There will be £1.5bn extra this year for NHS building and maintenance projects, according to Boris Johnson, in his speech in Dudley on 29 June, outlining measures to help the UK through the economic shock of the coronavirus pandemic. The £1.5bn is part of the “£5bn of capital investment projects, supporting jobs and the economic recovery”.

On closer inspection, most of the promises in the speech – on houses, schools and roads – have turned out to be money or schemes that have already been announced in the March budget.

The £1.5 bn for the NHS will be added on to the Capital budget and will be used “hospital maintenance, eradicating mental health dormitories, enabling hospital building, and improving A&E capacity.” according to the government statement.

New money?

In the case of the NHS, the £1.5 bn is new money on top of the planned capital spending for the Department of Health and Social Care for 2020-21 increasing it from £8.2bn to £9.7bn this year, but it’s impact will be very limited indeed.

The government’s own figures give the cost to eradicate the current backlog in maintenance of NHS premises as £6.5 billion. This figure does not include planned maintenance work, rather, it is work that should already have taken place. Then add on to this the costs of converting NHS premises to reduce the risk of coronavirus infection, and it is clear the £1.5bn falls well short of what is needed.

New hospitals?

Then, there is also the issue of the 40 ‘new hospitals’, promised back in September 2019 and a major feature of the 2019 election, and when questioned Johnson said they had not been forgotten: “Matt Hancock is setting out the list in the next few days, and that is just the beginning.”

What has also not been forgotten is that the 40 ‘new hospitals’ turned out to be £2.7 billion to fund just SIX new or refurbished hospital projects. Although, £100 million is also provided as “seed funding” for 21 trusts to draw up plans for another 34 hospital projects – which will potentially cost another £10 billion or more – after 2025.

Back in November 2019, The Lowdown reported that none of the six new hospitals that have been given the “immediate” go-ahead is actually near ready to start work.

Community beds?

Finally, another call on the £1.5 bn could be the creation of hundreds of new community beds. On the day of Johnson’s Dudley speech, the HSJ reported on possible plans to increase the number of community-based rehabilitation beds for patients recovering from coronavirus and respiratory illnesses across England. This would see regions competing with each other for money from the capital budget, according to the HSJ report.

The NHS in the North West of England has been asked to increase the number of community-based beds by 900, according to the HSJ, which would alone cost tens of millions of pounds to deliver.

Steep challenge

Capital spending has slipped back year on year: according to the Health Foundation the capital budget for hospital infrastructure has fallen in real terms over the last eight years, with NHS trusts in England seeing a 21% reduction in capital funding. NHS trusts have also been forced to raid the capital budget for day-to-day running expenses. 

One-off pots of money are always welcome, but what NHS leaders want is a multi-year capital budget that allows them to plan into the future. 

Saffron Cordery, deputy chief executive of NHS Providers, which represents NHS trusts:

“What trust leaders need is a multi-year capital budget, bringing expenditure into line with comparable economies, that allows them to plan for the future. This should be part of a proper spending review process encompassing other vital and long-overlooked issues including education and training and public health.”

Anita Charlesworth, director of research and the REAL Centre (Research and Economic Analysis for the Long term) at the Health Foundation, said that the NHS needed “a clear plan for long term investment” because the funding announced by the government “will only go a short way to addressing years of underinvestment.”

Professor Donal O’Donoghue, Royal College of Physicians registrar said: “But while new pots of one-off funding are welcome, what the NHS really needs right now is a sustainable funding package to support and grow the NHS workforce.”

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