Scepticism on private funding

Eileen Goodwin.

It must not do a deal as it did with food giant Compass a few years ago.

That deal locked the Southern District Health Board into a 15-year agreement amid strong opposition and virtually no transparency.

The public did not get a say on what proved to be an unpopular outsourcing with no clear benefit. People will not take kindly to something similar happening with their hospital.

The Dunedin Hospital project is attractive to private investors because it is a clean slate build on either a new site, or the grounds of the quiet Wakari Hospital.

Private investors do not like messy redevelopments on working hospital sites.

Commercial sensitivity concerns are real but should not be used as a convenient cloak.

New Zealand officials have no experience negotiating a health contract of anything like this magnitude with the private sector.

PPPs have a mixed record overseas, as hospitals can be landed with onerous costs and conditions.

Whether it ends up being Crown or private funding, there is a price tag.

It could put the board into debt for decades, and the business case shows the board in deficit until 2040.

There is no elected board at SDHB, meaning crucial decisions will be made without public representation.

A PPP will be contentious in the South, where people place high value on public healthcare and the interests of the community rather than private profit.  There is already wide scepticism about the delay-plagued project, as the Government prevaricated about whether to rebuild completely or redevelop the existing hospital campus. There is a risk of a disconnect between Wellington and the public in Otago and Southland.

The Government has been eager to keep the project off the front page of this newspaper until it was ready to make its stage-managed reveal on Saturday.

Even the leader of the doctors’ rebuild group, retired oncologist David Perez, is not allowed to make public statements about the rebuild without specific approval from the DHB’s communications office.

The business case was released to reporters immediately after the announcement on Saturday. That meant Prime Minister Bill English and Health Minister Jonathan Coleman could not be quizzed on specifics during the time allotted for questions.

Finding a central city spot with enough space is now the focus of officials, and it will not be easy. Hopefully, it will not lead to yet more delays.

The Government has a point when it says the project is much bigger than first envisaged, but deciding on the total rebuild took far too long.

Rumoured tensions between the ministry and some of the consultants working on the project cannot have helped. The ministry has not only kept a tight rein on information going to the public, but also, it is said, to the DHB and the rebuild partnership group appointed by Dr Coleman.

At a "case for change" rebuild workshop last November, project members identified "investment objectives and business needs".

One might have assumed the case for change was amply illustrated by the well-publicised state of the existing facility, but such are the ways of officialdom.

Let’s hope the "case for change" has finally been made, and officials will now get on with it.