The government’s official spending watchdog is to launch an investigation into Boris Johnson’s claim that 40 new hospitals will be built by 2030, amid growing concerns in Whitehall that the promise is unaffordable and has been largely oversold to the public.
In a move that could prove hugely embarrassing to the Prime Minister, the independent National Audit Office (NAO) has decided to carry out a ‘value for money review’ of the whole scheme, which was the cornerstone of the Conservative Party manifesto for the 2019 general election.
The NAO has also made it clear that it is concerned about the way the government maintains that it will build 40 entirely new hospitals, when in reality many will just be extensions or refurbishments of existing hospitals.
In a letter to Shadow Health Secretary Wes Streeting, who had raised questions about delays and rising program costs with the NAO, his top official – Gareth Davies, the Comptroller and Auditor General – said that he was already preparing a full value for money review.
Davies also said he took note “in particular” of the “implications of the delay for rising costs in this time of high inflation and whether all projects truly meet the classification of ‘new hospitals’. “”. Davies said he would report in 2023.
The NAO’s intervention will raise further questions about honesty and standards in Johnson’s government following the long-running Partygate controversy and a string of recent sex scandals involving male Tory MPs.
On Friday, Johnson’s former deputy chief whip, Chris Pincher, was suspended from the party after being accused of sexually assaulting two men at the Carlton Club in London. It was a week after their party lost two by-elections, both sparked by sex scandals involving Tory MPs who had to resign.
Many Tories fear their party is now wary of politics, having broken promises not to raise National Insurance, scrapped the ‘triple lock’ on pension increases last year and scaled back rail plans to high speed in the north of England.
The Tories promised to deliver “40 new hospitals” in their 2019 manifesto, but it has since been revealed that many of these projects are just upgrades to existing sites.
Last year it emerged ministers had instructed trusts to give an exaggerated impression to the public of the scale of the projects by calling the refurbishments ‘new hospitals’.
A guidance document, distributed to trusts and titled New Hospital Program Communications Playbook, said a “new hospital” could be “a major new clinical building on an existing site or a new wing of an existing hospital, provided it contains a full clinical service, such as maternity or children’s wards ; or a major renovation and modification of anything except the building frame or main structure, providing a significant extension of useful life which includes major or visible modifications to the external structure”. Staff have been advised that all schemes “must always be designated as a new hospital”.
Last month the BBC reality check The scheme sent an email to each NHS trust involved in the scheme, asking which of the three categories their project fell into. Of the 34 trusts that responded, only five said they were building a completely new hospital, 12 said they were building new wings and nine said they were rebuilding existing hospital buildings.
With inflation now above 9%, the government is also increasingly concerned that even some of these extensions may prove unaffordable. Several hospitals slated for construction work, including centers in Leeds, Leicester and Manchester, are among those still waiting to hear how much work may take place and when.
Already, delays in construction projects have resulted in additional costs to the taxpayer. Leeds General Infirmary estimates the cost of developing two new buildings will be £75million higher than expected due to construction start delays and rising construction costs.
Reacting to the NAO’s decision to launch a review and report in 2023 – ahead of the next general election – Streeting said: ‘The only place these 40 new hospitals currently exist is in Boris Johnson’s imagination. The election manifesto promise now appears to be another example of the Conservatives over-promising and under-promising.
“Workforce will get value for their taxpayers money and ensure that every penny given to the NHS is spent wisely, delivering better patient care.”
Deputy Leader and Liberal Democrat Health Spokesperson Daisy Cooper said: ‘Before MPs go their separate ways for the summer, the Government must publish a clear timetable for its new hospital scheme and explain why they are not living up to their number one commitment to health.
“If they don’t deliver on their number one health promise, it will be the ultimate betrayal.”
On its own website, the government says: “Hospitals come in many shapes and sizes and each new hospital will be designed to meet the needs of the region, staff and patients, now and in the future.
Matthew Taylor, the chief executive of the NHS Confederation, recently questioned whether many projects would take off. “The government launched these landmark new builds to great fanfare, but NHS leaders are growing increasingly frustrated that the money isn’t keeping up,” he said. “The fear now is that some of these projects may never see the light of day.”