The Royal College of Surgeons of England has set out its plans for a ‘New Deal for Surgery’ that would see the government provide an additional £1bn for surgery by every year for the next five years.
As part of the plans, the money would be used to create so-called surgical hubs that would be established to focus almost exclusively on dealing with the backlog of elective surgery that has built up as a result of the Covid-19 pandemic. Over a year since the pandemic first hit the UK, the number of people being treated remains far below what it was previously as social distancing measures remain in place – and for many months of the pandemic the NHS simply did not have capacity to undertake any elective surgery whatsoever.
So creating new centres across the country that can deal with this backlog certainly seems like a sensible solution.
However, the price tag of £1bn per year might be somewhat off-putting to a government that has already spent far beyond anything it would have anticipated when elected in December 2019 – and indeed, even more than was envisaged by its opposition in that election, the so-called ‘hardline socialist’ Labour party of Jeremy Corbyn.
So while the Department of Health has for some years been largely opposed to using private finance to deliver new premises, it may be time to look at the case for a PPP model once again.
One industry source suggests a PPP programme of small surgery facilities could be rolled out quickly, with projects up and running in three years for a capital cost of around £50m per scheme. The government would able to build many more of these hubs at once, by spreading the cost over the life of those contracts rather than having to pay the capital cost upfront.
The industry stands ready to play its part here – and has plenty of experience. After all, the surgeons’ surgical hubs concept is not far removed from the independent sector treatment centres (ISTCs) first set up under Tony Blair’s government, and since then we have seen initiatives such as ‘polyclinics’ and urgent care centres come and go.
Meanwhile, the Lift programme has delivered a wide range of new health premises over more than a decade, from new GP surgeries to wider services designed to take the pressure off accident & emergency services. Frustratingly, its planned successor, Project Phoenix, was stifled before it officially started, never getting the ministerial sign-off it needed to launch a wave of new investment in primary care.
Perhaps, then, the time is right to reconsider what the private sector can offer the health estate – especially at a time when the government has recognised the role that private partners can play in speeding up government priorities, such as the delivery of vaccines and the establishment of testing centres to combat the Covid-19 pandemic.
In a different sector, Transport Secretary Grant Shapps has already taken that experience and wants to use it in the development of transport infrastructure and services to boost the country’s productivity. In a recent speech suggesting the UK could become Europe’s largest economy by 2050, he said: “We invited the private sector to use its skills, agility, and speed to develop the vaccine at record pace, before then coming back to the public sector, for the NHS to efficiently inject it into tens-of-millions of arms.”
If we are to tackle the after-effects of the pandemic (and get anywhere close to Shapps’ vision of becoming Europe’s leading economy), making use of all the tools at the government’s disposal – including private finance into the health estate – will be critical.