BBCThe Princess Alexandra Hospital in Essex has been plagued by problems with aging buildings and equipment in recent years.
It has regular difficulties with flooding and sewage leaks across its site, which date back to the 1960s.
There have been reports of patients slipping on flooded floors, the smell of faeces filling A&E and leaks on the wards and in practical theater areas, posing a danger to patients and staff alike.
Combined with broken equipment and other building-related problems, it leads to so-called “infrastructure” incidents that occur three times a week on average, according to official NHS data analyzed by the Liberal Democrats.
Over the summer, two major operating theaters were out of action, disrupting care for patients requiring hip and knee surgery.
“We couldn’t get the ventilation parts. We couldn’t get the light fixtures,” Stephanie Lawton, the hospital’s chief operating officer, told the BBC.
“It took us several weeks to repair these theatres. The infrastructure is very old now – it is very difficult to maintain.”
From delight to disappointment
It shouldn’t be like this. In September 2019, there was joy in the hospital when it was announced at the Conservative Party conference that a new hospital would replace the existing one.
Hospital chiefs are soon anticipating the doors will open on the new site in 2024, with Boris Johnson promising Hospital England 40 new hospitals, including upgrades to existing sites, in his 2019 election manifesto.
But by 2023, Princess Alexandra’s planned end date has slipped to 2030 – and it became this week One of 18 hospitals there is being told rebuilding will be delayed even further in Monday’s announcement, which largely slipped under the radar as attention focused on Donald Trump’s inauguration as US president.
Construction work on Princess Alexandra will not begin until 2032 at the earliest. In the meantime, the hospital has no choice but to meander.
Ms Lawton says the hospital spends around £9m a year just maintaining and repairing the current estate.
“Staff come to work providing great care to our patients every day and working inside a hospital that is so old and falling apart is very frustrating for them,” she adds.
Torbay Hospital, one of the oldest hospitals in the NHS dating back to the 1920s, and Leeds General Infirmary have reported issues with sewage leaks and flooding too and are in the same situation.
Others have been re-run even further, with a number telling it may have been as late as the 1930s before it came into operation.
Bosses at St Mary’s Hospital in London, which has been given a potential start date of 2035 to 2038, She warned the chances of some parts of the estate closing due to patient safety concerns are “increasing by the day.” As electricity supplies, heating and water cannot be guaranteed.
“We are now providing care in some buildings that are over 180 years old,” chief executive Tim Orchard told the BBC.
Meanwhile, Sam Higginson, chief executive of Royal Devon Healthcare NHS Trust, says he is “deeply disappointed” that the redevelopment of North Devon District Hospital may have to wait until 2038.
“For us this is very far in the future,” he says. “There is a limit to how long we can operate that infrastructure and we are right on that limit.”
He says he will look for money from NHS England and the government to try to keep theaters and A&E running as best as he can, warning otherwise the drive to tackle the hospital waiting list could hit.
The government said it was committed to the projects. But, since they will all now slide into the next Parliament, and as such, there is no money yet committed to cover the costs, there is real concern behind the scenes about whether that timetable can be maintained.
“We all started in the long grass,” says one NHS leader, who wished to remain anonymous. “Committing to do something in 10 years is almost meaningless.”
Matthew Taylor, head of the NHS Confederation, which represents hospitals, says he understands such concerns, adding: “They feel let down.”
He says the government will need to take into account the extent to which NHS leaders are at risk with dilapidated estates when it comes to judging their performance in the coming years.
Who to blame?
Health Minister Wes Streeting has laid the blame at the Tories’ door, accusing them of leaving a hospital building program “unspoiled and undeliverable” to pick up.
This has been disputed by the Conservatives, who accused Labor of breaking promises and simply deciding not to prioritize the schemes.
The Liberal Democrats believe both parties have a case to answer. Health and care spokesperson Helen Morgan says the public has been “led the garden path” by the Tories, with the business accused of “Dithing and Delay” and treating those affected with “total disrespect” for trying to bury the news on the day of Trump’s inauguration.
Why is there a broader problem?
But Siva Anandaciva, of the King’s Fund Health Research Reservoir, says the problems run much deeper than these 18 late projects – and some others that have already been completed, started or approved for this contract.
It points out that the backlog for repairs and maintenance across the entire NHS has been growing for years as capital spending budgets for buildings and equipment have been squeezed.
“The scale of the declining NHS estate is much broader than the rebuilding in the new hospital programme,” he says.
“Much of the mental health estate is some of the oldest within the NHS and an estimated one in five GP buildings pre-date when the NHS was formed in 1948.”
He says this lack of investment is a “false economy” because it leads to poor patient care and hampers NHS productivity.
But it’s not just the health service affected. A report published this week by the NAO He noted that other parts of the public sector are also affected, with school, court and prison buildings all struggling with maintenance backlogs as well.
Sewage leaks and equipment failures at the likes of Princess Alexandra Hospital and other sites awaiting rebuilding are just the tip of the iceberg.
Data visualization by Hannah Karpel