A plan to replace the crumbling Victoria General and Centennial buildings is still a few months away and whatever follows the Halifax hospital will be different and smaller.

That was the message delivered by the CEO of the Nova Scotia Health Authority and the province's deputy health minister Wednesday at a meeting of the legislature's public accounts committee.

Before Christmas, Health Minister Leo Glavine said a plan to replace both buildings at the Victoria General Hospital site would be presented by the end of January. It doesn't appear that will happen.

"There isn't an accurate cost estimate," said Peter Vaughan, Nova Scotia's deputy health minister. "We don't want to develop something that will instantly be out of date."

What will eventually replace the hospital will be different and smaller. He said health care is changing "dramatically," with more services being offered on an outpatient basis.

"There will always be some highly centralized services — acute and tertiary — in the Halifax Infirmary," Vaughan said.

"Clustering those make a lot of sense from a human resources perspective and patient convenience, but not necessarily building a monolithic hospital."

Clinical service plan needed

Nova Scotia Health Authority CEO Janet Knox told CBC it's not clear if a replacement hospital will have fewer beds and more outpatient clinics.

"We do know over the last decades, we have changed from less inpatient stay and more outpatient services, with more services supported by specialists in the patient's local community," she said. "In the next few months, we should know what that plan will be."

Floods and pests

Plans drawn up under the previous NDP government put the VG replacement cost at about $1 billion and included a handful of services remaining at the site.

A series of floods and pest-control issues in the past six months have convinced the current government to retire the VG site and focus on moving out as many services as possible.

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The Victoria General site has flooded in recent months. (Brett Ruskin/CBC)

Knox said liver transplant operations have been moved from the VG to the Halifax Infirmary site. An undisclosed number of orthopedic surgeries are being carried out at the new Colchester Regional Hospital in Truro rather than the Centennial building.

When it comes to immuno-compromised cancer and transplant patients who continue to be cared for at the VG site, neither the Health Department or health authority would guess at how many months or years they will remain there.

"Work is already underway to deal with issues to decamp from the VG site," said Knox.

Transfers in the works

That involves transferring some patients and surgeries to the Dartmouth General. 

Although work is planned, the health authority said the problem is that construction hasn't started on the fifth floor of the Dartmouth General where 47 beds and eight operating rooms will eventually ease the strain on the VG's 16 operating theatres.

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Construction hasn't started on the fifth floor of the Dartmouth General Hospital. (CBC)

Both the premier and health minister have expressed hope a portion of the cost to replace the VG will qualify for federal funding under the Trudeau government's infrastructure program.

Knox warned money alone will not solve the problem.

"The fact that Nova Scotia is spending more and more on health care … and aren't getting any healthier shows that dollars alone are not the answer," she said.

"We need to talk about health, what it means to us, and how we can each contribute to it."