On Friday, December 29, the final work day of 2017, the province received a consultant’s report containing some highly anticipated information. The report included a preliminary cost estimate, timeline, and master plan to replace services delivered out of the crumbling Victoria General (VG) hospital and Centennial building.
Kasian Architecture of Ontario had been awarded a $1.9 million contract in November, 2016 to carry out the work. It also assessed which clinical services should be located in two new outpatient centres: one to be built on an expensive site in the Bayers Lake Industrial Park, and a second, more specialized facility to be constructed closer to the Emergency Department at the Halifax Infirmary.
Kasian was tasked with making recommendations related to replacing 15 operating rooms, diagnostic equipment, and more than 200 patient beds at the VG site.
Its findings will affect new construction at the Dartmouth General hospital and an expansion and renovation to the third and fifth floors of the Halifax Infirmary.
The McNeil government has previously indicated it will be 2022 before new facilities are ready, and the VG — which some patients and doctors have characterized as “Third World” because of its sporadic floods and legionella bacteria — may close.
Kasian met the deadline in the tender awarded by the Department of Transportation, Infrastructure and Renewal (TIR). Yet it could be another six months — June of 2018, in fact — before anyone outside of government sees the recommendations to government contained in the report.
“Once staff have completed this review, it will then be submitted to Executive Council (Cabinet) for approval,” emailed Marla MacInnis, communications advisor for the Dept of Transportation, Infrastructure and Renewal in response to a request from The Halifax Examiner. “Minister Lloyd Hines is not in a position now to speak about the report, and as he has not yet seen it, it would not be appropriate for staff to speak publicly about it either. At this time, we do not have a timeline or a cost estimate to share. The report and a cost-estimate will be publicly available in the next 3-6 months. This is an important project that we are taking the time to do right.”
It was much the same story (which journalists tend to translate as “please go away”) over at the Department of Health and the Nova Scotia Health Authority (NSHA) which share responsibility for the job to replace the VG. NSHA spokesperson Nicole deGier emailed, “At this point we do not have timelines and cost estimates to share. A draft report was received by Kasian but it is still being reviewed by staff.”
Meanwhile, work continues on the many moving pieces (including a revamp of cancer treatment delivered through the Dickson Centre and VG sites) that are part of a complex and challenging megaproject. It’s a juggling act that requires political will, co-operation and leadership to provide critical care to an aging population in the midst of a multi-year program to replace aging infrastructure. And decisions are being made largely behind closed doors.
Here’s a look at some of the work-in-progress:
• A second, unused operating room at the Hants Community Hospital in Windsor is expected to open later this winter after an extensive overhaul. Eight-hundred surgical procedures a year — hernias and minor orthopedic procedures such as shoulder and knee scopes — should take some pressure off the VG.
• Construction is also underway at the Dartmouth General Hospital on exterior additions, to be followed by another tender to build eight operating rooms to replace those to be demolished at the VG.
• A tender for construction management to oversee multi-million dollar renovations to the Halifax Infirmary (third and fifth floors) will be awarded at the end of this month to one of three bidders: Ellis Don, Pomerleau, or Lindsay Construction.
The tender for the Infirmary site was based on a draft design, with final approval by government (Health and TIR) expected at the end of December, according to a preliminary schedule attached to the tender. Asked when government will sign off on the final design for the Infirmary, MacInnis replied “soon.” No RFPs for actual renovation work will go out before mid-April at the earliest.
The Department of Transportation and Infrastructural Renewal will manage the Infirmary renovations. It remains to be seen how the two new outpatient centres will be built and financed. In July, the province hired the auditing firm Deloitte to look at P3 (public private partnership models) as well as other funding and operating avenues to build the clinics. Ownership is to remain in the hands of the province, unlike earlier controversial P3 deals that wound up with taxpayers paying twice for more than a dozen public schools — once to lease them from developers and a second time to buy them back.
Deloitte’s report to the province is expected in February or March although it will probably require persistence through Freedom of Information legislation to unveil its advice to government, long after a decision has (hopefully) been taken.
There are good reasons for the public to see this report before government moves too far along. One is design. Current thinking is that as many patients as possible should have a private room with a large window. This costs more in the short term, but less in the long term because patients recover faster in that environment and are less likely to relapse. We need to have a public discussion on this before cost-cutters in government get the upper hand and deliver a substandard product.
Also, some sort of P3 model can work as long as government has people who can competently negotiate and manage the contract. Books exist on how to do this. Another approach is to make it wholly private, with government as the sole bill-payer, much like the way GPs operate. I believe Scotia Surgery, a private company, stilll provides minor orthopedic services fo government under contract. Patient satisfaction is almost 100%.
Three P schemes pretty much always end in disaster – just have a look at the mega-mess unfolding in the UK with Carillion…..what an absolute fiasco:
https://www.theguardian.com/business/live/2018/jan/17/carillion-crisis-suppliers-job-losses-distress-global-risks-business-live
The UK has jumped on board the 3P bandwagon in a big way and much of their government infrastructure is outsourced……train maintenance, hospital cleaning, IT and food services, libraries school maintenance and lunches…..the list goes on and on. Now the government is scrambling to deliver these services……so precarious is the situation that fire brigades have been tasked to deliver school lunches. Workers that use credit cards to fill their gas tanks to deliver goods and services for the public are unable to do so because credit has been frozen.
Having said that, the McNeil government are pig-headed proponents of handing over public services to private interests, so any caution tales will most likely fall on deaf ears.
About those P3 approaches. Two major hospital projects in the UK are just half finished and the P3 “partner”, Carillon, has just gone under, halting all work. Lots of workers out of work, of course. But the retired director of Carillon still gets his ginormous payments, of course.
A private contractor on a hospital project in another country went into receivership.
Our hospital project, in our country, has a private contractor.
Therefore our hospital project will fail.
QED.