Issues continue to dog delayed new Royal Adelaide Hospital
IT was supposed to open in exactly one year but teething problems have dogged South Australia’s biggest infrastructure project — the new $2.1 billion Royal Adelaide Hospital.
THE 800-bed flagship will be bigger, greener, more comfortable and private, more technologically advanced and have more parking than the existing RAH.
However, with such a huge project everyone involved is on a steep learning curve and are looking at lessons learnt from problems at new hospitals interstate.
Concerns about the new RAH mirror the situation with Perth’s newest hospital, the $2 billion Fiona Stanley Hospital, which has had cost blowouts and delays.
As the new RAH project unfolded the big build has had major successes on its path to being Australia’s most advanced hospital but also a series of hiccups.
Initial promises all existing services at the RAH would be at the new facility were gradually broken.
RAH gynaecologists were so incensed all six visiting specialists signed a protest letter, saying being pushed to the Queen Elizabeth Hospital would be bad for women’s health. Only cancer gynaecology will be available at the new RAH.
Likewise RAH ophthalmologists have steadily lobbied for a centre at the new RAH despite a new home at Modbury Hospital.
They are backed by groups such as the Royal Society for the Blind who fear people needing eye work face hours on public transport or huge taxi bills unless they live near Modbury.
The Government and contractors SA Health Partnership remain locked in dispute over how much soil was contaminated at the site and whether the Government should pay more.
The size of the claim is commercial-in-confidence but The Advertiser has been told it is around $80 million.
The contractors blame contamination problems for construction delays.
Last June, Chris Pratt, development director of building contractor joint venture HYLC, was sidelined amid talk of friction with the State Government.
A bigger shock was the SA Health figure driving the project, David Panter, announcing in January he was going to the private sector.
Part of Dr Panter’s job was how to transfer a major hospital into a new one with minimum fuss, a task he took so seriously he toured Scandinavia and London looking at how health authorities had done it there.
Last month program director for the new RAH Andrew Nielsen also quit abruptly.
The massive project now has an acting program director in Mike Allsopp, who worked as project director for the Gold Coast University Hospital.
As rumours of delays and cost blowouts grew, the Government’s said they had not received any information from the contractors that the April 2016 deadline would not be met.
However, in December, Health Minister Jack Snelling announced the new hospital would not be open for business until the second half of 2016.
The latest plan is to have the new and old RAHs running in tandem for 73 days at a cost of $176.6 million.
In response to questions from The Advertiser, SA Health released a statement confirming ongoing arguments over contamination costs, but declined to put a date on when the new hospital will actually have patients.
“Under the contract, SA Health Partnership is entitled to compensation for works not identified as within its scope, this includes remediation of contamination that was not identified in the State’s extensive site information reports,” the statement says.
“SA Health Partnership has submitted its claim for remediating unknown contamination and the process to determine this value is ongoing.
“The hospital is due for completion in April 2016. The Government continues to work towards that date, but in response to an expert review of the program, the Government has updated the budget papers to reflect a completion date in mid-2016.
“The hospital is due to open in 2016. The first patients will be admitted in 2016.”
Then there is the issue of the Enterprise Patient Administration System (EPAS), the $422 million electronic patient record keeping system that was supposed to be rolled out to 75 hospitals across the State.
It is in just three hospitals and has been put on hold due to glitches.
Senior surgeons at the Repatriation General Hospital where EPAS is in operation have written to SA Health boss David Swan saying EPAS “represents a direct risk to patient safety.”
At the Fiona Stanley Hospital a similar system was abandoned at a cost of $6 million.
However, because there is no room at the new RAH for paper records the Government is pushing ahead with EPAS there.
AMA State president Dr Patrician Montanaro says if the new system puts patients at risk the Government needs to have a Plan B.
SA Health is preparing contingency plans which would require “modified processes and manual workarounds” but the impact these would have on patient care is “unknown”.
Many lessons are being learned on the road to a hospital for the future.
The new RAH at a glance
THE new Royal Adelaide Hospital will have 800 beds, including 100 same-day beds, compared to 680 beds at the present RAH.
IT will have capacity to admit around 80,000 patients per year and will be South Australia’s greenest hospital with numerous sustainable initiatives incorporated into the design.
THE hospital will have 40 identical technical suites (operating theatres, intervention suites and procedure rooms) five more than the RAH, each measuring 65m2 — there is only one of this size at the existing RAH.
ITS Emergency Department will be capable of treating an extra 24,000 (25 per cent more) patients every year than the existing RAH.
THE new RAH will feature 100 per cent overnight single patient rooms with private ensuites and facilities for visiting families to stay the night.
ROOMS will have natural light, opening windows to allow fresh air inside and easy access to outdoor areas and internal gardens.
TECHNOLOGICAL features at the new RAH will include patient weighing beds, wireless technology and equipment tracking capabilities and in-room entertainment and meal ordering for patients.
A RETAIL precinct will be on site, offering services to patients, visitors and staff, and may include a supermarket, restaurant, cafes, bank and post office.
ADDITIONAL facilities such as a gymnasium and childcare facilities will be available.
A FLEET of automated vehicles will help move supplies and equipment around the hospital.
THERE will be 2300 car parks on site, a majority underground, and an emphasis on outdoor spaces, internal gardens and access to views.