VG fix starts at $714 million

Two days into the election, no one seems to want to talk about the all-in cost of bringing hospital services in Halifax up to contemporary standards. In fact, about a year ago, the premier said it would be “irresponsible” to speculate about that.

But at Turpin Labs Irresponsible R Us. So I say the cost starts at $714.1 million, as of 2009, and rises with inflation.

My source is a PowerPoint deck by the Capital District Health Authority intended for presentation to the Treasury Board on April 22, 2009 — the waning days of Rodney MacDonald’s Conservative government.

It’s fun to imagine what the reaction to that must have been. The Tories were going to call an election in two months and no sane Nova Scotia politician would go to the polls with a plan to spend that kind of money in Halifax, even if many of its specialized services are used by all Nova Scotians.

And yet the $714 million number is in the ballpark. By comparison, a new 172-bed hospital slated for completion in Grande Prairie in 2019 looks like it will come in around $740 million. (I don’t know why Albertans tell taxpayers the cost of their hospitals. They’re just wild and crazy, I guess.)

By contrast, my information comes from a document obtained through the province’s tedious and execrable freedom of information process. You can download the deck below. The red circle on Slide 16 is mine.

TL Treasury_Board_Master_Plan_Presentation_April_22_2009.

You may hear that the 2009 and subsequent proposals that each of the previous three governments have seen were too expensive because of “frills” such as single-patient rooms with large out-facing windows. But research shows these features accelerate healing so much that they pay for themselves in reduced patient-load.

The deck says the earliest feasible target for vacating the Centennial and Victoria wings at the VG site is 2015. Yep, that’s right. It could have been done by 2015.

When Darrell Dexter’s NDP took over in June of 2009, the CDHA asked for a meeting the same day. But the Dippers appear to have sought minded-boggling budget cuts that in the end rendered the project moot.

Next up, Stephen McNeil’s government in 2013. They wasted maybe two years amalgamating the province’s nine health authorities, accidentally neutering Halifax’s in the process.

Finally, in April 2016 they announced a “plan” that was mostly cherry-picked from previous proposals. Hell, the Terms of Reference weren’t prepared until a month after the announcement. You can download that below:

Terms of Reference QEII Steering Committee May 25 2016

For an irresponsible comparison, here’s a TOR template:

TOR template-download

Here are some excerpts from the 2009 proposal:

• An aggressive “push down and out” of hospital services into robust, interdisciplinary and highly integrated community health services centres.
• Less about architecture, more about interpersonal networks and relationships in a wide array of services – i.e. community health centres and family health teams 
• Strategically located throughout our communities in locations that respond to community needs. 
• A mental health master plan.    
• And Phase 2 – 2018 to 2026:
  A menu of alternatives based on projected needs with flexibility to adapt to: 
• changing priorities and funding opportunities 
• Fitness, wellness & commercial building on VG campus 
• Expansion of Cobequid Health Centre 
• Freestanding, comprehensive suburban ambulatory centres 
• Comprehensive community health centres on new sites 
• Further expansion at HI, VG and DGH sites 

Will the next government follow through this time?

Here’s something George Moody, a health minister in the 1990s, said to the late, lamented Halifax Daily News around the turn of the century: “We’ll never get the health system working right until all the political parties agree on a plan that goes beyond a four-year mandate.”

So, my advice for voters is be cynical, be very cynical.