Health chiefs threaten to scrap new Sick Kids hospital

HEALTH chiefs are to consider scrapping plans to build a new Sick Kids Hospital at Little France after revealing the project has been delayed again.

The new £250 million hospital was originally due to be finished in 2013, but will now not be completed until at least 2017, admitted NHS Lothian – if it goes ahead at all.

The health board needs Consort, which runs the neighbouring ERI, to agree a land-swap for the new hospital to be built. But Consort needs the agreement of 11 different banks, and one has so far refused to sign up to the deal despite many months of negotiation.

Interim chief executive Tim Davison told board members that the project was “in danger of becoming a pawn in a complex game of chess”.

In a bid to end the deadlock with Consort, members of the NHS Lothian board have agreed to look again at their original “Plan B” for the Sick Kids’ future, which would mean staying put on the existing site in Sciennes.

The option was originally rejected in 2008 as it would not meet the main requirements for a children’s hospital. But board chairman Charles Winstanley yesterday ordered a paper to be drawn up reconsidering the option for discussion at the next board meeting.

The land needed for the new hospital, and the Department of Clinical Neurosciences which is to be built alongside it, is currently occupied by a car park.

NHS Lothian has built a new car park which it would hand to Consort in exchange for the existing plot. But that cannot happen until the so-called “eleventh bank”, which has not been identified, agrees to the land-swap, a deal known as Supplementary Agreement 6, or SA6.

Until that happens, no contractor can be appointed to build the new hospital.

Finance director Susan Goldsmith said yesterday: “What’s become clear is that the bank in question has no issue with the principle of SA6 but they want to agree a different commercial arrangement with Consort’s shareholders so they’re taking SA6 to open up a dialogue with Consort. That’s something that we as a board can’t resolve. The agreement is between Consort and the 11 banks so we’ve also been in dialogue with the [Scottish Government’s] Scottish Futures Trust and the Scottish Futures Trust have now stepped in to work with the Treasury and the bank in question and we understand that there will be a conversation with the bank this week.

“That means that I’m not in a position to advise the board when this will be resolved.”

NHS Lothian said until recently that the new hospital would be ready by 2016, but Mrs Goldsmith said at yesterday’s meeting of the board: “2016 is no longer do-able. It will be early 2017.”

Non-executive board member Richard Williams, who represents GPs, suggested that NHS Lothian should reconsider the option of staying at its current site in Sciennes.

He said: “We’re being held to ransom by an arrangement that we have no control over. I seem to remember there was a Plan B. Is it time to revisit Plan B? It might remind some of the other players in this game of chess . . . we can’t have these players believe they’re the only game in town.”

Mr Winstanley agreed, and asked for a paper to be brought to the next board meeting discussing the viability of keeping the hospital at its current site.

Fears have been expressed that Glasgow’s new children’s hospital, which is being paid for directly by the Scottish Government instead of through private funding, could become Scotland’s only centre of excellence for children’s medicine because building is already under way while Edinburgh’s project remains stalled.

The board’s deputy chairman, Eddie Egan, said: “I’m increasingly concerned that the new children’s hospital in Glasgow is going up at a rate of knots, with a car park full of cars and our car park is lying empty.”

Board members also expressed fears that there were currently no plans for improving facilities at the existing Sick Kids because it was expected to be decommissioned, but it would now have to remain in use for at least five years.

Director of public health and public policy Alison McCallum said the delay would have an effect not only on the building programme, but also the modernisation of some services. She said: “The concern that I have is that all of the things that we put into place to try to improve the care of young people with this new build are also now delayed.

“It’s not just the building itself. It will be five years before we’re able to have the physical manifestation of some of our ambitions.

“People have put a lot of time into helping design services that would help us meet all of the requirements of children’s rights and have a much higher quality services and some that we’ll have to do differently because we can’t rely on a new building. ”

Following the board meeting, Mrs Goldsmith said: “It is taking longer than we had hoped to complete the agreement with Consort and their funders over the changes to the lease which would facilitate NHS Lothian developing the building on what is now car park B.

“In developing the business case for this project we have investigated a number of alternative sites for this building.

“We are again reviewing all our options to ensure we minimise any further delays to this important project.”

A spokeswoman for Consort said: “Consort is in continuous dialogue with the remaining lender to conclude the deal as quickly as possible and is in frequent liaison with NHS Lothian with information regarding progress of the discussions.”

Dates with destiny

1895: The Royal Hospital for Sick Children is built in Sciennes Road.

1995: A new wing is built following a major public appeal to raise funds.

2003: The Scottish Child Health Support Group says: “The CHSG would urge early consideration of the long-term future of RHSC. Continued reinvestment to maintain the fabric of this institution seemed at first sight to be unproductive in the long term and it is clearly no longer fit for the purpose originally designed, although continued viability of the institution is essential in the short term. Its relative isolation within the city of Edinburgh makes access a problem for some services.”

2005: NHS Lothian approves the development of a business plan for a new Sick Kids.

Sept 2008: The Scottish Government approves NHS Lothian’s outline business case for a paediatric hospital at Little France, and pledges an initial £50 million.

Feb 2010: The New Pyjamas ppeal collapses after it raises barely a penny of the £15m it targeted.

March 2010 Holyrood says it will not stump up the £48m needed to build a brain unit at the hospital.

Oct 2010: The first delay is confirmed, with the opening date for the new hospital now estimated as the summer of 2014.

Nov 2010: The Scottish Government tells NHS Lothian to work with the Scottish Futures Trust to finance the hospital privately, pushing the opening date back to 2015.

June 2011: NHS Lothian reveals new plans for the Sick Kids, which would see it increase in size by a quarter.

Aug 2011: It emerges that there is no chance of the hospital opening before 2016, but chief operating officer Jackie Sansbury writes in the Evening News that “we expect the land swap to go ahead within weeks.”

May 2012: The land swap has yet to go ahead. Finance Director Susan Goldsmith admits the hospital could not now be finished until 2017. Chairman Charles Winstanley asks for a paper to be written up considering the possibility of the hospital remaining on its current site.

NO EASY OPTIONS

THE Sick Kids remaining in Sciennes would present its own difficulties.

• The Youngson Report recommended that children’s specialist acute services should be located alongside adult, maternity and neonatal services – this would be the case at Little France, but not in Sciennes.

• The new Department of Clinical Neurosciences is also due to be built as part of the new Sick Kids development at Little France – this was not included in the proposal to remain in Sciennes.

• In 2008, Little France beat both Sciennes and a third option of a new build at St John’s Livingston in a scored ranking based on financial appraisals, benefits appraisal, economic appraisal and risk assessment.

• The Sciennes Road site is based around a listed Victorian building and a series of additional properties, with limited scope for expansion or modernisation. NHS Lothian has been told it must attract a private sector partner to build its new hospital, and this could be more difficult for the existing site.

• Staying on the same site would require some building work to bring facilities up to scratch for the future, which is likely to entail disruption to existing services.