First, we had the new Jerome Walcott hospital. Then, the new David Estwick hospital.
Then, the refurbished David Thompson hospital.
Now, we have the new Donville Inniss hospital; a pledge in 2008; another promise in 2009; a withdrawal of that promise also in 2009; and now, the latest version of a promise in 2011.
By now, the people of Barbados must be sick of all these hospital promises.
Yet, we all live in hope of getting a better, new hospital – or not!
Last Thursday, Minister of Health Donville Inniss announced that a new multimillion-dollar general hospital would be constructed to replace the 47-year-old Queen Elizabeth Hospital (QEH).
Inniss estimated that it would cost more than $800 million and that Government would seek to raise the funds internationally.
While he was not able to say when construction would begin, three locations had been identified and Government was examining a “greenfield location” which was between 20 and 30 acres and easily accessible by the public.
“It would be one of the highest physical development projects to be undertaken in Barbados in the last couple of decades,” Inniss said.
He said the decision to construct a new hospital was made after extensive consultation with experts and after extensive research and reports on the condition of the ageing institution at Martindales Road.
“This Government has looked at it seriously since 2008,” Inniss said.
“In 2009, Cabinet had discussions with the British firm Capita Norman & Dawbarn, which was used in 2006 to investigate and report on the way forward for the QEH, with a view of exploring the option of a new general hospital on a greenfield site.”
In October 2007, the then Barbados Labour Party (BLP) Cabinet had decided to replace the 581-bed QEH with a 650-700-bed facility on the Enmore site, where medical facilities and doctors’ residence once stood.
The then Minister of Health Jerome Walcott said construction would take place over four years, but even after the new hospital was opened, the QEH would continue to offer medical services, including those for rehabilitation of patients.
The new City hospital would be “the backbone of health care delivery in Barbados for the next 50 years”, Walcott said, noting that there was no plan to pass on the expenditure to Barbadians in the user fees.
The plan to build another hospital followed a study that indicated that it would be more practical to have a new complex than to expand the QEH, according to Walcott, who is a surgeon.
“The study found that just 38 per cent of the physical plant at the QEH was of an acceptable standard, 60 per cent was below standard, and two per cent was totally unacceptable,” he said.
“In fact, the consultants found that ‘no part of the estate’ could be considered in Condition A – meaning that it was new and could be expected to perform adequately.”
The experts had several concerns about the state of the QEH, including the lack of fire safety provisions, including fire escapes, and original construction methods and materials that made it inappropriate for handling certain expensive pieces of modern health care equipment.
Other concerns were “a design that is inadequate for optimal environmental management” and “the inability of existing QEH buildings to stand up to natural disasters”.
“Massive refurbishment was deemed inappropriate,” Walcott said, “from the perspective of value for money.”
On what influenced Government’s decision to choose the Enmore site, Walcott said large numbers of working class people would continue to have easy access, by foot or by way of public transportation, to the major health care provider.
“Additionally, considerable consideration was given to the potential dislocation of thousands of QEH patients who utilize the scores of public and private medical support services that have sprung up around the QEH.”
In the lead-up to the January 2008 general election, the BLP made a new state-of-the-art QEH outfitted with the latest medical technology the centrepiece of its tertiary care health programme, according to its manifesto Only The Best For Barbados.
However, the then Opposition Democratic Labour Party (DLP), while acknowledging the serious deterioration of the physical plant at the QEH would only commit to a “Rescue The Queen Elizabeth Hospital Plan”, which it said would include: increasing the number of trained medical personnel, moving swiftly to effect change, including reduced waiting times at the Accident & Emergency (A&E) Department, constructing a new A&E wing and providing more beds and equipment, and expanding the Asthma Bay.
“The DLP believes there is no point in building a 21st century facility with 19th century attitudes,” said its 2008 manifesto Pathways To Progress.
But in August 2008, a mere seven months after winning the general election, the DLP announced it would build a new hospital to replace the QEH after all.
Then Minister of Health Dr David Estwick, also a physician, reported that the new Government was “going ahead with plans for a new hospital, without a doubt”.
“We have a 1959 plant in terms of its infrastructure,” Estwick said. “That cannot carry medicine in 2009.”
The plan was for “a new purpose-built facility that would give us state-of-the-art health care for the next 30 or 40 years, with few or no problems. Our objective is now to work the financing options out so that we have the money available”.
He said Government was selling its shares in the Insurance Corporation of Barbados (ICB) and the Barbados National Bank (BNB) to raise $200 million for the project and was looking to other sources for funds.
But Cabinet, Estwick said, was to decide “very, very soon” on where the new hospital would be built.
The former QEH board had recommended building the new hospital on the north grounds of the QEH, but Estwick said structural engineers and climate experts told him the area was unsuitable.
It was being ruled out by those people for reasons including its lowness, its poor or unstable substructure and its high level of risk to flooding and hurricanes, Estwick added.
He said Government was also looking at how best to utilize the old hospital structure – whether it would be converted into Government offices or used for geriatric care.
But about two days later, Prime Minister David Thompson would slap down Estwick’s grand plans, making it clear that there would be no new QEH; rather, the plant would be expanded at its present site at a cost of $400 million.
“Cabinet has agreed to the expansion of the QEH on its present site, estimated to cost over $400 million, and we have also begun to identify funding for this upgrade and expansion,” Thompson said.
He was responding to a query from then Leader of the Opposition Mia Mottley about whether Government was building a new hospital or refurbishing and expanding the QEH.
Mottley said she raised the matter in the face of two “obviously conflicting statements” in the space of just three days from the DLP on how it planned to go about tackling problems at the QEH.
Thompson said his Government would ask Parliament to approve a guarantee of a bond to be raised by the QEH in tranches over the next 18 months, and focus its attention on raising $60 million to invest in the hospital.
He repeated the plan to use funds from the sale of shares in ICB and BNB.
“At the same time,” he said, “Government has been advised that the value of its shareholding in those two companies is approximately $200 million . . . [But] since these shares are no longer useful in determining the strategic direction of these companies, Government has taken the decision to offer these shares firstly to Barbadian individuals, the National Insurance Board and local companies and then, if necessary, to the current majority shareholders of the two companies, if Barbadians do not take up all of the shares.
“The proceeds of these sales will be used to fund part of the upgrading and expansion of the QEH.”
The Prime Minister noted that there were “a number of bona fide local investors who had approached Government with substantial property investments in Barbados and (who) offered to raise philanthropic capital contributions for this upgrade and expansion of the QEH”.
With the DLP’s reversal of its plan, following Thompson’s death in October 2010, Walcott felt vindicated by the original Cabinet decision.
“The Government has finally seen the wisdom of the BLP’s Cabinet decision of October 2007,” he said, “when we agreed, and I stated publicly, that there was a need to construct a new general hospital in Barbados.
If the Government had not taken this long to dither before making a decision, the new hospital might have been completed or be nearly completed by now and would have transformed the delivery of tertiary health care to Barbadians.
“Indeed, the consultants’ reports and recommendations were available to them in January 2008. Instead, we now have more than $10 million in cost overruns on an electrical upgrade at the QEH, which was to be completed since last year and is still ongoing, while millions of dollars are to be expended on the air-conditioning system of the Lions Eye Care Centre.”
“The idea of [a new hospital] was decried and scoffed at by the then DLP Opposition; comments ranged from ‘there is no need for a new hospital, the QEH only needs more funds’ to ‘if the BLP is going to build a hospital for $700 million now, we hear it will cost $800 million’.
“It is reassuring that the minister is now ready to face reality and to implement the health plans as outlined on Page 21 of the last BLP manifesto: namely, to build a new state-of-the-art hospital and to provide X-ray and ultrasound facilities at polyclinics,” Walcott added.
So, is Minister Inniss’ word the final word? Or will Barbadians be made to wait for word from a new Minister of Health or a new Prime Minister?
