accommodation in Harlow by London councils have additional healthcare needs and come to our hospital for medical support, yet neither our local council nor the Princess Alexandra Hospital are given any extra funding to provide this. We face unique pressures on our health and social care resources in Harlow. Does the Minister not agree that a healthcare campus would help to alleviate these pressures as well as offering space for further expansion?

Fourthly, as a champion of skills and the ladder of opportunity, which I know the Minister in his previous role cared deeply about, we need this health campus to create a hub for learning, skills, training, research and development in Essex. Already, the Princess Alexandra Hospital is winning awards for its high-quality training, mentoring and career progression. Fair Train, a national organisation championing work-based learning, awarded our Harlow hospital the gold rating—the top rating—for its workplace opportunities.

That said, the hospital faces immense challenges with recruiting and maintaining qualified professionals, in part due to the appeal of London hospitals and private practices just 40 minutes away. The new health campus would bring with it exciting opportunities for scientific research collaborations with Public Health England and local enterprises. Apprenticeships and unrivalled training courses with Harlow College would help to upskill our workforce and give Essex residents new opportunities to further their life chances.

The new healthcare campus in Harlow could lead the way in health science education and training. Does the Minister recognise the wider benefits that the new healthcare campus would have in upskilling people of all ages in Essex and Hertfordshire, creating employment and research opportunities and boosting our economic prospects? Will he help to make Harlow the health science capital of the world by granting the capital funding to make that a reality?

As the steady stream of investment into our Harlow hospital shows, the Government are aware of the unique pressures that the Princess Alexandra Hospital faces. At the start of this year, I was privileged to open the Charnley ward, a desperately needed £3.3 million development constructed in just four months. Last December, we received £9.5 million to provide additional bed capacity, and in the autumn there was a £2 million investment to make preparations for the busy winter period ahead. Does the Minister not agree, however, that it is the Conservative way to consider what is best value for money for the taxpayer and that, while short-term cash investment provides much-needed relief, it does not go to the heart of the problem?

My right hon. Friend is making a brilliant case for a new health campus in Harlow. Will he allow the Minister in response to dilate a bit on the need for money to follow where population growth has taken place, as it has in Surrey and Woking? He makes a very good case for that in terms of his constituency, but of course there are wider effects as well, particularly in terms of capital investment, as he rightly says.

My hon. Friend is a brilliant constituency MP. I talk to him a lot about these matters, and he has just hit the nail on the head. Population growth is crucial. The money should follow population growth, and I accept that this is a problem not only in Harlow but in his constituency, in Strangford and across the country.

The existence of these quick, cheap add-on structures can actually add to the problems. They were described by the former Health Minister, my right hon. Friend the Member for Ludlow (Mr Dunne), as “sub-optimal clinical adjacencies”. The convoluted layout of our hospital is making the job of our NHS hospital staff more and more challenging day by day. It is slowing down their work and costing the taxpayer more. The Princess Alexandra Hospital in Harlow faces costs of £153,000 per week just to maintain its current position.

The cost of eradicating the maintenance backlog nationally—in other words, carrying out repairs to meet a certain standard—has climbed year on year to about £6 billion, and the day-to-day running costs of NHS estates have risen to £8.8 billion. Outdated, deteriorating infrastructure is costing the taxpayer more and more each year. I welcome the Prime Minister’s commitment of an additional £1 billion to improve and maintain existing buildings, but we must recognise that Elastoplast solutions only generate a need for greater spending down the line. We need a capital injection that will cure the problem—a vaccine—and not a simple patch-up job.

Time and again, I have been informed that we have a real chance of securing the capital funding. Previous Health Ministers have visited the Princess Alexandra, and it has been visited by the current and previous Health Secretaries on a number of occasions. We have been told that we have a good case for the £400 million of capital funding required to build our new health campus and that the Government will

“look very seriously at the proposals”.

That was confirmed by a former health Minister, the hon. Member for Wimbledon (Stephen Hammond), during his visit to the hospital in May. However, nearly a year on, we still have not seen the major investment for which we have been collectively calling.

Does the Minister not recognise that the financially strategic way forward for both the taxpayer and the Government would be to grant the Princess Alexandra the capital funding that would enable it to commence its plans for a brand-new health campus? The trust’s board has worked incredibly hard to start planning for “a preferred way forward” that would provide the best value for money for the taxpayer. The final hurdle is the £400 million of capital funding, which would save money in the long run.

This scheme would have extraordinary benefits for our town and release land for more than 400 homes. We cannot sit by and let the building continue to deteriorate, pouring taxpayers’ money needlessly down the drain. We need drastic action. We need a new health campus for Harlow that is fit for the 21st century and will last for many years to come. We need it for Harlow, and we need it for the wider population of Essex and Hertfordshire.

I congratulate my right hon. Friend the Member for Harlow (Robert Halfon) on securing this important debate. It is the first debate to which I have been able to respond in my new role. I know that my right hon. Friend campaigns tirelessly on matters of healthcare in Essex and, in particular, on the issue of funding for the Princess Alexandra Hospital NHS Trust. I also know that he met my predecessor to discuss issues, including the hospital’s workforce and the services provided by the trust. This is the fifth debate that he has initiated on this issue, which may be a record in the House of Commons. We in the Department, and my officials who are sitting in the Box tonight, are fully aware of the concerns that he has raised. Let me explain why we continue to take them seriously and want to continue to work with him.

Both my right hon. Friend the Secretary of State for Health and Social Care and my predecessor, my hon. Friend the Member for Wimbledon (Stephen Hammond), have visited the trust over the past few months and seen at first hand the excellent work that is being done by NHS staff despite the challenges faced by the estate, which my right hon. Friend has described. I should be delighted if he welcomed a visit from me so I could see the estate and thank the staff for the excellent work that they have done in improving the hospital. My right hon. Friend described in his eloquent speech the commitment that the staff have given to the hospital, across the board, and I should be delighted to see that at first hand.

As my right hon. Friend knows, the Government have already made significant funding available for health capital investment, recognising that the NHS faces the challenges posed by poor infrastructure and ageing estates. Between 2016-17 and 2018-19, we increased capital funding by £1.3 billion, an increase of about 30%. As my right hon. Friend said, we have also announced a £1 billion funding boost for the NHS, along with 20 new hospital upgrades to help staff to deliver the best possible health services in their buildings. I have had the pleasure of touring some of these potential new upgrades, including in Luton and Dunstable, which is relatively near my right hon. Friend’s patch, with a £99 million project, and Heartlands hospital in Birmingham, Barking, Stoke, Staffordshire and Croydon, to recognise that we do need to see upgrades—not just these 20 upgrades, but future additional upgrades.

My right hon. Friend the Secretary of State for Health and Social Care is committed to ensuring we make future investments in capital for the NHS. He recently set out that we will establish a new health infrastructure plan. This will be brought forward to deliver strategic major hospital rebuilding programmes, providing the necessary health infrastructure across the country. The shape of this will be confirmed in due course. I am not able to give specific details, but it will be similar to the road investment strategy process at the Department for Transport, with further long-term capital funding that we are discussing with our Treasury colleagues.

Delivering capital investment is a complex process and it takes time. I fully understand that my right hon. Friend has been very patient about the Princess Alexandra hospital, but this does need to be done thoroughly and professionally, alongside delivering the everyday healthcare services. There is a necessary process of assurance to ensure that services are transformed for the benefit of patients. This process is led by the trust, and includes a number of business case checkpoints and involves procurement, design, delivery and capability. Funding is provided when the full business case has been approved.

The 20 hospital upgrades announced in August were for hospitals that had just missed out on the sustainable transformation programme bid in December 2018, so were able to be progressed having followed the process.

I take the point raised on population growth. That is important in assessing future bids; they must be based on future patient demand, just as clinical commissioning group allocations are currently adjusted to population to take account of growth and movement. I take the point that the areas outside London in the home counties have increased population and population movement, and we are therefore constantly in a state of catch-up in local healthcare services.

I know that my right hon. Friend has also raised proposals to build a new hospital in Harlow with the Chancellor of the Exchequer; I know that because I saw a picture on his Twitter feed, and I am sure he will have listened closely to proposals to fund a new health campus in Harlow.

On 5 August the Government announced a £1.8 billion increase to NHS capital spending, on top of the additional £3.9 billion announced in the 2017 spring and autumn budgets. Some £1 billion of this increase will ensure existing upgrade programmes can proceed by tackling the most urgent projects, and £850 million of the funding will allow 20 new hospital upgrades. I am sure my right hon. Friend will welcome that Luton and Dunstable near his constituency will benefit from this. However, I know he will be understandably disappointed that the new health campus in Harlow scheme was not included on that list. However, the scheme has the support of the Secretary of State for Health and other Ministers, and I understand that the scheme is well developed. NHS Improvement and NHS England will continue to work with the trust to develop its options to tackle the challenges it faces and secure the best outcomes for patients.

In the wider Essex area, there have been several successful bids in the sustainability and transformation partnership tranche 4, which includes £4.2 million awarded to Luton and Dunstable renal dialysis unit relocation, £7.1 million awarded to the Hertfordshire and west Essex vascular surgery network, £11 million to the West Hertfordshire Hospitals NHS Trust emergency care transformation and in Suffolk and north-east Essex £18 million awarded to the East of England Ambulance Service NHS Trust for infrastructure and capacity transformation.

I am sure that my right hon. Friend will agree that this affirms the Government’s commitment to ensuring the region receives its share of NHS funding. We expect there to be further opportunities to access capital in future years, with the decision on what this looks like to be decided in due course. I am sure the Chancellor of the Exchequer and the Chief Secretary to the Treasury will continue to listen to my right hon. Friend’s appeals on this issue, and I will be happy to make representations on his behalf.

Earlier today, the Chancellor reaffirmed the Government’s commitment to a £33.9 billion cash-terms increase in the NHS budget by 2023-24. This includes a £6.2 billion increase in NHS funding next year. This historic NHS settlement provides the largest cash increase in public services since the second world war. There is not time to go into the specific details of how this will be spent, but I would urge everyone, as part of their bedtime reading, to turn to page 9 of the Blue Book of spending round 2019 to see how some of that money is being spent. I am delighted that it will also include a £250 million funding boost for Health Education England next year, which is equivalent to 3.4% real-terms growth.[Official Report, 5 September 2019, Vol. 664, c. 3MC.] This will allow staff at the Princess Alexandra Hospital, particularly nurses, midwives and allied health professionals, to access a personal training budget of £1,000 for every member of staff of those professions. Staff at the hospital will be able to benefit from some of the announcements that have been made today.

As a former Universities Minister, I pay tribute to my right hon. Friend’s work as Chairman of the Education Committee and to his statement about the importance of research in relation to the campus and the health hub. We recognise that, when it comes to training, there needs to be an holistic approach to funding. Yes, capital is important, but we must ensure that the individuals working in those new buildings feel that they have a place within their local NHS and that they want to stay there and continue to work there. That is why some of the announcements today on education and training are absolutely vital, and I am sure my right hon. Friend shares that commitment. Looking at some of the money that has been announced today, we also see that £250 million is to be invested in ground-breaking new AI technologies to help to solve some of healthcare’s toughest challenges.

When we look at the Princess Alexandra Hospital NHS Trust, we must also look at the Harlow science hub campus programme, which is incredibly exciting. I remember it being announced in the 2016 Budget, when I was the former Chancellor’s Parliamentary Private Secretary. There was enormous excitement, and I would like to commend my right hon. Friend for his tireless campaigning relating to the public health campus, which would not have happened if it was not for him making the case in the first place and going to the former Chancellor and securing the funding. It will be the largest centre of its kind in Europe, providing a new national centre for applied and public health science, as well as the headquarters of Public Health England. I know that this is still on schedule with the demolition work already under way, as is the preparation for the construction work, which starts early next year.

I know that Public Health England and the chief executive of the Princess Alexandra Hospital NHS Trust have been in discussions over the last 12 months about what opportunities can arise as a result of the move to Harlow, and I hope to hear more about this soon. Indeed, I will be delighted to come up to Harlow as part of the visit to the hospital trust and to look at how we can explore developing the wider benefits that the scheme may have.

I thank my hon. Friend very much for what he has said and for his commitment to visit the Princess Alexandra Hospital. Just to be clear, will he confirm that there will be a capital fund from the Treasury for significant capital funding programmes for significant hospital upgrades and that the Princess Alexandra Hospital is very much on that list?

This was announced today as part of the spending round document. Paragraph 2.4 states:

The Department for Health and Social Care will receive a new multi-year capital settlement at the next capital review. This will look to deliver a smarter, more strategic long-term approach to the country’s health infrastructure, with investment focused on local areas where the need is greatest. The plan will include capital to build new hospitals”.

I want to reassure my right hon. Friend that when it comes to the Princess Alexandra Hospital, it is under serious consideration in relation to ensuring that that refurbishment will be able to take place for the future.

Question put and agreed to.

House adjourned.