Editorial |The buck stops with Tufton

DR CHRISTOPHER Tufton, the health minister, is causing a lot of people to reconsider their perception of him as a quick study. It has taken him all of three years, the expenditure of more than a billion dollars of taxpayers’ money, plus the help of high-powered analysts to conclude that Jamaican architects, engineers and contractors cannot build hospitals. More likely, he has misdiagnosed the problem.

In other words, while they had a notion of what was to be done, Dr Tufton and his staff at the health ministry mischaracterised what was required at the Cornwall Regional Hospital (CRH) in Montego Bay, St James, leading to an imprecise terms of reference, and, ultimately, a lot of time-wasting and costly, unproductive outcomes. Or put differently, no matter how long ago Jamaica constructed its last hospital, it could not be difficult for properly briefed and appropriately resourced builders to make themselves au fait with hospital design and engineering elsewhere in the world and adapt their findings to Jamaican conditions. Even if they were only amateurs, there is something called the Internet.

In 2016, staff – medical and administrative – at the CRH started falling ill, without anyone able to say why, except that they sometimes smelt noxious fumes, which they could not identify. It made them nauseous. Some fainted. Initially confined to a few floors, the problem soon spread. In time, there was agreement that the building was sick, but what made it so remained, for a time, a mystery.

THE PROBLEM

At one time, it was suspected that the problem was the ventilation duct for a new air-conditioning system that was not properly cleaned before its commissioning. Eventually, in early 2017, an environmental hygienist, engaged through the Pan American Health Organization, determined conclusively that the issue was mould. Initially, it was thought the matter could be fixed by replacing the heating, ventilation and air-conditioning systems. The projected cost – around J$1 billion.

It took an extremely long time, while bickering went on over whether the hospital had to be completely closed for the job to be done, before the scope of work was decided on and contracts drawn up. Along the way, it was determined that the problem was more extensive than supposed, and may have something to do, also, with the original design of the multistorey hospital, which was built by Canadians and better suited, some critics argued, for temperate climes.

Apparently, the structure of the walls allowed water to seep into block pockets, keeping them damp and creating an environment for the breeding of mould spores. So, the project expanded to fixing the leaking roof to prevent the drainage into the walls. The bill, by now, had ballooned to J$2.2 billion.

Work lagged. In around May 2018, Dr Tufton appointed the Cornwall Regional Hospital Oversight Committee, chaired by the former principal of the Mona campus of The University of the West Indies, Professor Archibald McDonald, to monitor the progress of the renovations and to keep things on track. Soon thereafter, the completion date was given as August 2019. That deadline was not met.

In fact, in March 2019, the health minister disclosed that the cost of the project had gone up to J$3.5 billion. That, in part, was because, as Professor McDonald was to explain, the inside of the building had, essentially, to be gutted. Internal walls were being removed and rebuilt. The electrics, plumbing and information technology installations had to be replaced. Dr Tufton had said this was cheaper than building a new hospital, which would cost around US$150 million, or over J$22 billion.

CONSTRUCTION DELAYS

In October, Professor McDonald said he expected that the hospital rehabilitation would now be completed by early 2022, work having been slowed by the COVID-19 pandemic. This week, Health Minister Tufton added a twist: frustrated with the delays, he might have to contract outside builders to help on the project.

He said: “Too many recalibrations and too many re-evaluations, too many variations. And I believe it is, substantially, a function of inexperience.”

The cause of that inexperience, he said: “...We have not built a hospital for nearly 30 years. A hospital is not an apartment building. It involves a lot more complicated moving parts – airflow issues. And we just don’t have the local experience.”

We are yet to fathom the logic of the argument. It sounds, from Dr Tufton’s remarks, as if construction is being done on the fly. Which should not be the case.

It is doctors and other medical professionals who use hospitals most, and ought to know them best. Architects and engineers usually work from design briefs, which, in this case, should have come from the health professionals and their boss, Dr Tufton. Builders then work from the design plans, with oversight from their architects and engineers.

If the CRH renovation project, which is costing Jamaica’s taxpayers a pretty penny, did not proceed in this fashion, then somebody erred. The blame, then, would rest fundamentally with the public-sector technocrats. Either they did not proceed in the right way or they hired the wrong people. The buck, in this regard, stops with Dr Tufton.