The daily diet of news stories contains a few bitter ingredients about the capacity of the present State Government to manage anything.    News about the Desal Plant whose energy source is glossed over when we ask about the ability of SA's electricity supply to cope especially on a hot day when Victoria has a hot day too simply says the Governmnent hasn't a clue and if Martin OMalley CFMEU is right was being hurried too much and that jeopardised safety; and the water restriction abandonment was farcical - got to follow Victoria.   Why?  When Vic water capacity is 80% they have 4-5 years water, when we have 70%  we have about a year's supply.        News about the Adelaide Oval suggests that there is more and even more discussion to be done well after the Government imposed deadline - we could be forgiven I think if we got the impression that the whole deal was a stictch up between our Premier and AFL chief  Demetriou which gave a lifeline to the over committed Adelaide Oval.  Another capitulation to the self congratulation of Victoria?   News about the Nurses shows that the special relationship between the Union movement and the Labor Government claimed by the ALP is all so much spin.     Perhaps our diet needs something   to mask the bitter taste - a sweetener.    How about abandoning the unnecessary railyards project and finshing the RAH to the great and almost immediate benefit of South Australians 

Delusion and Ghosts

In case you've forgotten there was an approved refurbishment of the RAH approved in 2001.   At the time the Health Minister told the RAH Board how luck we were to have approved such a comprehensive modern upgrade of the hospital which would give the Public of SA access to the most advanced facilities in Australia.   So the hospital started to build and produced new theatres XRay, burns facilities and emergency department and so on.    What was NOT FINISHED was the plan to modernise the patient accommodation.      Then Minister John Hill put the kybosh on that part and then the gurus of the CNAHS and Health Dept came up with the "Marj"    But I said that in another post.    Then nothing happened.   So for the past 4 years at least the public has been cheated of its new facilities.    It would have been finished by now.     All we have is a half finished hospital, and of course the facilities that were built are dating, it is true they need alteration and expansion now because NOTHING HAS BEEN DONE FOR FOUR YEARS.    Why does the Government delude itself that a new hospital would not date in the same time frame - it is the nature of medical technology.      No one benefits from these grand plans that won;t see the light of day without precisptating a State financial crisis  Beware ghost of the State Bank     

Pan(t?)dering to the god development.

Somethings to ponder on a weekend while no new announcements are being made

The radio waves (891) carried a piece a few weeks ago featuring David Panter who is now designated the CEO of the Railyards Hospitl project.    The Presenters were feeding him questions so he could answer them.   For those of us who have been following this saga over the past 12 months, they were questions that had been not only asked, but argued before.     The capacity of the new hospital now about 800 I think he said.     Interesting to work out how that would be achieved without an increase in the cost.      If I am wrong and the capacity is still only 700, then any well researched questioner wouls know that is only a few wore than the designed capacity of the North Wing on Frome Rd without considering any otheer spot.     Then the matter of the new hospital being a clean hospital without the nasties (MRSA, VRE) that reside in the present site.    The assurances were given that this is a major advantage of the rebuild, showing an ignorance of the nature of human infection either in the interviewers or in the interviewee.      If Dr  Panter genuinely doesn't know anything about this mechanism, then we have a serious problem in a CEO responsible for the implementation.    I would suspect that he is well experienced and educated in the matter which then puts this airing into the category of propaganda - political spin, and if the interviewers have insufficient scientific education to see the problem , then it illustrates why governments get away with spin.    (And if you are wondering - these infections are brought in with the patients, the only way of avoiding colonisation is quarantine , keep all the patients waiting for a week before letting them in the door which wouldn't work for a major trauma hospital.     Anyway avoidance of  transfer of infection is best managed by rigorous handwashing and better staffing levels, just ask the infection control nurses)    And I am simply an ignorant layman, but I heard all this explained on 891 before the election.   Perhaps the interviewers were'nt listening at the time.

Hobby horses and ringing bells

News of the development plans for Torrens Island have an awful familiar ring to it.     
Government land carved up for ,in this case industrial purposes, when there are alternativees available.    eg Maritime Constriuctions which was displaced from the inner harbour at the Port to enable the construction of Newport Quays,  will be given river front land where they will have to construct a wharf to operate.   PA Enf Mayor Johnasen points out there is a vacant wharf on the Western Bank why not use that?    Is it that there is development money for the Government in construction work.   And the SARDI iodiesel pilot plant ftom West Beach to Torrens Island ,  why not locate it near the Desal Plant that used to be an oil plant, and anyway what is the space pressure at West Beach if the plant is not going to be expanded very much.
Just how much this is like the decision making over the railway yards hospital

Heard today that the election booth at RAH polled 7.8% swing against ALP,  if that had been expanded to the whole seat of Adelaide, then incumbent Kate Ellis would have suffered the same fate as he state predecessor Jane Lomax Smith.      Pity we were'nt able to interests the Libs in riding our hobby horse in the campagn.

Pearls before swine, but who are the real pigs?

The State Budget is due in September.    Already announced is the demand on the Dept Health to shave $450million off its expenditure.     Just where they will find the "fat" to trim?    If there is that much fat in the system, then what have the senior people been doing over the last 3 years?

In 2007 when the Rann/Foley/Hill junta stopped the redevelopment project at RAH some of us wondered then if they had simply run out of money and wouldn't admit it.    Then this "Marj" project was the pearl strewn before us swine, after all who could resist the appeal of a new hospital named after a much loved Governor? and one whose cost could be pushed off to the Commonwealth - PPP the money comes from the private sector then the State contracts to lease (ie formal rental agreement) it for an agreed term , in this case 35 years.    Recurrent expenditure a opposed to Capital is paid by the Commonwealth.     And stilll they want to shave $450million off the health bottom line.

Lets consider for a minute the published price is $1.7bn and the Developers will want to get their money back.     For ease of calculation presume interest at 10% pa,   The interest bill per year is $1700 million
By the end of the 35 years (as announced by Minister Hill around the March State election) the debt should be paid off, ie $485714285 per year,  so the amount due in the first year alone is $2.1bn +    I suppose it will be a reducing loan, but goodness knows what that pattern of repayment will be.    If the Commonwealth tells the State to finance it out of its annual allocation as opposed to a special grant each year , then the health services in SA will have to be reduced even further.       And what if the price escalates like the Adelaide Oval?

In Canberra the daily drama of minority Government is playing claim and counter claim - "I am more fiscally reposnible than you are" so can this State confidece trick be sustained?

Every now and then the claim by Premier Rann that after his near miss in March he and his Government will be listening to the people bubbles up and equally frequently is ignored.    Over 8000 voters in March departed from voter support on wider issues to specifically support "Save the RAH" candidates.  Just how much louder do the people have to shout to get this mesage through?

Completion of the redevelopment of the RAH in a timely manner woud have had all the facilities promised at the Railyards actually in use right now.  

The question is just what or who is driving this pig headedness in Health?

A quick update on remediation costs

Yesterday 24/8 I mentioned the proposed footprint of the hospital is about 2 ha, yet when we apply a simple logic to the proposals, the footprind could be 10 times that.     If we presume a linear relationship between volume of soil to be removed and treated and the cost then the estimated cost of $200m will be 10 times that.     As the clay layer slopes towards the Torrens then thwe larger the area the greater the depth of soil to be removed so the cost would be more than 10 times the estimate.     If that is so then the $2bn remediation added to the original published estimate of $1.7bn gets nearer to the estimate claimed by Isobel Redmond of more than $3bn.       We might as well build an Adelaide Oval with the small change!!     So Messres Rann, Foley Conlon and Hill where do the actual costs lie?

A conspiracy or a stuff up

I am told about a memo from the SA Health Dept to Department Heads that says that the proposed railyards hospital is tgo be 8 storeys.            When South Australians expressed concern about the proposal before the March election, the published concept drawings were a 3 storey building so that the view to the North  from North Terrace would be unsullied.   The Government assured us that the concept was firm and 3 storeys it would be!

Consider the practicalities.
(1)   On Frome Rd, the T shaped building known as the North Wing was designed in the late 1960's to have  3 wards on each floor each holding 30 patients = 90 patients with 6 occupied floors.  That's a capacity of 500 patients and its footprint would be about 1ha.        The proposed hospital is to have more beds than that in a modern layout .    Single rooms, each occupies at least 4x the space of a bed  so the area required would be 4 x the present size.    If 500 beds on 6 floors take up 1ha then 4x the space would be 4ha , over half the height means the space would be extended to 8ha.     The proposed plan is for 700 beds so they said, adding  more space and we have 10ha required for bed space alone!    This is without any treatment areas  - theatres, Xray, clinics, laboratories .     On the Frome Rd site, the Treatment areas are about the same area as the "hotel "space so on this simple logic the proposal at 3 storeys should be 20ha which then leads to another set of questions.
(2)     A problem in modern complex medical treatment  facilities is the distance patients have to traverse or be wheeled between clinics.    It can be done but, the walking patients need a guide, or orderlies wheel the bedfast/chairfast.      Over a 20ha (or to be kind a 10ha treatment only portion) site the traversing time is longer.    There is insufficient staff to manage this aspect at Frome Rd,  how many more staff would be required on the Railyards, and all of this in a financial climate where the Department is looking to SAVE ie REDUCE expenditure by $450m every year.    
(3)     The concept drawings published before the election showed a building with lots of glass.  It is high school physics that the amount of heat transfer (losing in winter, gaining in summer) is proportional to the surface area exposed.    This large spread out building maximises the heat transfer    Any such heat loss/gain is managed by the air conditioning systems which use energy which we know is costing us more and more. (just look at your Electricity bill next month. )    One way of reducing the problem is to reduce the surface area exposed, that can be done by condensing the building ie having a higher building with a smaller footprint.   Is this where the 8 storey concept story has come from?     But that would give a lie to the promises preelection.      Logic (of which there seems to be little) says that with all the expertise on this project the Government, the Dept of Health would have known all this at the planning concept stage.     
The only explanantions available are (a) a conspiracy, or (b) a stuff up.     My money is on a stuff up because a conspiracy takes vision, organisation, discipline, cooperation and nerve.     None of those qualities have been demonstrated in this saga.

SAVE THE RAH BACK IS BACK IN BUSINESS

The sleight of hand that transferred the cost of the proposed railways RAH from the State to the Commonwealth has placed the decisionmaking about the project squarely in the lap of whatever government is formed in Canberra.       That means that the influence of the Greens will be crucial.

An article in the Advertiser on 18th August (P16) raised the spectre of the huge cost of remediation of the site following more than 100 years of industrial spillage from abbatoirs, tannery and railways.    Presuming the facts have just come to light it ignored the fact that the Save the RAH Committee before the March election tried to interest anyone in the information provided from the drill cores but no one was willing to respond. 

We know that the contamination is extensive over the whole site, that it extends to a depth of about 10-15m where the clay layer has prevented it from soaking deeper.     The proposed hospital footprint of 2-3Ha means that the volume of soil that has to be removed is millions of cubic metres which not only has to be removed but treated as well.      On the Desalination Plant site about the same size, the cost I am told, is $200million. Is this kind of figure is  part of the $1.7billion hospital pricetag.?      If yes, then why bother when the restoration of the Frome Rd site woulc cost less,   If no, then the Adelaide Oval debacle is cheap by comparison.

Tenderers are seeking cheaper alternatives but any compromise (like one in India where the new hospital was built on a sheet of plastic!) leaves contaminated soil which under the weight of the new building contaminates will be squeezed out onto the clay layer and end up in the Torrens and from there to the coast.

Which brings us to the Federal sphere.    The significant vote for the Greens is claimed as the result of widespread public concern for environmental issues.      Now that the Greens have such a powerful voice in Caanberra will they veto this expensive , unnecessary and polluting development.     Tony Abbott said that a vote for Greens is a vote for Labor.    Is he right?  or will the Greens stand up for their environmental credentials in this matter.   Will the real Greens please stand up