In a move that could prove hugely embarrassing for the prime minister, the independent National Audit Office (NAO) has decided to carry out a “value for money review” of the entire scheme, which was a cornerstone of the Conservative party’s general election manifesto in 2019. The NAO also made it clear that it is concerned about how the government is still claiming it will build 40 brand new hospitals, when in fact many will simply be extensions or refurbishments of existing ones. In a letter to shadow health secretary Wes Streeting, who had raised questions about the delays and the resulting rising costs of the scheme with the NAO, his top official – Gareth Davies, the comptroller and auditor-general – said he was already preparing a full value for money review. Davies also said he took “particular” note of the “implications of the delay in raising costs at this time of high inflation and whether all the projects really meet the classification of ‘new hospitals’”. Davis said he would report back in 2023. The NAO’s intervention will raise further questions about honesty and standards within the Johnson government following the long-running Partygate row and a series of recent sex scandals involving male Tory MPs. On Friday, Johnson’s former deputy leader Chris Pincher was fired from the party after being accused of sexually assaulting two men at the Carlton Club in London. This was a week after their party had lost two by-elections, both sparked by sex scandals involving Conservative MPs who had to resign. The NAO’s Gareth Davies said it would look at “whether all the projects really meet the classification of ‘new hospitals’”. Photo: National Audit Office Many Tories fear their party is now increasingly distrusted when it comes to politics, having broken promises not to raise national insurance, abandoned the “triple lock” on pension rises last year and scaled back high-speed rail projects in the north England. The Conservatives promised to deliver “40 new hospitals” in their 2019 manifesto, but it has since been revealed that many of these projects are simply improvements to existing sites. Last year, it emerged that ministers were instructing trusts to give the public an exaggerated impression of the scale of the projects by referring to the refurbishments as “new hospitals”. A guidance document, distributed to trusts and entitled the New Hospital Program Communications Playbook, said a ‘new hospital’ could be ‘a major new clinical building on an existing site or a new wing of an existing hospital, provided that contains an entire clinical service. such as maternity or children’s services; or a major renovation and alteration of all but the building frame or main structure providing a significant extension of useful life involving significant or visible changes to the external structure’. Staff were told that all programs “must always be listed as a new hospital.” Last month, the BBC’s Reality Check emailed every NHS trust involved in the scheme, asking which of the three categories their work fell into. Of the 34 trusts that responded, only five said they were building a completely new hospital, 12 said they were building new wards and nine said they were rebuilding existing hospitals. With inflation hovering above 9%, there are also growing fears within the government that even some of these extensions could prove out of reach. Several hospitals earmarked for building work, including centers in Leeds, Leicester and Manchester, are among those still waiting to hear what scale of work might go ahead and when. Labour’s Wes Streeting: ‘The only place these 40 new hospitals’ exist is in Boris Johnson’s imagination’ Photo: Ian Forsyth/Getty Images Already, delays in construction projects have resulted in additional costs for taxpayers. Leeds General Infirmary estimates the cost of developing two new buildings will be £75m more than originally planned due to delays in starting construction and rising costs of building work. Reacting to the NAO’s decision to launch a review and report in 2023 – ahead of the next general election – Streeting said: “The only place these 40 new hospitals currently exist is in Boris Johnson’s imagination. The election manifesto promise now appears to be another example of the Conservatives over-promising and under-promising. “The work will deliver value for taxpayers’ money and ensure that every penny that goes into the NHS is spent wisely, providing better care for patients.” Lib Dem deputy leader and health spokeswoman Daisy Cooper said: “Before MPs break for the summer, the Government must publish a clear timetable for the new hospital scheme and explain why they are failing to meet the no. a promise of their health. “If they don’t deliver on their number one health promise, it will be a total betrayal.” On its own website, the government says: “Hospitals come in all shapes and sizes and each new hospital will be designed to meet the needs of the local area, staff and patients, now and in the future.” Matthew Taylor, the chief executive of the NHS Confederation, recently cast doubt on whether many schemes would go ahead. “The Government launched these landmark new builds with much fanfare, but NHS leaders are becoming increasingly frustrated that the money is not being paid for,” he said. “The fear now is that some of these plans may never see the light of day.”
