Those who campaigned for the new Dunedin Hospital may have been excited to see structures appearing above the site fenceline in recent weeks. Visible progress at last. However, this momentary thrill quickly loses its lustre when consideration is given to how much is still unknown about the future of this rebuild. The handsome outpatient building is due to open later this year. But while we can find information about the equipment expected to be in that new building and even instructions for patients on how to get there and what parking will be available, many other details are a mystery. If the original plans had been followed, both the outpatient and inpatient buildings would have opened around the same time. Now, largely due to the meddling and delay caused by the current government, supposedly to save the country from budget blow-outs and incompetent governance of the project, there will be a five- year time lag. Also, the years-long vexed question of how and where vital laboratory services will be provided is still not decided, awaiting the outcome of a national pathology services review expected later this year. The lag between the two buildings’ completion involves considerable logistical issues which will create expense which could and should have been avoided. The existing crumbling hospital with its myriad problems has to limp along for longer than expected. Last week it was revealed this will include replacing 10 ageing and inadequate lifts which will have been adding to the inefficiency of the current facility. The tender document said the technology used in the lifts was so old that finding replacement parts when there were faults was becoming difficult. While we cannot know what the budget is for this since this work is out for tender, it is unlikely to be cheap. Doing anything such as this is always more expensive than building something from scratch because of the constrictions involved with having to keep the hospital functioning while the work is undertaken. We have previously reported Health New Zealand Te Whatu Ora had set aside at least $23.6 million to keep the lights on at the existing hospital until the new inpatient building comes into play. Whether that is likely to be anywhere near enough is hard to tell since the amount of public information about any of this is limited. It has yet to be spelled how the existing hospital services will work with the new outpatient building. Presumably, there will be instances where patients will need to be transferred between the two buildings. Since the government is so keen on cost cutting, we have visions of suitably helmeted orderlies or nursing staff roller skating along Castle St pushing beds or wheelchairs. That is fanciful, but it highlights the lack of detail on the nuts and bolts of this transition period. Concerns were aired earlier this year by the Association of Salaried Medical Specialists about the lack of a staffing plan for this. Has that been resolved satisfactorily to ensure safe services can be provided at both sites, has it involved engaging extra staff, and what is the expected cost? Adding to the uncertainty is speculation about what parts of the existing ward block will be used, and what for, after the new inpatient building opens in 2031. HNZ has referred to continued service delivery there but was unable to say which departments would be affected because the site master planning process for the wider Dunedin health precinct remained ongoing. (The HNZ website says services remaining at the current Dunedin Hospital campus will include BreastCare, the New Zealand Artificial Limb Service, the Gibson Day Unit, childcare services and corporate functions.) That staff are raising concerns about the lack of information highlights, again, how poorly they have been served during this whole sorry saga. In order to keep staff who have been hanging on for the new complex, and attract new health professionals, HNZ must ensure they are fully engaged with the transition process and confident they can deliver safe and timely services. If HNZ wants to convince us all it has got this it needs to do a much better job of communicating it.
