For discussion FCR(95-96)106
on 12 January 1996

ITEM FOR FINANCE COMMITTEE

CAPITAL WORKS RESERVE FUND
HEAD 708 - CAPITAL SUBVENTIONS AND MAJOR SYSTEMS AND EQUIPMENT
Medical Subventions
New Subhead “Redevelopment of the operating theatre block and the rehabilitation block in Queen Elizabeth Hospital”

Members are invited to approve a commitment of $671.27 million in money-of-the-day prices for redeveloping the operating theatre block and the rehabilitation block in Queen Elizabeth Hospital.

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PROBLEM
PROPOSAL

Project scope and nature

JUSTIFICATION

Operating Theatre Block
Rehabilitation Block

FINANCIAL IMPLICATIONS
ENVIRONMENTAL IMPLICATIONS

Public consultation

BACKGROUND INFORMATION
Breakdown of the estimate for consultants’ fees for quantity surveying
Supplementary Note to FCR(95-96)106

Introduction
Service provision in the Rehabilitation Block to cope with increased demand arising from new services introduced in the QEH

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PROBLEM

The operating theatre (OT) block and the rehabilitation block in Queen Elizabeth Hospital (QEH) are run-down and the facilities are inadequate to meet present day requirements.

PROPOSAL

2. The Secretary for Health and Welfare proposes to redevelop the OT block and the rehabilitation block (Block D) in QEH at a total non-recurrent cost of $671.27 million in money-of-the day (MOD) prices.

Project scope and nature

3. The project will involve demolishing Block D to make way for a new OT block and constructing a new rehabilitation block within the compound of QEH. The new OT block will be a seven-storey building with a gross floor area of 15 950m^2.. The new rehabilitation block will be a four-storey building at the site enclosed by Blocks B, C, E and F and will have a gross floor area of 3 450m². A site plan showing the new and existing buildings is at Enclosure 1.

4. The new OT block will provide the following facilities -

1. 22 operating theatres;
2. a theatre supply department;
3. a central sterile supply department;
4. 30 recovery beds;
5. storage area for theatre equipment and consumables;
6. a burns unit; and
7. offices.

5. The new rehabilitation block will provide space for the following -

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1. a physiotherapy department;
2. an orthotic and prosthetic department;
3. an occupational therapy department;
4. an exercise room and patient activity area; and
5. offices.

JUSTIFICATION

Operating Theatre Block

6. The existing OT block (Block F), which houses 18 operating theatres and ancillary facilities, was built 32 years ago. With the age of the building, the building services and structures are worn-out and the different service systems break down frequently despite regular maintenance. Moreover, the building services and structures have to be upgraded to meet present-day standards. In addition, the OT facilities designed some 30 years ago are outdated and inadequate. For example, in the existing OT block, there is a shortage of recovery beds for patients and storage space for OT equipment. The number of operating theatres is also inadequate to meet increasing demand for services. This has hampered the hospital’s efforts and plans to reduce waiting times for surgeries. The shortage of operating theatres has also necessitated the sharing of theatres between various specialties such as cardiac surgery, neurosurgery and ophthalmology. This sharing arrangement inevitably involves the moving around of expensive equipment between theatres and between floors and is likely to cause unnecessary damage to the equipment and shorten their life-span.

7. The Director of Architectural Services (D Arch S) advises that redevelopment of the OT block at the existing site of Block D is the most cost-effective option because the new OT block will then be best positioned in terms of linkage to all wards, intensive care unit facility and other supporting facilities. After the new OT block comes into operation, the number of operating theatres will increase from 18 to 22 and recovery beds from 18 to 30. This increase will enable the hospital to reduce the waiting times for most specialties by about 20% to 50%. In addition, the new OT block will provide dedicated theatres for cardiac surgery, neurosurgery and ophthalmology and significantly reduce the need for sharing of operating theatres. The new block will also provide sufficient storage space for OT equipment.

Rehabilitation Block

8. The existing rehabilitation block (Block D) which houses the rehabilitation departments providing physiotherapy, occupational therapy and orthotics and prosthetic services to acute care patients was also built 32 years ago and is worn-out. Moreover, due to its outdated design, the effective usable areas are limited and inadequate space imposes severe constraints on the delivery of quality service. The proposed new rehabilitation block will allow much greater efficiency in terms of space utilisation which, in turn, will enhance the services provided by the departments.

FINANCIAL IMPLICATIONS

9. D Arch S estimates the total project cost to be $671.27 million in MOD prices, made up as follows -

A breakdown by man-months of the estimate for the consultants’ fees for quantity surveying is at Enclosure 2.

10. The estimated cashflow is as follows -

11. D Arch S derives the MOD estimate on the basis of the Government's forecast of trend labour and construction prices over the period between 1996 and 2004. According to experience, a hospital project of this nature will require a series of commissioning tests for medical equipment, furniture and equipment, fixtures and post-contract modifications which will last for a considerable period of time after the completion of the construction works. Thus, we expect that the project account will not be finalised until 2004.

12. D Arch S will tender the works under two fixed-price lump-sum contracts, one in respect of the piling and the other in respect of the superstructure. Subject to Members’ approval of the project, D Arch S will start piling works in November 1996 and complete the whole construction works in November 1999.

13. The Hospital Authority (HA) estimates the additional annually recurrent expenditure of the project to be $21.35 million at 1995 price level, made up as follows -

ENVIRONMENTAL IMPLICATIONS

14. The Director of Environmental Protection (DEP) vetted and agreed with the Environmental Review conducted by the D Arch S in March 1995 which concluded that it was not necessary to carry out an Environmental Impact Assessment for the project. D Arch S will commission a survey to assess the likely disturbance of asbestos-containing materials (ACM) due to the demolition works. He will ensure that the contractor will remove and dispose of any ACM in strict accordance with government guidelines. HA will equip the new OT block with air-conditioning so that it will not be subject to adverse traffic noise impact. It will also follow DEP’s guidelines on the disposal of clinical, chemical and liquid waste.

15. For short term construction impact, D Arch S will include in the construction contracts requirements for the contractors to control dust, noise and site run-off nuisance during construction through the implementation of mitigation measures.

Public consultation

16. The project has the support of the Yau Tsim Mong District Board and the Kowloon City District Board.

BACKGROUND INFORMATION

17. QEH is the largest acute general hospital in Hong Kong with a total of 1 900 acute beds. It provides a comprehensive range of secondary care services. In recent years, more and more tertiary services including cardiac surgery, neurosurgery, neurology, nephrology, reconstructive surgery, oncology surgery and radiotherapy, interventional radiology and intensive care services have been developed and further enhanced in the hospital.

Health and Welfare Branch
December 1995

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Enclosure 2 to FCR(95-96)106

Breakdown of the estimate for consultants’ fees for quantity surveying

Notes :

1. The average estimated cost per professional man-month is about equivalent to a professional on Master Pay Scale (MPS) point 44.
2. The average estimated cost per technical man-month is about equivalent to a Technical Officer on MPS point 20.
3. The estimated consultants’ fees represent 2.7% of the total construction cost and cover quantity surveying services for the project.

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Supplementary Note to FCR(95-96)106

CAPITAL WORKS RESERVE FUND
HEAD 708- CAPITAL SUBVENTIONS AND MAJOR SYSTEMS AND EQUIPMENT
Medical Subventions
New Subhead “Redevelopment of the operating theatre block and the rehabilitation block in Queen Elizabeth Hospital”

Members are invited to approve a commitment of $671.27 million in money-of-the-day prices for redeveloping the operating theatre block and the rehabilitation block in Queen Elizabeth Hospital.

Introduction

When the project was discussed by the LegCo Panel on Health Services on 8 January 1996, Members asked for supplementary information on the impact of new clinical services introduced over the years on the need for rehabilitation services at Queen Elizabeth Hospital (QEH). This note sets out the required information.

Service provision in the Rehabilitation Block to cope with increased demand arising from new services introduced in the QEH

2. QEH is a major acute hospital providing a comprehensive range of medical services. With the concept of hospital clustering and networking, QEH has played an increasingly important role in the Kowloon Central Cluster ¹ as a tertiary referral centre for the treatment of highly specialised cases such as cardiac surgery, neurosurgery, neurology, nephrology, reconstructive surgery, oncology surgery, radiotherapy and interventional radiology. Patients who have undergone such specialised medical treatment require intensive rehabilitation support, which has hitherto been provided at the existing rehabilitation block. Despite minor renovation and maintenance works carried out from time to time, the inherent physical constraints have rendered any major on-site improvement practically not feasible.

3. The new rehabilitation block is designed with updated user requirements taking into account the specialised medical treatment being provided at QEH. Upon redevelopment, the building will achieve greater efficiency in terms of space utilisation and offer a much better physical environment for patients.

¹ The Hospital Authroity has organised its hospitals into eight hospital clusters. Within each hospital cluster, the roles and responsibilities of individual hospitals of service type and level of care are clearly defined. The Kolwoon Central Cluster comprises three hospitals, namely QEH, Kowloon Hospital and Hong Kong Buddhist Hospital.

Health and Welfare Branch
January 1996

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