Boris Johnson has denied a report that his flagship pledge to build 40 new hospitals has been labelled as unachievable by an official watchdog, even though the health department has confirmed this is the case. Challenged about the programme during prime minister’s questions, Johnson conceded that not all the projects were completely new hospitals. A report in the Health Service Journal said the Infrastructure and Projects Authority (IPA), a government agency, had downgraded the hospitals programme to a “red” rating, meaning it “appears to be unachievable”. Asked by Keir Starmer in the Commons whether this was true, Johnson said “no” and accused Starmer of asking “frivolous questions”. However, in its response to the HSJ story, the Department of Health and Social Care (DHSC) did not deny it. Instead, a spokesperson told the HSJ that such concerns were normal and the department was “addressing the IPA’s recommendations in detail”. Starmer noted the contradiction, saying: “Well, this is strange, because the government hasn’t been denying the reports about the red flag. And now the prime minister does. There’s obviously some confusion on these benches. If he’s so confident in his answer, why doesn’t he publish the [IPA’s] progress report in full, and let us all see it?” Johnson ignored this question, prompting Starmer to say: “There we have it. The prime minister: ‘I deny my hospital building programme has been flagged red as unachievable, but I don’t have the confidence to publish the report.’ The more we look at this promise, the murkier it gets.” Starmer challenged Johnson on the claim to be constructing 40 new hospitals, pointing to a DHSC document called the “new hospitals programme communications playbook”, giving instructions to the NHS on how to describe the scheme in the media. A section called “definitions of a new hospital” says this covers not just a whole new hospital but also “a major new clinical building on an existing site or a new wing of an existing hospital”, as long as it contains a new clinical service; and “a major refurbishment and alteration of all but building frame or main structure, delivering a significant extension to useful life which includes major or visible changes to the external structure.” Starmer said: “We can all agree that refurbishments are a very good thing, but they’re not new hospitals. So prime minister, how many of the 40 are fix-up jobs on existing hospitals, and how many are actually the new hospitals he promised?” Johnson replied: “You obviously don’t always go around building on greenfield sites.”