The battle for health funding heats up Covenant Health is pitching a plan to revitalize the Misericordia, but AHS has a different vision
A fight over billions of dollars in hospital infrastructure funding is playing out in the provincial capital, where the NDP government is facing pressure to choose from a handful of competing demands.
Documents obtained by Postmedia through a Freedom of Information request show Alberta Health Services and Covenant Health are both pushing separate agendas on the province, although health leaders are reluctant to acknowledge any dispute.
The disagreements are particularly acute around the future of the Misericordia Community Hospital, the 48-year-old, Covenant-run facility in the city’s west end.
While AHS has recently called for redevelopment plans at the Mis to be scaled down — in part to steer funding toward the Royal Alexandra Hospital and other priorities — Covenant has fired back with its own proposal.
Documents show the Catholicbased health agency is asking the province for an incremental, though still extensive overhaul of the current Misericordia site that would include a mix of new buildings and renovations to existing structures.
“Building a new hospital for Edmonton is not economically feasible at this time, and is not required,” Covenant said in a report sent to Health Minister Sarah Hoffman on Dec. 8.
“The current fiscal realities, as well as emerging shifts in the model of care, make an incremental approach to site redevelopment favourable.”
The above map displays Covenant Health’s proposal for a multi-year redevelopment of the Misericordia Community Hospital that would include both new buildings and renovations to existing structures.
Alberta Health Services has advocated a different vision for the Misericordia.
It’s the first time Covenant has submitted its own “Capital Priorities” report, similar to a document AHS prepares each year outlining its view on the most pressing infrastructure projects around Alberta.
Covenant president and CEO Patrick Dumelie said in an interview his agency was asked by the province to prepare the report to “augment” plans that had already been submitted.
“I think what we have been able to do is really flesh out the detail and vision of how we can have a practical approach … to reach the long-term goal of a revitalized modern hospital,” he said.
“We believe the best solution is to expand on the infrastructure we already have.“
The Covenant proposal calls for immediate construction of a new emergency department with capacity for 55,000 visits a year and room for future expansion.
Like other Edmonton hospitals, the Misericordia’s current emergency department is frequently overcrowded, handling more than 51,000 visits annually in a space originally designed for 25,000.
Patients are often seen in the waiting room or on stretchers in hallways. The new emergency department would be followed by construction of a new hospital tower with room for 430 patient beds.
As for the much-panned current hospital building — where in recent years burst pipes, flooding and problematic heating have been an issue — the proposal says it should not be torn down, but instead remodelled to accommodate mental health treatment and other services. Parking structures would also be built on-site.
Including mental health and restorative care beds at nearby Villa Caritas, approval of the plan would more than double capacity of the Misericordia site to 930 beds from about 450 beds.
Dumelie wouldn’t provide an estimate, but it’s believed the overall construction price tag could be near $1 billion or more.
AHS declined to comment on Covenant’s new proposal, yet the scheme appears to conflict with the recommendations of two AHS reports on the Misericordia completed last February and March.
Those reports, also obtained by Postmedia, determined that any major redevelopment of the hospital should take place at an empty “greenfield” site since overhauling the existing location would take four years longer, cost $250 million more and cause substantial traffic problems.
No specific greenfield setting was pinpointed, although one of the reports suggested AHS had strong interest in a parcel of land at Anthony Henday Drive and 127 Street — deep in the city’s southwest and only a 15-minute drive away from Grey Nuns Community Hospital.
Although Covenant contributed to the AHS reports, the documents show the Catholic agency balked at the final recommendations.
In addition to questioning the projections of cost and traffic, Covenant executives accused AHS of using a flawed rating process, and blasted the potential 127 Street site as too far removed from the westend clientele the Misericordia currently serves.
“The selection of the greenfield location seems to be driven by the availability of Crown land instead of health services planning,” they wrote to AHS.
AHS responded in an effort to resolve the differences but “these attempts were unsuccessful,” the health authority’s master planning document said. “AHS continues to support the greenfield scheme … while Covenant Health remains committed to the brownfield (current site) option.”
Regardless, the debate turned out to be somewhat moot, as several months later AHS changed its position on the Misericordia.
As first reported by Postmedia last fall, AHS pulled its recommendation for a full redevelopment of the hospital in favour of a smallerscale “modernization” of the current facility to keep it operational for another 20 to 30 years.
The change was necessary to focus available resources on the Royal Alexandra Hospital, said the health authority, which is now also pushing for construction of a separate suburban hospital, and the development of at least a dozen community health centres.
While there appears to still be significant differences between the two health boards on the timing and scale of any Misericordia project, Dumelie said perceptions of a dispute are overblown. He insisted that AHS’s most recent position on the Mis actually brings it closer to Covenant’s thinking. Dumelie also shrugged off suggestions that an entirely new Misericordia Hospital built on a new site might be brought under AHS control rather than continue to be run by Covenant.
Adding fuel to the controversy, the Royal Alexandra Hospital Foundation recently launched an advocacy campaign centred around a puppet named Alex who says she is “the most frustrated hospital in Alberta.”
Foundation leaders told a Postmedia editorial board last Thursday they have been disappointed at AHS’s reluctance to publicly advocate for the Royal Alex at a time when the Misericordia seems to be garnering much of the attention.
Foundation president Andrew Otway said the new campaign is designed to build public awareness of the criticality of the Alex and ultimately give the NDP government the “social licence” to make the needed investments.
“And then if there is another pot of money to do the Misericordia the day after, we would be thrilled.”
Otway said the foundation knew the initiative might complicate AHS’s negotiations with the province, but went ahead anyway without warning the health authority.
Asked what he thought of the Foundation’s campaign, Dumelie said it was something his organization wouldn’t do.
Hoffman declined to comment for this story, but has previously said that investment in both the Royal Alex and Misericordia is a priority. It is unknown if the next provincial budget, due in March, will make good on that vow.
Modern hospital construction is an expensive proposition, with costs now reaching as high as $2 million per patient room. Alberta’s newest hospital, the South Health Campus in Calgary, cost $1.3 billion when it opened in 2012.
Besides the Misericordia, several more of Covenant’s health facilities are also in need of upgrades, the agency said in its capital priorities report.
For the Grey Nuns, Covenant is recommending a multistage project that would include construction of a nearby community health centre, enlargement of the emergency department and creation of modern vascular surgery suites.
The final phase calls for construction of a new patient care tower that would raise the hospital’s capacity to nearly 800 beds from 355 beds.
The 29-year-old Nuns is currently Edmonton’s newest hospital, but is facing considerable demand pressures, Dumelie said.
Covenant’s report also calls for projects of varying degrees at the Edmonton General Continuing Care Centre, Youville Home in St. Albert, St. Joseph’s Hospital in Vegreville, the Bonnyville Health Centre, St. Mary’s Hospital in Camrose, and Our Lady of the Rosary Hospital in Castor.
Building a new hospital for Edmonton is not economically feasible at this time, and is not required.