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Reinforced Autoclaved Aerated Concrete: Hospitals

Volume 832: debated on Wednesday 13 September 2023

Question

Asked by

To ask His Majesty’s Government what steps they will take to support NHS trusts with the cost of ensuring hospital sites are safe until reinforced autoclaved aerated concrete can be removed.

The NHS has had a mitigation plan in place since 2021 for hospital buildings with confirmed RAAC. That is backed by significant additional funding of £698 million for trusts to put in place necessary remediation and fail-safe measures. Additionally, in May, we announced that the seven most affected NHS hospitals will be replaced by 2030 through the new hospital programme.

I thank the Minister for his Answer. The NHS Confederation and NHS Providers both point out that they welcome the new hospital programme. However, the issue with RAAC is part of a much bigger maintenance backlog. Some hospitals that are not the most critical will have to wait up to 12 years for the concrete to be removed. Given that timeline and the risk highlighted in recent days, will the Government consider accelerating the new hospital programme?

First, we are doing everything we possibly can to make sure that the programme is accelerated as quickly as possible for good-safety reasons and for clinical reasons as well. In terms of the other hospitals, it is a case of making sure every step of the way that we have structural engineers and we take every safety measure. I managed to visit a lot of these hospitals over the summer and saw first hand the expert work they are doing there.

My Lords, to give credit where it is due, the DHSC has produced a very good fact sheet on RAAC in the NHS. I draw the Minister’s attention to the last line of it—the place where the bad news is usually buried. It says:

“Privately owned primary care estate is not part of the national programme. NHSE has issued RAAC guidance to private landlords who hold the responsibility for surveying and maintaining their own property”.

That reads a bit like “not our problem”. Can the Minister assure the House that the department will ensure that those smaller primary care settings get surveys done quickly? How will the department be staying on top of that?

We have given guidance and are making sure that everyone understands exactly what they should be doing across the estate, whether we are the landlord or not. Clearly, there is a difference where we are the landlord because then it is our responsibility to do it. The prime example of this is that in the NHS Property Services GP estate—which is quite extensive—we are dealing with three RAAC GP surgeries. Where they are owned by other landlords, we need to make sure that they are on top of it and do the work without taking responsibility for it ourselves.

My Lords, the noble Lord mentioned 40 new hospitals by 2030, but he will be aware of the NAO report in July which made it clear that the original 40 target will not be met because of the substitution of the eight RAAC hospitals. Can the Minister tell us what is going to happen to the eight hospitals that were in the original programme and have now been delayed?

I hope and trust that most of us would think that it was sensible to prioritise the RAAC hospitals. That meant that we had to move some others to the right-hand side of the budget envelope, so to speak. It is not publicised very much, but we now have an agreement with the Treasury to move to five-year capital cycles, like the Department for Transport, which I think is a real positive because we need long-term planning cycles. We are busy developing a 2030-35 programme now, which those hospitals that the noble Lord mentioned will be placed in.

My Lords, I want to follow on from the question from the noble Lord, Lord Hunt. My local hospital, Watford General Hospital, has been top of the rebuild list for 20 years. The town was delighted with the news on 23 May that it would be part of that group and is not part of the eight. Last week, the council was informed that there is still no confirmation of when funding will be approved by the Treasury. The town knows that it will run out of the chance to rebuild Watford General by 2030 unless that funding is confirmed very soon. Can the Minister say when it will be confirmed?

In every hospital—and Watford was one of the first ones I visited—there is a programme on which the draw-down of the funding depends; there is already a new car park there, for instance. I can assure the noble Baroness that the plans are in place to make sure that the draw-down is in time. I have also said on all the hospitals I have visited over the summer—I have seen about 20 or so—that I have a quarterback role where I have to project manage across them all and, where there are issues, they can approach me directly. I will raise today’s question with the Treasury and make sure that Watford is well in order.

My Lords, as the Minister said in answer to an earlier question, the Government will replace only seven of the 27 NHS sites confirmed to have RAAC in their construction, while the other 20 are set to be monitored and mitigated until it can be removed. How long will it take to complete the removal on these 20 sites? What assessment has been made of the risk to patients?

Three of those have already had the RAAC eliminated from them. The remaining ones are part of the programme and the commitment to have their RAAC eradicated by 2035, but in the meantime the remedial measures are there and that is what the £698 million is all about. I visited them first hand to see the work, and all credit to the team—they have become real experts on the subject. At every hospital I visited, you could see that the team were right on their game and understood very well what work they needed to do there, always using expert advice from the Institution of Structural Engineers and others.

My Lords, do the details that my noble friend gave in answer to the noble Lord, Lord Hunt, represent the current position in implementing the clear commitments given by Mr Johnson in the 2019 manifesto, which I do not think have advanced quite as swiftly as had been hoped?

The commitment to 40 hospitals is absolutely there, but, as noble Lords have mentioned, we have prioritised the seven RAAC ones—in fact five of those were new, while two were already in the programme—which clearly have to be done by 2030. So, just as we moved those in, we moved the others into the cycle of 2030-35, but we will still be delivering 40 hospitals by 2030, albeit, because of the RAAC hospitals, of a slightly different complexion.