An artist's impression of a new Dunedin Hospital.

An artist's impression of a new Dunedin Hospital.

Which site has been chosen for the new Dunedin Hospital?

The Minister has approved the site for the new Dunedin Hospital.

Dunedin’s new hospital will be built on the Cadbury site and on the block next door to the North which currently contains a Wilson’s carpark. The new site does not include the Otago Daily Times but it does include a Cadbury carpark over the road toward the Railway Station.

The new hospital will therefore take up parts of several blocks.

Why was this site chosen?

We asked architects and health planners to help determine a viable size. We always knew a new hospital would take up a fair bit more than one central city block.

We also wanted to maintain the compact nature of Dunedin’s health and health education facilities so we focused on central city sites north of the Octagon.

Over twenty different criteria were considered to weigh the various pros and cons of the potential sites. The Local Advisory Group provided valuable local input into the process.

In the end the decision came down to a shortlist of three sites which were all on flat land in downtown Dunedin. In all cases we needed well more than one city block and in all cases we wanted to be near Otago University. There was little difference between them. We chose the ‘Wilson’s/Cadbury’ site.

Why?

The Wilson’s site gives us a large piece of land close to both the University and the bits of the existing hospital that we will retain, such as the oncology precinct.

The Wilson’s site alone would not have been big enough. The Cadbury site was for sale, but as one block. Buying both blocks provides greater flexibility about where we build the various parts of hospital complex and for development further down the track.

For example, the main part of the hospital – the acute inpatient services building - could be built on either of the two main blocks and a second building for outpatients and day surgery might be built on the other.

Who owns the site?

The Ministry of Health owns the Cadbury site and took possession on November 1, 2018. Mondelez closed their factory and had approached the Ministry of Health to see if there was interest in it as a site for Dunedin Hospital. 

The site next door which contains the Wilson’s carpark has eight owners and it may take a bit longer to get through all the paperwork to purchase these properties.

How much will it cost?

The Government paid $11 million for the Cadbury site. The the price of the other land is not a significant part of the billion-dollar-plus budget.

How is it being paid for?

The purchase will be funded by the Crown. Before the election, the Government dropped the previous government’s plans for a public-private partnership.

How does the purchase process work?

The Public Works Act 1981 governs Crown acquisition of land - by agreement or by compulsory purchase. Where land is compulsorily acquired, the land owner is required to be compensated.

The Public Works Act requires landowners be treated fairly and we are committed to ensuring that does happen.

It is up to the landowners to let their tenants know about the plan to build a new Dunedin Hospital on this site. However there will be little change for the existing businesses for some time yet. There is still a great deal to do before we start construction.

The Ministry of Health will purchase the land using the Land Information New Zealand (LINZ) process under the Public Works Act 1981. Land Information New Zealand (LINZ) has a process in place to cover Crown acquisition of land. It requires a LINZ accredited agent to prepare the necessary reports, assist with the negotiation for the land and ensure the compensation negotiated is fair both to the landowner and the Crown.

The Ministry has already engaged an accredited agent, The Property Group, to undertake this work. The Property Group have extensive experience with these acquisitions having assisted the Crown with many of the land acquisitions within Christchurch following the earthquakes.

The Ministers of Health and Finance approve the funding for the purchase, while LINZ approves the acquisition of the site (under a delegation from the Minister for Land Information).

How long will this take?

The site next door to the Cadbury site which contains the Wilson’s carpark has eight owners and it may take a bit longer than the purchase process with Mondelez to get through all the paperwork to purchase these properties.

If agreements are unable to be reached it generally takes at least six to twelve months to compulsorily acquire land. However, this does not include a landowner using their right of objection to the Environment Court where their land is compulsorily acquired. The right of objection relates to the taking of the land, not to the amount of compensation payable. In the event of objections, this timeframe would be pushed out further – acquisition could take up to three years.

That is why we’ve started the site selection and procurement process parallel to the detailed business case and other preparation.

What will happen to Warehouse Stationery and the other businesses on the Wilson’s carpark block?

Questions should be referred to those landowners and tenants but we are not expecting any immediate changes – it will take some time to acquire the sites.

Are there any historic buildings or facades to consider on the site? What are you going to do about them?

There are some older facades on the site which have a modest level of protection under the current District Plan. Should we wish to demolish then we will go through the proper process. We have completed a shading study to confirm that new buildings need not unduly shadow the historic precinct if there is good design.

The design teams will look at the possibility of retaining the Cadbury Dairy Building façade – but we are a long way off any detailed plans for the hospital.

What are the next steps?

Now that the site is chosen, attention can focus on completing a Detailed Business Case to the satisfaction of Cabinet. That is a complex exercise with many different components. An Indicative Business Case has already been approved.

At the same time, we are starting the detailed planning and design process. Building a tertiary hospital the size of Dunedin is very complex. The planning and design process is a perhaps surprisingly large part of the overall budget - around 20%.

It is likely most design contracts will be let to offshore companies, or to joint ventures of NZ and offshore companies, rather than NZ companies alone. This is the largest capital project in the history of the NZ health system. As with other hospital projects it is beyond the resources and capacity of just NZ companies.

However it is also the case that construction might be undertaken through several contracts, each with multiple sub-contracts. In this way local and national firms ought to be able to compete readily.

After we’ve let the contracts, we can move from conceptual design to actual design.

We are taking every opportunity to speed up the process. For example even though the design process is just about to start, we can be getting on with other things. We can make a start on the resource management consent process, and geotechnical drilling to see what the ground is like and see where the foundations should go.

What planning permission do you need?

Obtaining planning approval for this project (whether by resource consent, plan change or designation) is a significant piece of work. None of the sites within the central city allow construction of a hospital of such scale as of right. Though we enjoy excellent relations with and support from the DCC and ORC, we must gain approval like anyone else. This means paying attention to detail and to process.

When will building work start?

The Government has said that construction will start before the next election, due in late 2020. We remain on course to meet that deadline.

When will it be finished?

This is New Zealand’s largest single hospital rebuild and long overdue. The project is currently scheduled for completion in mid-2026.

There are a number of areas that could impact on this completion date including the ability to secure an acceptable main contractor, securing a large workforce and housing them, unknown geotechnical problems, natural hazards and so on.

Forward planning means we can reduce the impact of each such issue.

Will the city’s transport system cope with the hospital on a new site?

Yes. The hospital will sit within the one-way system. Ambulance access is straight forward. Thought has been given to ensuring ready access for all public and private transport modes including walking. We have close engagement with NZTA and the City Council, and they will consider alterations to current roading if necessary. For example there may be a case for calming a section of St Andrew St or limiting it to ‘hospital only traffic.’

Why couldn’t you build on the current hospital site?

The first plan was to replace only the clinical services block. Then it became apparent that the main ward block was in a worse condition than originally thought. At that stage a near-total rebuild became necessary which is why this is NZ’s largest hospital building project ever.

Such a rebuild could, from an engineering perspective, have been built on site. But it would have taken longer, caused building site disruption to a working hospital for about 10 years, necessitated decanting patients throughout that time, and given us a [by then] 50 year old refurbished facility.

Why couldn’t you have built on the Wakari site?

It became very clear the people of Dunedin wanted the new hospital built where the current one is now, in central Dunedin and close to the University of Otago Medical School, and all the other health science education facilities.

Why does it take so long to build a new hospital?

Hospital developments typically take about a decade to progress from start to finish, through the planning, design and build phases. We’re not building a like-for-like replacement so we need to consider how the population is changing, how we want to deliver services (including delivering more services in the community), and how to future-proof facilities so they last for around 50 years. That work is nearing completion. Once that’s decided there’s also a detailed design phase, and then construction. The project is currently scheduled to take a little over eight years to complete.

Will the new hospital be bigger than the current one?

Only a little. The current hospital is 89,731 square metres with over 5,000 rooms but it is old with very inefficient use of space. The new hospital will be a modern state of the art building designed to fit in with the Southern DHB’s strategy for delivering health services for the next fifty years. Its size is yet to be finalised.

Some aspects of the new hospital will be no bigger than present whereas others such as the number and size of theatres, the number of ED beds and the ICU will be significantly larger.

How many beds will the new hospital have?

About 400, depending how you count them, compared with about 350 [depending how you count them] today. Figures are yet to be finalised. The new hospital is planned to open with some parts of some wards unoccupied, to allow for future expansion.

Will there be enough car parks?

Yes. Car parking can mean two things. First it means parking for those who travel to and from the hospital in to the community or those coming to visit or as outpatients, including those coming from out of town. They come and go.

Secondly it means those travelling to the hospital to do a day’s work. They come and stay. Either way there will be provision for parking, probably as a mixture of free and paid parking.

Well before the end of the new hospital’s life, autonomous vehicles will have rendered a lot of inner city parking space obsolete. However that is not at all likely when the hospital first opens so we will have to make provision for adequate parking in the near term.

How do you build for a future that is 50 years away?

The size of the hospital has been determined by modelling assumptions, which may or may not still be accurate decades from now. Healthcare is increasingly delivered away from hospital beds, in outpatient clinics, at the GP’s, at home, with nurses or perhaps via telemedicine. Conversely we are all living longer and older people use more healthcare. So there are trends that act in opposite directions.

The new hospital, like all other hospitals, will have room to grow if necessary, by ‘repurposing’ an area to another use, or perhaps building an extension. That is one reason why we have purchased more land than is strictly necessary at present. [On the other hand health facilities can ‘shrink’ too, as occurred when Queen Mary Hospital transferred into the current Ward Block some years ago.]

Will there be any loss of services – e.g. neurosurgery?

No. The range of services currently delivered at Dunedin Hospital is not changing but how they are delivered continues to evolve. The expected models of care on which the new hospital will operate are being defined with Southern DHB staff.

Ensuring the people of Dunedin and the wider Southern community have access to the high quality health services they need for the next fifty years is our priority.

In line with forecasts of future patients who will be older and present with multiple long term conditions, we are likely to see a move to more generalist delivery. This does not mean a loss of specialist services, it simply means having general wards which specialists operate out of.

Will the existing Dunedin Hospital buildings hold up during the construction period?

The DHB’s Interim Works programme is designed to ensure clinical services continue in current facilities while the longer term redevelopment is progressing.

We are very mindful of Dunedin’s deteriorating hospital facilities and continue to explore ways to fast-track the process to have new facilities built as soon as possible.

Who is overseeing the rebuild?

The hospital is being built by the Ministry of Health but on behalf of the Southern DHB. So it is important both central and regional issues are taken into account.

The Southern Partnership Group [SPG] acts as a bridge between national interests and regional interests.

The SPG provides the Ministers of Health and Finance with independent assurance about the project and its progress.

The SPG also sees itself as having an obligation to inform and engage the public along the way. This website is one example of that.

In addition a second group, the Local Advisory Group has been established to address non-health issues such as transport, energy provision, economic development opportunities, any issues affecting Māori, training the workforce, housing the workforce, interface with other planning concerning the Dunedin CBD and so on.