PWSC(97-98)48
For discussion
on 15 October 1997

ITEM FOR PUBLIC WORKS
SUBCOMMITTEE OF FINANCE COMMITTEE

HEAD 708 - CAPITAL SUBVENTIONS AND MAJOR SYSTEMS AND EQUIPMENT Medical Subventions
8007MA - Redevelopment of the Caritas Medical Centre

Members are invited to recommend to Finance Committee the approval of a commitment of $769.2 million in money-of-the-day prices for the redevelopment of two blocks in the Caritas Medical Centre.

PROBLEM

The Caritas Medical Centre (CMC) has insufficient space for clinical use and treatment facilities. It does not meet present day requirements of a modern hospital providing a full range of acute, rehabilitation and ambulatory services.

PROPOSAL

2.The Hospital Authority (HA), supported by the Secretary for Health and Welfare, proposes to create a commitment of $769.2 million in money-of-the-day (MOD) prices for the redevelopment of two blocks in CMC.

PROJECT SCOPE AND NATURE

3.The project will redevelop two existing sub-standard blocks - Wai Lok Block (nurse quarters) and Wai Mon Block (medical block) - into a new medical block. In parallel, part of two existing blocks, the Wai Ming Blockand the Wai Yan Blockwill be refurbished to facilitate the decanting of patients and services during the construction period. Two adjoining links from the new medical block to the neighbouring Wai Tak Block and Wai On Blockrespectively will also be constructed.

4.The new medical block will be a 14-storey building with a gross floor area of 27 557 sq. m. It will accommodate the following facilities, which are mainly located at Wai Mon Block and Wai Ming Block at present -

1. 716 beds for the clinical specialties of Medicine, Surgery, Orthopaedics, Paediatrics, Ophthalmology, Geriatrics, Obstetrics and Gynaecology; and

2. other facilities including an Accident and Emergency Department, Intensive Care Unit, Neonatal Intensive Care Unit, Special Care Baby Unit, Coronary Care Unit, Renal Dialysis Unit, Endoscopy Centre, Radiology Department and supporting facilities such as Operating Theatre Suite, Delivery Suites, Blood Bank, Emergency Laboratory, administrative offices and a new building services unit with medical gas plants.

After the redevelopment, the total number of beds in CMC will remain unchanged at 1 382.

JUSTIFICATION

5.CMC was opened in 1964 and now has a total of eight blocks. Except for two newly constructed/renovated blocks, the other six buildings, in particular the two blocks proposed to be demolished, are dilapidated, substandard and cannot be upgraded to meet the present day requirements of a modern hospital. Space for clinical use in the hospital is grossly inadequate. This has caused overcrowding in some of the treatment facilities, hindered the functional flow in the provision of medical services and limited the possibility for further improvements to meet modern standards.

6.The present situation in Wai Ming Block is particularly unsatisfactory. The block was originally designed for rehabilitation use. Because of a changing demand in services and the limitation of space in other blocks, it was converted into a block for acute cases. Space allocation for supporting facilities, especially for the Operating Theatre and Radiology Department, is hardly adequate. There is an urgent need to provide more space for upgrading these supporting facilities and rationalising the flow of activities so that the physical environment and patient services can be improved.

7.The project will involve the demolition of the Wai Lok Block and the Wai Mon Block. The former is currently vacant and no decanting arrangement is required, while the latter at present houses the Delivery Suite, Special Care Baby Unit, Neonatal Intensive Care Unit and 375 general beds. Prior to the construction of the new block, Wai Ming Block and Wai Yan Block will be refurbished to provide temporary accommodation for decanting part of the existing facilities from Wai Mon Block so as to minimise the reduction in services during the redevelopment.

8.After completion of the new medical block, the space allocation will be rationalised. The Accident and Emergency Department, Intensive Care Unit, Coronary Care Unit, Endoscopy Centre, Radiology Department, Operating Theatre Suites, Blood Bank and Emergency Laboratory presently located at Wai Ming Block and the Renal Dialysis Unit at Wai Yan Block will be reprovisioned in the new medical block.

FINANCIAL IMPLICATION

9.The Director of Architectural Services (D Arch S) and HA estimate the total project cost to be $794.2 million in MOD prices, made up as follows -

A breakdown of the cost estimate for consultant's fees and related services is at Enclosure.

10.The CMC has undertaken to contribute a minimum of $25 million in MOD prices over 5 years towards the capital cost of the project. This is equal to 3.2% of the total project cost, which is lower than the usual 20% contribution required from subvented organisations in similar projects. Given that the proposed redevelopment will result in improved hospital services for the community, the 20% rule will be waived, subject to CMC continuing to use its best endeavours to solicit donations above the pledged level during the course of the project. Accordingly, we propose a total commitment of $769.2 million calculated as follows -

11.Subject to approval, we will phase the expenditure as follows-

12.We have derived the MOD estimate on the basis of the Government's forecast of trend labour and construction prices over the period between 1997 and 2003. D Arch S will tender the works under two fixed-price lump-sum contracts for piling and superstructure respectively.

13.HA estimates the additional annually recurrent expenditure of the project to be $19.22 million at December 1996 prices made up as follows -

	$ million
Personal emoluments	6.54
Light and Power	6.93
Repair and Maintenance	5.75
Total	19.22

ENVIRONMENTAL IMPLICATIONS

14.In March 1995, D Arch S completed a Preliminary Environmental Review (PER) of the project and concluded that there was limited potential for adverse impacts on the environment. The Director of Environmental Protection vetted the PER and agreed that an Environmental Impact Assessment would not be necessary. D Arch S will conduct a survey to assess the likely disturbance of asbestos-containing materials (ACM) due to the demolition/refurbishment works. He will remove and dispose of any ACM prior to the commencement of any demolition/refurbishment works in strict compliance with relevant codes of practice and guidelines. HA will arrange for the management, storage, transport and disposal of chemical and clinical wastes as recommended in the PER and will equip the new medical block with central air conditioning to enhance the internal noise environment.

15.For short term impacts during construction, D Arch S will control noise, dust and site run-off to within established standards and guidelines through the implementation of appropriate mitigation measures in the relevant contracts.

PUBLIC CONSULTATION

16.The Sham Shui Po District Board gave its support to the project at its meeting held in February 1996.

LAND ACQUISITION

17.This project does not require land acquisition.

BACKGROUND INFORMATION

18.CMC is an acute hospital with a 24-hour accident and emergency service and specialised rehabilitation services. It also provides general and specialist out-patient services. Upon completion of the project, the current bed complement of 1 382 will be maintained.

19.We have completed site investigations for the project. We are finalising the layout drawings using in-house staff resources. Subject to approval , we plan to start the decanting work in December 1997 with a view to completing construction by September 2001.

Health and Welfare Bureau
September 1997

---

Enclosure to PWSC(97-98)48

DETAILS OF CONSULTANTs' FEES

Breakdown of estimates for consultants' fees

Notes

1.A multiplier factor of 3 is applied to the average MPS point to arrive at the full staff costs including the consultants' overheads and profit, as the staff will be employed in the consultants' offices. (At 1.4.96, MPS pt. 40 = $55,390 p.m. and MPS pt. 16 = $18,595 p.m.).

2.The figures given above are based on estimates prepared by the Director of Architectural Services. We will only know the actual man months and actual fees when we have selected the consultant through the usual competitive lump sum fee bid system.