NHS Lanarkshire has confirmed that £250.895 million was spent on the Monklands Replacement Project between April 2016 and September 2026, even though the hospital scheme developed during that period will not proceed in its previous form.
The figure, published in an updated project briefing on 3 November, covers more than ten years of expenditure. It comes four months after the Scottish Government rejected the existing full business case because its estimated cost had risen beyond £2.1 billion. Ministers have committed to a new hospital, but the project is being redesigned around a more affordable proposal.
The health board says the money already spent includes the purchase of the Wester Moffat site in Airdrie, land preparation, investigations, planning and design, infrastructure work, professional services and staffing. Those distinctions matter. The amount is not an identified write-off: NHS Lanarkshire retains the site, and some previous surveys and preparatory work may inform the redesigned scheme. The health board has not published a definitive breakdown of how much of the expenditure will remain useful and how much may need to be repeated.
The decision to reset the project was announced by Health Secretary Angela Constance on 25 June. The government said the previous £2.1 billion-plus design did not represent an affordable investment, describing it as approximately £5 million per hospital bed. That was an estimate used to explain the decision, not an approved final construction budget. Revised options are expected to be put to ministers in 2027.
The uncertainty extends beyond the replacement hospital. University Hospital Monklands continues to operate at its existing site, and its accident and emergency department is expected to remain part of the new acute hospital. NHS Lanarkshire has acknowledged longstanding pressures in the current buildings. Its project information identifies a maintenance backlog of £47.9 million at 31 March 2026 and says work is being considered to extend the hospital’s operational life until the replacement is available.
The reset therefore has two financial dimensions: expenditure already committed to a design that has been set aside, and further spending needed to maintain services in buildings that were supposed to be replaced. No confirmed opening date for the redesigned hospital has been published in the November update.
The central public-accountability question is now how much of the £250.895 million can be carried into the new project. An itemised reconciliation of reusable assets, design work and stranded expenditure would make it possible to distinguish necessary preparation from the financial consequences of changing course. Until such figures are published, treating the full amount as wasted would be misleading; treating it as unaffected would be equally premature.
Sources
Reset Phase Q&A — NHS Lanarkshire / New University Hospital Monklands, Updated 3 November 2026. https://www.monklands.org/reset-phase-q-and-a/
Health Secretary Updates on NHS Capital Projects — Scottish Government, 25 June 2026. https://www.gov.scot/news/health-secretary-updates-on-nhs-capital-projects/
