When The Lowdown first started in early 2019, the backlog maintenance bill for England’s NHS was estimated at £6 billion. By 2021, it had risen to £9 billion. In 2022, it reached £10.2bn.
But with the Tory government’s infamous policy of ‘austerity’ in full swing and restricting capital spending in the NHS up to the July election, and little had changed since, it is no surprise that the most recent figures show the total backlog has now rocketed to £13.8bn.
43 of the 215 trusts in England now have backlog bills of £100m or more, adding up to almost £8.6bn – 62% of the total backlog held by just 20% of trusts.
Thirteen trusts face backlogs of over £200m, six top £300m and four are over £400m – with the largest three being Imperial Healthcare, which includes the crumbling St Mary’s and Charing Cross (£814m), Guy’s and St Thomas’s (£504m) and Barts Health – including Newham Hospital and Whipps Cross (£464m).
It’s important to note that these are the estimates for overdue work to repair crumbling buildings and replace clapped out equipment – but not to completely rebuild or replace buildings, even when they are riddled with the problem RAAC concrete: those costs would be even higher.
The South East has the largest number of £100m-plus backlog trusts (10), followed by London (9). The East of England, North East, and Yorkshire both have 7, the Midlands have 5, the North West has 3, and the South West has 2.
A striking new addition to the £100m Backlog Club are two mental health trusts (South London & Maudsley, £151m, and Essex Partnership (£102m).
While some of the figures and placings vary from year to year in the Estates Returns Information Collection (ERIC) figures, it is clear that the decline in the fabric of NHS buildings and the rise in the backlog bill can only be halted by a bold decision to invest in the NHS and restore, repair, and rebuild it as necessary rather than pump money into private sector contracts.
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