The Bermuda Hospitals Board recently unveiled the plans for the new Acute Care Facility at the King Edward VII Memorial Hospital. It also unveiled the private consortium that will design, build and maintain the facility over the next three decades. Ruth O'Kelly-Lynch spoke with the Design Manager of the project to find out more about Bermuda's first capital project funded under the Private Public Partnership model.

The King Edward VII Memorial Hospital, parts of which are 50 years old, cannot meet the needs of modern medicine, according to experts who recommended Bermuda invest in expanding the building.

In 2005 Johns Hopkins Medicine International advised the Bermuda Hospitals Board it needed more space for its acute care services to offer the quality and range of services the Island requires over the long-term.

BHB Chief of Staff Donald Thomas echoed their views. "We need a new hospital from a medical point of view because we do not have enough space to do the programmes we need to do," he said.

"[The existing] hospital was built before the requirements for more equipment, more machines, more complicated procedures, so there is really not enough square footage to do all the procedures we need to do."

Three firms bid for the contract and Paget Health Services, a consortium of international and local companies, won. The final contracts should be signed next month.

When it is complete, the ground floor of the new hospital will house the new emergency department as well as an area for outpatient procedures.

The new building will also include oncology, dialysis and diabetes services as well as diagnostic imaging. It will also have 90 single patient rooms.

Alan Austwick, Design Manager for Paget Health Services, said: "We have designed the hospital so that it is flexible and can change as technology advances.

"We are looking at this as a 30-year relationship, this is not a project where we will come in, build and then leave.

"We have designed it so that the space is flexible and can be adapted as time goes by," he said. "We need to be able to adapt as medical technology advances."

The consortium has amassed the technical and design expertise here and abroad to meet the medical needs of today and decades in the future, he added.

Ensuring people feel comfortable has also been forefront in their minds, which is one of the reasons they have partnered with Masterworks to provide attractive art throughout the building.

"This particular project will impact every person in Bermuda, they will see huge happiness and sadness, times of great grief at the facility over the course of their lives," he said.

"We don't want people to feel anxious by their surroundings, which is why we have incorporated large windows so people can see the view, and art.

"It has been proven that if people feel more comfortable in a hospital it can dramatically increase their recovery time."

In addition to the technical nature of installing the advanced medical equipment, ensuring the current hospital remains fully operational while construction work is undertaken will make the Paget building site more complex than other construction projects.

The new hospital is being constructed around existing buildings on the same site.

Mr. Austwick said the company was mindful that its activities will not hamper the existing site.

They will be using machines outfitted to be more quiet than others throughout construction and will also be "damping down" the site to prevent large dust clouds from impacting patients. They will also be erecting large hoardings around the property to make sure no one wanders in.

As for the construction, Mr. Austwick said: "It will be relatively straight forward. The real issues will be the technical equipment. Oncology and dialysis equipment are incredibly advanced equipment and complicated to install."

Mr. Austwick said there will be a lot of collaboration between all the parties involved and constant communication, something he said BCM McAlpine are used to from their other large projects on the Island.

In addition to the $260 million estimate for building the new site, $55 million will be spent on upgrading the current building.

It will be the first Private Public Partnership capital project in Bermuda with the PPP model the private partner assumes most of the design and construction risk associated with the project.

For example, cost over-runs would be borne by the private partner, not BHB or Government.

KPMG recommended the model after doing a financial study on the project.

It also means repayments to the construction firm are spread over a longer period, reducing the annual amount spent.

Critics of PPP however say that overall, the cost is ultimately more expensive than if the project was financed by Government which can borrow money at a cheaper rate.

"I have been working in the PPP model for 15 years," Mr. Austwick said. "It is about how governments decide to finance and build capital projects.

"It is not for me to comment on if it is the model for Bermuda as I am not involved in the politics of the Island. "It was decided that this was the best model to design, build and maintain the hospital within the constraints Bermuda has, but I cannot comment on why they chose it because I do not know. "This model has worked elsewhere."