Airedale General Hospital’s perhaps surprisingly high position in the league table of backlog maintenance bills, at a massive £414m, is down to the building’s construction in the late 1960s using reinforced autoclaved aerated concrete planks (RAAC) in roofs, floors and walls, with a life expectancy of 30 years.
The planks are now likened to “a chocolate Aero bar,” riddled with bubbles that can break and allow water to seep through. 52 years after it opened there are real concerns over the safety of Airedale and fifteen other trusts, which between them have 34 buildings built using RAAC, and increasingly now at risk.
Ministers have now admitted to the scale of the problem, but avoided listing the trusts at risk, and offered only pitiful token funding to address the problems, which have in one case, Queen Elizabeth Hospital in Kings Lynn, led to the use of ever-increasing numbers of metal props to hold up the roof, and nurses deploying hundreds of buckets to catch rainwater.
In March 2021 Critical Care Unit patients at the QEH had to be evacuated so that emergency repairs could be carried out to avert dangers of a roof collapse. But its Chief Executive was branded as “sensationalist” by NHS England’s comms chiefs when she dared to speak out publicly on the threats posed to patient safety in the building.
Then 131 props were in use, but this has increased rapidly: the most recent figure is almost 2,500, more than ten times the number used a year ago. The Trust has warned that stopgap repairs and props could cost the trust a staggering £500m over the next ten years.
In her leadership campaign this summer Liz Truss promised to “put more money into the physical fabric” of the NHS, mentioning the QEH as an example that needed funding, and implying a commitment to ensure the hospital, bordering her constituency, would one of the eight new hospital schemes to be added to the ‘fake forty’. The pledge was implausible even while she was Prime Minister. But it is no more than a pipe dream now she is out and Sunak and Hunt are working together to reimpose austerity. The projected total cost of a new QEH has risen to £862m from an initial estimate of £679m.
Other hospitals facing problems with RAACs include Crewe’s Leighton Hospital (Mid Cheshire); Hinchingbrooke (North West Anglia FT); Wexham Park (Frimley Health FT); James Paget Hospital, Lowestoft; and West Suffolk Hospital (Bury St Edmunds).
West Suffolk Hospital chiefs have been so concerned over the threat that they hired a law firm to assess the risk of being charged with corporate manslaughter should any part of the hospital collapse and kill patients, staff, or visitors. Plans to evacuate patients from potentially collapsing buildings have been drawn up.
In 2019/20 the West Suffolk Trust reported a literally incredible leap in backlog maintenance costs to £741m, including £81m “high risk” and £544m “significant risk” issues at West Suffolk Hospital in Bury St Edmonds. This appeared to be at least the cost of building a new 450-bed hospital.
However the latest figures published in October 2022 show a total backlog miraculously cut back to £103m, of which just £61m is “high risk” issues in Bury. It’s possible this sharp reduction is the result of West Suffolk being included in the “Fake Forty” list of new hospital projects.
Similar unexplained changes have taken place in the reported figures from Mid Cheshire Hospitals, where the most recent data shows problems have worsened again, especially the major structural problems at Leighton Hospital. In 2019/20 this was rated as a ‘significant risk’, with an estimated cost of £311m to remedy: but this figure has subsequently been reduced – possibly also as a result of the Trust separately seeking funding for a new hospital.
However the chances of even the worst-hit hospitals getting the funding they need for new buildings are remote to say the least. While West Suffolk hospital bosses have remained tight-lipped on the likely cost of the plans they have submitted, it seems likely to involve a similar cost to the £679m QEH rebuild. Plans for a new Leighton Hospital are also in the same ball-park, at an estimated £663m.
Meanwhile both Frimley and the ‘Act as One’ health and care partnership that covers Bradford District and Craven (and thus Airedale) have gone for broke, proposing plans for new hospitals to replace the collapsing ones – but only as part of much bigger schemes, adding up to £1.26 billion in Frimley and a staggering £1.7 billion in Airedale. The total for these five schemes alone was close to £5 billion even before the latest spike in cost inflation.
Much more limited sums have been offered by a cagey Department of Health and Social Care, which has been allocated just £4 billion to cover the whole of the ‘fake forty’ list, and as yet given no more to cover the additional eight schemes, for which the winning bids have not so far even been selected.
The HSJ revealed there were no less than 128 bids submitted to be one of the additional eight new hospitals: whether any of them get anything like the cash they have requested to implement the plans they have spent time and money drawing up is anyone’s guess, as the purse strings are tightened across the public sector and a new government team feels even less committed to implementing Johnson’s empty 2019 promises.
In 2020 DHSC spokesperson insisted “We have … set aside over £685 million to directly address issues relating to the use of RAAC in the NHS estate.” That’s not even enough to build one of the replacement hospitals that are needed, but the way things are going that’s all they will get between them over four years. It won’t even be enough to keep the QEH supplied with props.
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