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The Minister for Health (Edward Argar)
It is a pleasure to serve under your chairmanship, Mr Hosie, and to respond to this debate, which was secured by my hon. Friend the Member for North West Norfolk (James Wild), about the quality of care and the estate at Queen Elizabeth Hospital, King’s Lynn.
As my hon. Friend has already alluded to, this is an important subject for him. It is rare that I pass him in the corridors of this place without him gently but firmly drawing me aside to raise this issue with me. I know that he does so because it matters hugely to his constituents. Indeed, as my hon. Friend the Member for Broadland (Jerome Mayhew) said, it also matters hugely to other people living in the region—the wider Norfolk area—and beyond.
My hon. Friend the Member for North West Norfolk rightly highlights the close interest that a large number of right hon. and hon. Members take in this subject. Indeed, I am conscious that even some Members in their lordships’ House take a close interest in this issue. I am grateful to my hon. Friend the Member for North Norfolk (Duncan Baker) for his words. He is absolutely right to highlight the dedication of our hon. Friend the Member for North West Norfolk to this cause. His constituents and, indeed, those represented by all hon. Members here today are lucky to have them, as they continue forcefully and firmly to argue the cause of the Queen Elizabeth Hospital, King’s Lynn.
As my hon. Friend the Member for North West Norfolk will be aware, the Government are backing our NHS with a significant capital settlement that will create a step change in the quality and efficiency of care up and down the country, including in Norfolk. We are pleased to confirm that an initial £3.7 billion has been provided over a four-year period—this spending review period—to begin making progress on delivering 48 new hospitals by 2030, with 30 of the hospitals already announced to be built outside London and the south-east. I am pleased that six of the 48 hospitals are already in construction and one has already been completed. Of course, this hospital building programme is in addition to the 70 upgrades, worth £1.7 billion, that are part of the wider programme of capital investment. Those commitments will result in outdated infrastructure being replaced by facilities for staff and patients that are at the cutting edge of modern technology, innovation and sustainability.
My hon. Friend the Member for North West Norfolk is, as always, passionate in putting the case for his local hospital to be among the next eight to be announced—I will turn to the process and timelines for that shortly. As he highlights, the Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust has been provided in recent times with significant national funding, including £5 million in 2021-22 from our targeted investment fund for the establishment of an eye care unit at the Queen Elizabeth and a modular endoscopy unit, and £2.65 million in 2020-21 for the emergency department expansion works and to address backlog maintenance across its locations. My hon. Friend advocated for both those investments.
Let me turn to a point that I know is a significant concern for my hon. Friend. We remain publicly committed to eradicating reinforced autoclaved aerated concrete from the NHS estate by 2035-36—I note my hon. Friend’s point highlighting that in his view and the view of others, that needs to happen more swiftly—and to protecting patient and staff safety in the interim period. As he said, we awarded the Queen Elizabeth £20.7 million this financial year as part of SR20 £110 million ring-fenced funding to address the most serious and immediate risks posed by reinforced autoclaved aerated concrete. In addition, further funding confirmed in the autumn Budget and spending review will allow for the continuation of this remediation work in the Queen Elizabeth Hospital and, indeed, on the wider NHS estate.
Let me turn to the next eight new hospitals. The proposal for trusts to submit an expression of interest to be one of the next eight was announced last year and, as my hon. Friend knows, his local hospital submitted its expression of interest. We have been reviewing all submissions against our robust assessment process, to identify a longlist of schemes to progress to the next phase. We will communicate with trusts in due course about the next stage of the process, and will announce the selected eight schemes later in the year.
I am conscious that my hon. Friend, his local trust and his constituents will be keen to see that progress as swiftly as possible. There is a challenge there. We want to ensure that the assessment is fair and rigorous. I am also sensitive to the upcoming purdah period for local election campaigns across the country, but I do take my hon. Friend’s point about the need for speed. I suspect that his local trust will wish to know swiftly whether it is successful or unsuccessful and, if it is successful, what it needs to do for the next stage. I hope that my hon. Friend will appreciate that I cannot comment, beyond those process points, on the specific bid that his local trust has submitted, save to say that it will receive very, very careful consideration in that process.
Let me turn to, more broadly, the quality of patient care and the points that my hon. Friend made in that respect. The CQC plays an important role, as he knows, in ensuring that NHS providers meet the standards of care expected by patients, families and carers. I recognise that the Queen Elizabeth had long struggled with financial and performance challenges, as previously identified by the CQC. The trust had previously been removed from special measures, now known as the recovery support programme, after being placed in the regime between 2013 and 2015, only for the CQC to subsequently recommend that it should fall back into those measures in 2018 when the regulator identified concerns across several core services.
Recent inspections in December 2021 and January 2022, which my hon. Friend highlighted, found significant improvements in the governance, leadership and culture of the trust. Although its overall rating was “requires improvement”, this represents a significant step forward from its previous rating of “inadequate”. I join my hon. Friend in paying tribute to the hard work and commitment of the chief executive, Caroline Shaw, the rest of the leadership of the trust and, crucially, all the staff at the Queen Elizabeth Hospital, King’s Lynn, who have clearly worked incredibly hard through even more challenging circumstances than they would usually encounter in the course of their work, and still made improvements in patient care and in the CQC rating. I pay tribute to all of them for the work they have done.
I welcome the commitment given to the CQC by the leadership to ensure that those improvements are sustainable and continue to be built on. As we would expect, the CQC will monitor the trust’s performance in order that the improvements are embedded and that further improvements in care and services are made for the benefit of patients and their families.
James Wild
I appreciate that my hon. Friend cannot get into the specifics, but can he assure me that the fact that this is the No.1 bid for the east of England will play heavily in the consideration of whether it will be on the shortlist and then chosen as one of the eight schemes?
Edward Argar
As my hon. Friend knows, each region will feed in its views about which of the schemes and bids in its area are the highest priority. Without prejudging that assessment process, I hope I can reassure him that one factor that I know he considers to be of significant importance—RAAC—will be considered. Patient safety and the safety of the buildings will be a factor in the analysis of which bids should go forward to the long list, but I do not want to go further than that at this point, however much he may charmingly seek to tempt me to do so.
Elective recovery is an area of real focus for the Department and for the whole Government, and I am aware that covid-19 has placed an unprecedented strain on routine and planned care, with waiting lists in England reaching a record high, at just over 6 million in January 2022. I understand that 19,366 of those patients are waiting for treatment at the Queen Elizabeth Hospital.
In February, the NHS published the “Delivery plan for tackling the COVID-19 backlog of elective care”, which set out a clear vision for how the NHS will recover and expand elective services over the next three years. That delivery plan commits to eradicate waits of longer than a year for elective care by March 2025. Within that, by July 2022, no one will wait longer than two years, and we will aim to eliminate waits of over 18 months by April 2023 and of over 65 weeks by March 2024.
To support elective recovery specifically, the Department plans to spend more than £8 billion from 2022-23 to 2024-25, in addition to the £2 billion elective recovery fund and £700 million targeted investment fund already made available this year to help drive up and protect elective activity. Taken together, this funding could deliver the equivalent of around 9 million more checks, scans and procedures, and will mean that the NHS in England can aim to deliver around 30% more elective activity by 2024-25 than it was delivering before the pandemic.
In highlighting the extra resources that we are putting into our NHS, it is vital to understand that this is not about the inputs; it is about the outcomes for patients and how those resources are used wisely to deliver improved patient outcomes and improved experiences for patients, with shorter waits. With regard to what is needed to achieve those outcomes, a significant part of that funding will be invested in staff, in terms of both capacity and skills.
I understand that an orthopaedic unit bid for about £18 million has been submitted by my hon. Friend’s local hospital trust. That is in the context of the £5.9 billion elective recovery funding, and the £1.5 billion from that for capacity and social hub improvements. Those bids will be carefully considered. They will need to meet the recommendations arising from the pilots that took place in London and the getting it right first time review, but I certainly look forward to considering the bid from my hon. Friend’s trust in due course.
Duncan Baker
Does the Minister know that the Queen Elizabeth Hospital was named after the Queen Mother? As it is Queen Elizabeth’s platinum jubilee this year, does he agree that it would be a fitting tribute to give the green light to rebuilding a hospital that is named after her mother?
Edward Argar
My hon. Friend is even more dextrous than our hon. Friend the Member for North West Norfolk in seeking to tempt me into an indiscretion or a prejudgment of the application process and consideration. I hear what he says and he makes his point eloquently, but I will not be drawn while that analysis and assessment of the bids is under way.
Ambulance services, like other emergency care services in the NHS, have come under significant pressure, as hon. Members will know. In February 2022, the service answered over 764,000 calls to 999—an increase of 13% on the number of calls in the same month before the pandemic. High levels of demand on the emergency care system, alongside the need for infection prevention and control measures, has resulted in higher instances of delays in the handover of ambulance patients to A&E in some areas.
I reassure hon. Members that significant support is in place for acute trusts, to help address handover delays. NHS England and Improvement and its regional teams are working with local systems—in this case, with the Queen Elizabeth Hospital in the constituency of my hon. Friend the Member for North West Norfolk—to improve their patient handover processes, helping ambulances get swiftly back on the road. Ministers are in regular contact with NHSEI on the performance of the emergency care system, including the ambulance service and accident and emergency departments.
In conclusion, I once again pay tribute to my hon. Friend the Member for North West Norfolk and all my hon. Friends who have spoken in this brief but very important debate for the work that they are doing to champion the Queen Elizabeth Hospital, King’s Lynn. As I say, his constituents are incredibly lucky to have such a champion of their cause, of healthcare in his constituency, and of investment in his local hospital, and I look forward to continuing working with him to ensure that the quality of healthcare his constituents receive is the best the NHS can provide. I note his very kind offer, which has been reiterated to me, to visit him in sunny Norfolk—as I suspect it will be in the coming months—to see his local hospital. If I am able to do so, I will be delighted to visit.
Question put and agreed to.