A senior architect involved in Edinburgh’s delayed new children’s hospital has offered Health Secretary Jeane Freeman a list of all the design flaws he knows about so they can be addressed before patients move in.
Robert Menzies claimed problems were “built into” the £150m hospital because political pressure to avoid further delays saw bosses unwilling to take time to make changes.
Among the problems he highlighted were a failure to include a larger lift to accommodate orthopaedic patients needing to be moved with equipment, a child protection suite with a corridor separating two rooms intended to have a one-way mirror between them and classroom doors too narrow for beds to get through.
The opening of the hospital at Little France, due to take place earlier this month, was postponed indefinitely after it was found the ventilation system in the critical care unit did not meet national standards.
Ms Freeman has ordered extensive further checks including the new building’s ventilation, water and drainage systems but Mr Menzies said: “She may have unwittingly opened a can of worms.
“I will now furnish her with a list all the non-compliance issues I am aware of in the current design and I look forward to seeing how she proposes to address these.”
Mr Menzies, who has 40 years’ experience building hospitals, said: “I witnessed a decision-making process which repeatedly placed the need to meet deadlines ahead of patient safety.”
He said he had warned the “reference” design – drawn up with clinicians to let those bidding for the contract know what was required – needed an additional three months’ work to make it viable, but that was refused because “a further delay was politically unacceptable”.
Mr Menzies said an insistence on sticking rigidly to the reference design when it had not been properly finalised led to problems.
“The orthopaedic team wanted a lift that was bigger than the normal bed lift because, when you’ve got a patient with attachments, it’s difficult getting them in and out of a lift, so I told the lead architect three times we needed at least one lift that’s bigger but it was never incorporated. It got to the point where I drew up a lift lobby layout with the big oversize lift and said, ‘That’s what they want,’ but they came back and said no, it was too late, it couldn’t be accommodated.
“Looking at the latest plans, it’s just a standard bed lift. I only have the drawings that went to planning. They may have caught it, but I doubt it.
“There’s a child protection unit – cases of child abuse can often be picked up in A&E – and it has two rooms which are meant to have a one-way mirror to allow staff to monitor the child during an interview, but the design had one room on one side of the corridor and one on the other.
“The architect refused to change it despite my instruction to do so. I was overruled from above on the grounds that I was ‘adding delay’. I hope this has not been built but I don’t have access to find out.”
He said some classrooms at the hospital had single doors despite repeated requests from teachers for a door-and-a-half to make it easier for children to be wheeled in in their beds
Mr Menzies added: “The comment I got back was, ‘We’re not interested in betterment, we’re interested in compliance’. They didn’t want any departure from reference design but they were agreeing actually our layout was better.”
He spoke out two years ago, warning the building would end up “not as good as it should be” because the pressure to meet deadlines led managers to ignore potential problems.
At the time Susan Goldsmith, then acting chief executive of NHS Lothian, dismissed his claims of design flaws and said there had been a “rigorous and lengthy design process”.
But Mr Menzies said the latest developments suggested he was right.
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He said: “The process didn’t take into account that the reference design wasn’t sufficiently advanced for it to be built as it was.
“We knew the clinicians weren’t happy with the layout but were forced to sign them off to avoid further delay. It’s not a good way to build a hospital.”
Ms Goldsmith, who is now NHS Lothian finance director, insisted the “disappointing current delay” moving to the new hospital was “completely unrelated” to Mr Menzies’ points.
She added: “The delay is caused by a problem with ventilation in critical care which was identified during the final checks. Further tests are being carried out in all clinical areas and in a further sample of general areas to gain additional assurance that the required standards are met.
“We are working closely with Scottish Government, Health Facilities Scotland and Health Protection Scotland to verify that all aspects of the building meet the necessary standards.
“We are exploring if a partial migration of some services, unaffected by this issue, may be possible in the shorter term.”