Hospital business case now released

The latest concept design image for the new Dunedin Hospital buildings, supplied by the...
The latest concept design image for the new Dunedin Hospital buildings, supplied by the Government late last year. IMAGE: SUPPLIED
The new Dunedin hospital will be 2000sqm smaller than originally proposed.

The much-delayed detailed business case, which was meant to be considered by Cabinet 18 months ago, was revealed yesterday.

Much of the delay appears to have been due to the hospital project, initially budgeted to cost $1.4billion, requiring Cabinet approval to exceed that.

It is now set to cost $1.47billion, which included contingency costs, the Ministry of Health report said.

‘‘There is a database of risks, and analysis of that database suggests that delays due to decision-making, late design process or other hold-ups, such as lack of workforce, could be as impactful as construction price and quantity risk,’’ the plan said.

‘‘Further, the risk of scope changes is identified as a very material and likely risk, with high impact.

‘‘The contingency that has been made for design and scope changes is very likely to be fully committed as the project progresses .over the next 10 years but is expected to be sufficient.’’

The initial business case proposed a 93,000sqm hospital.

That was scaled down a year ago to an estimated 89,000sqm.

The business case said the hospital’s concept design had now finalised its size as 91,000sqm.

The existing Dunedin Hospital is 70,000sqm.

The new hospital will have 421 beds, fewer than proposed in the 2019 site master plan.

A 2018 architect’s report said the present hospital had 364 physical overnight beds and 31 emergency department bays.

There will be 16 operating theatres (expandable to 20) and 30 intensive care and high dependency beds, expandable to 40.

The plan, the second to last major planning document required for the project, stressed that the hospital was a regional facility.

‘‘The hospital provides tertiary services for the whole of the Southern District Health Board population, and in 2016-17, one-third of inpatient events were patients from outside Dunedin city.

‘‘This proportion has not changed since the indicative business case and is a key aspect underpinning the service demand forecast,’’ the report said.

Southern health facilities were already coming under pressure from increasing demand from an ageing population, and doctors were treating more complex patients, the report said.

The new hospital needed to work in tandem with the SDHB’s community health strategy to ensure the building was not overwhelmed by the expected increase in patient numbers in the next 30 years.

‘‘The clear message is that the average complexity of patients will increase across the hospital and there will be substantial pressure upon bed capacity under existing models of care.

‘‘There is the risk that demand may exceed what is forecast, or that efficiency assumptions are not achieved, and there is some room for expansion in key areas such as ICU beds and theatres if that is so.’’

The plan also gave a strong hint that the Government has accepted it will need to fund a replacement for Wakari Hospital, which several reviews have determined is largely unfit for its current task of providing mental health services.

‘‘The financial case shows that the DHB will have enough financial headroom to cover the spending required over the lifetime of the project,’’ the report said.

‘‘However, we note that there will be other projects that will need funding, including a redevelopment of mental health services.’’


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It will end up being 1 bedroom with a receptionist out the front and 15 managers.

"The new Dunedin hospital will be 2000sqm smaller than originally proposed", why bother building it if it won't be fit for purpose, why bother building it when it's going to disrupt roading, a state highway, why bother building it when it won't have any car parking?. Has anybody carried out a detailed business case on refurbishing the existing hospital?.

2000sqm is only losing 2.15% of the original design, it's not actually a very significant amount. To refurbish the current hospital you'd need to either stagger it to not disrupt capacity which means itll take significantly longer to achieve, probably cost just as much, and result in what would still be a sub-par hospital. The new build does result in some minor inconveniences to people during construction but it means we don't lose any capacity during the build, and we will end up with a brand new state of the art facility that is 30% larger.

Why do people in Dunedin have such an aversion to walking? For the people who need it there will be parks, ED, Ambulances, those are really the only ones who need on site parking. People who struggle with mobility are going to be able to get dropped off, and for everybody else they have these options within 500m:
Lower Moray place car park building
Upper Moray place car park building
Great King street car park building
Meridian Mall car park building
Wall Street car park building
Railway car park (Including the one just on the other side of the railway)
Thomas Burns street car park

There is also conveniently a bus hub within 150m

The building of the new hospital is already taking a significant amount of time, $1.47 billion would make for a nicely refurbished hospital with some "minor inconveniences", the elderly, the ill and infirm, pregnant mothers etc would like a word with you about not having parking nearby and why build it between two thoroughfares?, you think that's going to be a "minor inconvenience" too?.

Interesting that 2000sqm can be made to sound like an insignificant amount......a mere 2.15%
Let's term it in another way represents an area that four Dunedin Villa's have historically been built upon..... quite simply, half an ACRE. How many wards and beds do you suppose could be placed in a half acre of floor space Kyle?
Playing down the floor area loss sounds like some sort of 'political calming speak' in an effort to soothe the public "hey, it's ok, no big deal, a mere 2.15%" ....."and by the way ma'am, please accept the complimentry SDHB logo'd umbrella, its raining today".

Seems easy for people to say, "hey, what's wrong with using exisiting carparks around the city and just walking to and from the hospital". There's a reason the public want onsite parking. It's about protection from the elements. Wind, rain, snow, ice, sweltering sun, and a guarantee you get a park when you really need it the most. Then there's those who are discharged from hospital, not many of them would want to negotiate pedestrians, electric scooters and pedestrian crossings let alone an over-bridge to the 'other' car park in any type of weather, and some of those people are on crutches, in wheel chairs or holding onto newborns with family carrying their bags. The shelter and convienience a dedicated and covered car park offers is in stark contrast to what is at best a lottery around the streets in the rain. I can't think of any hospitals, anywhere, that don't have a carpark. The ones I can think of that are out in the open, are still close and dedicated to those accessing the hospital only.

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