Health Infrastructure Plan — House of Lords, 2019-09-30
Topic: Health
Kathryn Pinnock (Liberal Democrats, Centre to centre-left): My Lords, I am not my noble friend Lady Jolly, as you might have noticed. She is on holiday, so I have the pleasure of responding to this Statement. Clearly, any additional funding is to be welcomed in our NHS and will be a huge relief to those hospital trusts seeking to deliver world-class care in wretched buildings However, it seems the funding is inadequate compared with the desperate need. The NHS England chair, the noble Lord, Lord Prior, said that £50 billion of capital investment is required to bring the NHS estate up to scratch. In comparison, this £2.7 billion is a drop in a very large ocean. In addition, as the noble Baroness, Lady Thornton, has said, an additional £6 billion-worth of urgent repairs have been identified on the NHS estate. They too need capital funding. It is no good having political headlines when basic needs are being neglected. In that context, this seems too little and too late. Further on the funding question, we ask where the money will come from. Presumably it will be government borrowing, which will therefore have a revenue consequence. I am sure the hospital trusts want to know whether that will be passed on to them to fund, as revenue consequences from capital investment The next area that I want to explore is the apparent ending of the PFI funding approach, which has put such a burden on too many hospital trusts that have PFI payments on their bottom line. The IPPR think-tank published a report on this—earlier this month, I think—in which it said that NHS hospital trusts have been crippled by the private finance initiative and will have to make another £55 billion in payments by the time the last contracts end in 2050. Those payments relate to an initial £13 billion of private sector-funded investment in new hospitals, so the approach will cost the NHS in England a staggering £80 billion by the time all contracts come to an end. Some trusts are having to spend as much as one-sixth of their entire budget—I stress, one-sixth—on repaying debts due as a result of the PFI scheme. Can the Minister supply the evidence that has resulted in such a U-turn on how capital builds are now being funded? Presumably, the Government are changing from a PFI approach to their own funding approach. Have they decided that PFI funding is not value for money? If such a conclusion has been reached, can the Minister assure the existing PFI hospitals that additional funding support will be provided to those hard-pressed trusts Moving on to the list of those hospital trusts that are to benefit, I am obviously pleased that the six in the first phase of the scheme are there. But the question remains: how were they chosen? Where is the data to support such choices and will the Government please publish it, so that we can all be assured of the transparency of decision-making? I am absolutely sure that plenty of hospital trusts across the country are wondering why their particular hospital was not in that first six. Why are there only six in the first list? If there are so many in urgent need of renewal why are there not seven, eight or 10? If the Government are so keen on having world-class facilities, perhaps they ought to be more ambitious I move on to what I call the "maybe" list. The headline in the Statement is about, "40 hospital building projects across the country", but we have the six—so that is a reduction—and then we find that there are 21 identified somewhere. I have a little list somewhere of which they will be; I was not filled with optimism about them. What I have discovered from the list of 21 which are to have seed funding is that there are absolutely none in my own Yorkshire and the Humber area. I think there are three in the north-west but none in the north-east at all. Perhaps the Government will be able to tell me that there are no hospitals in Yorkshire and the Humber, or in the north-east, that require any seed funding to develop plans for new builds. If the Minister is struggling to answer that, perhaps I may refer him to the Huddersfield Royal Infirmary, which is in desperate need of investment. Perhaps he will be able to explain why it and other hospitals are not on this list of 21. It leads me to wonder, if that list gets us to 27, where are the other 13? I am sure that many Members around the House will be able to supply the Minister with the names of hospitals that could be added to this list We then move on to the fundamental issue of recruitment of doctors and nurses, as referred to by the Minister in the Statement, to enable the NHS to deliver the high quality of care that we want in the new buildings that are apparently to be built. We know that there are currently 40,000 vacancies for nurses in hospital trusts and 20,000 vacancies for doctors. The Statement as it was published in the Printed Paper Office refers to the, "wonderful staff … at the heart of the NHS"— we can all agree with that—and talks about "bolstering the workforce". However, there is then a phrase that the Minister omitted when reading it out. The published Statement says, "bolstering the workforce through greater international recruitment" I wonder why the Minister omitted that phrase, because, unless that is the case, we will be unable to have a sufficient number of qualified nurses and doctors in our hospitals Finally, I want to draw attention to the conclusion of the Statement, which refers to, "a long-term, strategic investment in the future of our NHS" Where is it and where is the money that goes with it? Announcing funding for six hospital trusts is not a strategic plan; some of us would probably call it an electoral bung. Where is the funding and where is the plan for a wholesale upgrade of the NHS trusts estate? If there is no funding, I have to conclude by saying that fine words butter no parsnips.