The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

A former health minister yesterday blasted the proposed $290m new hospital as “an absolutely insane idea” and challenged why the cost has risen more than five-fold under the Davis administration.

Dr Duane Sands, who held that Cabinet post under the former Minnis administration, told Tribune Business he fears the Government is “about to waste tens of millions of dollars of the Bahamian people’s money” already sunk into upgrading the Princess Margaret Hospital (PMH) with its plans to construct a second such facility in the Perpall Tract area.

Asserting that he cannot see “the necessity or rationale” for another New Providence public hospital, he contrasted the near-$290m price tag with the $55m cost estimate publicly unveiled by his immediate successor, Renward Wells, for a similar facility at the PMH site.

Mr Wells, during the 2021-2022 Budget debate, said the then-Minnis administration planned to invest some $55m to construct a six-storey tower at PMH’s downtown campus that would house several medical units including a new children’s ward, surgical ward, maternal care and gynaecology ward.

That plan has seemingly been abandoned, with Dr Michael Darville, minister of health and wellness, confirming to this newspaper that the planned Perpall Tract hospital will house many of the units eyed for that six-storey tower - maternal, childcare and adolescent health, together with the blood bank, “hub for tele-medicine” and unit for infectious diseases - to ensure The Bahamas can better handle another pandemic.

While the new hospital will house more units than the dropped six-storey tower, Dr Sands nevertheless argued that it represents a 428 percent cost increase on the former administration’s price tag. He also asserted that having two separate sites will cause “duplication” of medical services, and questioned why the Government is expanding hospital facilities when it presently lacks adequate workers to staff PMH.

“I think it’s an absolutely insane idea,” Dr Sands told Tribune Business of the new hospital. “The amount of the people’s money that’s been invested into the planned redevelopment of the downtown campus, the Government is about to waste tens of millions of dollars of the Bahamian people’s money like they did with the Central Bank headquarters project.

“I’m not sure they have a good reason. We had done extensive cross-administration studies looking at phased redevelopment on the PMH campus starting with the Critical Care Block. The next step was the child health, maternity and emergency room. The idea was to invest in the campus downtown [PMH] in a way that was sustainable, affordable and would not break the bank.”

Both the Christie and Minnis administrations had hired the Beck Group, a US architectural and engineering firm headed by Bahamian, Fred Perpall, to plan the redevelopment of the PMH campus. Its 141-page report, which has been seen by Tribune Business, called for the demolition of existing buildings, including the PMH warehouse and oncology units, to make wake for the new six-storey tower and a helipad.

Further phased redevelopment called for the demolition of existing clinics and storage and their replacement by a medical/surgical tower; expansion of surgical services; and other facilities. Beck Group had proposed a five-phase approach that also involved the creation of additional parking and a clinical housing complex according to the plans seen by this newspaper.

As a result, Dr Sands argued it was “simply absurd” to drop this plan and “start afresh” especially since it had previously been supported by both PLP and FNM administrations. “Why are we abandoning a bi-partisan approach prepared by the Beck Group?” he asked.

“This was not something that was an off-the-cuff idea. This was something that we spent months and years coming up with. I’m deeply concerned. This is not objecting for objecting’s sake. This is about how we move public health forward.

“The Critical Care Block is the single biggest public health investment in the history of The Bahamas and it’s falling into disrepair. It’s not been maintained. How are we going to spend $290m when we cannot maintain this investment asset? It’s absolutely stupid, and pandering to the belief that somehow there’s an infinite resource of recourse.”

Dr Darville, though, told Tribune Business that the issue of whether to further redevelop/expand PMH or “go to a greenfield site” with a new hospital had been thoroughly studied by healthcare planners. The latter option was chosen because it was thought better to “create a specialist hospital” to handle maternal and child health issues. This, in turn, would free-up space at PMH to expand surgical and other services.

“We assessed the situation on reports left behind and some additional work,” Dr Darville explained. “It was clear to us that PMH cannot be moved as a lot of money has been invested there. We felt we should decouple specialist services from PMH and use the space left behind for the development of general surgery and medicines.

“Most countries have specialist hospitals and we wee advised to move in that direction. It doesn’t take staff away. The former administration wanted to create a child and adolescent wing. We wanted to create a child and adolescent hospital, and this would allow PMH to improve the services left behind.

“Our healthcare planners guided us in that direction. This is a proven approach to the delivery of these services.” Dr Darville said this model is a track that other Caribbean countries have taken, and he argued that there are “a lot of issues with child and maternal health that need to improve”, including mortality and morbidity rates, “although we’ve pumped a lot of money into it”.

“We can do a better job with that,” the minister added, “and follow suit with the rest of the region. A specialist hospital for child and maternal care is long overdue. We’ve decided to go in that direction.”

Dr Sands, though, was far from convinced especially given the new hospital’s $290m price tag even though the project is set to be financed at a concessionary 2 percent interest rate via a 20-year loan issued by the China Export-Import Bank, the same Beijing government-owned institution that financed Baha Mar’s multi-billion resort development.

“I don’t see it. I don’t see the necessity or the rationale for this decision,” Dr Sands reiterated to Tribune Business. “I think that, for a number of reasons, this ought to be rethought. I don’t see what real benefit accrues to the Bahamian people.

“The first thing is that, as you may recall, the minister of health that followed me, Renward Wells, he would have given the House of Assembly a report that said we would have gotten funding for the maternal/child wing at a cost of $55m on the site of PMH. How is it this is locked at $290m? The maths still ain’t math-ing.

“You also have a situation where you start the disintegration of healthcare. It means you have to duplicate various services. You have to have a laboratory, an imaging unit, over at the new hospital but you don’t have enough human resources or equipment to maintain what you have now,” Dr Sands argued. “What makes you think you will be able to afford and maintain duplicate facilities?

“Right now, PMH or the Public Hospitals Authority (PHA) is under-funded by about $30m per annum. You don’t have enough nurses in critical care, the operations room or the Neonatal Intensive Care Unit (NICU).

“If you are going to run a maternal hospital, you need an NICU. We already have the largest NICU in the Caribbean, which is not maintained. If you cannot maintain the single largest unit for healthcare already, why redo it somewhere else when all the experts will have to travel back and forth and will have to do so in traffic.

“We already have a situation in The Bahamas where a significant portion of healthcare facilities are shut down because we don’t have sufficient human resources. Now you want to make that problem worse? How dumb is that?”