Together with going ahead with building the new hospitals for Mitchell's Plain and Khayelitsha, the provincial government of the Western Cape have identified the rebuilding of Tygerberg hospital as a priority mega project and is now looking into the inclusion of public private partnerships.
Commissioned in 1972 as an academic hospital for the University of Stellenbosch, the hospital is internationally acclaimed for its high level of training and the excellent learning and exposure opportunities that patients offer to medical students in training. Since that time, the demands placed on the facility have changed significantly. Initially built for 1 900 beds, but at present operating with 1308 beds, the hospital is running more than 35 percent below its original design capacity.
Following a major assessment in 2005 and a series of unfortunate incidents that relate to inadequate security at the hospital and insurmountable maintenance problems, this provincial cabinet has made a unanimous decision that neither rehabilitation, nor re-modeling, will solve the hospital's long term problems. A principle decision was made to rebuild Tygerberg hospital.
The site covers about 5,9 hectare and the gross floor area of the main building is 209,826 m2. Due to inadequate design and maintenance over a prolonged period, the condition of the facility is poor, resulting in an inadequate service environment.
Many technical and engineering systems have reached the end of their planned life. Problems relating to plumbing, sewerage and fire systems are critical and are receiving ongoing urgent attention. Other priority issues include theatre air-conditioning, potable water, electrical systems and lifts. All of these have become a major maintenance burden. However, the overall shell of the building, with the exception of the roof, is in relatively good condition.
The present facility measures nearly twice the area per bed than currently accepted norms, resulting in, among others, security concerns in that there is no clear entrance or point of arrival at the hospital.
In 2005 the Departments of Health and of Transport and Public Works commissioned the Council for Scientific and Industrial Research (CSIR) to undertake a high level assessment of the hospital. The study found that the scattered location of departments lead to poor functioning, operational inefficiencies, pressure on staff and risk to patients. The physical shape of the building, the poor functional layout of wards and intensive care units, constrains efficient circulation and movement.
All of these factors lead to bad operational practice, such as intensive care units (ICU's) being used as through fares, all of these resulting in high infection risks to patients and staff alike. Three re-development options were identified either the rehabilitation, meaning re-using the existing hospital buildings with minimal alterations and upgrading; or the re-modelling, meaning the re-use of the existing shell with extensive remodelling to address key functional, condition and compliance constraints.
Finally the last option of building a new facility was recommend. While this option has higher capital costs, the operational expenditure will be the lowest of the three options. In the short term it would become more economic than working with the existing facility. A new hospital will provide a more compact and purpose-built design.
The objectives for the Tygerberg Hospital Mega Project are as follows to:
* provide a well-designed and functional health facility in line with the comprehensive service plan
* provide level two services to Metro East (Tygerberg, Khayelitsha, Mitchell's Plain, Helderberg)
* provide level three services as part of the Western Cape tertiary platform
* provide a facility for the training of undergraduate and post-graduate students.
It is roughly estimated that the construction cost for building the new hospital will be R2,4 billion. This cost is based upon a bed complement of 598 level three beds and 723 level two beds. These costs exclude medical equipment, all other loose equipment and Value Added Tax (VAT). The cost for medical equipment is roughly estimated at R1 billion. Some of the current health technology could be retained.
Although there is principle support from National Treasury for the funding, the
Western Cape is looking into the possibility of procuring this project as a public private partnership. "We have already received offers from the private sector," confirmed Botha.
Additional income can also be generated by upgrading the current facility for use as office accommodation. This could potentially be used for the sharing of office accommodation between government and private companies, or to let the available office accommodation to private companies.
Enquiries:
Helene Rossouw
Tel: 021 483 4426
Cell: 082 771 8834
E-mail: herossou@DgwC.gov.za
Issued by: Department of Health, Western Cape Provincial Government
1 September 2009
