Bobby Dean

My hon. Friend makes an excellent point: this is about not just buildings, but equipment and digital and technical infrastructure, all of which are crucial to getting the NHS to operate in the way it should. She also highlights how we need to upgrade ageing equipment to a very basic level, let alone take advantage of all the opportunities that the latest innovations in new equipment could provide us with, if we were able to purchase those. I mentioned that maintenance backlogs are soaring. They have doubled from around £6 billion in 2015 to over £13 billion in 2024. The critical thing to stress is that it did not have to be this way. The UK invested around a third less in health capital during the 2010s than other comparable nations. According to OECD data, the UK has 10 CT scanners per 1,000 people compared with an average of nearly 20 per 1,000 across Europe. We have 8.5 MRI scanners per 1,000, compared with an average of 12 per 1,000 across other EU nations, and our bed capacity is pitiful. We operate at around 2.4 per 1,000 people, compared with an OECD average of 4.4. The issue has not only been a lack of money; it has also been a lack of certainty and flexibility. The approvals process for capital bids is slow and cumbersome. Even when capital is available, trusts often receive final sign-off so late in the year that they physically cannot begin procurement, get survey work done and start construction in time. The money therefore goes unspent not because of poor planning locally, but because the system itself creates delay.