The public interest, not private shareholders, needs to drive hospital design says Alison Johnstone.
I, like many others, was dismayed to learn last Wednesday that the new Royal Hospital for Children and Young People will not be open until next year. Like everyone else, my first question was how could this happen? How could it be that a mistake in a document seven years ago was never picked up and led to repeated delays and eye watering costs? The answer may be found in the Scottish Government’s non-profit-distributing model which financed the hospital’s construction.
The argument made by supporters of private finance was always that the risk would be borne by the private sector. This has been disproved time and time again, not least by the Edinburgh schools PFI scandal. It was just three years ago that a wall collapsed at a primary school in Oxgangs, with nine tonnes of masonry falling during a storm. This resulted in closures at 17 other schools amid concerns about subpar construction standards. Yet it seems that lessons have not been learned. As long as private financing models are used for public building projects, private companies will continue to receive the profits and bonuses while bearing no responsibility for the risks.
There have long been concerns raised about NPD. Audit Scotland announced in 2016 that it would undertake an audit of the model after it breached European Union rules on government spending. This audit is underway but, almost three years after it was announced, no findings have been published. We need answers, not least about the real cost of the delayed opening. The current estimate of additional costs for the remedial works is £16 million. The Scottish Government must be open about how much the public will be expected to pay including details regarding ongoing maintenance and the delayed sale of the old Sick Kids site.
In addition to the financial cost there is the inarguable human cost. I am glad that the Health Secretary has affirmed that patient safety is her main priority, however, continuity of care will no doubt be affected. Appointments have already had to be postponed and it is essential that any further disruption to patients’ treatment is minimised. Staff who have long been preparing for the move will also now be stuck in limbo until autumn next year. Some may be facing issues with commuting or childcare, or just experiencing general disruption to their lives. Our NHS workers are our most valuable asset and it is imperative that morale is maintained.
The way we can best serve patients and staff, however, is to break the endless cycle of delays and construction errors and bloated costs that have caused so much harm. To do this we must go back to basics. If we cannot get construction of ventilation or drainage or even a wall right, we need to start from scratch and design a system that works for the public, rather than shareholders.