Summary of Capital, Public-Private Partnerships and Alternative Service Delivery Projects

Three-Year Capital Spending Plan

The Ministry's three-year capital spending plan encompasses maintenance, renovation, replacement or expansion of health infrastructure consistent with regional priorities. This spending is key to keeping the health system functioning effectively and efficiently.

Restructuring Allocation

A $100 million restructuring allocation for health authorities was established in the 2002/03 Service Plan. The objective of this funding is to convert existing health facilities to more appropriate uses consistent with new regional priorities. This work will be completed by 2005/06. Some examples of restructuring projects are:

• Interior Health Authority — $7.8 million shared food services project.
• Fraser Health Authority — Burnaby Hospital's $2.6 million renovation to consolidate mental health services.
• Provincial Health Services Authority — B.C. Children's and Women's Health Centre's $1.6 million Labour Delivery Suite/Surgical Day Care Unit renovation.
• Northern Health Authority — MacKenzie and District Hospital's $305,000 renovation to remodel the acute care facility and integrate community health services.
• Vancouver Coastal Health Authority — Vancouver General Hospital's $2.3 million Emergency Room renovation to accommodate expected increased patient volumes.
• Vancouver Island Health Authority — Victoria General Hospital's $2.1 million renovation to develop an inpatient rehabilitation unit. (The province is contributing 60% of the project's cost.)

Mental Health Plan — Riverview Replacement

Riverview Replacement involves moving patients from Riverview to new facilities in their local health authority so appropriate care can be provided in patients' home regions. The Provincial Health Services Authority is leading the comprehensive and collaborative tertiary redevelopment process with its health authority partners.

This project has a budget of $138 million over five years, starting in 2002/03.

Health Care Renewal Accord — Diagnostic and Medical Equipment Fund

The 2003 First Ministers' Accord on Health Care Renewal established a $1.5 billion national diagnostic and medical equipment fund. Of that total, $200.1 million was allocated to B.C. for the three-year period ending in 2005/06. These funds will be invested in diagnostic and medical equipment and training.

Major Capital Projects

Under the Budget Transparency and Accountability Act, a summary of the business case for major capital projects must be made public. A major project is defined as any capital commitment or anticipated commitment that exceeds $50 million.

Project Name: Vancouver Coastal Health Authority, Vancouver General Hospital (VGH) Redevelopment

Objectives:

• To update the VGH site to meet patients' needs over the next 20 years or more.
• To complete the project by January 2007.

Cost: The approved total project cost is $156 million and will include 15 separate component projects, the most significant being the completion of the inpatient floors of the Jim Pattison Pavilion in May 2003. Other components include:

• Generator and Code upgrades to the Jim Pattison Pavilion;
• Renovations/Upgrades to the Centennial Pavilion and the Willow Pavilion; and
• A new Hyperbaric Chamber, Power Plant, and 300+ seat Auditorium.

Benefits: New patient areas and consolidation of hospital services within the Centennial Pavilion and the Jim Pattison Pavilion will provide operational efficiencies for clinical services, clinical support and facility management programs.

Risks:

• Changes in economic and market conditions, including potential for labour and material cost escalation and shortages.
• Technology and building code changes.

Public-Private Partnerships and Alternative Service Delivery

The ministry and health authorities are committed to ensuring maximum value for health care dollars and are exploring new approaches for capital projects and the delivery of some non-clinical services. In accordance with that approach, the ministry and the health authorities are pursuing public-private partnerships (P3s) and alternative service delivery (ASD) arrangements to leverage private sector innovation and capital.

Abbotsford Hospital and Cancer Centre (AHCC) — Fraser Health Authority and Provincial Health Services Authority

Objective: To build a regional referral health campus to replace the existing Matsqui Sumas Abbotsford (MSA) hospital and incorporate a new cancer centre.

Cost: The capital cost of the project is estimated to be approximately $300 million. The Fraser Valley Regional Hospital District is contributing $71.3 million towards the project. When it is finished, annual operating costs for the AHCC will be approximately $150 million.

Benefits:

• Creating a modern 300-bed hospital and cancer centre to meet the needs of Fraser Valley residents for the next 30 years.
• Integrating a cancer centre with a full-service regional hospital from the ground up.
• Regional referral health campus with state-of-the-art equipment will provide much needed services and will also help attract and retain health professionals to the area.

Risks:

• This is the province's first P3 project for a major acute care facility. To mitigate the first-time-through risks, the project is, in part, building on the experience, documentation and advice of other jurisdictions that have successfully completed similar projects.
• Changes in economic and market conditions, including potential for labour and material cost escalation and shortages.
• Technology and building code changes.

Academic Ambulatory Care Centre — Vancouver Coastal Health Authority (VCHA)

Objective: To replace outdated facilities and coordinate outpatient care services at the VCHA Vancouver General Hospital — including specialty clinics, medical education, physician practice offices, research and related commercial/retail activities.

Cost: Approximately $90 million capital cost, borne by the private sector proponent.

Benefits: By centralizing medical disciplines, this modern facility will enhance patient access, scheduling and care by allowing the coordination of specialists visits, clinic visits and diagnostic testing in one location. In addition, medical students will benefit from increased interaction between academics, researchers and practicing clinicians.

Risks:

• Changes in economic and market conditions, including potential for labour and material cost escalation and shortages.
• Technology and building code changes.

Health Benefits Operation

Objective: To improve MSP and PharmaCare services without incurring significant capital investment by the Province.

Cost: The value of the services is estimated to be approximately $25 million annually. These operations involve over one million transactions with a value of approximately $2.2 billion annually.

Benefits:

• Improving service to the public while protecting privacy and personal information.
• Maintaining or improving service to health care professionals.
• Permitting the ministry to focus on its core business — stewardship and leadership for the health system in B.C., as opposed to direct service delivery.
• Avoiding capital costs associated with upgrades/replacement of existing systems.

Risks:

• Finding a proponent who can deliver all the benefits within budget constraints.
• Negotiating a successful partnership agreement where risks and benefits are appropriately apportioned between both parties.