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Government & Policy

Montreal super-hospitals pass technical review

Montreal’s two proposed super-hospitals have passed a technical feasibility review headed by former Canadian Prime Minister Brian Mulroney (pictured at left) and former Quebec Premier Daniel Johnson. But the committee said that to stay on budget, each hospital should reduce the number of beds in their original plans.

The super-hospital project calls for a modernization of current facilities in Montreal by scrapping many of the old buildings and erecting two new hospital structures – one to serve the English-speaking community and one for francophones.

The anglophone hospital, organized by the McGill University Health Centre (MUHC), intends to build on the site of the Glen railway yards between Westmount and Notre Dame de Grace.

The francophone Centre hospitalier de l’universite de Montreal (CHUM) had opted for a parcel of land on St. Denis street, opposite the Rosemont metro station.

The commission agreed with the MUHC’s plan for the Glen railway yard site, but urged the government to consider expanding St. Luc Hospital on Rene Levesque Blvd. E. to accommodate the new French-speaking facility.

Quebec Health Minister Philippe Couillard appointed Mulroney and Johnson last summer to evaluate the project’s technical feasibility. The Quebec cabinet will discuss the committee’s findings and make its own decisions later this year.

Couillard had set out certain rules for the commission: that the cost of each super-hospital not exceed $1.1 billion; that there be no increase in the operating budgets of the new institutions; and that the Montreal General and Notre Dame hospitals remain open.

After studying the projects in depth, however, Mulroney and Johnson arrived at the conclusion that neither super-hospital could be built at the estimated price tag.

The commission estimated the McGill plan would cost about $265 million more than expected, and the CHUM project an additional $490 million.

The only way the two hospitals could be completed on budget, the commission concluded, would be to build them with fewer beds. It suggested the McGill super-hospital house about 500 to 550 beds, down from the 608 it projected.

The CHUM super-hospital also would house 500 to 550 beds, down from the 700 in its plan. However, the commission advised the government to increase the number of beds at the Montreal General and Notre Dame to compensate.

“So the community is not dispossessed of the ultimate number of beds,” said Mulroney.

At the same time, the commission suggested an alternative proposal of a public-private partnership that would allow the super-hospitals to be built as originally intended.

Under the proposal, a private developer would take on the expense of constructing the facilities at greater cost, and rent the buildings back to the government over a 30-year period.

The super-hospital concept has aroused controversy in Montreal for several years, with supporters arguing that existing facilities are cramped and outmoded, and that healthcare would be improved by concentrating services in a single building.

Critics have answered back that upgrading existing facilities would be more cost-effective, and that demolishing hospitals would have a negative effect on the communities they serve.

“I’m thrilled,” Dr. Arthur Porter, executive director of the MUHC, told the Montreal Gazette. “I look at this, most importantly, as a green light after 12 years of discussion.”

Cathy Rouleau, an aide to Couillard, said the Charest government is interested in the proposal of a public-private partnership, or PPP.

“We’re always open to PPP projects,” told the Gazette. “But PPPs can take lots of different forms, depending on the level of the partnership and who would be in charge of which parts of the building.”

The commission drew its inspiration for a private role in the super-hospitals from Great Britain, where a number of hospitals and schools have been built with private funding.

“A public-private partnership ensures that the risk of overruns is transferred to the private sector,” Mulroney said.

Johnson insisted this would not mean a privatization of health care. Still, the proposal is bound to provoke complaints among unions and some advocates of public healthcare.

Couillard has pledged $800 million for each super-hospital. The MUHC and CHUM would have to raise an additional $200 million each in donations. The federal contribution would be $100 million for each project.

The McGill super-hospital would replace the Montreal Children’s, Royal Victoria and Neurological hospitals. The CHUM plan would have eliminated Hotel Dieu and St. Luc hospitals. In the commission’s report, St. Luc would effectively turn into a super-hospital.

“The major thing for us is the go-ahead for our project,” said Dr. Denis Roy, the CHUM’s executive director.

The commission calculated that the yearly operating costs for the McGill super-hospital would rise by up to $65 million, and for the CHUM, by up to $125 million.

It recommends that a single development corporation oversee the construction of the two super-hospitals.

No date has been set for construction, although the commission predicts the buildings would be completed by 2010.