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Health kick

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The curious story of the St Mary's Hospital development alongside Paddington Basin in west London has yet to be fully explained, even though it involves a high-level resignation, the biggest PFI hospital scheme in the country, and the future planning for demographic change and hospital design criteria. The Observer was the national paper that broke the story two Sundays ago, with a lurid headline: 'Design blunder undermines flagship PFI hospital plan'. A thumping first paragraph gave a flavour of what was to follow: 'One of Tony Blair's flagship projects for using private cash to build NHS hospitals is in jeopardy with the hasty departure of its director after he realised that the wards would be too small for patient needs'. The director in question was Eric Sorensen, the highly competent former head of the London Docklands Development Corporation, and before that a high-ranking career civil servant. He took over the project management role on the £400 million development after a rigorous selection process, and appeared to be steering a sensible course between the requirements of PFI procedures and the sensitivity of a difficult site. It contains one retained modern building, best described as a dog, and a series of lesser structures, some of historic interest, which has attracted the interest of English Heritage in a big way.

Westminster council has been monitoring the story to date with a beady (but highly professional) eye, in the person of strategy planner Graham King. It is a complex scheme because it involves relocating two other facilities and partly financing the new project by redeveloping their sites. The point at issue seems to be new criteria developed by NHS Estates in relation to the amount and type of space devoted to middleaged and elderly people, and the proportion of the new hospital's space they would occupy.

Guidelines released in November 2001 suggested that capital costs would increase to allow for this. Health Service Journal, which has its finger on the pulse of these matters, reported earlier this year that there was confusion over whether the new standards were voluntary or mandatory.

Curiously, a project spokesman has told HSJ that Sorensen's departure is not linked to the increased space (and therefore costs) which the St Mary's scheme will have to take on board. In that case, why has he gone?

Sorensen is keeping a low profile, and has yet to make any comment. But looking at this from the outside, one is drawn to the following conclusion: either it was considered that the masterplan by Skidmore Owings & Merrill (other architects have yet to be appointed) has been produced to an incomplete brief; or the brief provides the maximum space possible, and therefore estimates of number of single rooms, for instance, will have to be downplayed. Another way of saying this is either there is not enough money for the required numbers and standards to be met; or the site is incapable of providing what is desired. This story is not going to go away for one simple reason: it is PFI that is under the microscope as much as the scheme in question.

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