This Supplemental Report of the Health Services Restructuring Commission (HSRC) follows its initial report, Thunder Bay Health Services Restructuring Report and intended directions (June 1996) and the Thunder Bay Health Services Restructuring Report and directions (October 1996).
On May 1, 1997, the HSRC received a copy of the Thunder Bay Regional Hospital's (TBRH) functional program concerning the consolidation of acute care, acute mental health and mental health forensic services on one site. The HSRC reviewed the functional program with the assistance of its consultants, The RPG Partnership.
The HSRC concluded that there is significant variance between the planning assumptions and cost estimates in the TBRH's functional program and the HSRC's estimates of October, 1996. Consequently, the HSRC engaged the services of a consultant with experience in hospital planning and design who had not had prior involvement with either the HSRC or with the TBRH. On June 18, 1997 the HSRC engaged the services of Parkin Architects Limited (PAL), a firm which has a long history of planning and designing health care facilities, to assess the planning assumptions used by the HSRC and the TBRH in arriving at their respective conclusions.
PAL was asked to review the HSRC's analysis and all of the documents that have been provided to the HSRC by the TBRH and the Thunder Bay District Health Council (DHC) and to comment on whether:
1. the assumptions used by the HSRC to determine the average space allocations, including cost estimates, for the programs and services to be provided at the Port Arthur General Hospital (PAGH) site are reasonable and consistent with industry practice;
2. the assessment and conclusions reached by The RPG Partnership in their review of the TBRH's functional program against the HSRC's assumptions are reasonable and consistent with industry practice; and
3. the assumptions used by the TBRH to determine average space allocations, including cost estimates, for the programs and services to be provided at the TBRH's Port Arthur site are reasonable and consistent with industry practice.
PAL has completed its review and its report to the HSRC is included in this document.
There are two major options under consideration, the construction of a new hospital (Greenfield site) and the redevelopment of the Port Arthur site.
The review undertaken by PAL of a greenfield site estimates the cost of a new hospital exclusive of site development, furniture and equipment to be $144 million compared to the TBRH estimate of $146 million. Both estimates include the cost of relocating the regional cancer centre. There is no material difference in our view between the cost of a new hospital estimated by TBRH and the estimate prepared by PAL.
The review of the cost estimates of the Port Arthur site undertaken by PAL highlights significant variations between TBRH estimates and the HSRC's estimates. The major variations are a consequence of the following:
The difference in construction cost estimates between the PAL analysis and TBRH is significant. This difference would add approximately $10 million to the $20 to $22 million that would need to be raised in the Thunder Bay region to cover the local portion of the re-development.
Based upon analysis of the TBRH functional program by The RPG Partnership, the DHC and Parkin Architects Ltd., the HSRC has concluded that the functional program is founded on assumptions that are not consistent with its directions and the application of established health care facility planning guidelines and practices when redeveloping and expanding an existing facility. The HSRC will advise the Minister of Health that we have re-iterated our direction to the TBRH to submit a functional program to redevelop the Port Arthur site.
The HSRC remains convinced that its direction of October 4, 1996 to the TBRH to consolidate all acute care services on the Port Arthur site and close the McKellar site are appropriate and should be implemented by the TBRH. The HSRC is prepared to recommend to the Minister of Health that the capital estimates should be revised to reflect the conclusions of PAL concerning the amount of new construction and renovations and the revised estimated costs.