Boris Johnson’s flagship hospital building programme and three levelling up funds are mired in delays and unlikely to deliver on time, two highly critical reports by parliamentary watchdogs have found.
In a sobering verdict on the former prime minister’s promise to build 40 hospitals by 2030, the public accounts committee said it had “no confidence” that even the new target of 32 would be delivered by that date.
The cross-party committee of MPs said “very little has happened from the perspective of patients” since the programme was announced and called on the Department of Health and Social Care (DHSC) to urgently examine how new hospital building programmes would bring “tangible results for patients”. It also warned there was a risk that future hospitals were being designed to be too small.
Dame Meg Hillier, the chair of the committee, said: “The physical edifice that is the NHS is quite literally crumbling before our eyes. There was nothing inevitable about this heartbreaking crisis. It can be laid squarely at the door of the decision to raid budgets reserved for maintenance and investment in favour of day-to-day spending.”
Matthew Taylor, the chief executive of the NHS Confederation, which represents hospitals and providers of ambulance, mental health, community care and GP services in England, said the report showed an “urgent need for capital investment in the health service, not least to tackle the current maintenance backlog of £10.2bn which is critically limiting productivity”.
He added: “Like parts of the crumbling NHS estate, the new hospitals programme risks falling apart if capital budgets continue to be raided for day-to-day spending. As the report points out, the repeated diversion of funds to plug revenue gaps is what has got us into this mess, and the consequence is that our buildings are becoming increasingly unsafe to deliver care in, and hindering efforts to improve productivity.”
A second report by the National Audit Office (NAO) found that three funds – the towns fund, the levelling up fund and the shared prosperity fund – were running behind schedule in their ambition to complete £10bn of “shovel-ready projects”. It said that by March of this year just £1bn of the money had been spent by local authorities.
The NAO found that the government’s deadlines were unlikely to be met, with 50% of the construction contracts for projects due by March next year unsigned, rising to 85% of construction contracts for those due by March 2025. It said that by March this year only 64 projects had been completed, with more than 1,000 under way and 76 not started at all.
The NAO identified that one problem was that the funds were “overlapping” but councils had to apply for them in different ways with different deadlines. It said the reasons for delays were “multifaceted, including inflationary pressures, skills shortages, and wider construction industry supply challenges”, as well as “detrimental” decision-making by the Department for Levelling Up, Housing and Communities (DLUHC).
The NAO highlighted the UK shared prosperity fund was launched in April last year and councils had to submit investment plans by August 2022, but the DLUHC did not approve these until December 2022, giving local authorities only three months to spend their 2022-23 allocation. It acknowledged that the department was seeking to improve its project delivery and was providing an additional £65m of funding.
The funds were part of Johnson’s drive to “level up” the country, with Michael Gove put in charge of a newly renamed department to reflect its central mission, although the shared prosperity fund was originally announced under Theresa May to replace some lost EU funding.
However, the towns fund was heavily criticised by Labour for giving money to areas dominated by Conservative MPs, particularly in areas where the Tories wanted to retain their seats.
Gareth Davies, the head of the National Audit Office, said the levelling up department had improved its approach but needed to work together with councils to “unblock projects which are delayed or have not started and set realistic expectations for delivery”.
“It is important that DLUHC shares the insights from its evaluation work with local decision-makers to help them achieve better value for money and reduce regional inequalities by improving the places people live,” he said.
Zoë Billingham, the director of the IPPR North thinktank, said the report highlighted a “litany of missed deadlines, moving goalposts and dysfunction in the way levelling up funds have been allocated to councils as part of the government’s flagship programme”.
A spokesperson for the DLUHC said the figures were out of date, adding that in the last eight months since March a further £1.5bn had been paid out to local authorities.
“We continue to work closely with local authorities to support their delivery of their vital projects,” the spokesperson said. ““We have committed £13bn to levelling up, supporting projects to improve everyday life for people across the UK.
“Major regeneration projects take time to deliver, but a number of projects have completed. This includes the redevelopment of the Farnworth leisure centre in Bolton, delivered as part of a £13.3m commitment to Bolton council through the future high streets fund. Thanks to the towns fund also, the Ingenium Centre in Darlington and a digi-tech factory in Norwich have both opened their doors.”
The DHSC has been approached for comment.
