Source · Select Committees · Public Accounts Committee
Recommendation 41
41
Acknowledged
Under-investment in NHS capital impedes productivity and compromises modern healthcare environment standards.
Conclusion
In written evidence, the NHS Confederation also highlighted to us that the NHS was suffering because of the under-investment in capital. It said this was hampering productivity and efficiency at a time when record numbers of adults were unable to work owing to ill health and progress needed to be made on the long NHS waiting lists.93 According to the NHS Constitution, NHS providers are required to comply with legal requirements to deliver care in a clean, secure and suitable environment that is properly maintained. Parts of the NHS estate do not meet the demands of a modern health service.94
Government Response Summary
The government acknowledged the Committee's findings on under-investment in NHS capital, stating it provides record amounts of capital and is committed to providing more certainty through rolling investment programmes.
Government Response
Acknowledged
HM Government
Acknowledged
8.1 The government agrees with the Committee’s recommendation. Recommendation implemented 8.2 The government recognises the importance of capital investment in the NHS and the role it plays in an effective and productive healthcare system. The department is providing the NHS with record amounts of capital, including £12 billion of operational capital between 2022-23 and 2024-25 to address the most pressing priorities. 8.3 The decision to switch capital budgets to revenue is only made in exceptional circumstances. When such switches are enacted, capital programmes with forecasted underspends are prioritised for a switch rather than proactively delaying programmes. The department also enacts some adjustments where, to meet the same programme aims, the currency of spend has changed from capital to revenue. 8.4 Although the government agrees with the Committee’s recommendation in principle, it is right that the department regularly assesses its priorities so that budgets are targeted effectively. Therefore, the government suggests that the usual processes when advising Ministers of the impact of financial decisions, including switching of capital budgets, continue to be followed. The department will continue to make these considerations clear as part of Ministerial advice, with any switches then being approved by HM Treasury. 8.5 Looking forward, the government is committed to providing more certainty for NHS capital through rolling programmes of investment in NHS infrastructure.