The government appears to be in two minds about the Hospital.
Should we refurbish or should we build new?
Refurbishment sounds cheaper and quicker and Barbadians have grown weary of big expensive projects, with escalating costs, strong whiffs of corruption and long delays.
But the problem with refurbishing an old hospital, making it compliant with modern safety standards and ready for new equipment is that it can be very expensive. I understand that the basement would require substantial work to allow the installation of new heavy medical equipment. I understand that in the face of a hurricane the existing hospital is poorly located, but I am no expert. Refurbishing can be so expensive that it may make economic sense to build a new one. Refurbishing costs of $400-500m have been bandied around while a new hospital would probably cost $600-700m.
It is also hard to refurbish a hospital with patients in it. I have asthma like many Barbadians. Imagine being in a hospital which is a construction site with an asthmatic attack? We would have to have a transition plan that may add further to the costs.
All this sounds like an argument for new but I recognize that the budgetary seduction of a new hospital financed by the private sector using a commitment from the government’s annual budget (Public Finance Iniatives like BOLT) may be clouding good judgement of the hospital “consultants”. That said, this government is so keen to undo everything the last government did (for good or ill) that as the last government favoured a new hospital, they are probably inclined to prefer refurbishment at whatever cost. Most countries have gone the route of new versus refurbishment. I recall a figure of 40 new hospitals in the UK over the past 20 years using BOLT.
I also think – an excellent point first raised on these pages by Georgie Porgie, who I do not normally agree with – that the issue is not just about the physical infrastructure but also the organization of treatment in Barbados and management of the clinics and hospitals. The sad case of Leslie Barrow who could not get to the hospital in time because there were no ambulances is one aspect of this. Should we upgrade our clinics first, allow them to take some strain off the hospital, and then refurbish? This is partly about education as Bajans think of the hospital as the place to go.
Moreover, many of the expensive spaces in the hospital are taken up by people who are not ill (anymore), but have no where else to go. Do we need to start with a less expensive “ly-ing in” place or consider alternative “treatment” for such people. It would be far cheaper to pay rent and for a part-time nurse than to keep a well person in a hospital bed needed for emergencies.
What do Barbadians think? New, old or re-organisation?
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