NHS Capital Spending

Lisa Smart Excerpts

Wednesday 4th March 2026 Westminster Hall

[Bobby Dean (Carshalton and Wallington) (LD)]

I beg to move,

That this House has considered NHS capital spending.

It is a pleasure to serve under your chairship, Mr Western. I am grateful to have secured this debate on NHS capital spending. This subject goes right to the heart of how the NHS functions, and yet it is not discussed enough in this place. I had a look through some ministerial statements and questions in preparation for this debate, and I found that we often talk about staffing, specific illnesses, waiting times and other operational performance issues, but the simple truth is that all these challenges will be much more difficult to deal with until we improve NHS buildings, equipment and technical infrastructure. I get it: it feels much more impactful and immediate to talk about lifting nurses’ pay or commissioning a new medicine, and those things are important. But however arduous the process, or however far beyond our electoral terms the output of capital investment may be, it is vital for the long-term healthcare of our constituents that we fight for these slow returners, too.

[Lisa Smart (Hazel Grove) (LD)]

My hon. Friend is starting to make a compelling point. In my local area, Stepping Hill hospital has a reported repairs backlog of £138 million. That means, in practice, that only four of the 14 lifts are working, staff are having to physically take meals upstairs to patients, and family members with a mobility issue cannot visit their relatives on higher floors. Does he agree that, while we are talking about bricks and mortar, we are also talking about people and their quality of life?

[Bobby Dean]

I am grateful for the point my hon. Friend made, and I will come to make very similar points about the impact that maintenance backlogs are having.

It is partly because of the slow payoff of capital investment that we are in this mess. The last Conservative Government completely undermined the NHS’s future by overpromising, underdelivering and sacrificing long-term investment to plug holes in their mismanagement of the public finances. While capital underspends being plundered for revenue black holes is not a total innovation, it did accelerate under the Conservatives, with the most acute period seeing more than £4 billion raided from the capital budget in the five years up to 2019 to cover deficits in day-to-day spending. I note that that was prior to the pandemic, when operational pressures were clearly stress-tested to the limits, and I have no doubt that that under-investment left us more exposed than we otherwise would have been during that period.

The outfall is staggering. If we had simply matched existing levels of capital spend, more than £30 billion of additional capital would have flowed into the NHS. Instead, we watched buildings decay, equipment age, diagnostics fall behind and maintenance backlogs soar.