Doncaster Royal Infirmary

Question

15:11:00

Asked by

To ask His Majesty’s Government what assessment they have made of the impact of the conditions at Doncaster Royal Infirmary on patient care.

My Lords, Doncaster Royal Infirmary has a backlog maintenance bill of approximately £114 million, and serious infrastructure issues are indeed presenting challenges to delivering high-quality patient care. Repairing and rebuilding our healthcare estate is vital in creating an NHS fit for the future. South Yorkshire ICB has been provisionally allocated more than £150 million in capital investment for 2025-26 to begin to tackle estate challenges, including the condition of DRI.

I thank the Minister for her Answer. She may be aware that one recent estimate of the costs involved in bringing the infrastructure of DRI into good repair came to an eye-watering £478 million. In 2021, a water ingress into the electrical circuits in the maternity ward caused the evacuation of premature babies in incubators and women in labour. In 2023, the collapse of a significant portion of plaster work in a hospital corridor ceiling resulted in no human injury only by the providence of God. How does the Minister intend to monitor the conditions at DRI to ensure that any future deterioration does not put the safety of patients and staff at risk?

I am very aware of the unacceptable situation that the right reverend Prelate describes. I can confirm that, in terms of capital commitments, in 2025-26 the Government are backing NHS systems with over £4 billion in operational capital, £750 million of targeted estate-safety funding, which will be crucial to DRI, as well as £440 million to tackle crumbling RAAC. Why is this all so important? It is all about keeping staff, patients and their families safe, and it is also about providing the best possible care. I should say that the Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, which DRI comes under, is discussing—indeed, it absolutely should be discussing—options with the ICB to steer the programme allocations towards DRI.

My Lords, system allocation guidelines of January this year state that systems will receive at least 80% of their 2025-26 core operational capital in each year of this Parliament, relative to their 2024-25 allocation. With many hospital buildings in serious financial capital backlog, why have the Government put in a system that could see some areas’ day-to-day capital allocation cut by 20%?

I can tell your Lordships’ House that we have inherited an undercapitalisation over the past few years, and it is essential—including to cut waiting lists and provide proper care—that we provide resources. However, the noble Lord is very aware of the extent of the backlog; it stands, according to the latest NHSE figures for 2022-23, at £13.8 billion. Even more worryingly, the critical infrastructure risk within that, which the highest-tier hospitals are wrestling with, is £7.6 billion. We have had to find the best route forward to be fair and efficient. Is it a major mountain to climb? Yes, it is. Are there various options for doing it? Yes, there are, but we believe that we have been as transparent and fair as we can be.

My Lords, I know that Secretary of State Wes Streeting is determined to increase NHS productivity. DRI’s bid for urgent work to the tower block would do just that; for example, by stroke services having a same-day emergency care centre linked to the in-patient ward with a knock-on effect on vascular services. That is all impossible with the current state of the hospital. Will my noble friend the Minister ensure that Ministers, officials and, crucially, the Treasury not only are aware of the patient safety concerns raised by the right reverend Prelate, but know that the DRI bid will increase productivity and efficiency, as well as improve patient care?

My noble friend is right about the effects of a poor estate. In addition to productivity, it very much affects safety, staff working conditions and capacity. The benefits are considerable, as she identifies—and indeed as the noble Lord, Lord Darzi, identified. I assure my noble friend that we are working across government—including with the Treasury and, to the right reverend Prelate’s point, with the local ICB and trust—to tackle this. My noble friend is aware that this Government committed nearly £20 million from the critical infrastructure risk fund to the hospital’s NHS foundation to move a section to the ground floor—not the part to which my noble friend referred, but it shows the seriousness with which we are taking this.

My Lords, the injection of capital to Doncaster Royal Infirmary is welcome. When the CQC inspected DRI in 2024, it found that the hospital “did not have enough maternity staff with the right qualifications, skills, training, and experience to keep women safe from avoidable harm”. While the Government develop their 10-year and workforce plans, what action are they taking in the meantime to address safety concerns from a lack of adequate staffing in maternity services? While we are on the subject, given the recently announced crackdowns on immigration and that many people who work in our health and care system are immigrants, how do the Government intend to encourage more British workers to fill vacancies in health and social care?

On that point, I feel that the Government taking the backlog very seriously, against the background of what we have inherited, will make conditions far better for staff, which will make it a far more attractive place to work. That will be reflected when we report on the workforce plan. To the point about maternity, we are recruiting extra midwives and we are looking extremely closely at how we can better support best practice—as I saw just last week—how we can extend that and how we can bring better patient safety measures into the system. I am afraid that it is another area that we inherited in a difficult position, but noble Lords can be assured that we are working on it. I look forward to updating your Lordships’ House.

My Lords, I am going to come back at the Minister. I accept that the backlog is there. My question was: why have the Government put in a system that will reduce day-to-day capital expenditure, potentially by up to 20%, for some areas? That is this Government’s new plan. The Minister said at the Dispatch Box that the ICB in South Yorkshire has been allocated £150 million this year. It was allocated £161 million last year. How does this help Doncaster, Sheffield, Rotherham and Barnsley with their capital backlog?

I understand that the noble Lord is, as I am, very keen to resolve this situation, but the fact is that DRI is in an extremely difficult place, which was the reason for the right reverend Prelate’s Question. To pursue the particular point he made, I will be very pleased to come back to him. However, I emphasise that the Autumn Budget made exceptional support for capitalisation, which is not just for the physical estate but also the digital estate. DRI has, for example, been updating patient records on paper. That is not the way forward and they will now be digitally brought up to date. On his particular point, I will be very pleased to look into it further and come back to him.