Royal Alex needs more help than Misericordia, AHS says

Alberta Health Services is urging the province to build a new hospital in the Edmonton area while scaling back suggested upgrades at aging hospitals like the Misericordia.

Report eschews previously planned upgrades at Misericordia in favour of new cost-saving options

The aging Miserecordia Hospital has been on the AHS priority list for repairs and upgrades for some time. (CBC)

Alberta Health Services is urging the province to build a new hospital in the Edmonton area while scaling back suggested upgrades at aging hospitals like the Misericordia.

The recommendation is part of a report recently released on the AHS website that lists suggested priority health-care infrastructure projects.

Referred to as a "health campus," the proposed new hospital would include inpatient beds and emergency, rehabilitation, mental health, diagnostic and ambulatory services.

"Development of a new comprehensive health campus will allow the growing needs of the zone to be met in a more expedient manner than the other complex staged redevelopments proposed for the existing centres," the report says.

"A new campus will more efficiently and cost effectively achieve spaces and service delivery models that align with contemporary standards."

Misericordia maintenance

The report also says renovations to the aging Misericordia — smaller than promised in previous budgets — should be a priority, as should upgrades to the Royal Alexandra Hospital.

Major infrastructure problems at the Misericordia have long been the subject of community outrage and political posturing.

Major flooding in 2013 forced surgery postponements. A similar incident a year later prompted the then-opposition NDP to hold an urgent news conference, requesting a brand-new replacement hospital. Staff at the time described the conditions at the facility as worthy of "the Third World."

Less than a year later, the ruling PCs announced $3.4 billion in spending on health facilities over five years, which was set to include renovations and expansions to hospitals in Edmonton and northern Alberta.   

At the time, the NDP roundly criticized that announcement, calling it a drop in the bucket and repeating calls for a replacement hospital.

After the NDP was elected to govern, however, its first budget included $20 million for development planning only at the Royal Alexandra and Misericordia hospitals, with no immediate funds for renovations.

Hard choices

Dr. David Mador, AHS vice-president and medical director for northern Alberta, told CBC News that the reasons behind these new recommendations are mainly financial.

Dr. David Mador is the vice-president and Northern Alberta medical director for Alberta Health Services. (Min Dhariwal/CBC News )

"The current financial situation of the government means we don't know how quickly we're going to get to these projects over the next 20 years," Mador said. "So we have to prioritize the work that we do, and we have to do that in a real way."

He explained that the Royal Alex's size alone is reason enough to prioritize renovations there, ahead of work at the Misericordia.

"The old area of the [Royal Alex] hospital, which is the area that is an inpatient area of the hospital, is more than twice the size of the whole Misericordia hospital," he said. "So the risk for us and the need for us has a higher priority."



1) 3rd floor severely damaged after flooding

THEN: the space was not usable, requiring the transfer of 50 patients 

NOW: The space is still closed, but Covenant Health says it was redeveloped and will open at the end of November. 

2) 8th floor renovations needed to create more inpatient space

THEN: construction was underway to convert administrative offices into patient rooms

NOW: "There is a Medicine unit (33 beds) and a Mental Health unit (25 beds)," said Covenant Health.

3) Required expansion and renovations at the ICU, which was built as a temporary facility 13 years earlier

THEN: Outstanding.

NOW: Still outstanding. 

4) Required expansion and renovations of the emergency room

THEN: The ER typically saw an estimated double the number of patients for which it was built

NOW: "The ER was built for 24,000 and it is still seeing more than double annually," said Covenant Health. 

New works

Also prioritized in the AHS report are the first two major planks of a proposed Royal Alex redevelopment and expansion plan, broken down into three parts.

"You can't run a hospital like that. You'd expect that in Namibia, but not in Canada," said Dr. Monica Henry of much-needed repairs at the Miserecordia in 2014. (CBC)
The first is consolidation of child and adolescent mental health programs at the Glenrose and Royal Alex into a new facility at the Alex campus, at an estimated capital cost of $200 million.

The second proposes a new building on the Royal Alex campus to house services that will need to be moved during redevelopment of the rest of the hospital. The estimated capital cost is $150 million.

The third, listed as Phase 1B of the project, proposes building a new tower for acute and rehabilitation beds, at an estimated capital cost of $1.4 billion.

The list of suggested health projects also includes several new community health centres in Edmonton.

The report did not specifically list how many centres were required or where they should go. But it did say that without those facilities, the health-care system will not be able to meet the population's needs by the year 2020.

Covenant Health sent a statement by email when CBC requested an interview.

"We have a significant amount of planning to do before final decisions are made, and we are ready to work with Alberta Health Services and government," wrote spokesperson Rayne Kuntz.

She added Covenant Health is committed to "using the planning funding provided, to discern the best possible solution for Albertans."