There is a contingency in funding for repairs to a Middlemore Hospital building for the possibility that more sewage leaks may be found in its walls.

The Scott Building has become a symbol of the poor condition of buildings owned by Manukau District Health Board. It has weathertightness problems including leaks, rot and mould, asbestos issues and sewage leaks. There were two sewage leaks in the building last year.

The Government recently signed off on an additional $11.5 million for repairs to the Scott Building, taking the total for the project to $27.5m.

Manukau District Health Board said that despite the "dramatic language" that had been used around sewage issues at Middlemore Hospital, they were so small that one was a stain that was cleaned up with water.

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"There was no sewage spilling into the building, just some staining on the ground within the soil stack duct. To clean it up, engineering had to mix water on it, so the quantity was less than a bucket," the DHB said in a statement.

Health Minister David Clark said all the stories about sewage had originated from the DHB.

He told the Herald on Monday there was money set aside in repair funds in case more sewage leaks were found.

"I'm aware that there is a contingency in the money for the Scott Building repair that allows for the possibility of further sewage or other issues to be found in the walls.

"I've been made aware previously that there was stuff found in the walls and that that's a possibility again in the future, albeit merely a possibility not a certainty."

A multitude of building issues at Middlemore Hospital and the extent of them have been revealed recently: Rot and toxic mould caused by leaking, asbestos, seismic and power supply issues, and the sewage leaks.

The worst affected are the Scott Building, Kidz First, McIndoe Building and the Manukau SuperClinic.

DHB acting chief executive Gloria Johnson declined to be interviewed but confirmed to RNZ on March 28 that there had been sewage leaks and said she believed other buildings at Middlemore could be affected.

A Middlemore Hospital document on its website said only the Scott Building had sewerage pipes made from PVC, which was more prone to breaking.

The rest of the building's sewer stacks will be inspected as it is reclad to fix weathertightness issues.

Clark said he had been repeatedly reassured by the DHB that there was no risk to patients from the leaks.

"They have a plan in place to manage the challenging set of infrastructure they have and that is their responsibility to manage that."

Prime Minister Jacinda Ardern has said the situation at Middlemore is emblematic of a much wider problem in health, and Clark said the DHB's issues were not much different to those faced by health boards around the country.

"This is not the only building in the country that is problematic. Every DHB has buildings that they are concerned about," he said.

The Middlemore saga may already have cost acting board chairman Rabin Rabindran and another board member their jobs. Clark has asked them to make submissions on their positions but Rabindran has reportedly already told the minister he no longer wants it.

It has also drawn Clark into spats with Johnson and former Health Minister Jonathan Coleman over who was told, what they were told and when they were told.

Both Clark and Coleman received reports outlining broadly that there were issues and the buildings weren't fit for purpose, but both were adamant they didn't know the details of the problems. They also both signed off on regional DHB health plans which said nearly 20 per cent of the buildings were in poor or very poor condition.

The DHB's Strategic Assessment Case written in November sets out $123m worth of work needed across multiple buildings at Middlemore Hospital, although that figure is now regarded as an underestimate.

Clark has said previously that if Coleman didn't know about the extent of issues when he was minister in the previous National Government, he should have.

Coleman said he spoke to and visited the DHB regularly and was not told anything of the problems. It also did not mention any specific issues at a select committee hearing two months ago.

Johnson suggested through an email to board members on March 23 that Clark should also have been aware of the problems, saying documents handed to him on March 13 "[spell] out succinctly the scale and nature of the facilities issues". Clark said he was told of the rot, mould and sewage in the Scott building only.

Former Counties Manukau DHB chairwoman Lee Mathias has weighed in to the debate, saying there was "nothing dodgy or secret about the state of buildings at Middlemore".

She said the problems were all well-known and had been regularly reported.

Clark has set the Ministry of Health's capital investment committee (CIC) the task of creating a record of all the DHBs' assets so there is a clear picture of the state of hospital buildings across the country and what work they need.

"What we find out might be uncomfortable but it's what taxpayers and their representative decision-makers at Parliament need to know."

Clark now says he doesn't want to "quibble" about the past but instead wants to focus on the job in front of him.

On whether the previous Government or Coleman were in possession of all the details of Middlemore's building woes, he said: "I'm six months in and I'm beginning to develop a sense of the issues. The former Government was there for nine years and broadly must have understood the pressures building up in the health sector.

"That is the thing that I will be held accountable for, and what I expect the Government to be held accountable for, is how we get on and address those historic infrastructure issues."

The players

David Clark - Health Minister

Says he was told about specific problems only in the Scott Building, not the others.

Calls the state of the hospital the result of years of underspending and pressure on DHBs to stay in surplus.

Jonathan Coleman - former Health Minister
Says he wasn't ever told of the specifics or the extent of building problems at Middlemore. If there were the problems now being reported, the DHB should have been "shouting from the rooftops".

Gloria Johnson - DHB acting chief executive
Middlemore Hospital's from 2012 to 2017 before becoming acting chief executive. Says Clark was told about specific problems and was handed a "wodge" of documents spelling them out on March 13.

Rabin Rabindran - DHB acting chairman
Has been in the job less than four months, following the resignation of former chairman Lester Levy in December.
Was appointed by Coleman as deputy chairman in December 2016. Clark says Rabindran has apologised for not mentioning the other buildings on March 13. Has been asked to consider his position but has reportedly already stepped down as acting chairman.

Timeline

• 2012 - Large cladding panel falls off the Scott Building. Checks reveal weathertightness problems and leaking. Leaks also fund at Manukau SuperClinic

• 2013 - Leaks found at Kidz First

• 2014 - Leaks found at McIndoe Building

• 2016 - Leaking issues outlined to Ministry of Health, according to DHB

• Mid-2016 Auditor-General's report shows Counties Manukau reporting it had 89 per cent life left in its buildings

• 2017 - Sewage and sanitation problems are again raised with the board

• Feb 2017 - Treasury rates Counties Manukau among top half of DHBs for repairs and maintenance

• Mid-2017 - DHB commissions first overall expert appraisal of buildings

• Nov 2017 - Independent surveyor Alexander and Co report for DHB outlines problems with buildings

• November 22 - DHB Strategic Assessment Case sets out $123m worth of work across multiple buildings. That amount is now known to be an underestimate.

• Feb 21, 2018 – Counties Manukau DHB appears before health select committee. No mention of specific problems are raised.

• March 13 – David Clark visits Middlemore, where he says he was told about rot, mould and sewage in Scott Building but no other buildings.

• March 20 (circa) - Government approves additional $11.5m towards repairs in Scott Building

• March 22 - RNZ reports based on OIA that four hospital buildings are full of rot and mould. Health Minister David Clark says he knew about only one, the Scott

• March 23 - Former Health Minister Jonathan Coleman says he was not briefed about extent of problems at Middlemore. Clark says he expects DHB to outline plan for managing the issues. Email from Gloria Johnson to board members say documents handed to Clark and his adviser "spells out succinctly the scale and nature of the facilities issues"

• March 27 - DHB says it did not do repairs because Coleman wanted it to stay in surplus

• March 28 - DHB confirms report of sewage leaks in Scott Building

• April 4 - Leaked documents reveal $8.6m extension of Ko Awatea to go ahead but not the $7.3m reclad of Kidz First, nor the $5.2m remediation of the McIndoe Building

• April 3 - DHB confirms report of major power supply failures at Middlemore and Super Clinic since 2017

• April 12 - Rabin Rabindran reportedly tells Clark he is stepping down as acting chairman after the minister wrote to him and another board member about their positions.

• April 16 - Clark reveals Rabindran had apologised for not bringing up the issues across multiple buildings in March 13 meeting.

(Source: RNZ, NZ Herald)