NHS Capital Spending

Luke Taylor Excerpts

Wednesday 4th March 2026 Westminster Hall

[Luke Taylor (Sutton and Cheam) (LD)]

Thank you, Mr Western. An MP Josh Taylor—that would be a beast, would it not? It is a pleasure to serve under your chairship. I thank my constituency neighbour and hon. Friend the Member for Carshalton and Wallington (Bobby Dean) for introducing this incredibly important debate. He and I have written op-ed articles for our shared local newspaper in recent weeks, describing our constituents’ despair at the state of emergency care and facilities at St Helier hospital.

When I posted my article on Facebook for local residents to read, somebody commented on my post to say that they were fed up of the endless discussions on the topic, and they rightly pointed out that St Helier has been a totemic issue in Sutton for decades. They angrily demanded action, not words, from us all to get something done about it. The truth is, I could not remotely fault my constituent for their outrage at the imbalance of words and action that they, and everybody in Sutton, have had to live with for far too long. This is what happens when Governments fail to act; people lose faith that the system and their politicians can deliver results. When people hear grand words but see no action, it is no wonder that politicians are the least trusted profession in the UK.

Before I was elected I was an engineer, which is one of the most trusted professions. Then, with the support of more than 16,000 of my constituents, I instantly became a member of one of the least trusted—it is a funny old world, is it not? When the policy area at hand is something so visceral as whether people and their families can go to their local hospital safe in the knowledge that it is equipped to care for them properly, that loss of faith is absolutely corrosive to all faith in politics.

[James Naish]

The Minister will know the health centre I am about to mention. It is in East Leake in my constituency of Rushcliffe, and it has been talked about for over 20 years. It has clinical rooms that are out of action because there has not been the appropriate investment. The hon. Member for Sutton and Cheam (Luke Taylor) represents a relatively affluent part of the country, but does he agree that there is something called building deprivation? The reality is that health centres are not in a good enough condition for our constituents and, irrespective of the relative affluence of an area, we still need to invest in our infrastructure.

[Luke Taylor]

I could not agree more with the hon. Member’s point. When the condition of an asset does not attract staff, particularly in more deprived areas, the challenges will be greater. Those compounding challenges are borne out visibly through the physical asset, and everything becomes much more difficult.

I should not have to be here making points about political faith and delivery—or the economic arguments that have been made by other Members—but I will make the important humane case, based on the experiences of my constituents. I recently did a health survey where residents wrote in and told me their stories. One of them was a woman whose husband spent 54 hours in A&E with sepsis, lying on a trolley in a room so small it could have been a broom cupboard. Another, who is in her late 80s, sat waiting on a chair for 10 hours after a suspected heart attack, while another woman, who was unable to sit on a chair because of her pain, had to lie on the floor crying and wait for several hours.

Almost half of those who responded to the survey said that they had waited for more than four hours in A&E at St Helier hospital. We have the NHS numbers, too: across the Epsom and St Helier trust, 18,600 people waited for more than 12 hours in 2025. That is sickening; it is an example of a system that is not working. “Sickening” is the right word: like thousands of people across Sutton, I am sick to the back teeth with the endless delays that have got us here.

There is another important angle. In almost every one of the stories I was told, there was nothing but deep appreciation for the dedicated staff on the estate, many of whom the respondents credit with saving their lives in spite of—not because of—the conditions that they find themselves in. How can we keep recruiting into the NHS or uphold its public image if these are the conditions that we are expecting staff to work in? This is normally the part of the speech where I talk about the Government’s awful inheritance from the Conservatives, but I do not feel like making that point any more, because the people of Sutton have had enough context-setting and this Government is almost two years old now.

I thank the Minister for her discussions of this topic with me and other colleagues. I feel that we are engaging openly and positively, and I want to make that very clear for the record, but I ask the Government to listen to the pleas of our constituents, and to please provide the money to expand our emergency department. At risk of returning to my point about trust, if we do not fix this, we risk a catastrophe in Sutton that might undermine the faith of my residents and the broader public in the entire model of the NHS.

My speech has been about expanding, refurbishing and fixing St Helier hospital, but there is the separate issue of the real and urgent need for the specialist emergency care hospital that our NHS and residents were promised by the previous Government. We need that too, and we need it quickly. The expansion of our A&E would complement the provision in Sutton, and it needs to be brought forward.

[Matt Western (in the Chair)]

I now call Josh Babarinde.

--- Later in debate ---

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

I, too, associate myself with the comments about the hon. Member for West Lancashire (Ashley Dalton) on her stepping down as a Minister. She was a formidable opponent and will be sorely missed. I am sad to see her step back, but she has made the right decision for her, as in this place we should all do.

I thank the hon. Member for Carshalton and Wallington (Bobby Dean) for securing this debate. He was absolutely spot on when he said we do not scrutinise the process of NHS capital spending nearly enough. I was taken by what he said on that point, but less surprised that not many solutions came forward, although that is key to having this debate, because it is hugely technical.

I will use an example from my constituency for both the pros and the cons, the good and bad stories about capital investment. I was elected in 2019 and Hinckley is my biggest town. Healthcare is an important priority for my constituents and talk of improved hospital services there has been ongoing for 30 years now. On the good side, we were lucky enough to be picked to have a community diagnostic centre, a £24 million investment, and I was lucky enough to open it last year. That shows what good can come of capital investment. Under the previous Government, at August 2024, there were 165 similar good news stories of community diagnostic centres being opened across the country, not to mention the 108 surgical hubs that have not been talked about, but that are increasing patients’ ability to be seen and treated quickly, helping to deal with the waiting lists.

I also come with a negative story related to the same hospital. We were looking for a second project, a £10 million day case investment, but unfortunately, despite funding having been secured, delays in the system and difficulties with changing need have meant that that has been cancelled. The NHS papers specifically on that case state:

“The STP Capital business case for the Hinckley Day Case Unit received national approval in March 2024”—

but then struggled. The papers go on to say:

“However, since business case approval there have been further key changes… Changing financial context nationally and local financial challenges… Increased capital costs of the scheme circa £2m compared to that approved by the board… Programme delays resulting in a significantly reduced capital resource”.

They go on to explain that further delays to the programme occurred due to

“Cost pressures that exceeded the STP capital allocation…Since the approval of the STP Capital Business case in 2024, delays can be attributed to…The planning application phasing (considering the contention surrounding the demolition of the Hinckley District Hospital…The delay in submitting the planning application to allow the development of a robust design to address the Local Planning Authority’s concerns”.

We can already see the difficulties in how need is being allocated across Leicestershire and how planning and inflation interfere. That is the process issue at the heart of making these capital decisions.

That leads us to the bigger picture that confronts the Government today. As has been mentioned, funding is important, so what is the best document we can look at to see what the Government are trying to do? The 10-year plan is clear:

“We will continue to use private providers to improve access and reduce waiting times, to return the NHS to its constitutional standards. As we outlined in our Plan for Change, we will not let spare capacity go to waste on ideological grounds. We will continue to make use of private sector capacity to treat NHS patients where it is available, and we will enter discussions with private providers to expand NHS provision in the most disadvantaged areas.”

The Opposition agree with that, but I am not sure that all Government Members will, so I am interested to know whether all the Minister’s hon. Friends are aligned with it. I agree with the concern that the previous Government’s private finance initiatives, which brought in £13 billion of investment for new hospitals, cost the taxpayer more than £80 billion in repayments. We are still paying for that now.

Turning back to the NHS 10-year plan, a section called “Harnessing new investment” states that

“we will learn from previous experience with the Private Finance Initiative…In other cases, however, PFI was a costly mistake which represented poor value for money. Contracts were too complex and lacked proper transparency.

As the government considers new sources and models of private investment, we do so with this experience in mind.”

How do we know that? Where is it set out that the Government have learned this time? In the same section, the Government tell us they will “evolve” their

“infrastructure finance models and…consider the use of Public Private Partnerships…where there is a revenue stream, appropriate risk-transfer can be achieved, and value for money for taxpayers can be secured.”

Those are not small tests; they are the fundamental ones that we must ensure are in place, so my simple question is this: what is different this time? How will we assure value for money, and who will make that decision? How will we see genuine risk transfer being assessed, rather than simply pricing it into decades of payments? How will that work?

The 10-year plan also states:

“We will codevelop this with the National Infrastructure and Service Transformation Authority (NISTA), building on the successful NHS Local Improvement Finance Trust programme, and will look to drive competition in the market to incentivise others, including third party developers, to improve their offer to deliver better services at lower cost to the taxpayer.”

That is great—but LIFT is used only for small practices, so what model will come forward for everything else? The plan states:

“We will engage with the market on this programme and support NISTA in its wider market testing of a new PPP model.”

What is that model? Can we see it? What does it look like?

I note from the Minister’s answers to written questions that 120 neighbourhood health centres will be operated by 2030; 70 will be new buildings, 50 will come from refurbishment and, of those, 80% will be funded through PPPs. However, there are no plans to publish the business case. That raises legitimate questions. Why are the Government hiding this? We have been here before, and the country is nervous about this, so why can we not see what is being brought forward? If a new model is genuinely different, transparency should not be a threat; it should be a strength. Why will Parliament and the public not see it?

[Luke Taylor]

It would be remiss of me not to ask at this point, while the hon. Gentleman is speaking about transparency and funding for hospital projects, about the previous Government’s imagined 40 new hospitals. I invite him to give some transparency as to where the money to fund that hospital programme was supposed to come from and where it ultimately disappeared to. My residents are still suffering from the impact of his Government’s not providing that money. Can he expand on what happened to that money, which never arrived?

[Dr Evans]

I am grateful for the chance to put this on the record. The health infrastructure plan 2019 had the £3.7 billion, which was the seed funding to look into the projects to bring things forward. That also dealt with the first wave—the three hospitals that were brought forward to allow the second and third waves to come on. The hon. Gentleman will also know that, as the Government and the Opposition have stated, all big national infrastructure is done through a series of spending reviews. The money—£20 billion—was committed through those stages on the basis of that plan. The Government throw the same argument back at us when it is convenient for them to say, “We are not increasing defence spending because it needs to come in a spending review.” Both sides are playing politics, but there was money allocated in that plan. I appreciate that the hon. Gentleman was not in Parliament at that time, but he can ask the House of Commons Library to look at it so that he understands it, and he can then pass that on to his constituents to answer that question.

If we have a new model, we in this House need to be able to scrutinise it. GPs’ rents and rates are reimbursed, but there is concern that if we have further PPPs, similar to the previous PFIs, GPs may be on the hook for ongoing premises costs. We must have crystal clear guarantees, so they understand what they are and are not accountable for.

The 10-year plan states:

“We will also work with NISTA to consider the opportunities for health that could be achieved through private financing of revenue-raising assets (such as key worker accommodation and car parks)”.

That will set alarm bells ringing, as it looks like the Government will use key workers, or staff and patients coming into car parks, to generate funds. I would be grateful for clarity about what the Government actually mean by that statement, because this is a contentious issue. People know that we need to have funding coming into the health services, but where will those streams come from and what will they look like? If the 10-year plan is looking at revenue-raising assets, I am keen to understand exactly what that looks like.

Overall, there is a desire in the 10-year plan, which is shared across the House, to improve healthcare. Nobody disagrees with that, but the criticism of the 10-year plan is that there is no delivery chapter. I am grateful to the hon. Member for Carshalton and Wallington for securing this debate so that the Opposition can ask questions about what delivery will actually look like when it comes to improving the health of the nation.