The cost of repairing 18 deteriorating hospitals is expected to surge to £5.7bn due to prolonged delays in their reconstruction, new analysis reveals.

These 18 hospitals are part of the 40 new facilities promised by Boris Johnson in 2019. However, construction on them will not begin until at least 2030—when all 40 were originally scheduled to be completed—due to financial constraints.

NHS trust leaders have expressed concerns that some of these hospitals, including St Mary’s in London, may deteriorate to the point of collapse before work even begins. The delays are projected to push the cost of addressing maintenance issues at these sites from £2.1bn to £5.7bn, based on calculations by the Liberal Democrats.

The annual increase in the maintenance backlog has averaged 10.45% since Johnson’s initial pledge. If this trend continues, the estimated cost of necessary repairs could reach £5.7bn by the time construction starts in the 2030s. At seven hospitals where rebuilding is postponed until 2037, the repair bill could rise from £722m to £2.378bn. These hospitals include Nottingham’s two acute hospitals, the Royal Berkshire in Reading, and facilities in Bexhill and Hastings.

The NHS Confederation warned in December that some hospitals are in such poor condition that they pose serious risks to staff and patients. Torbay Hospital in Devon, the NHS’s third-oldest hospital, has faced issues such as sewage leaks in wards, water damage, and falling concrete. Despite plans for demolition, £1m per year is spent on keeping its buildings functional.

Health Secretary Wes Streeting recently announced significant changes to the New Hospital Programme, pushing back many projects. The decision, made following discussions with the Treasury, which allocated £3bn annually to the programme, has sparked frustration among hospital executives and local MPs.

Siva Anandaciva, head of policy at the King’s Fund, criticized the move, saying, “The government has delayed parts of its hospital building programme to cut immediate costs, but this could backfire, as millions will have to be spent maintaining outdated buildings instead of replacing them. Some NHS facilities are already unsafe, and these delays may only worsen their condition.”

Liberal Democrat health spokesperson Helen Morgan condemned the situation, stating: “Communities are being forced to endure unsafe and crumbling hospital buildings for much longer than promised. It’s a complete betrayal. The Conservatives misled the public, making commitments they never intended to fulfill. Instead of rebuilding the NHS, they are allowing it to decline.”

A Department of Health and Social Care spokesperson defended the government’s actions, saying: “We inherited a struggling NHS, and Lord Darzi’s review confirmed that capital investment had long been neglected. The New Hospital Programme was based on an unrealistic timeline and lacked funding. We have now put it on a sustainable path and remain committed to delivering all projects.”

The spokesperson highlighted that next year’s £13.6bn investment in NHS capital is the highest annual amount since before 2010. This includes addressing critical maintenance backlogs and removing dangerous Raac concrete to ensure hospitals remain safe.

They also argued that the Liberal Democrats’ manifesto allocated £17bn less for health and social care than the government’s budget. “If the Lib Dems were in charge, they would be building fewer hospitals, not more,” the spokesperson added.