Ringing the alarm on Nova Scotia's new hospital construction project

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Here's something to feed your nightmares. According to the last estimate, it would cost a cool $1 billion to replace the troubled Victoria General hospital in Halifax.

Obviously there's a need to swallow hard in a province that's already feeding a considerable herd of white elephants. If anything goes wrong this could be the alpha bull.

The government is about to release a plan to go forward -- the key considerations apparently being: whether to renovate (and it does seem to me the problems of burst pipes and dirty rooms are not with the building itself but the failure to maintain the insides), build something smaller as part of a more decentralized system geared to less hospitalization, and whether to go for the controversial public-private partnership formula to finance it, an arrangement that has frequently failed in the past.

Either way, it looks as though there will be a construction project.

Allow me to be mildly alarmist. Big construction projects are very complex and in the public sector especially they have a tendency to get out of control.

Hospitals especially so -- with their mazes of special wiring, tubing, modern medical gear to be fitted in, and so on.

Making sure one thing doesn't interfere with another, keeping the sub-trades from tripping each other up and managing the materials requires a virtuoso performance that can easily go awry if things have to be undone and redone, wrong materials installed, plans changed mid-stream, bad judgments made and so on.

I've got a feel for all this because a good many of my friends and family are in construction and I've heard many stories. Before I dispense any advice, let me share some stories with you.

A family member is in charge of drywalling at a major new hospital (this one outside the country -- we're not alone in this stuff). He's on the phone. The conversation goes like this.

Me: "Hi Ian, how's it goin'?"

Ian: "Fine." (In an ironic tone of voice that means "not fine.")

Me: "Oh, what's up?"

Ian: "They're ripping up my drywall for the sixth time."

Me: "What is it this time?"

Ian: "They forgot to wire in the nurses' emergency buttons."

Here's another one. It's a hospital renovation, this one in Nova Scotia. It's the big meeting before the final go-ahead. The architects, administrators and others are there, and more or less as a courtesy they've invited the little old nurses in to comment on the plan.

According to my informant, the little old nurses proceed to lay waste to the big shots with a series of devastating questions, the first of which is: "And how are we supposed to roll a five-foot bed through a four-foot door?"

Uh oh. Recommendation No. 1: keep the nurses in the loop throughout the project.

Rec. No. 2: Make sure the wiring, plumbing, etc., are all in before you put the drywall up. (You'd think this was obvious, but you'd be surprised what can go wrong when everything's happening at the same time.)

Here's my ultimate story. It's the big meeting, some 30 years ago, to decide whether to go ahead with the big QEII hospital complex in Halifax. The premier -- John Buchanan -- is there. A medical consultant who was part of the process, sounding still rattled decades later, told me the premier had only one question: "Are there any votes in it?" (Rec. No. 3: We come from a dark place. Keep politics out of it.)

Here's my ultimate advice to you, the bureaucrats and politicians who will decide all this. First, recognize that you are clueless and are seen by the architects, engineers, consultants, lawyers and others assembled by large construction companies as raw meat.

How to get around this and get some vital ground-level perspective?

Fortunately -- if I can use that word -- we have a recent debacle to learn from. I'm talking about the Bluenose II. You'll remember that Lunenburg shipbuilders who actually knew something were shunted aside, left to watch in horror as the consultant-bureaucrat complex made a hash of it, costing tens of millions of dollars extra and embarrassing the province.

The hospital equivalent to the Lunenburg shipbuilders would be veteran construction superintendents who have worked on hospitals before. These are mostly people who started as tradespeople and worked up, learning all the angles as they went, as opposed to the top-down experts.

They're the ones who know the real story. They tend to be get-the-job-done types who aren't media- or bureaucracy-savvy.

If you're lucky enough you'll get maybe three of these -- perhaps recently retired ones -- to watchdog the job, backfeed you and blow the whistle if things go awry.

Just don't believe everything you hear from the experts.

This is not so much a column as a prayer for delivery from the white elephant herd. Amen.

Ralph Surette is a freelance journalist in Yarmouth County. This column was first published in the Chronicle Herald.

Photo: Stewart Rand/flickr

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