Hospital inspections to cost $4.6 million
Study of physical condition of B.C. facilities will help determine future spending
VICTORIA — B.C. is playing catch up on tracking the physical condition of its hospitals, after allowing inspections to get more than a decade out of date.
The government is spending millions on consultants to generate new “facilities condition index” reports for hospitals. The reports catalogue such things as structural safety and the condition of electrical systems, roofs, elevators, stairwells, flooring, plumbing, fire alarms, boilers, sprinklers and ventilation systems.
These reports look at all aspects of a hospital’s physical structure, except for earthquake safety, which is done through a separate process using specialized consultants.
The knowledge of what is aging, broken and in need of repair in hospitals is supposed to form a key part of how government decides to spend the more than $2.75 billion in upgrades for health care buildings it has budgeted over the next three years.
The facilities database ranks repairs by priority, giving government a clear list of critical upgrades (such as a failed fire suppression system, or a collapsing ceiling), as well as less urgent upgrades, such as aging floors and leaky windows.
But much of the information is now up to 12 years old, after the Ministry of Health allowed its facility assessments to lag without update since they were first completed between 2003 and 2006.
A copy of the government’s facilities condition index database, provided to The Vancouver Sun, showed that many of the assessments of B.C.’s 81 hospitals (defined as those with in-patient beds and emergency rooms) are so out-of-date as to be functionally useless.
Health Minister Terry Lake said the reports are “one part of the tool we use to determine priorities for capital.” Other considerations are demographics, government priorities and whether a building is functional for future health care needs.
Even though much of the information is outdated, it still provides valuable base data, like the year the hospital was built and its replacement value, he said.
The government spent $6.6 million on the original facilities reports, and is spending $4.6 million to update all the reports by 2017. It has the option to refresh the assessments again in five years.
“It’s valuable information to the health authorities, and when you consider the ($11-million cost) versus the capital plan of $12 billion over 14 years it’s a fairly small number,” said Lake.
“When you are building a business case for each of these facilities and trying to say, OK what comes higher on your list is it this facility or that facility, every element you have is valuable for making that assessment.”
Critics say the government’s failure to keep its inspections up-to-date has left it flying blind in how to spend taxpayer money on repairs.
“It’s really a mystery to me why the government doesn’t have a clear up-to-date assessment on the physical state of our hospitals,” said NDP critic Judy Darcy.
The Health Ministry built the facilities database as a way to track all of its buildings, set spending priorities, and give an independent way to assess whether B.C.’s six health authorities have defensible arguments when they argue for millions of dollars to renovate or replace a hospital.
Instead, the outdated data has left government to rely on the health authorities, whose staff are the only ones with firsthand knowledge of what’s broken and what’s repaired inside buildings.
The old facilities reports are often invalidated by renovations, upgrades or, in some cases, building replacements done in the subsequent decade.
For example, more than $86 million in repairs identified in facilities reports for Surrey Memorial Hospital were calculated in 2003-04, and rendered redundant when the new emergency department and critical care tower opened in 2013.
Inspections of Fraser Health Authority’s hospitals in Langley, Burnaby, Delta, Mission and New Westminster are as old.
Vancouver Coastal Health Authority hospitals — with the exception of Vancouver General — were more recently reassessed in 2013 or 2014, but remain at risk of being outdated as illustrated by more than $6 million in thermal energy upgrades at UBC Hospital that aren’t reflected in the reports.
Health authorities say it’s time for a refresh of the hospital data, which complements the dayto-day real-time work they do maintaining hospitals.
“If you think about taxpayer dollars and the stewards of it, I wouldn’t want them refreshed every year, that’s a waste,” said Marco Buccini, executive director of strategic development and real estate for the Lower Mainland Facilities Management group shared by Metro Vancouver’s health authorities.
“But on the flip side I wouldn’t want not to do them, because you are getting a processional opinion from engineers and architects to say here’s where you are at, in case you guys have lost track because your nose is in the day to day. It’s a nice balance point.”
Plus, with a common set of baseline data, nobody can claimignorance about what needs to be done and the cost.
“FCI is still worth having, it’s a very objective tool,” said Buccini. “Then government can’t say they didn’t know something. It exposes them in a way that’s a good thing they know what’s in good shape and bad.”
B.C. Nurses’ Union president Gayle Duteil said the physical state of a hospital affects patient care, due to the quality of things like infection control, the absence of basic hand washing sinks, restrictive washrooms, and the absence of seclusion rooms for agitated or violent patients.
“Having an up-to-date condition index for health facilities is important,” she said.
The government reports give each health care building a facility condition index score, based on the value of the repairs divided by the building’s replacement value. Only eight per cent of buildings were considered “good” or “excellent” using government’s internal scoring, and the rest were listed as poor.
Lake said he’s still confident B.C. hospitals are in safe condition.
He pointed to several upgrades and new buildings, including a patient care tower in Penticton, acute care centre at B.C. Children’s and Women’s Hospital, a mental health facility at Vancouver General Hospital, two hospitals on northern Vancouver Island, the Interior Heart & Surgical Centre in Kelowna, the Queen Charlotte/Haida Gwaii Hospital and the patient care tower at Royal Jubilee Hospital in Victoria.
“We’d like to rebuild more and as resources become available we’ll be able to add to that,” said Lake. “Hopefully if we continue with surplus budgets and bring in more revenue with LNG development, then we will see perhaps an acceleration of the capital plan. But until then it’s still pretty aggressive.”
Inspection reports only tell part of the story in how government chooses new hospitals, he said.
An example is Royal Columbian Hospital’s Sherbrooke Centre for mental health in New Westminster, which scores acceptably overall in the facilities reports but was originally built in 1963 to be a nurses’ residence, said Lake. “It wasn’t built for the purpose it’s being used, so it needs to be redeveloped,” he said.
Government announced $260 million last month to replace it with a new 75-bed mental health and substance abuse facility.
fair or
It’s valuable information to the health authorities, and when you consider the ($11-million cost) versus the capital plan of $12 billion over 14 years it’s a fairly small number.
TERRY LAKE
B.C. HEALTH MINISTER