HEALTHCARE INFRASTRUCTURE
Internal and external views of the radically designed Alder Hey Children’s Hospital in Liverpool – where young patients were extensively consulted on the design and desired features.
Issues like alliance contracting and Modern Methods of Construction may sound boring and technocratic, but when people are asking why new facilities aren’t coming on stream faster, developing these at pace might be part of the solution. Fourthly,” he said, “I hope that in a decade or two, we’re not looking back and acknowledging that, yes, we have 40 brilliant new hospitals, but that we should have invested in 40 brilliant healthcare infrastructure campuses, or networks of different facilities, to deliver modern clinical care. My final point is that the short and medium-term demands on
healthcare are uncertain. We are building facilities that can last for generations, so we can’t put a high enough premium on flexibility, adaptability, and avoiding over- specification. That is a point Nigel Edwards actually taught me, so now is a good point to hand over to him.”
Lessons from the previous hospital-building programme Chris Green thanked Siva Andanciva for ‘a ‘brilliant scene-setting presentation’, before Nigel Edwards of the Nuffield Trust began his presentation, explaining that he
would both ‘pick up on’ some of the previous speaker’s comments, and look at the potential learnings from the previous hospital building programme. He said: “Siva optimistically says that we’ll get back to the OECD average, but we have been so far below it for so long that that seems like thin gruel.” Compared with other OECD economies, the UK ‘massively underinvested’ in infrastructure generally, including in healthcare, ‘leaving us way behind’ in both hospital buildings and diagnostic equipment, which had ‘major implications for patients’, and was, he believed, partly behind the UK’s poor international figures on, for example, cancer survival. He added: “Put in the long-term context, and even the bonanza of the early 2000s hardly gets us close to the OECD average. An astonishing amount of money was poured into hospital and primary care developments, and – as you can see on this slide – in the last decade or so we’ve really been bucking a trend, where other European countries have been putting money into infrastructure.”
A ‘common problem’ in the last hospital-building programme A ‘common problem’ in the last hospital building programme had been ‘massive over-optimism’ about the system’s ability to manage demand and reduce stay lengths. While there was ‘undoubtedly a very substantial opportunity’ to reduce hospital stay lengths, the UK had not so far made the required investment, ‘particularly in rehabilitation and community services’. Very often services had been planned, but without a concomitant investment in those areas. Nigel Edwards said: “Rehabilitation is
January 2022 Health Estate Journal 33
©Alder Hey Children’s Hospital
©Alder Hey Children’s Hospital
©Alder Hey Children’s Hospital
©Alder Hey Children’s Hospital
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