[A-List] UK infrastructure crisis: hospitals

["Michael Keaney" <michael.keaney@xxxxxx>]

One of the great tragedies, or stupidities, of the Blair era has been the
almost complete acceptance of Thatcherism as that has been embedded into the
state policy consensus. The chronic underinvestment of her era is now paying
dividends, but because of the incorporation of Thatcherite tenets into New
Labour's conventional "wisdom", Blair et al cannot blame her or Major,
despite the fact that they are indeed responsible. Instead they are stuck
with policies that don't work, a crumbling infrastructure that isn't
working, and a mounting repair bill which requires them to run at ever
greater speed simply to stand still.


Bill for backlog of hospital repairs climbs to £3.4bn
By Paul Waugh Deputy Political Editor
The Independent
12 February 2003

The Government was accused of presiding over a "crumbling" NHS yesterday
when figures revealed that the bill for the backlog of hospital repairs had
soared to £3.4bn.

The total has risen by 21 per cent from £2.8bn in March 1997 when the Tories
were in power.

The Liberal Democrats said the figures contrasted with the Government's
target in its NHS plan of cutting the repairs backlog by 25 per cent by
2004.

According to a written parliamentary answer to Dr Evan Harris, the Liberal
Democrat health spokesman, the backlog bill is now £3.4bn across all regions
in England, equivalent to £117 for every taxpayer.

Backlog maintenance is defined as "the amount of money required to bring the
physical condition of the estate, the statutory safety condition and the
fire safety condition, up to Condition B". Condition B is broadly defined as
"sound, operationally safe, and exhibits only minor deterioration".

The physical condition of NHS estates are assessed in three categories:
internal and external buildings; mechanical systems; and electrical systems.
Dr Harris said: "Our hospitals have been so cash-strapped for so long that
they are in a very sorry state, and getting worse. This has serious
implications for the safety of patients and staff.

"While our hospitals are dilapidated, the Government are going around with a
white cloth, trying to meet cleanliness targets. Crumbling hospitals make it
harder to stop infections. Patients need to be reassured that they are being
treated in a health service fit for the 21st century."

A spokesman for the Department of Health said the two main reasons for the
increase were high building costs and tougher Whitehall standards.

"The construction rate of inflation is more than double the normal rate of
inflation. That plays a part, but also the department now requires all
trusts to have estate strategies with higher standards for cleaner, better
decorated and tidier hospitals," he said.

A government source said not a single privately financed hospital suffered
from a repairs backlog because the work had to be done by the private
sector, not the taxpayer.

The Liberal Democrats said other reasons for the dilapidated state of
hospitals were poor design and under-funding under the Conservatives, and
under Labour in the previous Parliament.

Poor short-term repairs made because of a lack of cash and the system of
capital charging under the Tory internal market were also blamed. The
internal market was supposed to encourage trusts to get rid of old or
under-used assets. In practice, it forced many trusts not to replace ageing
equipment or buildings, to avoid incurring a capital charge.

Other factors were a reallocation of cash to other priorities, for example
mixed-sex wards, another government target. The cost of allowing access for
people with disabilities under a law that takes effect next year is
estimated to be £540m.