Health Infrastructure Plan — House of Lords, 2019-09-30
Topic: Health
James Bethell (Conservative, Centre-right): My Lords, I thank noble Lords for the warmth of my welcome to this initiation in the art of Statement-giving; I shall try my hardest to answer as many questions as were put. They were terrific questions I start by reiterating the point made by the noble Baroness, Lady Pinnock, which is that this is fabulously good news. An announcement of an investment such as this does not come often. It is a cause for celebration and something in which we should take pride as a country The question of new money is always important when there is a major spending announcement, so let me cut to that first of all. This is additional funding; it is not moving cups around, and it comes directly to the department’s capital budget, the CEDL, which is being increased accordingly. The vast majority of the funding will be in the form of public dividend capital, which is commonly understood as a grant, but the one caveat is that where schemes have related land disposals the proceeds from those land disposals will contribute to the scheme funding The funding for this investment is £2.8 billion; £2.7 billion is for the six schemes that I mentioned and £100 million is seed funding to assist the further 21 HIP schemes in developing their plans. That is very important money and I shall come back to it later in my response. Future funding will of course be agreed with the Treasury in due course On the number count, the noble Baronesses, Lady Thornton and Lady Pinnock, raised questions about the 40. Let me explain. Six new hospitals are getting the full go-ahead now and 21 more schemes will get the green light at the next stage of developing their plans. Some of those schemes are multi-site: therefore, there are 30 hospitals within the 21 schemes. That is why we get to a number that is over 40. Maintenance was brought up. It is critically important. We can invest all we can in the staff and the science but, if we do not have good infrastructure—clean, non-leaking hospitals with wi-fi and the latest technology—the system will not work properly. I think that the NHS acknowledges that its infrastructure has fallen behind. This investment is a recognition of that fact. There is a maintenance backlog: the Government have put in £3 billion in capital funding to fix the leaking roof. We provided an additional £1 billion in August, which will enable the NHS across the country to take forward existing plans for more investment and to address urgent capital issues in line with local priorities. The NHS’s full capital needs will be provided for as part of the DHSC’s settlement in the next capital review I thank noble Lords for bringing up mental health. Of course, some of the hospital projects have mental health dimensions to their locations. However, I confirm that the health infrastructure plan covers all types of investment, including mental health. We will invest in community and mental health facilities when the long-term capital budget is confirmed in the second round I can confirm that none of these projects will be financed using PFI. We will see a return to financing major health infrastructure projects from the government grant. This is part of a change in approach that will see a long-term plan for health infrastructure that can be fine-tuned as the years go by, informed by NHS England and interactions with stakeholders. It can be a really clear route map for how we do investment, and it can be funded reliably and without dependency by government funds, which means that there is no negotiation or third party that we have to handle in funding these hospitals I thank noble Lords for asking how the hospitals were chosen. It is a very important question. NHS England conducted a strategic assessment of hospital estates and came up with a list of priority schemes selected on the basis of age and/or where a combination of other metrics indicated a high need for investment in the estate. Based on that, a small number of schemes were identified as suitable for full funding now, given their advanced level of readiness to deliver in the near future. I emphasise that point: the number of shovel-ready plans on the conveyor belt and ready to go today is quite limited. A very limited list met the criteria. The £100 million that has been set aside to help hospitals invest in those plans is a really important part of developing the capability and resources within hospital and trust capital planning teams, so that they can put together the thoughtful and persuasive plans that mean that they will qualify for the next round. The remaining list of priority schemes was then filtered, based on a combination of criteria including the level of critical infrastructure risked in the estate and the overall check of regional breakdown, to make sure that no regions were overrepresented or underrepresented It is a concern for the Government to make sure that we have enough staff to fill these new hospitals. That is why the noble Baroness, Lady Harding, is putting together her workforce plan for the NHS, which we hope will answer the question of how we will develop the NHS workforce to man these hospitals.