Work on the new Dunedin Hospital at the site of the former Cadbury's building. Photo: RNZ/Tess Brunton
The government is being unrealistic and ignoring the needs of an ageing population, an associate professor of psychiatry says.
Dr Yoram Barak - also a consultant psycho-geriatrician at Dunedin Hospital - said the government's revised plan for the city's replacement hospital is wishful thinking on its part because there was no way to wave a magic wand and make the growing health needs of older people disappear.
Health Minister Simeon Brown says the revised plan announced on Friday will deliver the project within budget, and it has also been future-proofed to allow for growth in the region.
The rebuild was paused last year after a report estimated costs could climb to $3 billion; the government's budget is about $1.9b.
Today the government confirmed the build will go ahead at the former Cadbury Factory site.
The new hospital will open with 351 inpatient beds - 59 fewer than originally proposed, but with capacity to expand to 404 beds over time.
There will also be a staged delivery of more operating theatres and imaging services like Xrays and MRI although no timeline was given.
Associate Professor of Psychiatry and consultant psycho-geriatrician at Dunedin Hospital, Dr Yoram Barak told Checkpoint he was "leaning heavily" towards disappointment.
Otago and Southland had populations that were ageing faster than the rest of the country and both regions were "in dire straits already" when it came to management of those suffering from dementia.
Associate Professor Yoram Barak Photo: Otago University
While he had no official confirmation, he believed psycho-geriatric beds had been cut by 50 percent.
"So yes disappointed."
On those grounds the revamped design was an unrealistic decision by the government, Professor Barak said.
"Cutting down on older persons' health is the worst decision possible when we're looking ahead into the future.
"The ageing of the population is not going to go away. You can't wave a wand and just wish that Alzheimers disease and other major mental health challenges for the ageing population will go away.
"They're here to stay and they will be increasing tremendously."
He said by 2035 the country would be struggling with a shortage of 12,000 resthome beds for elderly people with dementia, government data showed.
If services at the hospital were reduced it would not be able to deliver them in a safe way for its community.
Around the world there was a tendency to ignore the needs of older people and he was frustrated the New Zealand government seemed to be following the same pattern.
More than 60 percent of services across GPs, outpatient clinics, inpatient services and surgery were used by those aged over 65.
"The government is simply ignoring that."
Asked about his confidence in the new health minister he said he was unhappy with Brown because he did not believe he was prioritising the needs of elderly people.
Changes are 'nuanced' - Health NZ manager
The head of infrastructure delivery at Health New Zealand Blake Lepper said it was an exciting day because the project now had some certainty.
The hospital would have many of the key features that had been promised previously, however, clinical staff had been enlisted to help determine which features could be dispensed with for the initial phase.
Lepper told Checkpoint the details of the changes had been made public but it was difficult to describe them within an interview.
"A lot of these changes are quite nuanced and hard to explain in a building that is 70,000 square metres, 11 storeys, with dozens of clinical specialities in there. A simple list is not particularly easy for me to run through."
He agreed there would be fewer beds, fewer theatres, and fewer geriatric mental health beds from what had been originally proposed.
However, all the "core functionalities of a modern tertiary hospital are still completely within this hospital".
The clinical leadership group had provided feedback to Health NZ that they were confident it would have what they needed to work effectively.
"We've absolutely had to make trade-offs and we've had really difficult conversations through this period as we've sought to work within that budget that's been given us."
Asked about timeframes of when some deferred work might go ahead, such as extra patient beds, he said 351 would be enough at the time the new hospital opened and in coming years the region would still need to pay for other health services, including in areas such as Invercargill and Central Otago.
Lepper refused to say how much it had cost to have the project stalled for several months.
The local clinical advisory group for the new Dunedin Hospital has welcomed the government announcement.
In a statement they noted the fit-out of several areas will be staged, and there would be redesign work to come. Members were confident the new design could provide safe care, could be adapted in the future, and will be efficient to run and staff.
Members would work with the design team to deliver the best possible hospital for the Southern community.
Dunedin mayor Jules Radich has welcomed today's announcement. Photo: RNZ / REECE BAKER
Mayor Jules Radich said he was happy as could be expected with the announcement.
It was pleasing to have confirmation that the build would go ahead on the former Cadbury's site as planned, and that the size of the building remained the same.
"Clearly, we are not getting all the services and facilities upfront, but there is clear intention to provide them. So there is clear intention to build all of the services and facilities that the region needs. But the critical element for that is having the full and complete structure."
Radich said he was confident demand would not reduce and additional services would be needed.
'A promise has been broken'
Nurses Organisation president Anne Daniels said she suspected the new plan was purposefully meant to divide residents.
She said the region was not getting what it was promised with the 2017 business case for a new hospital.
"I understand that there is a feeling that building a shell that would allow us to fulfil that promise in the long term is something that some people think is a good idea, but at the end of the day it is a promise that has been broken. It is not going to be the hospital that we need right now."
Daniels said the new hospital would open with 16 fewer beds than the existing hospital and even after it was scaled up over time, it would have six beds less than originally promised.
About 100 protesters gathered at the site of the announcement, among them medical student Kate Bryant.
She said the government was selling the plan as good news, but they had not stuck to their promises.
"This is a hospital. Isn't this the one thing you don't undercut? This is for the health of the people. This is one thing you are meant to give as much as you can. It just shows how much this government doesn't care about its people."
Bryant said she feared people would die if the region ended up with a sub-standard facility.
