THE plan to relocate the old Edinburgh Sick Kids hospital from the city centre to a much larger, modern site on the outskirts of the capital started life more than a decade ago.
The first outline business case was submitted to the new SNP government in 2008, but was delayed because of a lack of money.
However the draft budget of November 2010 got the ball rolling again, with ministers saying they would fund it through their alternative to PFI, the non-profit distributing model (NPD).
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A revised draft plan signed off in spring 2012, when Nicola Sturgeon was health secretary, and said the Sick Kids would co-locate with the Department of Clinical Neurosciences at Little France, the site of the new Edinburgh Royal Infirmary.
It then took until summer 2014 before a final business case was ready, with an intention to open the new Royal Hospital for Children and Young People by May 2017. It was not to be.
Overall responsibility for the project lies with the board of NHS Lothian, with most of the risk, in theory, borne by consortium IHSL Ltd.
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However in order to prepare the site, NHS Lothian agreed to undertake “sewer and services re-routing”, and take responsibility for it too.
The governance of the project is fiendishly complicated, but the senior responsible officer is NHS Lothian’s Director of Finance, Susan Goldsmith, who chairs the project steering board and reports to the board’s Finance and Resources Committee.
By February 2015, when Shona Robison was health secretary, the final contract was signed with IHSL. Total cost was put at £432m over 25 years, including maintenance, with £150m for the build element. By now the opening date had slipped to September 2017.
NHS Lothian’s board minutes give glimpses of behind-the-scenes tensions on the project.
In March 2018, an extraordinary meeting of the Finance and Resources Committee discussed raising a court action against IHSL to force it “to design and install a compliant ventilation system” to 24 rooms with beds with six air changes per hour.
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The minutes state the board “remained concerned as regards quality, workmanship and general lack of progress in relation to witnessing, testing and commissioning MEP [mechanical, electrical and plumbing] infrastructure in particular.”
By July 2018, the same committee heard the Board had struck a new commercial agreement with IHSL “to resolve disputed issues to effect the completion and handover” of the project.
Two months later, the committee heard more bad news about IHSL’s “financial difficulties”.
There was also an early reference to problems with the drainage at the new hospital.
The minutes of the meeting refer to “residual technical issues with the key issue being around drainage systems”, as well as the “leadership and competence around IHSL”.
Indeed, so significant was the drainage issue, the Board came to a separate “supplementary agreement” with IHSL “to govern the delivery of the drainage aspect of the facility”.
Despite the ongoing problems, NHS Lothian paid IHSL a £6.28m “milestone payment for construction work” as recently as March this year.
The hospital’s opening was finally scheduled for July 9, more than two years late.
However in the weeks running up the date, tests were run on the ventilation system in isolation rooms, operating theatres and critical care areas.
At the end of June, engineers advised the board that in the critical care areas there were only four air changes per hour, not the ten per hour required.
Jeane Freeman - the fourth health secretary since work on the project first began - intervened to call off the entire move on July 4.
According to minutes of the Board’s healthcare governance committee, the hospital is likely to be closed for “several months”.
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