Opinion: A Capital Letter - Hutt hospital, the earthquake risk - and three key problems

Hutt Hospital's Heretaunga block, which has been deemed earthquake-prone. Photo / Mark Mitchell

OPINION:

District Health Board meeting papers reveal three key problems with decisions made about the future of Hutt Hospital.

In May 2022 the hospital’s main building, which houses a quarter of the region’s hospital bed capacity, was deemed earthquake-prone.

As a result, the local DHB made the decision that services and patients would need to vacate the Heretaunga Block over a period of time.

In my view, this decision was made too quickly.

More consideration should have been given to how engineering intersects with the realities of everyday life.

The reality in this case was an already stretched healthcare system.

The first problem with the Hutt Hospital decision is that it was made without a clear plan to exit the building.

DHB papers from May acknowledged decanting the building would have “flow-on implications” for the wider Wellington hospital network. They warned there was a very high risk of insufficient capacity to decant the building in a safe and timely manner.

Some analysis had been completed on options to exit the building. Detailed planning, however, required direct engagement with other service providers and the DHB wasn’t keen on that yet given the “sensitivities” involved.

Board members agreed that subject to any material change in engineering advice, the building should be decanted as soon as possible.

But a subsequent ministerial briefing and DHB meeting papers from June revealed patients could not be moved out of the building without their care being compromised.

“Options to move services into existing capacity without significant and material impacts on patient care do not exist,” the documents said.

The papers said it would only be viable to vacate the building in an emergency situation like after an earthquake, and the DHB would have to commandeer capacity at other hospitals using emergency powers.

There was talk of prefab buildings on the Hutt Hospital site instead. When the Herald asked in November whether a “pop-up” style hospital was still going ahead, Te Whatu Ora Health New Zealand did not give a definitive answer.

“Te Whatu Ora – Health New Zealand is currently working through the planning stages that may be required for any possible mitigation, remediation or replacement of Hutt Hospital’s Heretaunga Block”, a spokesperson said.

The question about a pop-up hospital was included in a wider Official Information Act request by the Herald.

But Te Whatu Ora has withheld this information because it’s under active consideration.

Lower Hutt mayor Campbell Barry says Te Whatu Ora needs to get its act together and tell people what's going on. Photo / Georgina Campbell

The second problem with the decision to exit the Heretaunga Block is that it was based on a draft detailed seismic engineering assessment that was yet to be fully peer-reviewed.

DHB papers from May show information from a draft version of the peer review was available when the decision was made, along with another engineering opinion, and legal advice.

The papers said that based on these additional engineering opinions, the finalised assessment was unlikely to materially change and the overall rating would remain at 15 per cent of the New Building Standard (NBS).

Anything less than 34 per cent NBS is earthquake-prone.

But material changes were made - even though the building retained its earthquake-prone status.

The final assessment found the external cladding was now the only part of the building that was earthquake-prone, instead of several parts.

As a result of this revelation, Te Whatu Ora told the Herald in December there was no plan to move services from the Heretaunga Block at this stage.

Fencing has been installed to isolate the area around the building where debris could fall in an earthquake.

The third problem with the Hutt Hospital decision is that it was made on the cusp of a massive overhaul of the country’s health system.

As of July 1, just over a week after the DHB last met and made decisions on the Hutt Hospital issue, the DHB no longer existed.

The country’s 20 DHBs were disestablished and their functions merged into Te Whatu Ora. This was no one’s fault, just less than ideal timing.

The DHB only had to worry about its patch where as Te Whatu Ora has the entire country to think about.

As it turned out, Hutt Hospital was not the only building with an earthquake risk.

The Herald revealed there are about 100 earthquake-prone hospital buildings across the country, of which a third are so important they must be operational immediately after a disastrous event.

The biggest problem with decision-making over Hutt Hospital is how it has all been communicated to the public.

Lower Hutt Mayor Campbell Barry said Te Whatu Ora’s statement about there being no plan to move people from the building was a significant change from what has previously been said publicly.

He said Te Whatu Ora needed to get its act together and let people know what was going on.

To add to the confusion, the top of the website page that provides updates on the hospital building still says the plan is to shift staff and services from the Heretaunga Block over time.

There are more questions than answers about the future of Hutt Hospital, which is unnerving for patients and those in the local community. They deserve better communication on such an important issue.

• Senior Wellington journalist Georgina Campbell’s fortnightly column looks closely at issues in the capital.