Most hospital buildings in Sussex are in pretty good health but there are some exceptions and keeping them up to 21st century standard can be an expensive and sometimes impossible business.

It’s not surprising therefore that the cost of maintaining the older, more dilapidated sites just to bring them up to scratch can run into millions.

However, it has now emerged that the backlog of repairs starts turning into tens of millions and in some cases includes urgent high risk problems.

The £120 million repair bill uncovered by The Argus this week ranges from urgent down to minor maintenance issues but whatever the level, they all need to be dealt with.

No one is suggesting that a roof is going to suddenly cave in on a patient’s head but if the hospitals are classing repairs as urgent or a significant risk then sooner rather than later is the key.

As Tony Reynolds from the Central Sussex Independent Patients Forum points out, not handling minor maintenance issues now could lead to more serious and expensive problems in the future.

Part of the problem, he believes, is that over the years hospital managers have been forced to make cuts and savings wherever they can to keep themselves on financial track, meaning some minor repairs are put on hold for a while.

He says dealing with them immediately is far better and in the long term, less expensive approach.

Obviously, as a publicly funded organisation, the NHS needs to be seen to be spending its money wisely and efficiently.

During the past decade, most of the hospital trusts in Sussex have found themselves getting into some severe financial difficulties and had to bring in some outside experts to help them.

Now things are a lot less precarious with hospitals balancing the books and hitting their financial targets but it has been a struggle with jobs being lost and bed numbers cut.

With the prospect of less Government spending on the NHS coming up, it seems unlikely there will be a massive extra investment in building maintenance programmes so managers will have to continue as best they can by juggling their bills, keeping repairs within budget and keep on top of the “significant” repairs to-do list.

This approach will work in the newer and more easy to maintain buildings like the multimillion- pound Royal Alexandra Children’s Hospital in Brighton, which only opened in 2007.

When it comes to sites like Southlands Hospital in Shoreham, the Worthing Hospital catering block or the 180-year-old Barry building at the Royal Sussex County Hospital in Brighton, it is a case of throwing good money after bad just to keep them usable.

When you take a closer look at the break down of repairs, it is not surprising that it is the older buildings with most of the problems.

Southlands Hospital has a repair bill of more than £30 million compared to the younger Worthing hospital’s £29 million.

The two-year-old Royal Alex has no outstanding repairs while the Royal Sussex has £17.6 million.

However, things are looking up and steps are being taken to tackle the problem.

The obvious and best solution would be to pull these old buildings down and replace them with purpose-built easy to manage sites and that is precisely what is happening.

Worthing has plans to redevelop its west wing and catering block to bring it up to standard with the rest of its site.

And there are ambitious proposals for a major £350 million redevelopment at the Royal Sussex which include ripping down the Barry and Jubilee blocks.

Those plans are currently waiting to be approved by the South East Coast Strategic Health Authority and after that, funding needs to be given the go-ahead from the Department of Health.

Things are looking promising at the moment but there is still an element of uncertainty until the decision is made.

The future of Southlands is a little less certain although Western Sussex Hospitals NHS Trust, which owns the building, has always said it is committed to providing services there.

There are long-term plans to move inpatients there to Worthing but the hospital does have a large day case and outpatient department.

However, some residents and campaigners are convinced the hospital will eventually be sold off and developed into flats and say this is why its repair bills backlog runs into more than £30 million.

Why spend large amounts of money on something if in a few years time you don’t need it? In an ideal world, every old hospital building would be torn down and replaced but it is going to take time.

Apart from the cost, there are the practical issues such as moving patients and staff around while the work is being done.

Having a hospital as a building site is not much fun even if the end result is good.

So for now, hospital managers will have to manage with the buildings they have and keep them up to a standard that ensures patients are not put at risk until they get the chance to do something about them.