The Scottish Government has refused to approve the £2.1 billion business case for a replacement Monklands hospital and ordered the project to be redesigned, placing its planned 2031 opening date in doubt.
It comes seven weeks after the SNP told voters that work on replacing the ageing facility was “already well underway”.
Health Secretary Angela Constance insisted the decision was a “reset and not a stop”, promising that a replacement hospital would still be built and that its accident and emergency department would be retained.
READ MORE:
- Lanarkshire corridor care crisis as A&E hit 225 per cent capacity
- Plans for new hospital go to Scottish Government for final approval
Ms Constance said: "This is a difficult decision but it is the right one."
However, the redesign will not be completed until the middle of 2027 and construction is now only an “ambition” for 2028, subject to further ministerial approval.
No expected opening date has been given, casting serious doubt on the previous target of admitting patients to the new hospital in 2031.
The decision comes seven weeks after the May 7 Holyrood election and follows an SNP manifesto which highlighted the Monklands replacement as one of its major NHS construction projects.
Published on April 16, the manifesto said: “Work is already well underway on major capital projects including replacements for University Hospital Monklands.”
NHS Lanarkshire’s full business case had been submitted to the Scottish Government in December, meaning ministers had the £2.1bn proposal throughout the election campaign.
Today, Ms Constance told MSPs: “This Government will deliver a new Monklands Hospital.
“That commitment has not changed, and it will not change.
“However, having carefully considered the Full Business Case submitted by NHS Lanarkshire, I cannot approve it in its current form within our current financial landscape.”
Scottish Labour has described the move as a "complete halt" which will 'bitterly disappoint' residents of Lanarkshire.
Scottish Labour Health spokesperson Jackie Baillie said: “The people of Lanarkshire and the hardworking NHS staff will be bitterly disappointed with this announcement.
“This is not a reset – it’s a complete halt.
“It has taken the SNP just seven weeks to start ditching manifesto promises.
“At best, the SNP was economical with the truth and made promises they had no budget to deliver.
“The SNP needs to start being honest with the public and set out clear timescales for delivering this badly needed hospital.”
Reform's Helen McDade questioned where the money to redesign the hospital will come from. Ms Constance said the government needed to "do things differently" and make "hard decisions" through public service reform.
The SNP also faced heat from their own benches.
Representing the area, the SNP's Fulton MacGregor said "I cannot stand here and say I am happy" about the move as he said Monklands "urgently needs replaced" raising concerns about ageing infrastructure, abestos and water contamination.
"I don't fully understand how we have arrived at where we have today", he said, "NHS Lanarkshire have been developing their plans for a long time, they've kept MSPs and all stakeholders up to date and that presumably includes the Scottish Government."
The latest estimated cost is £756 million—or 56 per cent—higher than the £1.344bn figure contained in the outline business case approved by the Government in July 2023.
Official figures also show that £92.4m of capital expenditure had already been incurred on the replacement programme by the end of the 2024/25 financial year.
The Government has not disclosed how much of that work can be retained under the redesigned scheme or whether further costs could arise from changing existing contracts.
NHS Lanarkshire approved its full business case on December 4 and said at the time that government approval would allow construction to begin in 2026 at Wester Moffat, near Airdrie, with an opening targeted for 2031.
The health board described the proposed building as Scotland’s most advanced hospital and said it would contain all the services provided at the existing Monklands, including A&E.
Ms Constance announced a “comprehensive redesign” of that proposal, to be conducted jointly by the Government, NHS Lanarkshire and other health organisations across the west of Scotland.
Ministers estimate that the existing proposal would cost about £5m for every hospital bed and say its overall price would be greater than that of either Glasgow’s Queen Elizabeth University Hospital or the new HMP Glasgow.
Ms Constance said: “The proposal before us, with an estimated cost of around £2.1 billion, would represent an unprecedented concentration of capital investment in a single health project.
“Proceeding in this cost envelope would significantly limit our ability to invest in services and infrastructure across the wider NHS.”
She added that the proposal is “significantly more expensive than comparable programmes” and that investment on such a scale must be fully justified.
The Health Secretary argued that the design is too dependent on providing care inside a large acute hospital and is inconsistent with the Government’s plans to move more treatment into community settings and patients’ homes.
“To proceed with the current proposal would risk locking us into a model that does not represent the best use of public investment in the years ahead,” she will say.
The replacement will instead be redesigned as part of a wider system incorporating acute care, community services, diagnostic facilities and digital healthcare.
Ministers say the aim will be to create a modern hospital with a “more efficient footprint”.
The statement does not specify whether the redesign will result in fewer beds, operating theatres or clinical specialties.
Ms Constance sought to reassure patients and staff that the hospital will not be downgraded.
“This is not about downgrading services,” she said. “This is about delivering the right services in the right place.
“Core services, including accident and emergency, will be retained.”
However, the commitment to protect “core services” falls short of guaranteeing that every service currently provided at Monklands will remain in the new hospital.
The Health Secretary also announced an unspecified investment to tackle immediate infrastructure risks at the existing hospital while the replacement is redesigned and built.
She acknowledged that the current estate is ageing, creates operational problems and restricts the delivery of modern healthcare.
“I recognise the challenges faced by staff and patients in the current hospital,” Ms Constance said.
“This will ensure that safe, high-quality care continues while the replacement programme is taken forward.”
The decision carries particular political sensitivity because the hospital lies in the constituency of Neil Gray, the current Justice Secretary and Ms Constance’s predecessor in the health brief.
The statement specifically acknowledges campaigning for the replacement hospital by Mr Gray and fellow SNP MSP Fulton MacGregor.
Under the revised timetable, alternative designs are expected to be completed by the middle of 2027 and returned to ministers for a decision.
Detailed design work would then continue, with the Government aiming to start construction in 2028.
Ms Constance promised “demonstrable progress” before the end of the current parliamentary term, but the statement contains no commitment to complete or open the hospital within that period.
The Government says reducing the scale of the Monklands scheme will allow it to spread capital investment more widely across the NHS.
It plans to develop community health hubs combining GP surgeries, nursing, mental health, diagnostic and outpatient services.
Initial facilities are planned for Port Glasgow, Cowdenbeath and Lochgelly, and East Calder, followed by proposed hubs in Hamilton, Cumbernauld, Edinburgh, Ayr, Kincardine, Inverness, East Dunbartonshire and Glasgow.
Ms Constance also announced a new GP walk-in facility in a converted retail unit in Lanark and confirmed plans for a walk-in service in Shotts.
She said the revised approach could allow ministers to support other NHS projects, including any further investment required to open the delayed Baird Family Hospital and ANCHOR Centre in Aberdeen safely.
Concluding her statement, Ms Constance said: “We will build a new Monklands Hospital.
“We will do so as part of a wider transformation of care across Lanarkshire and the west of Scotland.
“And we will ensure that this investment meets the standards required for managing public money by delivering the best possible outcomes for patients, staff and the people of Scotland.”
