• Cost estimate for essential health security infrastructure has risen by over 500% from £530 million in 2015 to £3.2 billion in 2023.1
  • £400 million already spent but government has not yet made a final decision on the location of the new site.
  • Best-case scenario for programme delivery is now 2036 – 15 years later than originally planned and 30 years after initial identification of need for new facilities.

The UK’s future resilience to dangerous pathogens – ranging from Ebola to COVID-19 – is being undermined by decision-making failures regarding a planned health security campus in Harlow, Essex, according to a new National Audit Office (NAO) report.2

For eighteen years, government has been considering how to replace its high-containment laboratories in Porton Down, Wiltshire and Colindale, North London, which form part of the UK’s essential health security infrastructure.3 The majority of the facilities at Porton Down are now over 55 years old, and replacing the high-containment laboratories is becoming an increasingly urgent issue.

In 2015, HM Treasury (HMT) approved Public Health England (PHE)’s outline business case for a new £530 million national integrated hub for public health science in Harlow.

Funding for this programme was to be used to purchase and adapt a site in Harlow then owned by GlaxoSmithKline (GSK) and to relocate high-containment laboratories and workforce from sites in Porton Down and Colindale. The Department of Health authorised the purchase of the site for £30 million in 2017.4

Yet there has been little progress since, despite the UK Health Security Agency (UKHSA) and its predecessors spending just over £400 million on the programme up to the end of October 2023 – around 75% of the initial £530 million cost estimate. On top of the £30 million spent on the site, these costs have largely centred on design, revenue,5 project/programme support and management, and construction (at £91 million, £89 million, £76 million and £66 million respectively).

By 2023, the cost estimate had risen to £3.2 billion – £2.7 billion (or over 500%) more than the approximation in the 2014-2015 outline business case. Contributing factors to this increase include changes to the scope of the programme, timetable delays and inflation.

The programme is now at an impasse after UKHSA concluded in 2023 that the Harlow hub cannot be built within the £2 billion that HMT has indicated it is willing to fund and that the Department of Health & Social Care (DHSC) wants to stick to. UKHSA has been asked to explore remaining in Porton Down as an alternative but has consistently assessed Harlow as the best value-for-money option for bringing together and consolidating multiple sites.

The long-standing uncertainty surrounding the preferred location for the programme caused UKHSA to suspend all its main construction suppliers in 2022 at a cost of over £2 million after DHSC reprioritised funding away from the programme, in agreement with UKHSA and HMT. The agency has not been in a position to remobilise its suppliers and since 2022 only minimal enabling work has taken place at the Harlow site.

UKHSA’s latest assessment is that if the programme remains in Harlow, it will become fully operational in 2036 at the earliest. This is 15 years later than the timeline put together by PHE in its 2014-2015 outline business case.

“In 2006, government determined that replacing and modernising its high-containment laboratories was critically important to ensure the UK has the capabilities to identify, study and respond to the most dangerous pathogens in the world.

“In the eighteen years since, it has made very little progress at significant cost. Unrealistic cost estimates, uncertainty over scope and location and escalating forecast costs have undermined both the UK’s future resilience to public health emergencies and value for money.

“UKHSA, DHSC and HMT must act decisively to agree a way forward for the programme and avoid further delays and cost increases in replacing this essential health security infrastructure.”

Gareth Davies, head of the NAO

Read the full report

Investigation into the UKHSA’s health security campus programme

Notes for editors

  1. PHE revised the £530 million figure to £888 million later in 2015 to include an assessment of potential inflation and contingency costs, as well as VAT liabilities.
  2. The NAO conducted preliminary discussions with UKHSA in spring 2023 and was told that a future decision on the programme was expected by ministers over summer 2023. When it became apparent that decision had been delayed, the NAO decided to investigate the issue in detail to understand the causes for delay in the programme.
  3. This problem was first identified by the Health Protection Agency (HPA) in 2006: until 2013, HPA had responsibility for protecting UK public health through the provision of support and advice to bodies including DHSC and the National Health Service (NHS). HPA was superseded by PHE in 2013, and in 2021 PHE merged with NHS Test and Trace and the Joint Biosecurity Centre to form UKHSA.
  4. The Department of Health became the Department of Health & Social Care in 2018.
  5. Revenue expenditure is expenditure on the programme that cannot be categorised as developing an asset.

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