I remember when the Ward Block opened in 1980. So I was surprised when then Prime Minister Bill English announced over seven years ago it would be cheaper and quicker to replace the Ward Block than to refurbish it. It has a definite future, perhaps in ancillary health services, tertiary education, student accommodation, for businesses or whatever. Just not for inpatients.
Russell Lund knows a lot more about design and construction than me. That wouldn’t be hard — before entering politics I was a veterinarian.
Indeed, his dismissal of all past analyses and indeed all current designs would seem to indicate superior knowledge. Yet among the architects, engineering firms, economists and health planners he takes to task lies considerable experience building hospitals.
When Mr Lund says "clearly the existing theatres are fit for purpose", any room for agreement between the two of us vanishes. The existing theatres are not fit for purpose. They are awful. Nor are they even part of the Ward Block. Might Mr Lund not know this?
There are many reasons why Cabinet decided in July 2017 not to refurbish the Ward Block, which I won’t revisit. But since then, several new headwinds have arisen, and they deserve attention.
The first is that the seismic rating will need to be lifted, because of a proposed change of use compared with the 2017 analysis. Mr Lund airily advises that this would be "very easy"; I am not so sure.
A second is that Cabinet will have to compare the planned inpatient building on the Cadbury’s site, now almost completely designed, with a back-of-an-envelope plan to refurbish the Ward Block which will not be much more advanced than Mr Lund’s analysis. The room for error in the first is now low; in the second it is high.
Third is that spending on the Cadbury’s site is now running above $200 million and counting. This is predominantly the architectural and engineering costs of the past five years of design. And redesign and redesign. But there are also other costs — legal, project management, quantity surveying — as well as the $50m spent demolishing the chocolate factory and driving piles. All this money would be wasted.
Mr Lund says that the 2017 decision to not refurbish the Ward Block was taken when the budget was $1.4 billion. Now that cost is a lot higher, it is reasonable to revisit the decision. The cost is higher because ongoing indecision allowed much higher building costs to creep in. But these higher building costs apply to all construction in New Zealand, including today’s cost of refurbishing the Ward Block.
Patients would suffer, as they did in recent times when the ICU refurbishment dragged on and on for several years. But staff would suffer more, because the Ward Block refurbishment would not happen quickly. It would take almost 10 years. Patients might be discomfited for the three days or three weeks of their stay; for staff, the experience would last for a big chunk of their careers.
For most of a decade, staff would be trying to care for patients in a construction zone. I do not know what the effect of that might be on morale, retention or recruitment because I have not yet heard of a directly comparable undertaking in any other hospital, anywhere. It is this, more than anything, that causes me concern.
So why might this idea, bad as it is, still be attracting the attention of health officials? Why have ministers asked them to do the analysis again?
One answer might be that the idea is sufficiently loopy that, when it is ditched, the public will be relieved and will accept any downsizing of the planned inpatient building. Call it the red-herring explanation.
A second answer is even worse. It is that the government has decided to construct hospitals in stages. That means three buildings in Dunedin, spread over many years. The outpatient building, a new acute services block on the current site of the children’s pavilion, and a refurbished Ward Block. Our new hospital would be split over three unconnected sites and completed in the 2040s.
Why do I offer this never-never explanation? Because that is what they are already doing in Nelson. And because in recent weeks master planning for three buildings in Dunedin has come to light. That in turn is the result of the political choice to curtail health spending.
— Pete Hodgson is the former chairman of both the Dunedin hospital project and Southern District Health Board, and former minister of health.
