The least bad option

The Government’s decision to build the new hospital in the Botanical Gardens is the best of a poor set of options.

Phased redevelopment of the existing site would have been the most expensive, longest, and riskiest option. Turning the current hospital into a building site, and having to rely on it beyond the building’s useful life, would at best be an inconvenience to any of us who had to be treated there, and at worst could have put our health at risk.

The Arboretum, which I initially favoured, would have been the quickest and cheapest to develop, and would have enabled the whole of the existing hospital area to be absorbed into the Botanical Gardens. In hindsight, however, the poor access from the western parts of the island was probably an unacceptable and insurmountable obstacle.

That's not to say that the new location isn't without major disadvantages too. Although the Bermuda Hospitals Board (BHB) have said that they will return the existing site to green space once the new facility has been built, this will result in the new hospital being bang in the middle of the Botanical Gardens. It’s hard to see how this will not detract from their appearance, although perhaps some clever landscaping will be able to minimise the impact. Putting all car parking underground would help.

That said, some of the criticism levelled at the BHB and the Government for the decision is overblown. It’s wrong to suggest that this decision somehow undermines the Government’s commitment to sustainable development. Sustainable development does not mean that open spaces should be protected at all costs. It is not solely about the environment. As Health Minister Patrice Minors pointed out, “Sustainable development does not mean ‘no development’ it also means sustainable healthcare.”

I also think that it was unfair of Steve Conway, director of the National Trust, to criticise the Government for making the decision without seeking public input. The hospital did seek public feedback on its proposals, both on its website and at a public meeting.

Nevertheless, I can understand why many people are upset by the decision. Perhaps the Government might consider turning a substantial part of Morgan’s Point into parkland, to help alleviate the sting.

» More comments on the decision to locate the new hospital in the Botanical Gardens can be found here.

Comments

[ken on 31.08.06 at 13:52]

Limey,

Thanks for a very fair assessment of the situation. I thoroughly agree with your view of this.
I can't for the life of me figure out where sustainable development means that we should not develop at all. I think this option was definitely the best of the available options...is it perfect, of course not, but hopefully with the right architects, and landscaping etc, the impact on the beauty of the botanical gardens will be minimized. The Government and the BHB have a responsibility to provide quality healthcare to our residents. To do this effectively means to have a facility that is up to date and fully functional and where standards are high, both physical and professional. We all know that the current hospital is in desperate need of upgrading. For all the criticisms, I haven't heard anyone suggest a better alternative.

The most vocal argument is that we are destroying open space. It was clearly stated that the current site will be returned to open space and provide 4 acres more than currently exist. Therefore I render this argument null & void. I don't believe that by building this hospital that it means the Government is ignoring the topic of sustainable development, I think it actually reinforces this idea by turning the land back to the gardens. Had the Government decided to create condos or offices at the current site, then the criticisms would be well founded.

[Angry Cahow on 31.08.06 at 13:53]

The current proposal puts the hospital at the very heart of the Park. That is totally uneccessary.

[ken on 31.08.06 at 13:59]

Angry Cahow,

How would you suggest it be laid out?

[observor on 31.08.06 at 14:01]

The most vocal argument is that we are destroying open space. It was clearly stated that the current site will be returned to open space and provide 4 acres more than currently exist. Therefore I render this argument null & void

ken - I realise the choice for the BHB was not an easy one but I don't see how these magical 4 acres will ever be returned to totally comparable open space. Furthermore is there not another corner of the botanical gardens which could be used instead of popping the massive medical edifice smack dab in the middle of the park?

We really need to see a 3D rendering of the plan (a fancy scale model including the entire surrounding area would be nice) and every effort should be made to put as much of the structure underground as possible (parking, maintenance, admin offices, diagnostics, cabinet office :-), etc.) as the only people who really need a park view are the ones there for treatment and recovery.

[ken on 31.08.06 at 14:03]

Observor,

I agree that to fully understand the layout etc we will probably need a 3-D model etc, but I also do not believe that the intention of the press conference yesterday was for that purpose. I think it was because the information had been leaked to the public. I would hope that the public will see a scale model of the surrounding areas to gain a better perspective on the project.

[sleepy on 31.08.06 at 14:07]

The leak was only 24 hours in advance. It didn't change the content of the press conference, other than the Minister being on defense rather than having the upper hand.

[ken on 31.08.06 at 14:09]

Sleepy,

I actually found Minister Minors, Ms Symonds and Mr Richardson to speak very well about the entire project. They spoke confidently, and assuredly about the rationale of the decision and how the project will carry out.

[Guilden M. Gilbert, Jr. on 31.08.06 at 14:12]

Observer,

Maybe by putting the hospital in the selected location there will be minimal digging to install sewerage lines, to re-route electrical ad telephone line, etc.

[sleepy on 31.08.06 at 14:14]

I don't disagree Ken. But rather than being in control of the info and dishing it out with the best spin, they were having to react.

It seemed to me that you were suggesting that the press conference rushed them and they couldn't give all the details. That wouldn't have been the case.

It was the same press conference 24 hours later, but with the press aware of the details and prepared.

[Angry Cahow on 31.08.06 at 14:21]

Can you say "coordinated spin"?

[vitruvius on 31.08.06 at 14:21]

"I also think that it was unfair of Steve Conway, director of the National Trust, to criticise the Government for making the decision without seeking public input. The hospital did seek public feedback on its proposals, both on its website and at a public meeting."

Posted by the Limey

"We know the community was in favour of a same-site development......" Minister Patrice Minors quoted in the RG.

Did I hear someone say Lip-Service?

[ken on 31.08.06 at 14:23]

Vitruvius,

I am not sure what you mean. Just because the people that responded to the survey said they preferred same site development does not mean that the Government has to accept that. Then these same people may be complaining about the 100M extra and the extra time etc. Those factors may not have been in these peoples' minds when they chose same site development.

[Tiggy on 31.08.06 at 14:51]

Royal Gazette swooped by the Bermuda Sun yet again!!!

I'm disappointed, I'll admit, as I initially thought they could rebuild the current KEMH in phases without too much disruption. Having read the RG today, I understand this really wasn't an option. That being said, no-one has come forward with an alternative and I think the planners did what they had to do considering location, access, space etc.

So does this mean the old King Edward Memorial Hospital will die a sorry death and the new Frederick Wade Hospital rises?

Too bad the old dump area isn't fit to build on yet. Or is it????

[Tiger Bay on 31.08.06 at 14:52]

I very much doubt they were ambushed by a leak. They were ready with this website and brochures:

http://www.bermudahospitals.bm/newBuildingSite/index.html

I suspect they have a proposal on the table from someone to build it for them on a lease back arrangement.

[sandgrownan on 31.08.06 at 14:54]

Tiger Bay - a PFI project? The most discredited way of keeping capital expenditure off the balance sheet?

[Tiger Bay on 31.08.06 at 14:58]

Tha's right ... Two possible means have been discussed; one with money being borrowed by Government to finance the project, the other with a contractor footing the bill and then leasing the building back to the BHB.

[Tiggy on 31.08.06 at 15:00]

Will have to be a very large contracting company!

[eh on 31.08.06 at 15:08]

My first reaction was NO NO NO! After reading the obviously carefully crafted press release, I can see the merits in encroaching on the Botanical Gardens. However the proposed siting is abysmal. The siting of the building in the centre of the Gardens destroys the integrity of one of the jewels of the parks system. This is one of the few quiet oases on the island in which it is very pleasant (therapeutic even) to lose yourself.

See that "New Acute Care Hospital Lawn"? Don't be fooled. That is either going to be additional car parking or the location of a new expansion that the BHB has planned as a future project. That's why you put a development in the centre of a green space - it maximises your options for expansion on any side of the building! So don't be fooled by the +4 acres of green space - this layout sets them up to be gone in the long run.

I would much rather see them take over the conveniently flat arena grounds, excavate the hill to the east, and utilize some of the existing site. This would let them phase the migration effectively and reuse some of the existing site, without having to build and operate in the same structure. It would also let them locate emergency access conveniently near to Berry Hill Road. What circuitous route would arriving ambulances be taking in the current layout?

Do they even own that "Springfield Woodlands" to the west? If so, why hasn't it been a part of previous proposals? Heck, they could build over that area AND the arena AND rebuild the existing site, to get an even bigger facility, and that would STILL be better than this layout.

Some of the buildings that are being taken out are Parks Dept operations where their industrial vehicles are stored. That will take out one of those new green acres by itself.

Pity the poor folks organizing the Agricultural Exhibition.

[SmokingGun on 31.08.06 at 15:20]

eh - I would agree. I'd personally much prefer something along the lines that you suggest. And I also agree that letting the fox into the hen house always ruffles a lot of feathers down the line. The fox always gets too greedy and kills more than he needs to.

[sandgrownan on 31.08.06 at 15:20]

PFI has been discredited to such an extent in the UK, particularly in the healthcare field, that I shudder to think of the implications for Bermuda.

I sympathise with having to make a bunch of tough decisions, I just think this is wrong.

[Pompous G Windbag III jnr. on 31.08.06 at 15:36]

PFI has had problems in the UK - although as a former No.11 advisor I would argue much of the criticism has been poorly argued and should have been directed at the project rather than the method of finance.

The danger in Bermuda where there is such lax accounting oversight and so little transparency of financing government projects is that this adds another layer of obfuscation. If Paula Cox is anything to go by I seriously doubt whether there is a great deal of understanding of the end results of off balance sheet transactions such as this.

[Tiggy on 31.08.06 at 15:48]

Just ask international business to pay for it like everything else?

[Tiger Bay on 31.08.06 at 15:48]

"Will have to be a very large contracting company!"

Or HSBC, who have discussed such measures with Gov for both the hospital and causeway according to previous coverage in the local media.

[Tiger Bay on 31.08.06 at 15:50]

"That's why you put a development in the centre of a green space - it maximises your options for expansion on any side of the building! So don't be fooled by the +4 acres of green space - this layout sets them up to be gone in the long run"

BINGO - this proposal already effectively cuts the Botanical Gardens into two. The western portion would be under heavy pressure for development.

[sandgrownan on 31.08.06 at 15:55]

PGWIIIJr - then you should know better. It's a scheme that burdens the tax payer with much greater expense than if the the project was kept in the public sector in the first place. What it really is, is a crude accounting trick to keep borrowing off the balance sheet.

You are correct in one sense though, given this Governments lack of ability to control finances effectively, the results would be catastrophic.

Presumably you read the late Paul Foot's expose of the real costs of PFI?

[Pompous G Windbag III jnr. on 31.08.06 at 16:02]

Mr S

I love Foots work and have contributed to Pressdram regularly over the years but some of his assertions were a little eroneous. I am no real fan of the net effect of PFI in the health sector but it has worked in higher multiplier areas such as airport facilities.... Anyhoo - I think we might agree that what Bermuda really needs for this project is transparency, accountability and competence.

I'm not holding my breath.

[sandgrownan on 31.08.06 at 16:05]

Agreed.

[Tiggy on 31.08.06 at 16:07]

"The western portion would be under heavy pressure for development."

Especially along Pitts Bay Road which has now become Doctors Office Golden Mile!

[SmokingGun on 31.08.06 at 16:10]

I imagine there are a number of well connected plpayers drooling over the contracts as we type.....

[thisgrassman on 31.08.06 at 16:10]

Anybody been to Central Park or Hyde Park - the reason these spaces work as a green oasis in the urban context is because at the center you have the illusion of escaping the built environment around you.

[sandgrownan on 31.08.06 at 16:16]

I have to favour redevelopment of the existing site, even at greater financial cost and at the risk of disrupting patients.

Smoking...you can almost hear them ordering new boats, cars......! PGWIIIJr is quite correct in that this needs to performed in the full glare of public scrutiny. They owe it to us after the Berkeley fuck up.

[Angry Cahow on 31.08.06 at 16:17]

I agree. Large contiguous blocks of land should not be broken up.

[wyrdsister on 31.08.06 at 16:36]

given the difficulty they had building the school does anybody think this government capable of building a hospital?

Is there no way that they can knock down the old hospital building, which for the most part appears to be empty, buld there, move the hospital over and then renovate KEMH? Why can they not renovate the hospital in stages? It maybe a cheaper option in the short term, but what about the long term impact on the whole of the Island, because if you believe that the current hospital land will be returned to green space, I have a bridge to sell you. What will be the cost of doing that? Will they just bulldoze everything to the ground and then plant on top? Why is it that a building that is only 40 years old is now past its Best Before Date? Was it that badly built?

There ends my rant for the day!

[Tiggy on 31.08.06 at 16:43]

Sorry, Point Finger Road.....

[thisgrassman on 31.08.06 at 16:47]

wyrdsister,

there are major parts of the hospital that are less than 10 years old. The new surgical wing (as you drive in from Point Finger Road)and the new medical waste incinerator - both built at vast cost to the taxpayer. These structures have many years of use left in them. How wasteful and unsustainable is it to be demolishing buildings that can be useful for many more years?

But that is Bermmuda - we are a throw away culture with a short term vision.

[Angry Cahow on 31.08.06 at 16:52]

Ther's no dispute that KEMH needs to be replaced - a renovation will not suit the changing needs, traffic flows, and technology.

But that doesn't mean sacrificing a key piece of Bermuda's green space. What's next, giving up the parkland Ferry Reach, Martello Tower, and/or Coney Island because we need a new causeway? Because that's also on the table.

Or filling in a chunk of the Harbour because the Corporation wants a bigger tax base? Because that's also been proposed!

Government did not give design constraints to the planner - thus they have taken the maximus approach.

[Zoom on 31.08.06 at 16:58]

Freddie Wade Hospital, yes, I can feel that one coming.

[SmokingGun on 31.08.06 at 17:00]

I just googled the site to get another view and I'm starting to have a hard time justifying the use of any of the botanical gardens.

If they did a three phase development they would not only be able to stay within the footprint already being used but they could actually reduce it with underground parking and a better layout.

A: Build a new facilty north of Berry Hill Road where the parking lot/catchment area is. This would be to house all the doctors offices etc. as well as have a significant parking garage underneath. A future underground tunnel or sky bridge will rejoin the complex.

B: Once section A is built move all doctors and clinics over to it and demolish the buildings currently housing them. Build out the main hospital complex on that site directly abutting the old facilty.

C: When finished move everyone over and tear down the old building. Build additional underground parking as well as elderly housing/nurses quarters overlooking the Botanical Gardens. Connect everything with tunnels and/or sky bridges.

As construction will be happening in perimeter areas and can be easily cordoned off with seperate dedicated points of egress the actually operation of the hospital will have little disruption.

[Tiger Bay on 31.08.06 at 17:41]

They have previously announced plans to develop housing for nurses and overseas doctors on the hillside north of Berry Hill Road (currently parking, water catch, and trees).

[SmokingGun on 31.08.06 at 17:50]

Housing would need to be the last phase. They could always use Gilbert Lope's SDO space for initial housing until the hospital site ones are ready. Ideal location as they're just down the road.

[googlybda on 31.08.06 at 17:51]

I think this is a reasonable option, if the current site is returned to open space.
I believe the financing should come directly from the community, including International business at a favorable interest rate. Rather than pay a long term profit for rent to a developer or finance company. These Bonds would be useful for Pension Funds to get secured rate of interest and retirees to get a good income. Say 8%, well with any return expected by a developer (10%+). Either way the taxpayers have to pay.

[SmokingGun on 31.08.06 at 17:55]

googlybda - I totally agree that floating a bond would be the best financing for such a project. Especially as it will allow for more oversight.

[Horst on 31.08.06 at 21:21]

I feel I have to add my 2 cents worth here; I am DISGUSTED with the plan to build in the Botanical Gardens. Let's remember that many of the trees over there were specifically imported as botanical specimens and are historically important. The plan I saw doesn't show how the access roads, parking and support facilities will impact the area. And I very much doubt that the old site will ever be returned to green open space (some bright spark will make a case for other development).

It might cost more and take longer, but in the long run destroying one of the few green spaces left is a bad idea to say the least.

The plan that might work better is to put emergency / trauma / out-patient facilities at each end of the island, and build the new hospital on the site of the old hospital (now used by various health services and labs). I understand that Government has purchase almost all the land between Berry Hill Rd and the current complex; use that space if needed.

[stuart J Hayward on 31.08.06 at 23:23]

Ken writes:

I can't for the life of me figure out where sustainable development means that we should not develop at all.

No one has ever suggested such. None of the arguments or counter proposals has even hinted at ‘not developing at all’. That statement by the Minister was purely a PR device and a dishonest misrepresentation of SD. The government will have a difficult time selling its sincerity for SD if at the same time it devalues SD and SD proponents through such spin-driven statements.

The most vocal argument is that we are destroying open space. It was clearly stated that the current site will be returned to open space and provide 4 acres more than currently exist. Therefore I render this argument null & void. I don't believe that by building this hospital that it means the Government is ignoring the topic of sustainable development, I think it actually reinforces this idea by turning the land back to the gardens.

Unfortunately, another piece of PR. All 24 acres, the old and new sites, are being put under the control of the BHB. The BHB plans to use both sites for future expansion. In effect the public lands will be depleted by ten acres of high environmental quality green lands and the BHB lands will be enriched by ten acres, which they will be able to do with what they wish, how they wish and when they wish. In fact, once this land is put into the hands of the BHB, the government will have no say in what is done with it. Thus the Minister’s statement that her government will “ensure that open space is maintained for generations to come” is not only hollow, it is patently false. And the Minister is attempting to deceive the public by making such a statement.

[thisgrassman on 31.08.06 at 23:46]

Mr Hayward, sir......you are a champion.

[Tiger Bay on 01.09.06 at 07:39]

Thank you Stuart; I had not realized that the magic acres that "would be returned to the park" would in fact remain under BHB control and not a "protected area" under the Parks Act.

(Not that the Parks Act means anything these days. It ranks right up there with "public consultation" for emptiness).

This project is another massive step towards the negative urbanization of Bermuda.

They've been taken by their designers, who of course want to build the most imposing edifice to enhance their portfolio (much like the crazy overbuild proposed for the Hamilton waterfront). After all, most hospital projects of this kind are required to rebuild on their existing sites!

[Horst on 01.09.06 at 07:58]

Stuart, thank you... I did not realize that the BHB would retain control of this space. 'Spin' and 'PR' are terms too polite for what has been said.

I'm not 100% up to speed, what faith do we have in the accuracy of the financial projections, have the design details been released?

There can be no faith in the current administration.

[sandgrownan on 01.09.06 at 08:54]

It was interesting to see Minors on TV last night talking about fiscal resposibility and transparant use of the public purse. I beggers belief that anyone from this administration has the balls the stand up and say that with a straight face. Laughable.

[weaselguard on 01.09.06 at 09:03]

Thank you for your input Stuart. Yesterday on the recently deceased Replacing the Hospital thread, I asked if you might stand down from the Government's SD project in protest. Maybe you are needed there as the fox in the hen house. However maybe a march could still be arranged. It depends on people and what they want Bermuda to be.

Right now I see some in government wanting monuments to themselves. They do not love Bermuda, the entity, the sky, earth, water and critters.

Does Bermuda need another be all, end all edifice to stroke the egos of those in power.

Why not, smaller, but better.

[weaselguard on 01.09.06 at 09:40]

Governments past and present have often depended on and encouraged the ignorance of the people to manipulate events and activities.

I think this is happening here. Sometimes the people's "ignorance" backfires on those in power, recently the signing of the referendum by those who didn't know what they were signing comes to mind.

I hope that Bermudians see this as a community issue and not allow those in power to create further division by characterizing it as a black/white, UBP/PLP challenge.