Rishi Sunak blocked plans to rebuild five hospitals riddled with crumbling concrete three years ago, prompting warnings of a “catastrophic” risk to patient safety, the Guardian has learned.
Just two of the seven hospital rebuilding projects requested by the Department for Health were signed off by the Treasury at the 2020 spending review when Sunak was chancellor and Steve Barclay, now the health secretary, was his chief secretary.
The other five were finally added to the new hospitals programme in May, when the government amended the list, but it has meant a three-year delay in starting to rebuild dangerous hospitals. In their most recent risk assessments, all five have been graded at “catastrophic” risk with warnings that an incident is “likely”.
The five hospitals are Frimley Park hospital, in Surrey; Airedale general hospital, Keighley, West Yorkshire; Hinchingbrooke hospital, Huntingdon, Cambridgeshire; Leighton hospital, Cheshire; and the Queen Elizabeth hospital in King’s Lynn, Norfolk.
The revelations will revive the row over reinforced autoclaved aerated concrete (Raac) which dominated the start of the new parliamentary session, with Sunak and his education secretary, Gillian Keegan, coming under fire for uncertainty and disruption over crumbling concrete in England’s schools.
NHS bosses have told hospitals across England to be ready to evacuate staff and patients if buildings containing concrete at risk of collapse start to fall down.
NHS England issued the instruction to all 224 health trusts on Tuesday in a letter from Dr Mike Prentice, the organisation’s national director for emergency planning and incident response, and Jacqui Rock, its chief commercial officer, telling trust officers that they should familiarise themselves with a “regional evacuation plan” drawn up by the NHS in the east of England so that hospitals can implement it in the event that buildings that contain Raac start to crumble.
The 2023-4 risk register of Frimley Park hospital, which serves Michael Gove’s constituency, reported widespread crumbling across its buildings. It warned: “There is a risk of injury or death to patients, visitors, and staff due either to delamination of a roof plank whereby a part of it falls, or a sheer collapse with no warning due to limited bearing on the concrete support beam.”
Across the five hospitals there were more than 100 incidents, according to NHS figures, where estate or infrastructure failures resulted in clinical services being delayed or cancelled in the year after the Treasury’s decision not to include them in the new hospital building programme.
Between them, they had a “high risk” infrastructure backlog – where repairs must be urgently prioritised to prevent major disruption – totalling £117m, but less than a third of that amount was spent. There were 21 patient safety incidents related to critical infrastructure risk in 2021-22 at the five hospitals.
An NAO report in July, Progress with the New Hospital Programme, suggested the risk of Raac to the five hospital buildings was known at the time of the Department for Health’s bid to the Treasury. However, the government decided against including all seven hospitals because “further assessment” was required.
Yet after a school roof collapse led to a national alert in 2019 about the risk of sudden failure, NHS England asked trusts to survey their estates for Raac. Forty-one buildings at 23 trusts contained the material, including the seven hospitals with Raac present throughout, which were at particular risk.
At a Westminster policy forum on Tuesday, Tim Phillips, director of Health Value for Money at the National Audit Office, said: “The NHS knew back in October 2020 that it had a lot of Raac across its estate, including seven hospitals that are to all intents and purposes constructed entirely of Raac.
“Back in 2020 the Department of Health actually proposed to the Treasury that NHP should be used to replace all seven Raac hospitals at that point, so in effect that all seven hospitals should be part of 40 new hospitals as early as 2020.
“But at that time, government decided that only two of the seven would be put in the programme. What we’ve seen since is that government has had to row back on that decision.”
Wes Streeting, the shadow health secretary, said: “Rishi Sunak and Steve Barclay are the guilty men of the crisis in our NHS. They literally failed to fix the roof when the sun was shining, putting patients and staff at risk and leaving taxpayers to pick up the bill.
“There is no image that better sums up what the Conservatives have done to our public services than the sight of crumbling hospitals and schools.”
A source close to Barclay suggested that as chief secretary to the Treasury he was responsible for setting the overall spending envelope, and that it was for the department to prioritise schemes.
A government spokesperson said: “These claims are untrue. The funding was not rejected by the Treasury, or the chancellor and chief secretary at the time, and there was an agreement to link these decisions into the wider new hospitals programme.”
They added that the full extent of Raac issues were not known until 2022 following an independent report by engineering consultants Mott MacDonald.