Editorial: Middlemore must minimise risk to patients

The people have no choice but to trust the experts that the risks to patients can be contained and the monitoring and checking will be done. Photo / Doug Sherring

It does not sound healthy that part of Middlemore Hospital is to be reclad while patients remain inside the building. The risks include mould spores entering areas where acute patients are being treated.

This is admitted in a paper from the Ministry of Health's capital investment committee which states, "This project is classified as high risk. Internationally there have been few examples of recladding in a live hospital environment and none that have been found to replicate this project."

The Scott Building, poorly constructed and recently found to have rot and mould in the walls, contains more than half Middlemore's beds for adult acute patients, including those receiving coronary care. It also houses the renal dialysis day unit and a cardiac catheterisation laboratory.

The ministry's paper says of the repair project, "This work's methodology is untried in New Zealand but has been tested in a limited way...... The evident risks involved here have been mitigated as far as practicable....., the remediation work is very necessary and must proceed to ensure the Scott Building's... long term use."

Clearly these are not risks a district health board would take lightly. But the project is likely to take two and half years and equally clearly, the Counties Manukau DHB cannot do without the building for that length of time. Nor presumably can its acute services be relocated to temporary buildings.

So patients who hear, see or smell the work going on nearby will need to trust the DHB spokesperson who says the "designed methodology" will be carefully adhered to and infection control teams will regularly check the effects of the work.

Health Minister David Clark does not sound entirely confident of the proposed precautions. He declined to comment on the remediation method since it is an operational decision for the DHB. But back in March when he announced funding for the repairs, he said, "The DHB's advice is that patient safety is not at risk as long as any rot and mould are contained in the walls. That will be of little comfort to the people of Counties Manukau who rightly expect their hospitals are up to scratch."

The people, like the minister, have no choice but to trust the experts that the risks to patients can be contained and the monitoring and checking will be done. It is not easy to find that confidence when reading the chapter of errors the Scott Building has produced.

It was constructed between 2002 and 2006. The first sign that it was a leaky building came in 2012 when an exterior panel fell off. Remediation was to start the following year but the DHB was still pressing for a $12 million settlement with Hawkins Construction.

The board eventually settled for $3 million, a fraction of the $18m Hawkins requires to carry out the repairs. The cost has risen to $27.5m partly because of sewerage problems that became apparent as cladding was removed.

The minister's review of the public health service should look closely at the Scott Building saga and tell us how such a sick hospital construction happened.