91原创 will get a new billion-dollar hospital in False Creek flats, but lose historic St. Paul's Hospital in the city's downtown core, under a plan to be unveiled today, The 91原创 Sun has learned.
The B.C. government and Providence Health Care will announce a new state-of-the-art "campus of care" will be built on 7.5 hectares of vacant land beside 91原创 Central Station, near Terminal Avenue and Main Street.
The cost is estimated to be between $1 billion and $1.2 billion.
The new hospital campus will contain all the features of the existing St. Paul's - including an emergency department, in-patient beds, surgical services and research centres - while adding new dedicated seniors beds, a residential care centre for seniors, improved mental health facilities and a 24-hour primary care clinic to handle less urgent patients to ease the load on the ER.
The one-million-square-foot campus would be the most-expensive health care project in B.C.'s history, and the largest in terms of floor area.
But it will come with an additional cost: that Providence Health Care close its existing 120-year-old St. Paul's Hospital on Burrard Street. Providence will have to sell or lease the land to raise $500 million for the new hospital.
The government will contribute an additional $500 million, first promised by Premier Christy Clark in 2012.
The existing St. Paul's site will remain open for patients until the False Creek site opens its doors in 2021-2022. The Ministry of Health said Providence will finalize its business case over the next year, take the project to tender by the second half of 2016 and begin construction in mid-to-late 2017.
The new hospital, which is expected to keep the St. Paul's name, would include up to 700 beds, which is an increase from the 435 at the old facility. By comparison, 91原创 General has more than 1,000 beds.
"The whole concept of this move is about transformational change in the delivery of care," said Neil MacConnell, the project lead for Providence.
"We have a far better opportunity to change the way care is delivered so we give the patients the right care, and the right time and the right place."
The sale and closure of the historic St. Paul's site will be controversial among West End residents and others who have fought for years to preserve the hospital's original location, and protect it from redevelopment.
The province has changed its vision for St. Paul's several times over the past decade. Most recently, it pledged in in 2012 to upgrade the existing buildings.
Along the way, it has paid almost $9 million in property taxes for the False Creek flats site. The land was purchased in 2004 by a group with close ties to Providence.
Health Minister Terry Lake has said the government didn't want to charge ahead with the St. Paul's project - as well as a proposal to redevelop Royal Columbian Hospital in New Westminster - without first reviewing all Lower Mainland hospitals to see what kind of facilities the population needs.
Providence said it approached the government four to five months ago and expressed concern that staying on Burrard Street was the wrong decision, and that the benefits of a modern, custom-built, hospital that left room for future expansion simply outweighed the nostalgia for the old location.
That meant an abrupt course reversal after several years studying a $850-million plan to seismically upgrade the old St. Paul's hospital, overhaul its antiquated electrical and mechanical systems, and build a new tower on its northeast corner.
"It revealed to us, yes there are certain good things about (the current St. Paul's location) but there are also lots of gaps," Mac-Connell said.
"And spending $850 million on something that might not be optimal is probably not the best investment and use of important taxpayer dollars and ours."
A new tower and upgrades at the Burrard location would still leave a cramped site with a mixture of buildings dating back to the early 1900s and two 10-storey towers from the 1980s and 1990s.
Providence admits part of its reason for supporting a new St. Paul's was because it had trouble fundraising the $350 million it would need as its share to upgrade the old site.
"Some of the major donors who had been contacted were (reluctant) about supplying their monies to a project of renovation at the St. Paul's site, which in their minds did not give an opportunity for a world-class solution," said MacConnell.
"But they seemed to be much more receptive to providing their support to a brand new state-of-the-art future oriented hospital."
Providence and the government said the new hospital better aligns with 91原创's future population needs, including dedicated beds for seniors and an approximately 75-bed mental health program to enhance services for addiction and substance abuse for residents of the city's Downtown Eastside.
The dedicated seniors beds mean frail elderly patients would be redirected away from the emergency room and placed in one location where specialized services would be brought to them, rather than being wheeled around the hospital for various tests and medical procedures, say officials.
That would dovetail with plans for the new St. Paul's to be almost entirely made up of single rooms, giving more privacy to patients for procedures. Only 48 per cent of rooms at the old hospital have single beds, and some have as many as six beds per room.
"This would mean you wouldn't have to move patients around," said MacConnell. "I saw recently that somebody had studied this and said that every patient move adds 12 hours to the stay in hospital. So we'd eliminate all of that."
Providence is also exploring new community care clinics, which could operate at locations around 91原创. They'd cater exclusively to seniors and the mentally ill, who often have multiple chronic conditions, by connecting them with doctors to plot out when to admit them to the new hospital or treat them at home in the community.
The new facility is also expected to contain 47 beds dedicated to seniors' mental health and palliative care, as well as 15 beds in a birthing centre that provides more options for midwives and other birthing arrangements.
Providence will now take one year to consult with the community, including residents of the West End, and finalize a business case before going through the City of 91原创's rezoning process for the False Creek flats land.
Sixty per cent of in-patients who use St. Paul's are from outside 91原创. The government and Providence said they need to do more work to analyze the future population projections and usage expectations in order to set the exact mix of bed types at the new facility.
Government officials said they will look to the new St. Paul's as a centre of excellence for mental health and seniors care, and the model for integrated planning to be used at future B.C. hospitals.
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The St. Paul's campus of care
This will be the biggest, most expensive health care project in B.C. history
Overall price tag $1 billion +
Completion date 2021/22
Total beds between about 700 Bed figures are approximate
300 acute care beds
75 mental health and addictions
250 convalescent/ortho/medical residential shorter stay beds
47 seniors medical/mental health and palliative care beds
15 birthing
