The UK Health Security Agency and the Department of Health and Social Care should consider setting up a dedicated delivery agency for the government's new Health Security Campus because of spiralling costs that have now hit £3.2bn, MPs have said.
Members of parliament's Public Accounts Committee set out their concerns in a letter to UKHSA chief executive Prof Dame Jenny Harries this week following an evidence session on the project, which has seen a 600% cost increase since 2015.
The UK Health Security Campus is supposed to replace existing UKHSA infrastructure, principally high-containment laboratories, as well as deliver a new headquarters. It is earmarked for a site in Harlow, Essex, that was previously occupied by pharmaceuticals giant GlaxoSmithKline. The site was acquired in 2017 by UKHSA's predecessor Public Health England in 2017 at a cost of £30m.
The Treasury approved a business case for the project in 2015, when its total cost was estimated at £530m. Since then, the estimate has rocketed by a further £2.67bn. PAC said the Treasury had only confirmed it would contribute £2bn to delivering the campus, which UKHSA says is not enough.
As a result, UKHSA is considering building a pared-back version of the project at Porton Down in Wiltshire, which it believes can be delivered for £2bn.
PAC launched an inquiry into the development earlier this year and took evidence from Harries and DHSC second perm sec Shona Dunn, among other witnesses, on 13 May.
Prime minister Rishi Sunak's decision to call a general election on 4 July and the dissolution of parliament today meant there was not enough time for the watchdog MPs to write a full report on their campus inquiry.
Instead, PAC chair Dame Meg Hillier set out the panel's concerns in a letter to Harries along with a handful of recommendations.
She said that seven years after the Harlow site was acquired, it is still unclear where the UK's new high-containment public-health laboratories will built. She noted that the earliest completion date is now 2036 – but that this is "clearly at risk" because work on the programme has stopped and ministers have yet to decide on when the programme will continue, or where.
"As more time passes with no decision on this critical programme the risk of a gap in service for the UK’s high-containment public health laboratories grows, with concerning implications for our health security," she said.
The letter accepts that changes to the scope and technical specification of the Harlow campus proposals have contributed to its escalating costs. But it flags that UKHSA "does not have a full grasp" on the relative cost implications of the options it has under consideration, "particularly the long-term implications of developing a cost-constrained option at Porton Down".
"UKHSA told us that the costs associated with the Porton Down option are not confirmed and accepts that more work is needed to understand the true cost of the option, and that additional investment would be needed in future," Hillier said. "UKHSA and DHSC cannot base this crucial decision on incomplete assessments."
The MPs said UKHSA and DHSC should set out a clear deadline for when a decision will be made on where the new high-containment laboratories will be built – and give a timeline for when the full scope of the programme will be confirmed.
PAC also said UKHSA should set out the breakdown of the costs for each of the two main options it is considering for the programme, with full clarity on the scope of any costs associated with additional maintenance and modernisation at Porton Down.
The committee noted that £406m has been spent on the Harlow programme so far, with "at least £295m" set to be written off if the proposals do not progress there. Members said UKHSA should ensure that sunk costs related to Harlow are taken into consideration in any decision to move the programme elsewhere.
MPs added that UKHSA and DHSC had been "unable to explain" who was responsible for the mishandling of the programme or "describe any actions taken to hold leadership accountable when it became apparent costs and timescales were significantly overrunning".
They called on the agency and the health department to conduct a "thorough review" of the reasons costs had spiralled on the project, who had been in the responsible positions at the time and what actions should have been taken to prevent the problems that arose.
"Given the troubled delivery performance by UKHSA," they said, consideration should be given to "setting up an entirely new delivery agency for this large, expensive nationally important departmental programme".
A UKHSA spokesperson said: “Continued investment in our existing laboratories means we can respond safely and effectively to current health threats but there is an urgent need to modernise and replace our highest containment facilities to ensure we are prepared for the future.
“The Covid-19 pandemic and subsequent creation of UKHSA has required a review of the best way to deliver the specialist laboratories needed for the UK. This has considered a range of options including the Harlow scheme and the potential use of existing sites.
“We will continue working with ministers to ensure that we have the right infrastructure in place to protect people from a wide range of health threats.”
This story was updated at 12:30pm on 31 May 2024 to include a UKHSA response