Only 32 of 40 new hospitals promised by Boris Johnson to be built by 2030 – and some may be too small, audit suggests

Published

2 years ago

July 17, 2023

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The government is set to finish only 32 of its promised new 40 hospitals by 2030 as part of an over-budget and hard-to-deliver scheme, that might result in medical facilities that are “too small”, according to a “damning” report.

The National Audit Office (NAO) has completed an investigation into the programme, initiated by the 2019 Conservative manifesto and reaffirmed in October 2020.

The report lays out myriad difficulties the government faces in completing a promise first made by Boris Johnson and often repeated by the Conservative Party since.

The investigation found the government is now set to miss the 40 hospitals by 2030 pledge – with at least eight facilities set to miss the close of the decade target, and it has also highlighted problems with a government plan to use mass-produced, preconstructed hospitals that could see patients unable to be treated.

Shadow health secretary Wes Streeting branded the results “shocking” and “damning”.

The promise

One of the central tenants of Mr Johnson’s 2019 election win was a pledge to build 40 new hospitals.

Even at the time, there were questions about what this actually meant and how achievable it was.

In October 2020, Mr Johnson said he wanted to build the new hospitals by 2030. In November 2020 Rishi Sunak – then chancellor – told parliament they were increasing capital spending to “fund the biggest hospital building programme in a generation – building 40 new hospitals and upgrading 70 more”.

The NAO points out that, after Mr Sunak made that announcement, the definition of a new hospital was changed to include a whole new hospital, a new clinical building or wing, or a major refurbishment and alteration of “all but the main structure of an existing hospital”.

The audit also points out that, at the time of Mr Johnson’s October commitment, “for most of the schemes the issue of affordability had not yet been considered”.

The report states the scheme to build the 40 new hospitals by 2030 was always “likely” to change the timescale or scope, and “this was not made clear to the public at the time”.

May 2023: Barclay insists 40 hospital target will be met

What is being built?

The scheme was initially split into four cohorts, although this was later expanded to five.

A total of 48 hospitals make up the cohorts, as there are eight facilities which already had plans in place.

Of the eight projects in the first cohort, only one counts towards the total of 40 – as the other seven were already in progress.

The other four cohorts are not set to start construction until at least next year, with one of the cohort two projects also making up the eighth previously planned hospital.

Cohort three and onwards are set to use “hospital 2.0” guidelines – where blueprints of the hospitals and construction are standardised and partially made off-site.

The plans for this project have not yet been published, and there are concerns from the construction sector about whether it will be feasible to build.

Furthermore, the NAO criticised a lack of transparency in how the 40 new projects were chosen, saying there was “a failure in record keeping” and they cannot say how the hospitals were chosen.

August 2022: Majority of 40 hospitals unlikely to be finished by next election

Hospitals ‘too small’

As part of its design for the new “hospital 2.0”, the government came up with plans for what would be the minimum viable hospital – the cheapest functioning facility.

But the NAO states that this specification risks being “too small”, and the estimated capacity of new hospitals is based on assumptions that “may be unrealistic” about the number of people able to be moved out of hospitals for social care.

And estimates by the government that average stays will fall by 12% “seem poorly supported by the evidence”.

Furthermore, when the Department for Health and Social Care went to the Treasury for funding, it asked for £21.3bn, but was instead given £18.5bn.

In order to find savings, the government may need to move even more schemes into the 2030s, or lower the lowest specification of the new-style hospitals further to save money, the NAO said.

December 2021: Johnson accused of calling refurbishments ‘new hospitals’

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What are the delays?

One of the key factors in the delays, according to the NAO, is issues with reinforced autoclaved aerated concrete.

This material, used extensively, has now been found to be unsuitable for building past around 30 years.

As announced earlier this year, an extra five hospitals with the concrete have been added to the new hospitals scheme.

According to the NAO, only 32 of the previously promised hospitals will now be complete by 2030 to make space for the new five projects – and the eight others will be finished in the next decade.

Even this estimate is generous, as it includes regenerating facilities not previously included and splitting one project into two parts to up the figures from 31 to 32.

A lack of construction contractors has also been raised – with infrastructure projects like HS2 and a lack of clarity over what the designs will be causing uncertainty.

When will they be built, and how much will it cost?

The NAO has taken an estimate of costs and time frames.

Back in 2020, the government estimated it needed between £20bn and £30bn to build the 40 hospitals promised – plus the eight already started – by 2030.

It wanted between £3.7bn and £16bn for the first five years – and was given £3.7bn by the Treasury under Mr Sunak.

As such, a decision was taken to do smaller projects first and aim at completing large ones later in the decade.

In the first three years, “slow progress” was made on the hospitals – but three opened by June of this year, although none of them were part of the 40 new hospitals.

The other five suffered delays of between one and 16 months.

Cohort two was expected to start in 2022, but as of May 2023 no building had started, although £11m of preconstruction work had taken place.

The first of the 40 new hospitals is expected to open in late 2023, and the second in late 2025.

Cohorts three and four were expected to start in 2025, and the fifth later in the 2020s.

Now, the NAO reckons Cohort three will not open until 2029 or 2030.

In terms of cost, both cohorts one and two have risen by almost 50%, overrunning by a total of £1.2bn.

On top of the £3.7bn for the first half of the 2020s, the Treasury has indicated it will supply £18.5bn for the rest of the scheme – but this was only up to 2031, and with the overrun more money could become available.

Inflation will also eat into the budget, and the NAO suggest the Treasury and health department might have to renegotiate the budgets.

Gareth Davies, the head of the NAO, said: “The programme has innovative plans to standardise hospital construction, delivering efficiencies and quality improvements. However, by the definition the government used in 2020 it will now deliver 32 rather than 40 new hospitals by 2030.

“Delivery so far has been slower than expected, both on individual schemes and in developing the hospital 2.0 template, which has delayed programme funding decisions.

“There are some important lessons to be drawn for major programmes from the experience of the New Hospital Programme so far. These include strengthening the business case process to improve confidence on affordability and delivery dates, and improving transparency for key decisions.”

Shadow health secretary Wes Streeting said: “This shocking report could not be more damning of the failing new hospitals programme.

“The so-called 40 new hospitals are over-budget, behind schedule, and may be too small. Many are not ‘new’, others are not ‘hospitals’, and there aren’t 40 of them. In fact, just one hospital is on track to be built by the next election.”

A DHSC spokesperson said: “The NAO’s report acknowledges that despite changes to the original programme, 40 new hospitals are still expected to be delivered by 2030 and praises the programme’s innovative plans to standardise hospital construction, deliver efficiencies and improve quality.

“We remain firmly committed to delivering these hospitals, which are now expected to be backed by over £20bn of investment – helping to cut waiting lists so people can get the treatment they need quicker. Three new hospitals have already opened and more will open this year so patients and staff can benefit from major new hospital buildings, equipped with the latest technology.”

Politics

Watchdog criticises ‘unprecedented’ government offer to delay local elections – as five councils confirm requests for postponement

Published

19 hours ago

December 19, 2025

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Watchdog criticises 'unprecedented' government offer to delay local elections – as five councils confirm requests for postponement

The elections watchdog has criticised the government for offering to consider delaying 63 local council elections next year – as five authorities confirmed to Sky News that they would ask for a postponement.

On Thursday, hours before parliament began its Christmas recess, the government revealed that councils were being sent a letter asking if they thought elections should be delayed in their areas due to challenges around delivering local government reorganisation plans.

The chief executive of the Electoral Commission, Vijay Rangarajan, hit out at the announcement on Friday, saying he was “concerned” that some elections could be postponed, with some having already been deferred from 2025.

“We are disappointed by both the timing and substance of the statement. Scheduled elections should, as a rule, go ahead as planned, and only be postponed in exceptional circumstances,” he said in a statement.

“Decisions on any postponements will not be taken until mid-January, less than three months before the scheduled May 2026 elections are due to begin.

“This uncertainty is unprecedented and will not help campaigners and administrators who need time to prepare for their important roles.”

Mr Rangarajan added: “We very much recognise the pressures on local government, but these late changes do not help administrators. Parties and candidates have already been preparing for some time, and will be understandably concerned.”

He said “capacity constraints” were not a “legitimate reason for delaying long planned elections”, which risked “affecting the legitimacy of local decision-making and damaging public confidence”.

The watchdog chief also said there was “a clear conflict of interest in asking existing councils to decide how long it will be before they are answerable to voters”.

Sky News contacted the 63 councils that have been sent the letter about potentially delaying their elections.

At the time of publication, 17 authorities had replied with their decisions, while 33 said they would make up their minds before the government’s deadline of 15 January.

Many councils told Sky News they were surprised at yesterday’s announcement, saying that they had been fully intending to hold their polls as scheduled.

They said they were now working to understand the appropriate democratic mechanism for deciding whether to request a postponement of elections. Some local authorities believe it should be a decision made by their full council, while others will leave it up to council leaders or cabinet members to decide.

Multiple councils also emphasised in statements to Sky News that the ultimate decision to delay elections lay with the government.

Reform UK has threatened legal action against ministers, accusing Labour and the Tories of “colluding” to postpone elections in order to lock other parties out of power – a sentiment echoed by Liberal Democrat leader Sir Ed Davey.

But shadow local government secretary Sir James Cleverly told Sky News this morning that the Conservative Party “wants these elections to go ahead”. Sky News understands that the national party is making that position clear to local leaders.

A spokesperson for the Ministry of Housing, Communities, and Local Government, said it was taking a “locally-led approach”, and emphasised that “councils are in the best position to judge the impact of postponements on their area”.

They added: “These are exceptional circumstances where councils have told us they’re struggling to prepare for resource-intensive elections to councils that will shortly be abolished, while also reorganising into more efficient authorities that can better serve local residents.

“There is a clear precedent for postponing local elections where local government reorganisation is in progress, as happened in 2019 and 2022.”

The five councils that confirmed they would be seeking postponements were:

Blackburn with Darwen Council (Labour);
Chorley Borough Council (Labour);
East Sussex County Council (Conservative minority);
Hastings Borough Council (Green minority);
West Sussex County Council (Conservative).

The councils in Chorley, and East and West Sussex, had decided prior to Thursday’s government announcement that they would request a delay.

An East Sussex County Council spokesperson told Sky News: “It is welcome that the government is listening to local leaders and has heard the case for focussing our resources on delivery in East Sussex, particularly with devolution and reorganisation of local government, as well as delivering services to residents, such high priorities.”

They also pointed to the cost of electing councillors for a term of just one year, and argued that it would be “more prudent for just one set of elections to be held in 2027”.

West Sussex County Council echoed those reasons and said it would cost taxpayers across the county £9m to hold elections in 2026, 2027, and 2028, as currently planned.

Chorley and Blackburn councils also cited the cost of delivering elections, and said they would prefer that money be spent on delivering the local government reorganisation and delivering services to local residents.

Meanwhile, 12 councils confirmed to Sky News that they would not be requesting delays:

Basingstoke and Deane Borough Council (Liberal Democrat-Independents);
Broxbourne Borough Council (Conservative);
Colchester City Council (Labour-Liberal Democrat);
Eastleigh Borough Council (Liberal Democrat);
Essex County Council (Conservative);
Hart District Council (Liberal Democrat-Community Campaign);
Hastings Borough Council (Green minority);
Isle of Wight Council (no overall control);
Newcastle-under-Lyme Borough Council (Conservative);
Portsmouth City Council (Liberal Democrat minority);
Rushmoor Borough Council (Labour minority);
Southampton City Council (Labour).

Politics

Samourai co-founder claims Biden-era lawfare in calling for Trump pardon

Published

21 hours ago

December 19, 2025

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Samourai co-founder claims Biden-era lawfare in calling for Trump pardon

Keonne Rodriguez, who pleaded guilty to one felony count related to his role at Samourai Wallet, is calling on US President Donald Trump to pardon him, citing similar language that has been successful in previous pardon applications.

In a Thursday X post, Rodriguez said he would report to prison on Friday, where he will serve a five-year sentence for operating an illegal money transmitter. The Samourai co-founder claimed there were no “victims” to his crime, and blamed his incarceration on “lawfare perpetrated by a weaponized Biden DOJ.”

In a message tagging Trump, Rodriguez expressed hope that the US president would issue a federal pardon for him and William “Bill” Lonergan Hill, another Samourai executive who pleaded guilty and was sentenced to four years. Rodriguez blamed “activist judges” for his legal troubles, claiming he was targeted by a “political anti-innovation agenda.”

“I maintain hope that [Trump] is a fair man, a man of the people, who will see this prosecution for what it was: an anti innovation, anti american, attack on the rights and liberties of free people,” said Rodriguez. “I believe his team […] and others truly want to end the weaponization of the DOJ that the previous administration wielded so effectively […] I believe he will continue to wield that power for good and pardon me and Bill.”

Bitcoin Wallet, Law, Politics, Court, Crimes, Donald Trump — *Source:* *Keonne Rodriguez*

Rodriguez’s public plea followed Trump’s statement that he would “take a look” at a pardon for the Samourai co-founder, claiming that he had no knowledge of the case. It’s unclear whether Rodriguez filed an official application for a pardon or is relying on public statements to get the president’s attention.

Other crypto execs successfully lobbied for a Trump pardon

One of Trump’s first acts as president in January was to issue a pardon for Silk Road founder Ross Ulbricht, who had been serving a life sentence for his role in creating and operating the darknet marketplace.

Former Binance CEO Changpeng “CZ” Zhao, who pleaded guilty to one felony in 2023 related to the exchange’s Anti-Money Laundering program, served four months in prison but also received a pardon from the president. Trump later said he “[knew] nothing about” Zhao when asked about the pardon in a November interview.

Rodriguez’s language addressing Trump mirrored comments from the White House on previous pardons. For example, Press Secretary Karoline Leavitt said it was a “weaponization of justice from the previous administration” when the president commuted the sentence of David Gentile, who was convicted of defrauding “thousands of individual investors in a $1.6 billion” scheme in 2024.