For discussion FCR(95-96)133
on 8 March 1996

ITEM FOR FINANCE COMMITTEE

CAPITAL WORKS RESERVE FUND
HEAD 708 - CAPITAL SUBVENTIONS AND MAJOR SYSTEMS AND EQUIPMENT
Medical Subventions
New Subhead “Queen Mary Hospital - Radiotherapy and Oncology Department Extension”

Members are invited to approve a commitment of
$113.57 million in money-of-the-day prices for the construction of an extension block for and refurbishment of the Radiotherapy and Oncology Department at Queen Mary Hospital.

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PROBLEM
PROPOSAL

Project scope and nature

JUSTIFICATION
FINANCIAL IMPLICATIONS
ENVIRONMENTAL IMPLICATIONS

Public consultation

BACKGROUND INFORMATION

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PROBLEM

The Radiotherapy and Oncology Department (RT&OD) at Queen Mary Hospital (QMH) is inadequate in terms of space and treatment facilities to meet present day requirements.

PROPOSAL

2. The Secretary for Health and Welfare proposes to construct an extension block for the RT&OD at QMH and refurbish the existing RT&OD at a total non-recurrent cost of $113.57 million in money-of-the-day (MOD) prices.

Project scope and nature

3. The project will involve construction of a new seven-storey extension block with a gross floor area of 3 180 m², as well as refurbishment of the existing RT&OD situated mainly on G/F and 1/F of the Professorial Block at QMH. A site plan showing the proposed extension block and the Professorial Block is at the Enclosure.

4. The expanded RT&OD at QMH with a total gross floor area of 4 905 m² will provide the following facilities -

1. an additional linear accelerator to provide radiation treatment;
2. an expanded out-patient clinic with five additional consultation rooms;
3. a new day care centre with six beds, a minor operating theatre and supporting facilities such as preparation room for cancer drug therapy and blood testing laboratory;
4. a Nuclear Medicine Division with two gamma camera rooms, one examination room and new radioactive drug administration facilities;
5. an enlarged central medical record store for improved management and storage of x-ray films, magnetic tapes and patient records;
6. endoscopy services;
7. staff common room and a new patient resource centre; and
8. medical and nursing staff offices.

JUSTIFICATION

5. The existing RT&OD with a gross floor area of 2 210 m² is inadequate to cope with rising demand for its services. Since 1987, the incidence of cancer and the number of out-patient attendance handled by the RT&OD have increased annually by 4% and 2% respectively. Due to acute shortage in space and facilities, the queuing time for consultation is long. Moreover, all activities including consultation and treatment procedures have to be carried out in a very congested environment. On occasions, treatment and consultation have to be carried out in the same room. On others, two doctors have to share the same room for consultation thus depriving patients of comfort and privacy.

6. In addition, nuclear medicine facilities, which are an integral part of services to cancer patients, are now provided in three scattered locations in the hospital compound. This has caused inconvenience to patients and is not conducive to the efficient use of resources.

7. The proposed project will help to rectify the inadequacy in space provision of the RT&OD, enhance space utilisation and improve treatment facilities for patients. Upon completion, the new extension block will increase the number of specialist out-patient (SOP) consultation rooms from five to ten and provide additional diagnostic and treatment facilities. This will enable the department to significantly reduce the queuing time for SOP consultations and the waiting time for treatment, thereby enhancing the quality of patient care. In addition, centralisation of the nuclear medicine facilities will achieve efficiency in the utilisation of expensive equipment and manpower and provide a central point of services to patients.

8. The extension block will also provide space for the following new services and facilities -

1. a new linear accelerator in addition to the existing three machines, making a total of four. This new machine is essential to improve the treatment outcome with reduction in complication for cancer patients by improving the standard of radiation dosage applied;
2. a new day care unit with six day beds to provide appropriate treatment settings to patients undertaking diagnostic, radiotherapy and cancer drug therapy procedures, which currently have to be performed either as in-patient or in the cramped out-patient setting;
3. new radioactive drug administration facilities for the Nuclear Medicine Division for preparing and dispensing radio-pharmaceuticals;
4. combined clinics for breast, urology and stereotactic radiotherapy and screening of Nasopharyngeal Carcinoma, to provide multi-disciplinary approach in cancer management; and
5. a Patient Resources Centre to provide integrated support services to cancer patients and their family members in terms of psychological and spiritual support, counselling, as well as health information and education.

FINANCIAL IMPLICATIONS

9. The Director of Architectural Services (D Arch S) estimates the total project cost to be $113.57 million in MOD prices, made up as follows -

10. The estimated cashflow is as follows -

11. D Arch S derives the MOD estimate on the basis of the Government’s forecasts of trend labour and construction prices over the period between 1996 and 2001. He will tender the works under a fixed-price lump-sum contract as the scope of works can be clearly defined in advance, leaving little room for uncertainty.

12. D Arch S is finalising the design drawings and plans to start construction works in July 1996 for completion in September 1998.

13. The Hospital Authority (HA) estimates the additional annually recurrent expenditure of the project to be $4,879,000 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 D Arch S in January 1995 which concluded that an Environmental Impact Assessment is not necessary. The proposed extension will have no major long term environmental impact since central air-conditioning will be provided to improve the internal noise environment and no pathological incinerator will be installed. HA will follow DEP’s guidelines on the disposal of clinical, chemical and liquid waste. The Director of Health will also advise HA on the disposal of any radioactive waste.

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

Public consultation

16. The project has the support of the Southern District Board.

BACKGROUND INFORMATION

17. QMH is the largest acute hospital on Hong Kong Island with a total of 1 386 in-patient beds. It is also a centre of excellence for the treatment of cancer and provides a comprehensive range of secondary and tertiary care services for cancer patients referred from other hospitals.

Health and Welfare Branch
February 1996

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