Hospitals in critical condition - NHS Lothian faced with £191m bill to maintain crumbling facilities

New statistics have revealed that more than £104m is needed for maintenance at nine aging hospitals – and more than £87m worth of work is needed at other buildings owned by NHS Lothian.

At the 570-bed Western General Hospital, which is a regional centre for cancer and clinical neuroscience, almost £30m is needed while at St John’s Hospital in Livingston, home to specialist burns wards and a special baby unit, more than £26m worth of maintenance is required.

Overall, at the hospitals, which also include the Royal Edinburgh, Liberton and Sick Kids sites, but not the Royal Infirmary (which is not owned by the health board), £18m is needed to make them compliant with fire regulations, £16m of spending is required for the internal fabric of buildings and there is a backlog of electrical work that will cost £11.5m to put right.

Former MSP Dr Jean Turner, director of the Scotland Patients Association, said it was unacceptable that staff were being asked to offer world-class health services in sub-standard buildings, and warned that patients could  potentially be put in danger.

She said: “It’s shocking that it’s been allowed to deteriorate like this. These are working buildings and they have to be fit for purpose.”

The latest figures, compiled by the health board for the State of NHS Scotland Assets and Facilities Report 2012, show that the hospitalS still needs £3.2m worth of spending on windows.

A further £9m is needed to fix roofs as it emerged that months after a legionella crisis in Edinburgh claimed three lives, £597,000 is needed for “legionella avoidance” measures across five buildings.

NHS Lothian chief executive Tim Davison said this week that he hoped to accelerate plans to replace the Royal Edinburgh, which needs £22m worth of work.

Health bosses have pledged an extra £10m to deal with the backlog over the next two years, but it will still leave a significant shortfall, with 70 per cent of the required investment representing a “high or significant risk”.

The maintenance backlog went down across Scotland but increased in Lothian this year, and health bosses are preparing to visit sites in coming weeks to “consider options available to address high risks in the immediate term”.

Conservative Lothians MSP Gavin Brown said that inflation in construction costs would only cause the price of repairing the NHS Lothian estate to rise in coming years, and called on the health board to act quickly. He said: “I would encourage NHS Lothian to look very carefully and see if it can establish a way of getting the bulk of this done sooner, without impacting on frontline services.”

NHS Lothian’s chairman, Dr Charles Winstanley has admitted the health board is in “a real bind” with regards to the maintenance backlog. Following a discussion of the “difficult” financial position it was in at a recent board meeting, he said: “We have got £140m to find and we have discussed our revenue position earlier on. I don’t see the resolution.”

The health board has said it wants to sell some of its buildings, which would reduce the burden as it would no longer have to maintain them. The Sick Kids, Royal Victoria and Edenhall hospital sites could bring in more than £20m, buildings not used for clinical purposes could fetch £7m and vacant properties are valued at £2.2m.

But NHS Lothian will only keep the revenue it raises above the agreed value of the buildings, with the bulk of the cash going directly to the Government, which then redistributes the money to health boards across the country.

A Scottish Government spokeswoman said that NHS Lothian had been given a £51m capital budget and would receive year-on-year increases to deal with backlog maintenance issues.

She added: “In today’s property market some boards are finding it increasingly difficult to sell properties, so a central pot helps boost all boards’ capital funds as well as helping with time pressures on spending commitments.”

Susan Goldsmith, NHS  Lothian’s director of finance, said: “A comprehensive review of our buildings, maintenance needs, changes to legislation and the investment required was carried out last year. This review has been used to help develop our property management strategy which ensures that we maintain standards while working to modernise and further rationalise our estate.

“The NHS Lothian board has agreed to provide an additional £10 million over the next two years to address some of the maintenance priorities that are over and above our routine programme of upgrades and repairs. This will cover improvements on eight key patient sites.

“This is in addition to the significant investment that is being made in new buildings which is allowing us to reduce the size and age of our estate.”

In July, we exclusively revealed how motor neurone disease sufferer Goldie Lyall, 80, was soaked as she lay in her bed at the Western General Hospital after water began running into a cancer ward from above a window.

ANALYSIS:

Sarah Boyack, Lothian list MSP

The environment in which people receive treatment has a big impact on recovery times while improving workplace conditions and staff morale.

However, almost half of the NHS Lothian estate is over half a century old and some facilities are no longer fit for purpose. That’s the home truth NHS Lothian is confronted with and the maintenance figures should act as a wake-up call.

The board say they are acting. Some facilities will be sold, others refurbished and other investment identified. But all of this was evident last year – why is it only now that the board is visiting sites to prioritise the work?

Continued maintenance is only planned for the Sick Kids at Sciennes until 2014. At best that means three years of fingers crossed before the new hospital opens in 2017.

Across Scotland, support is needed from the SNP Government to address the backlog. A useful first step would be to allow health boards to ring fence money raised through the sale of surplus land and property that could then be ploughed back into maintenance or capacity issues.

The numbers

The figures show the total costs of the backlog maintenance needed at St John’s Hospital, the Western General, the Royal Edinburgh, Roodlands, Astley Ainslie, Liberton, Lauriston and the Sick Kids hospitals and the Princess Alexandra Eye Pavilion

Fire precautions: £18,050,086

Internal fabric: £16,394,115

Electrics: £11,577,114

Heating systems: £9,183,158

Roofs: £9,059,919

Windows: £6,314,998

Ventilation and air conditioning: £5,460,576

External fabrics: £4,475,431

Generators: £2,864,700

Hot and cold water systems: £2,464,321

Lifts: £1,578,051

External drainage: £1,107,782

Legionella avoidance: £597,220