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New Hospital Programme

Volume 728: debated on Friday 24 February 2023

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

I begin by thanking you, Mr Deputy Speaker, and the Speaker’s Office for granting me this Adjournment debate. I give particular thanks to the Minister for responding to today’s debate. I understand that his Department is incredibly busy at the moment and is in the grip of very tough negotiations, so I appreciate his taking the time to come to the Chamber today to talk about this topic, which affects so many, not only in my constituency, but around the country.

In the 2019 Conservative and Unionist party election manifesto, one of the key pillars of our plan for the nation was to deliver 40 new hospitals by 2030. That truly remarkable investment in buildings and equipment across the NHS would ensure that our world-class healthcare system and staff have the facilities they need for the future. Later, in October 2020, the then Prime Minister levelled up the pledge, with a further eight schemes invited to bid for future funding, taking the total number to 48—the biggest hospital building programme in a generation.

There are four set cohorts within the new hospital programme, each of which includes a wide variety of schemes: in flight, early small schemes, pathfinder and full adopter. The new hospital programme has now met some major milestones: the first of the full 48 hospitals, the Northern Centre for Cancer Care, has been completed, and six further hospitals are under construction.

My hon. Friend will no doubt be speaking about his constituency, but I would like to thank the Minister for recently visiting Watford General Hospital and seeing the challenges we face and the fantastic staff we have there. Does my hon. Friend agree that making sure Watford General has the best world-class facilities is paramount, not just for the patients, who deserve it, but for the staff and the local community across the whole of west Hertfordshire?

I am grateful to my hon. Friend for that intervention. He is a fantastic champion for Watford—indeed, I see him here far too often talking about issues to do with Watford—and he has once again demonstrated why his community are lucky to have him as their local Member of Parliament.

Healthcare improvement in Carshalton and Wallington was a key pillar of my personal pledge to constituents at the last general election, which was to protect our local hospital, St Helier, and build a brand-new, state-of-the-art hospital in the borough. I am incredibly grateful and proud that as part of the new hospital programme, the Government have committed the funding to do just that: to create a purpose-built major specialist emergency care hospital in the London Borough of Sutton and to transform Epsom and St Helier hospitals, ensuring that local people can access the care that they need, from life-saving emergency care to out-patient appointments. Despite the scaremongering by Labour and the Liberal Democrats over many years, it is a Conservative Government who are delivering the biggest investment in healthcare in south-west London and the Surrey region in a generation.

When I delivered my maiden speech in this House, I made it clear that healthcare was the single greatest issue affecting my constituents and the single greatest opportunity to improve Carshalton and Wallington. It remains the greatest issue today, along with tackling the cost of living, and St Helier is one of the many recurring topics under my name in Hansard. I am grateful to the Minister and his Department for working so closely with me on the issue in recent years. I assure him that the sooner the new hospital is built and upgrades are made to St Helier, the sooner I will stop banging on about it; I give the Speaker’s Office the same assurance.

Let me set out the background. St Helier Hospital predates the NHS. It was first commissioned in 1934 and became operational in the early 1940s, during the second world war. At the time, it was considered a state-of-the-art, modern design; I believe it was the largest hospital of its type anywhere in the country. It was damaged by a bomb in an air raid less than a month after its completion, and by two flying bombs later in the war, but it remained open and operational. It showed the same resilience throughout the pandemic.

Like many people in Carshalton and Wallington, I and many members of my family were born in St Helier. I owe the hospital so much, not just for bringing me, my family and my constituents into the world, but for saving my constituents’ lives, my loved ones’ lives and, not that long ago, my own life. St Helier has served our community for generations, but we are now in desperate need of an upgrade to provide healthcare fit for the 21st century. That is why the announcement of the new hospital and the improvements at St Helier was so welcome.

There has been a lot of scaremongering about St Helier in the past, as I am sure the Minister is aware, so I want to do some fact checking. The new hospital in the London Borough of Sutton will provide major services, including accident and emergency, critical care, acute medicine, emergency surgery, in-patient paediatrics and maternity services, particularly births. The plans will also involve at least—I stress “at least”—£80 million being spent across Epsom and St Helier hospitals to deliver essential repairs and refurbishments and to enable them to focus on delivering excellent elective care. That will enable the sickest patients to get a fast diagnosis and start treatment more quickly to speed up recovery, with bigger teams of expert staff at the specialist emergency care hospital. Some 85% of patients will continue to be treated at Epsom and St Helier, and there will be urgent treatment centres across all three sites. Under the plan, the refurbished St Helier Hospital will be here to stay, providing the majority of local health services, and the sickest patients will get state-of-the-art treatment in the brand-new specialist emergency hospital in our borough.

It is important to stress that unlike previous reorganisations, including the reorganisation planned by the last Labour Government, this is not a Government-led scheme. The NHS has come up with a plan and has told the Government what is needed to improve the delivery of healthcare in south-west London and Surrey. I am pleased to say that the Government have listened and have allowed the NHS to get on with it.

The initial plan was that the new hospital would open in 2025, but for multiple reasons—the covid-19 pandemic was obviously the biggest reason, but another was the attempt by some Opposition parties to block the investment from reaching my constituency in the first place—the opening has inevitably been delayed. Although the headline news is still very positive for our area, with the Government spending hundreds of millions to improve local healthcare, the delays are causing a number of complications that need to be addressed.

As I am sure the Minister is aware—I am sure this is the case across many hospitals in the UK—Epsom and St Helier have had a particularly challenging winter, made even more difficult by the old, tired estate. Patients are being cared for in near-impossible conditions: wards are flooding, roofs are leaking and heating failures are causing cold temperatures. Epsom and St Helier University Hospitals NHS Trust has already spent vast amounts of money trying to maintain its old buildings, and its backlog of maintenance costs is awful—well over £100 million. There is also the expense of duplicating services across the two hospitals.

We are now in the position that 98% of the St Helier estate is considered to be in a poor or bad condition, so we desperately need more up-front funding so that the trust can submit a planning application and start building work on the new hospital and the renovation works at St Helier much quicker. I would appreciate the Government’s comment on that. Every day that the decision is delayed makes the maintenance bill more expensive, and that money has to come from somewhere. I know the Minister is aware of the shocking report by ITV News, which aired on Monday night, that showed the appalling state of some parts of St Helier Hospital. I walked around the estate recently with the chief executive to see that for myself.

These issues are not new—they are exactly the reason that the Government are funding the new hospital programme—but their impact only grows with each day that the new hospital project cannot get off the ground. I will not go into explicit detail, but I do not think it is too melodramatic to say that the hospital is nearing its breaking point. The trust has had to move one ward out of a 20-year-old temporary building because the foundations were sinking. Earlier in the winter, it had to vacate parts of the hospital due to flooding, and there are regularly buckets in the corridor. Last summer, to cope with the stifling weather and temperatures stubbornly above 35°C, the trust did everything it could with portable fans, but those are not sustainable conditions, and patients and staff should not have to tolerate them.

The trust does not have enough bed space to meet infection, prevention and control standards, and that was further compounded by the pandemic. Even before the pandemic, it was not uncommon for patients to be transported across the site by ambulance because the lifts are so old that they do not fit modern medical beds—they are also more likely than not to be out of order. Only a quarter of in-patient beds are in single rooms, only half of which have en suite bathrooms, and only a third of which meet the current bed spacing standards. Patients deserve a better standard of care. The trust’s new model of care, with modern healthcare facilities as part of the new hospital programme, will reduce length of stay, increase the quality of care and improve outcomes.

Duplicate services are currently being run across two sites, which means that the workforce is over-stretched. Continuing to run duplicate services for longer is making nurse and medical rotas hard to fill and clinical guidance on nursing and consultant levels hard to achieve. For example, the trust struggles to meet the consultant workforce standards to have 24/7 consultant cover on both sites. It has vacant consultant posts and gaps in the staff rota, which reduce the quality of care and create financial pressures. It has a shortage of doctors and nurses, so it must train or employ temporary staff to fill the gaps in the rota. Running duplicate services is also very expensive due to the higher cost of using temporary clinical staff to cover vacancies and gaps in staff rotas. It increases the cost of maintaining hospital buildings and reduces the opportunity to make savings.

Everyone who works at Epsom and St Helier hospitals does an absolutely fabulous job. They contribute every single day to delivering safe and effective care, despite the huge challenges with the estate. As a former NHS worker in south-west London, I want to thank them for all the amazing work they do. I know from working in the NHS previously that there was not such a thing as a quiet day in the NHS even before the pandemic, and I know the pressures they are up against at the moment. The new hospital programme and the new model of healthcare that goes along with it need to be delivered, because they will address the staffing issues. A new hospital is so much more than just new buildings.

Building the new hospital in Sutton and improving St Helier is more important than ever because of the learning from covid-19. It will allow us to increase infection prevention and control with more patient bathrooms, single rooms with en suite facilities, and beds spaced further apart; to provide more flexibility to increase critical care capability; and to continue to deliver non-emergency services and treatments at the refurbished sites.

Unfortunately, the best case scenario under the delayed timeline is that the new hospital will open in 2027 or 2028. I appreciate that that still falls within the Government’s pledge of 40 new hospitals by 2030 and, again, the overall headline message is still positive: the Government are delivering the greatest transformation of our local healthcare in almost a century. I have lived in Carshalton and Wallington for my whole life and I cannot count the number of years that we have had campaigns to save St Helier, because the future of our local hospital has been in question. Thanks to the investment that the Government have committed, we know that the hospital is here to stay, which is welcome news. We now need movement to address the issues at St Helier and to get on and build the second hospital.

I have been working closely with people in our NHS trust since I was elected in 2019. I know that they are wholly committed to delivering on the upgrades to St Helier and to building a new hospital, and I appreciate all the work that they have done on it. I know that they would love to invite the Minister and the Secretary of State to come to St Helier Hospital to see the current situation first hand.

I will briefly outline where the business case is at the moment, because that is where there is delay. We need to get the business case for the new hospital and the upgrades signed off as a priority to ensure that the necessary funding is allocated to get the ball rolling on the planning application and to start work on some of the vital issues at St Helier. I appreciate that other projects across the country, as part of the new hospital programme, are also in need of expediting—not to mention the trusts that are having to work around old concrete structures, the severe state of which I do not believe the Department of Health and Social Care could have imagined prior to the programme’s launch.

I understand that more than £20 million has already been spent in Sutton alone, but I say again that with every day that goes by, the costs will only rise. It is in the Treasury’s best interest to ensure that we expedite this project and allow the trust to get on with doing what it knows it wants to do—refurbishing St Helier and building a new hospital in Sutton.

Ultimately, however, the priority must be patient safety and patient outcomes. For NHS trusts such as Epsom and St Helier where we are seeing unexpected delays to new hospitals, there needs to be greater consideration of how we can mitigate the impact on patients. I would appreciate it if the Minister elaborated on what steps the Department is taking to ensure that St Helier and other older hospitals being improved as part of the programme are receiving the support that they need to operate safely until the new hospitals are open—and, indeed, beyond.

I appreciate and agree that the new hospital programme is an extraordinary initiative and undertaking by the Government to improve the healthcare that we receive. It is absolutely right that the programme exists and I am incredibly proud of it. I am also incredibly proud that Carshalton and Wallington patients will be some of the first to benefit from having a new state-of-the-art hospital working inside our much-loved local St Helier Hospital, which is now safe for the future. It will provide all the services that the trust currently provides and more, and it will work in partnership with other hospitals such as the Royal Marsden Hospital so that, for example, cancer patients in Carshalton and Wallington no longer have to travel to the Chelsea site but can access cancer surgery in my constituency.

The fact that we are falling short with timelines, however, is causing unexpected problems and is having an impact on patient safety. I hope that the Minister can reassure residents in Carshalton and Wallington that the new hospital is on the way, that steps are being taken to tackle the maintenance issues at St Helier, and that patients can expect to continue to have world-class healthcare on their doorstep for many years to come.

I congratulate my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) on securing the debate. He campaigns tirelessly for his constituents, and I know he recently met Lord Markham to discuss plans for the new hospital scheme. Although responsibility for this area sits with our Minister in the Lords, I am happy to respond to some of the points he has raised today.

We are working closely with Epsom and St Helier University Hospitals NHS Trust on its plans for a new specialist emergency care hospital in Sutton, with general acute services to remain at the current Epsom and St Helier hospitals. All schemes within the programme have been grouped into cohorts on the basis of readiness to progress and the extent to which the schemes can realise the benefits of the national programme approach.

Epsom and St Helier is a cohort 3 pathfinder scheme, as my hon. Friend said. This means it will be one of the first of the larger and more complex schemes to be taken forward, in line with the national programme approach. The trust is currently at outline business case stage, and we are working closely with it to incorporate the national standardised approach.

We have always been clear that, after entering the new hospital programme in 2020, any planned timescales for delivery will change to align with the national programme approach. As my hon. Friend said, the trust has received £20.5 million in public dividends to date to progress its scheme. This includes fees for design work and a contribution towards the cost of a new electronic patient record system. Further allocations for the scheme, including the total individual allocation, will be decided through the proper business case process. This will ensure deliverability, alignment with the national programme standards and, of course, value for money.

The programme has developed an integrated systems approach known as “hospital 2.0”, which spans the whole hospital lifecycle from business case and design through to construction, commissioning and handover. Hospital 2.0 is the vehicle through which the national programme approach can ensure we get the maximum value for taxpayers’ money and deliver more efficient designs. Our hospital 2.0 process will drive efficiencies by up to 25% compared with traditional methods of delivering infrastructure.

Lord Markham recently visited the manufacturing technology centre in Coventry, where he saw at first hand how this work is advancing. This includes prototypes of the standardised hospital rooms that will be part of the designs for the new hospital scheme. The Department is planning a range of events, communication pieces and milestone moments to show the progress being made on delivering these new hospitals. This will, of course, include a parliamentary event in the coming weeks to demonstrate what these new hospitals will look like, including standardised rooms, as well as roadshows at each of the new hospital locations. I hope my hon. Friend will be able to attend.

Lord Markham, our Lords Minister, has also agreed to visit the hospital when his diary allows—I can certainly agree to that request—to see at first hand how the new hospital scheme will benefit the staff and patients of Epsom and St Helier University Hospitals NHS Trust.

My hon. Friend asked about maintenance, and we certainly recognise that backlog maintenance can pose challenges to the efficiency, safety and quality of NHS services. Although individual NHS organisations are legally responsible for maintaining their estates, the Government have been clear that they expect NHS organisations to use existing capital budgets and assets to maximum effect. I am pleased to see that the level of backlog maintenance in the trust has decreased every year since 2016-17.

At the spending review we backed the NHS with substantial operational capital investment for trusts to prioritise and deliver locally to maintain and refurbish their premises. The Government are investing record sums to upgrade and modernise NHS buildings so that staff have the facilities needed to provide world-class care for patients, including £4.2 billion this year and £8.4 billion over the next two years.

While this major scheme got under way over the 2020-21 and 2021-22 period, we supported Epsom and St Helier University Hospitals NHS Trust with other capital investment, including £6.1 million to expand the emergency department and the same-day emergency care unit at St Helier Hospital, and to extend waiting room space and mental health cubicles at Epsom Hospital. We have invested £11.6 million to eradicate backlog maintenance across the trust’s estate.

The new hospital programme has been undertaking ambitious work. Two hospitals, the Northern Centre for Cancer Care and the Royal Liverpool Hospital, are now open to patients. Five schemes are in construction, with one due to complete shortly, and 22 schemes have received either full or outline permission, which is a vital step on the road to delivery. This programme will deliver facilities that are at the cutting edge of modern technology and will engage with clinical staff to ensure that we are providing them with a better working environment, enabling increased efficiency, promoting staff wellbeing and, importantly, improving staff retention.

Again, I thank my hon. Friend for his continued engagement on the new hospital scheme. I appreciate and recognise how tirelessly he campaigns for his constituents, and I assure him that we are committed to the delivery of a new hospital for Epsom and St Helier University Hospitals NHS Trust.

Question put and agreed to.

House adjourned.