Sponsored 
By Earl Huntley
St Jude hospital reconstruction project (SJHRP)
It is now ten years since the fire on September 9, 2009, destroyed St Jude hospital (specifically the surgical wing and operating theatres) and during those ten years, the renovation and/or reconstruction of the hospital has not been completed. The SJHRP has instead become mired in political controversy.
Here are some of the most salient facts of the St Jude saga.
One of the first and most important facts to grasp about the St Jude story is that the plans for the restoration of the hospital went through several changes, the scope of the work kept expanding and this is one of the major contributing factors to the inordinate length of time it has taken to complete the restoration.
The changing plans were as a result of the facility being 70 years old, originally a World War II US military hospital built in 1941 and had been used as a public hospital for 43 years from 1966.
The plans went from (i) reconstructing the surgical building and renovating two other buildings and in the medium term constructing a new 90-bed hospital for St Jude at another site in Beausejour. Once this was completed the old buildings would be used for other medical-related purposes. This decision was taken by the United Workers Party (UWP) administration of Stephenson King who was the prime minister when the fire occurred. The renovation work on the surgical and other buildings commenced on September 9, 2010, with a targeted completion date of September 2011.
(ii) August 2011: The King – led administration decided to expand the scope of renovation to include the entire facility because of its age and state of disrepair and dangerous elements like asbestos material and poor electrical infrastructure and to reconfigure the hospital layout. This change of plans meant that the renovated complex would be retained for a smaller specialist hospital on a new site.
(iii) After the Kenny Anthony administration came to office in November 2011 the plans were changed again. St Jude’s hospital reconstruction was not to be moved to a new site, but the scope of work was expanded aiming for a modern hospital. They added components which were not in the original design but were regarded to be critical for such a hospital. The St Jude hospital management board was the body pushing for this new hospital and was in constant and close consultation with the project management unit for the project.
The hospital was being designed and implemented simultaneously and developed was ongoing in phases. The expansion of the scope of works was being carried out with recommendations by accreditation Canada which in 2014 had started working with the St Jude hospital management board for the accreditation of the new facility. One of these changes was an expanded surgical wing.
Delays in construction were also caused by issues with contractors – the main contractor – Cyril Donnelly – had to be terminated on December 2013 and was replaced with OBSES. The Taiwanese firm, Hold Year Construction had to demobilize from Saint Lucia due to implementation delays and took about a year to re-mobilize.
Intermittent funding delayed the project as the money available was insufficient to meet the expanded scope. In November 2013, Dr Kenny Anthony negotiated a US $20 million loan from Taiwan which was not available until 2015. According to the consultant’s handover report, from the commencement of SJHRP in February 2010 to July 21, 2016, the total project expenditure was EC$98, 451,346.85.
The government estimates also indicate that, at the beginning of the financial year (2017/2018), EC$98.5 million had been spent on SJHRP`. This includes the cost of the project management unit, the cost of project consultancies including EC$11 million to Halcrow Group Ltd and EC$82.4 million on construction.
According to information from the estimates and the handover report of the project manager, it can be deduced that a total amount of EC$140.1 million was raised for the SJHRP.
This can be broken down as follows: (a.) Bonds $47.7 million (b.) Loans $56.6 million (c.) Grants $35.8 million.
Funds available for completion: The Allen Chastanet led administration, from 2016, therefore, had access to about EC$41.6 million to complete SJHRP.
Of this, it had a balance of seven million from the first tranche of the Taiwanese loan and the remaining 50 percent of the loan, giving a combined loan amount available of $34 million. Additionally, there was the balance of Mexican and Taiwanese grant funds which were sourced from friendly governments and lending institutions specifically for use in the project.
Regrettable, the Chastanet, United Workers Party (UWP) government suspended construction of the hospital in August 2016. Hospital sources assert that at that point the completion of the hospital was less than six months away with a target date of February 2017. The worst-case scenario at that time for completion was one year.
Accreditation Canada had been working with the St Jude’s management board from 2014 on accreditation for the hospital were directly involved in the physical aspects of the building in 2016 when work was stopped. In fact, many mistakes were corrected after recommendations from accreditation Canada and helped identify a contractor to assist St Jude hospital with the transfer from the George Odlum Stadium to the new facility.
In September 2015, the fire service had appraised the building site which it found “in an advanced stage of construction”. The fire service endorsed the majority of the work and made certain recommendations. Once the recommendations were implemented and verified a fire certificate would have been granted.
It was expected that an honest government which had the interests of the people at heart would have rushed to finish the hospital – especially when in its election campaign it had pledged to do. Instead, what happened?
Construction was stopped August 2016, and a series of bizarre, conflicting, puzzling statements and actions emanated from the economic development minister Guy Joseph – health minister Mary Isaac and prime minister Chastanet about the future of SJHRP with Joseph taking the lead role.
Prime Minister Chastanet government actions
Ten days after taking office in July 2016, minister for health, Isaac and economic minister Joseph toured SJHRP. They state their concern about the delay but did not express any apprehension, about the quality of the facility that they had inspected.
Ten days after assuming office, economic minister Joseph declares that the project coordinator and consultants should be held accountable for failing to deliver the project and if he had his way, he would fire them.
Within a week after that declaration, the contract for the design and supervision consultant for the project was terminated. The basis for this is the need to review the project; but how can you terminate before you review? Must you not first review; and based on your review decide whether to keep or terminate the consultant? The project manager’s contract is also not renewed.
Economic minister Joseph insinuated that there has been widespread fraud in SJHRP, and he continues to do so for a while. An Untold Stories television documentary on St Jude, at that time, mimicked the same.
In August 2016, economic minister Joseph appointed FDL Constructs to undertake a technical audit of SJHRP at a cost of $980,000. The preliminary technical audit report is handed to the government in January 2016. Joseph, however, refuses to make the technical audit report public as he promised but states that the report is being sent to the attorney general. More insinuations of fraud.
Following the submission of the technical audit, the government spokesmen – the trio of Joseph, Isaac, and Chastanet, launch a series of statements indicating that there are serious defects in the buildings. This was and is still being made without making the report public, except to make unfounded statements to the public – to make believe – that the technical audit is the basis for their statements.
Isaac suggested on September 12, 2017, that one option is to demolish the entire complex and make a fresh start. In the public furor that ensues, Joseph said – not all the buildings need to be demolished. The new narrative from the government is that there are terrible defects with the building and that, the Saint Lucia Labour Party (SLP), administration is responsible, while prime minister Chastanet revealed that his government has not yet decided on the way forward.
In the course of natural justice, SJHRP technical audit was leaked. It does not support the call for the demolition of the facility and/or confirm that the buildings are so seriously defective that they cannot be used. The report points to deficiencies in architectural design, electrical and plumbing installations and fire safety issues. It describes the project as “a mess of herculean proportions”, criticises the project management and execution, and states that the buildings are 50 percent completed, and declares, without giving details, that $100 million is required to complete it with a new master plan.
However, SJHRP technical audit does not pronounce the deficiencies with the hospital to be fatal and states: “the issues highlighted are significant in nature; however we do see a great value present in the works completed to date and believe that the project is salvageable and could be converted into a facility that can properly serve the needs of Saint Lucia, as St Jude hospital is designated a primary healthcare facility with one of its primary roles to ensure effective acute and referral services in the south of the island with future potential for growth and development.”
David Prescod wrote an excellent series of articles in the Voice, analysing the Chastanet-led UWP administration handling of St Jude; namely, St Jude and the Art of the Con.
Prescod wrote: “To put the audit report into context the review of the building site, the architecture of individual buildings and assessment of the mechanical, electrical, plumbing systems together with a commentary occupy 17 pages of a report comprising 186 pages. Much of the remainder of the audit is devoted to an examination of the performance of the design and supervision consultant and the procurement of works (contractors subcontractors and goods). The report makes serious allegations in these areas and while in hindsight the procurement of the St Jude Hospital Reconstruction works has not been perfect the solution now proposed is ludicrous. The approach recommended by the audit report is termination then completion of the work by others”.
SJHRP technical audit was given to the government in January 2017 but nothing happened with the re-construction of the hospital, except that the government continued its narrative that the hospital re-construction is defective and that there are indications of fraud, blaming the last SLP administration. It was announced that the government is considering building a new hospital on a new site.
In May 2018, economic minister Joseph announced St Jude will remain on the existing site, and a new wing will be constructed to replace the East Wing, which is said to be below standard and some of the existing buildings will be retained for use.
In July 2019, after three years of different pronouncements on what the government will do about St Jude, however, continued condemnation of the standard of re-construction by economic minister Joseph, prime minister Chastanet and others with no evidence, not even from their own technical audit to support statements which are being contradicted by professional engineers and architects.
All be it, no one is or has been charged with fraud, despite all the insinuations the government reveals that there will be a sod-turning ceremony with Taiwan president Tsai Ing-Wen, for construction work to complete what will be a Level 4 hospital for St Jude.
In normal pretense, Chastanet declares: “The St Jude hospital reconstruction project will deliver a 90-bed facility that will cater for both inpatient and outpatient services. It will comprise a new wing to incorporate all the functions and services of the existing East and Surgical Wings; interconnected two-story structures to be erected on the left- hand side of the entrance to the existing site; integration through retrofitting of some existing buildings to achieve a fully functioning hospital to match the services of a Level 4 facility; and revision of the internal layout of buildings to be integrated for functional efficacy and compliance to minimum standards.”
The project is to be undertaken by a Taiwanese firm with a new $US20 million loan from Taiwan plus the $US 10 million left over from the original loan. The sod-turning ceremony took place on July 19, 2019, and it is said that the hospital will be completed in 2020.
Prescod in part two of his series, St Jude the Art of the Con, published in 2018, wrote: “As [the] prime minister Chastanet sought to justify a proposed forensic audit of St Jude’s to the parliament on February 13, 2018, he indicated that the audit report had stated: “that there is an EC $50 million of quantifiable expenditure based on the physical work on the ground and that there is expenditure or disbursements of EC $118 million. In making that statement prime minister Chastanet was doubly misleading of the parliament as nowhere in that leaked audit report is to be found an assessment of the value of the work done at St Jude.
“And as we have just seen according to the leaked audit report the amount disbursed on the reconstruction of St Jude is incorrectly stated as EC $82.5 million not the EC $118 million quoted by the prime minister. This is the pattern of behavior that has emerged with this government. Statements are issued that support the government’s narrative for construction of a new hospital or for a forensic audit, statements that are not supported by fact and that in many instances are easily refuted.
“These statements mislead the public into a negative assessment of the reconstructed St Jude and cumulatively drive the public to acceptance of the government’s goal of constructing a new hospital. We have not had this type of government before. We have had high-handed government; we have had secretive government, and we have had combinations of the two. But never have we had a government that has so openly misled us.
“And never have we had a government that has established an absence of transparency and accountability in public affairs as government policy. As the St Jude debacle has so amply demonstrated, in the absence of transparency and accountability in public life this government’s propensity to mislead the public is the greatest threat to our democracy that we as a nation have so far had to face.”
Prescod writing in February 2018, applies even more after July 19, 2019.
Therefore, as I have reiterated – Not a damn seat for them to quote from Lord Kitchener’s 1981 calypso immortalizing George Chambers prediction of a Peoples National Movement (PNM) victory in Trinidad and Tobago elections.
Related: Facts, truth and leadership in government – Part 2
To be continued… The conclusion of facts, truth and leadership in government.
