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National Health Service Infrastructure

Volume 801: debated on Thursday 9 January 2020


Asked by

To ask Her Majesty’s Government what assessment they have made of the consequences for patient safety of the backlog of maintenance and repairs to National Health Service infrastructure.

My Lords, the Government recognise that the quality of infrastructure, including backlog of maintenance, can pose challenges to the efficiency, safety and quality of NHS services. That is why we have launched the Health Infrastructure Plan, which includes the biggest hospital building programme in a generation. This substantial investment will support many of the hospitals facing the biggest challenges from their estates.

I thank the Minister for her Answer. NHS Providers says that the cost of the backlog is now £6.5 billion, and last year 15,844 patient incidents and 4,810 clinical incidents were caused by estate and infrastructure failure, and there were 1,500 fires in which 34 people were injured. The backlog includes wet walls in wards preventing babies’ incubators being plugged in. This is extremely serious. Will the Government provide the necessary funding to catch up—I am not sure that it is available yet? What is the timescale for catching up with the backlog—not building necessarily the 40, or six or however many, new hospitals that have been tendered?

The department acknowledges that parts of the NHS estate do not meet the demands of a modern health service and that there is unmet need for capital within the NHS. That is why we announced £2.1 billion of capital for health infrastructure in August and a further £2.8 billion injection in September. This is to ensure that staff are safe to deliver the world-leading health service that they should in a modern, efficient environment. We are also going further by reforming the capital regime to establish a clearer set of capital controls and the right incentives for organisations in respect of their infrastructure. The Chancellor has also confirmed that DHSC will receive a new multi-year capital settlement in the next capital review. Backlog of maintenance across the government estate will be a key theme of the spending review.

My Lords, I declare my interests in relation to emergency medicine. Will the Government undertake to look specifically at the problem for emergency departments, given that many of them do not have enough cubicle space for the number of ambulances that arrive and the number of patients who are blue-lighted in? Staff do not have enough space to take a short break from the front line of some of the most harrowing cases that they have to deal with.

The noble Baroness is very expert in this area, and she is absolutely right that the NHS estate must prioritise areas of most need. This is why we have put in a serious amount of investment. NHS Improvement is also conducting a backlog review to understand where the areas of greatest need are and to assist NHS trusts in prioritising capital spending over the next few months and years.

My Lords, equipment such as CAT scanners also comes from this source of income. Many are now not operating properly or are out of action awaiting repair. How many days of treatment are lost each year as a result of this?

Data on the proportion of capital equipment that is out of action or on days lost is not currently collected and the responsibility for that is with local NHS organisations, but the Government have recently supported investment in new diagnostics. As outlined in our Health Infrastructure Plan, we have invested £200 million to deliver new state-of-the-art diagnostic machines, such as MRI machines, CT scanners and breast-scanning equipment, to 78 trusts. We recognise that we need to improve the number of scanners that are younger than the “golden rule” of 10 years old.

My Lords, I welcome the Government scrapping car parking charges, which will support people who are caring. I also welcome the new money that will be put into the infrastructure project, which is vital, as the noble Baroness, Lady Thornton, has pointed out. Can my noble friend say, however, whether AI and new technology will be used, and whether funding will be put in place to help carers and people living in their home?

I thank my noble friend for her question. She is absolutely right that we want to prevent people from going into hospital in the first place. We have made a £200 million investment in the AI lab to reduce the burden on doctors in the first place and to make use of the benefits of AI in diagnostics. A number of centres up and down the country are trialling this to reduce the burden on clinicians so that they can become more human and work on their caring responsibilities. We are also trialling a dementia care test bed, so that there is support for carers and so that people with dementia can remain in their own home. This is going on in Surrey and has been hugely successful; it is a very exciting development.

My Lords, given that the NHS is seeking to shift to being a more community and primary care-based organisation, can the Minister say more about what investment is going into community and primary care in capital terms?

We have been looking at providing additional funding and support to councils to meet the rising demands and to continue to stabilise the social care system. We announced access to an additional £1.5 billion of funding for adults and social care, and we will be considering this further in the spending review.

My Lords, the noble Baroness will be aware that there was a spike in the incidence of flu just before Christmas; I do not know whether it has diminished, but it certainly was quite high. As a consequence, a number of people who perhaps would have much preferred not to go to hospital were forced to do so. She might like to know that, in one London hospital to which one of my family was obliged to go, the queue for A&E was out into the street. Many of those people were ill and should not have been outside in the cold. The reason for it was partly to do with availability of staff but more to do with the availability of chairs. Does she understand that hospitals need capacity beyond what their expectation might be of how many people will turn up, precisely to cope when there is a spike of this kind?

The noble Baroness is right that there has been a significant increase in demand over recent years. That is partly why we have secured the significant funding increase from the Treasury of £33.9 billion, which we will be enshrining in law for the first time to give certainty to hospitals. It is why we are increasing the capital investment, which will address some of the challenges that she has raised, and it is also why we have run a vigorous flu vaccination programme to prevent people from getting into that problem in the first place. We recognise that we need to reduce the demand from those going into A&E unnecessarily and to support those very hard-working staff who were in those situations over Christmas and the new year. We thank them for their hard work over that period.