Much of England’s 1500-strong hospital estate is old and deteriorating. Dozens of hospitals, in fact, are so old it’s not worth renovating them.
After years of underinvestment, these buildings may experience problems like flooding, leaks, electrical issues and equipment failure. A handful of the most serious cases are at risk of collapse.
These problems send maintenance costs spiralling and interrupt patient care: a major bottleneck on efforts to reduce waiting lists that have risen dramatically over the pandemic.
In 2020, then-prime minister Boris Johnson pledged to build 40 new hospitals by the end of the decade in an effort to modernise the country’s facilities.
But delays and meandering over what counts as a “new hospital” mean the programme looks somewhat different to those initial promises.
And, as a new report from watchdog the National Audit Office, that headline “40 hospitals” target is now very likely to be missed altogether. This is despite the fact that the programme has since been expanded to include more building projects, including several hospitals constructed from a type of concrete that is now at risk of failing altogether.
The agency predicts the government will manage to build 32 new hospitals by 2030, with the bulk of construction taking place in the latter half of the decade.
This in itself is a concern for auditors, who say it may be hard to find enough builders for the consecutive projects, pushing up costs.
The agency warned against grouping major rebuilds together again in future programmes.
Gareth Davies, who leads the NAO, said in a statement: “The programme has innovative plans to standardise hospital construction, delivering efficiencies and quality improvements. However, by the definition the government used in 2020 it will now deliver 32 rather than 40 new hospitals by 2030.”
Part of the reason behind the slow delivery of these hospitals, he said, has been the development of a standardised hospital-building template called “Hospital 2.0”, which policymakers hope will enable quicker builds and better value for money.
But the report authors warn these efforts to save costs could result in hospitals that are too small to meet the growing demands of an ageing population.
Nigel Edwards, who heads up health policy think tank, Nuffield Trust, said in a statement that the government had started with “a big and quite vague promise” which has been “confusing” from the start.
“While there has been a substantial amount of rebuilding and development, many of the projects are not entirely new hospitals on new sites,” he said. “It is extremely unlikely that ministers will meet their target of completing the programme by 2030, and the NAO report adds even more doubt, especially given how slowly this ailing programme has been progressing so far.”
Edwards expressed regret funding had not come earlier, describing the last ten years as a “lost decade of investment” in England’s hospital buildings.
“If the money being committed now had been invested a decade ago there is no doubt that the National Health Service would be in a far better position,” he said. “Letting hospital buildings languish for this long has meant that the high priority critical list for repairs has ballooned.”
Rather than being able to decide which areas of investment would provide the best care for patients in the long term, he added, “We’re in a position of needing to spend money on whichever hospital is most dangerous or most likely to fall apart.”
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