In this period of recession and economic downturn, the Government has to find $5.4 billion in the coming months to bring to completion four major health facilities that are under construction.
The task will be daunting, but chairman of the Urban Development Corporation of T&T (Udecott), Noel Garcia, asserts that completing these public health institutions is imperative in order to expand and improve the country’s healthcare services.
Of the four institutions—the National Oncology Centre (NOC), Point Fortin Hospital, Couva Children’s Hospital and the Arima Hospital—Garcia admitted that the long-awaited NOC, which comes with a $700 million price tag, was faced with problems.
Speaking to the Sunday Guardian alongside Udecott’s chief operating officer Abena Richards, Garcia recently gave an update on the NOC, which he said has been hindered by ongoing delays and issues.
Promising that this project will be completed next year, Garcia said one bugbear was implementing legislation to deal with radiation which will be administered to treat cancer patients. He said the Government has to bring special legislation “to deal with the radiation. There is the whole issue of the cyclotron (a machine used to accelerate charged particles to high energies). There is an issue of the cost of the equipment. There are a number of issues that we are working closely with the Ministry of Health, the contractor and Udecott to resolve. Hopefully we will resolve those very soon.”
Asked the overall cost of the NOC project, Richards replied, “My estimate is probably around $700 million.”
When the sod for the NOC was turned in 2007 under then minister of health John Rahael, the project was estimated to cost US$24 million ($144 million) by contractor EllisDon Consulting, a Canadian-based firm.
Nine years later, the project has ballooned to $700 million and is still outstanding. This is some $556 million more taxpayers will have to fork out.
Construction of the NOC is being undertaken by French contractor Bouygues Batiment T&T Construction Company (BBTTCC).
Garcia described the government’s health projects as “frightfully expensive.”
In outlining the cost of each health project under Udecott’s control, Garcia said the Point Fortin Hospital was estimated to cost $1.6 billion. Construction of the Arima Hospital comes with a price tag of $1.4 billion, while the Couva Children’s Hospital, which was budgeted at $1.7 billion, is expected to be wrapped up in March. Work at the Arima and Point Fortin hospitals had reached five per cent. He said the Couva Hospital was 97 per cent complete, adding that halting work on the facility “does not arise.”
When Garcia tallied the expenditure for the four projects, the figure amounted to $5.4 billion.
“We are talking about $5.4 billion worth of health projects in a time of recession and economic downturn. That is posing as a real challenge to the minister of finance.
“How do we carry through with these projects which we inherited? The question is where will the money come from? How do you prioritise? The minister of finance has no intention of stopping work on the Point Fortin Hospital. It is just that we have these budgetary constraints. What the minister is now doing is looking at innovative ways to make sure work on the hospital does not stop.”
He said once these facilities were opened to the public, the Government would also have to find money to operate and maintain them.
“It’s like a balancing act,” Garcia said.
Garcia said, however, that Udecott would trim whatever waste needed to be trimmed.
“This is not the first time we would have to balance the developmental needs to budgetary constraints. Udecott would have to adjust itself, in that where we would get more for less.”
Udecott: $205.4m budget for medical equipment
Udecott’s media, events and community outreach manager Roxanne Stapleton-Whyms, in response to questions about the NOC by the Sunday Guardian, stated that when Udecott took over the project in 2012, $152,339,414.63 had been disbursed to the design consultant and contractor Canada-based Farrow Partnership Architects, which was the initial company hired to design and consult on the project. In 2012, Farrow Partnership Architect was awarded a contract to resume work on NOC but the company subsequently went bankrupt, according to former health minister Dr Fuad Khan.
Stapleton-Whyms said although Udecott was yet to award a contract for the major medical equipment, a $205.4 million budgeted allocation in question was “based on an estimated budget.”
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On September 11, 2013, Bouygues Batiment T&T Construction Company (BBTTCC) was awarded the contract to build and outfit the NOC at a cost of $445,183,891 (VAT exclusive).
However, on February 27, 2015, BBTTCC took over responsibility and liability for the design, construction and outfit with minor medical equipment of the project at a revised contract sum of $465,059,791.
To outfit the health facility with major medical equipment was estimated at another $205,400,000, bringing the figure to $670,459,791.
BBTTCC is the third company contracted to restart work on the NOC project.
NOC background
The NOC will serve as the country’s main treatment facility for cancer, offering a sustainable, comprehensive, state-of-the-art system of cancer control.
It will offer diagnosis and treatment including a 21-station chemotherapy suite.
Some of the major and minor medical equipment will include linear accelerators and PET/CT scanners, imaging/MRI scanning, diagnostic, radiation with shielded treatment bunkers, HDR brachytherapy, a cyclotron facility, CT stimulation suite, planning, outpatient clinic services, same-day surgical services, biomedical engineering and pharmacy.
NOC features
The centre is a three-storey structure with four radiation treatment bunkers linked to the hospital via walkways. Features of the centre include:
• Establishment of a data bank for tumour reporting and effects of treatment
• Introduction of a quality assessment system for diagnosis, oncology surgery, medical oncology and radiotherapy
• A centralised quality-controlled outpatient unit for chemotherapy
• Development of integrated psycho-social and palliative care.