So, how are those 40 new hospitals getting on, Mr Johnson?

Amid so much frenetic recent political activity – the King’s Speech, a reshuffle, the Autumn Statement, the Rwanda vote – it would have been easy to miss our sovereign Parliament doing its essential day-to-day work, holding Ministerial feet to the fire and posing tough questions about how they spend our taxes.

Back in October 2020, Prime Minister Johnson determined that the Covid doldrums called for some Boris boosterism. “PM confirms £3.7 billion for 40 hospitals in biggest hospital building programme in a generation” trumpeted the Government press release. This restated a key pledge from the 2019 Conservative election manifesto, in fact going beyond it by promising that 48 hospitals could be completed by 2030. It was intended to be a landmark programme, addressing the crumbling state of many National Health Service facilities.

With significantly less fanfare, the stalwart and diligent members of the influential House of Commons Public Accounts Committee (PAC) have now quietly published a highly critical report on the New Hospital Programme's lack of progress, after taking extensive oral and written evidence. The report warned that the Government is highly unlikely even to construct the 32 new hospitals that it is now aiming to complete by 2030, after the commitment to build all 40 by then was abandoned in May 2023. No one is talking about 48 anymore.

“The physical edifice that is the NHS is quite literally crumbling before our eyes,” said the Committee’s respected Chair, Dame Meg Hillier MP. “There was nothing inevitable about this heartbreaking crisis. It can be laid squarely at the door of the decision to raid budgets reserved for maintenance and investment in favour of day-to-day spending. The sharp distinction between capital and revenue budgets exists for a reason. We are now seeing the consequences of this short-termism visited on patients and services.”

The PAC called for the Department for Health and Social Care (DHSC) to urgently examine how the New Hospital Programme can be made to deliver some tangible results for patients. The report also made a number of recommendations to support swifter action to tackle reinforced autoclaved aerated concrete (RAAC) in hospital buildings. By early 2023, DHSC had identified 41 NHS buildings with RAAC. If rebuilding of the seven hospitals constructed entirely of RAAC is not sped up, some hospitals may have to close before replacements are ready.

Speaking to local press, Alex White, Chief Redevelopment Officer at Watford General Hospital, said much of the groundwork for that project is complete but the government has not yet signed off on the business case before releasing funds. The people of Watford cannot yet be sure that their new hospital will definitely be built.

In another case, Frimley Park Hospital in Surrey is one of the seven hospitals most affected by the ‘RAAC’ crumbly concrete issue, with 7,000 planks making up around 65% of the structure. It has now been concluded that replacing the hospital on its current site is not a viable option and the Trust is urgently seeking a new, larger site as close as possible to the existing location, for which local authority and community support will obviously be needed, for a new hospital to be completed by the extremely challenging deadline of 2030. The Government has ordered the NHS to stop using the structurally unsound current hospital by that date.

Dame Meg Hillier added: “Quite aside from the fact that the planned new hospitals risk being too small for future purposes, funding does not even appear to be in place to construct them in time, all underpinned by failures of basic record-keeping and fresh and urgent concerns over RAAC.”

This all obviously increases the pressure on Ministers and Officials to find cost efficiencies in the programme, so there is a real and urgent opportunity for the construction industry and producers of the latest building materials and systems to present their innovative solutions to the decision makers. Members of Parliament, notably the restless inquisitors of the Public Accounts Committee, would certainly be supportive of some fresh thinking.