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DURING the past 13 years of Conservative stewardship, there has been a disastrous increase in NHS waiting lists together with staff vacancies and public dissatisfaction.
Austerity has been associated with almost a third of a million excess deaths while research by the Royal College of Emergency Medicine indicates overcrowding in hospitals compounded by the crisis in social care may be causing a staggering 500 deaths a week.
Insufficient numbers of GPs having to battle with increased workload means that patients are finding it more difficult to get appointments and staff subjected to huge stress are simply leaving.
A report commissioned by government from the King’s Fund concluded that a “decade of neglect” by successive Conservative administrations had weakened the NHS to the point that it was unable to tackle the enormous backlog of care.
The report pinpointed David Cameron’s decision to reduce the NHS’s annual budget increases from Labour’s 3.6 per cent to an average of just 1.5 per cent as the key reason for the service’s loss of capacity.
According to the Health Foundation, investment in health care from 2010-2019 has been around £40bn less each year than comparable European countries, and capital investment has fallen an astonishing £33bn behind.
This has led in many places to crumbling buildings and outdated equipment that are simply not fit for purpose.
Given the importance the electorate attaches to the NHS, it is perhaps no surprise that government, in order to attempt to dispel any unfortunate impression that it was quietly satisfied with this picture, announced in September 2019 that 40 new hospitals would be built under the New Hospital Programme (NHP).
Initially, this meant £3.7bn to build six new projects (“pathfinders”) together with small amounts of funding to enable 20 other project plans to be developed.
Leeds Teaching Hospitals NHS Trust (LTHT) promptly announced that it would be building “two new hospitals” – a much needed and long-awaited Children’s Hospital for Yorkshire, and a wing for adult patients providing clinic rooms, imaging, day surgery, therapy and endoscopy facilities.
The 40 new hospitals were promised by 2030, the number then increasing to 48.
The Department of Health and Social Care (DHSC) sent out guidance to NHS trusts on “key media lines” to use when responding to questions about the pledge.
These included that a “new hospital” could also be a major new clinical building on an existing site or a new wing of an existing hospital, or a major refurbishment and alteration of all but the building frame or main structure – these “must always be referred to as a new hospital.”
Questions were raised about funding for projects to go ahead other than the six pathfinders - due in 2025 but none of which have yet progressed.
Land for construction on the Leeds General Infirmary estate was enclosed by glossy hoardings embellished with images of what the buildings might look like (aptly named “hospitals of the future”) together with the smiling faces of Leeds patients and family members.
Some old buildings were demolished to clear the site, and passers-by invited to “come and see your new hospitals taking place here.”
The site has remained brick strewn and derelict, although LTHT remains doggedly optimistic, with its website proclaiming on May 25, 2023: “We’re delighted by the announcement today by the Secretary of State for Health that confirms the New Hospitals Programme cohort 3 schemes, of which Leeds is one, are fully funded and will be delivered by 2030.”
In Health Secretary Steve Barclay’s speech of May 25 we were indeed back to 40 new hospitals by 2030, however, this was now to include the rebuilding of an additional five hospitals built with aerated concrete blocks and in imminent danger of collapse.
There was an admission that at least eight schemes would therefore now not be completed by 2030.
The pathfinder schemes (now in cohort 3) were to go ahead, but a standardised modular design referred to as Hospital 2.0 was to be imposed in order to reduce costs, meaning plans would need to be redrawn.
Curiously, while delays and inflation have been pushing up costs, investment in the whole NHP was stated to amount to only £20bn despite a total projected cost estimated by the Health Service Journal at £35bn.
Promises made about the New Hospitals Programme started to look very shaky from the outset. Investigations by the BBC and Full Fact revealed that of “40 new hospitals,” 22 were in fact rebuilding projects, 12 were new wings within existing hospitals, three involved rebuilding non-urgent care hospitals and only three were actually new hospitals in the commonly understood sense.
In reply to a recent Freedom of Information request, LTHT admitted there will now be only a single wing constructed (still being described as “two hospitals,” as per instructions!) and that the Outline Business Case for going ahead, despite the funding announcement, had still not been approved.
The share of the £20bn allocated to Leeds has not been made public and local Labour MPs have been denied this information.
LTHT says it knows the figure but won’t divulge it on the grounds that “its disclosure……would, or would be likely to, prejudice the commercial interests of any person, including the public authority holding it.”
To have this figure in the public domain would, however, make it more clear how much of the original plans costed at £600m some four years ago are now likely to survive intact.
There is no doubt that the management team in LTHT want new and better facilities for the people of Leeds and have been working hard to this end, while at the same time being constrained by the DHSC in terms of what they can tell the public.
Expect an announcement nearer the election, but in the meantime, the people of Leeds like those in other towns and cities will have to keep asking “where are our new hospitals?”
This raises the important question: who can we trust with our NHS?
Labour has said that it will review and assess all NHS capital projects, allowing Barclay to tell the House of Commons that it was the opposition who posed the only threat to the NHP.
Surely it is time for Labour to step up and commit to significant capital investment, a long-term plan for the NHS based on its founding principles, and a new deal for its hard-pressed workforce?
Dr John Puntis is a retired paediatric consultant at the Leeds Teaching Hospitals Trust, and is national co-chair of the Keep Our NHS Public campaign. The Trust was asked for a statement on the current situation regarding the building of the new children’s hospital and adult treatment centre.
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