Based on the public discussions regarding Saint Jude Hospital, I can better appreciate Carl Jung’s observation that for most people thinking is difficult. To escape thought, added the legendary psychoanalyst, they simply parrot the latest line fed them. I make no claim to being especially prescient. But I relish informed and intelligent debate, especially on matters of public policy. No surprise, then, that I am at this time disappointed, depressed and downright discouraged by what passes for public policy discussion. If only for my own mental health, I offer what follows, perchance it might inspire useful dialogue among the social media experts and other spreaders of disinformation, wherever they may be!
That we are no closer to commissioning St Jude Hospital than we were on 6 June, 2016 is an acknowledged travesty. However, it is counterproductive simply to say every administration since the September 2009 fire is responsible. Such claims are analogous to blaming an entire relay team because the team was disqualified on account of the third leg dropping the baton and attempting to pick it up outside the exchange zone.
In September 2009, when fire gutted the SJH, Saint Lucia was constructing a new national hospital. Prior to that fire, nowhere in government’s contemplation were there any near-term plans to rebuild/expand the facility. Thus, there would be no financial allocations made in respect of one.
On the converse, plans for the new national hospital were almost a decade in the making. Financing for the hospital had been secured. With the concurrence of the EU, the government had decided to use the entire allocation of the 9th EDF to fund construction of the hospital. But critically, at the time of the fire Saint Lucia, like the rest of the world was grappling with the fallout from the global financial crisis. Consequently, the government could not simply go to market and raise the required financing.
In October of 2010, Hurricane Tomas destroyed significant national infrastructure, making it even more difficult to prioritize borrowing money to construct a new SJH. General elections were also imminent, typically muddying the space for policy dialogue.
Although Stephenson King’s UWP administration began construction and promised a new hospital before the elections of 2011, it was truly impractical and more wishful thinking to have expected a new hospital within that time frame.
The Kenny Anthony administration took over from where Stephenson King left off. Contractors, project management and staff were, in the main, left in place to complete the task. Of course, there were no financial allocations available to complete the task. During KDA’s term in office, there was an increase in the scope of works to ensure a modern health facility in the south of the island. No doubt the increased scope also meant increased cost, funding for which was not easily accessible. This difficulty had nothing to do with poor fiscal management on the part of KDA, but everything to do with the state of regional economies at the time. Investors were worried about the contagion effect: four of the OECS economies (Antigua, Dominica, Grenada and St Kitts) had either defaulted on their loans or had to undergo debt restructuring. There was concern that another domino would topple, given the islands’ debt ratios. However, KDA did secure funding to complete SJH.
Given the pace at which the required finances were secured, construction slowed down, but did not stop. By June 2016, SJH was at an advanced stage. Given the issues already identified, it was truly unrealistic to have expected SJH to have been commissioned at that time. But that didn’t stop politicians and their supporters from fermenting that expectation. For illustrative purposes, there was no comparable uproar or concern over the OKEU (which had been planned for, had a secured budget and commenced construction with hospital construction experts from the EU– all before 2009).
Keeping in mind all the recriminations regarding the completion of the SJH, it was neither surprising nor wrong for the Allen Chastanet administration to conduct a technical audit of the project. However, that audit need not have equated to a stoppage of the project. And certainly not for as long as three years. The technical audit, or at least the versions that made their way into the public domain, did not indicate that the project was mired in deficiencies necessitating abandonment. There were no declarations of malfeasance.
While some cite low ceilings as a basis for project abandonment, I’ve been unable to find in the audit report anything related to ceilings that were so low as to be hazardous or non-functional. As for those who insist on the contrary, none have pointed to the actual height, or whether ceilings throughout the buildings were too low to facilitate relevant services. There were no suggestions that the doors to the various rooms were below regulation height.
The proponents of the low-ceilings viewpoint, also refer to the building as an eighty-year-old facility–a facility that served as a hospital up until the 2009 fire. So, hospital services could have been provided there before the fire, with stated heights, but now the ceilings are too low? The buildings are in excess of eighteen feet high.
Some have even chosen to call the facility a chicken coop, again with reference to its dimensions. The abandoned facility had a floor area larger than that of the completed OKEU. The KDA administration claims that on June 6, 2016, the SJH was approximately 80% completed. Whether or not one chooses to accept that declaration, it is undeniable that the facility already had piping for water, electricity and medical gases.
During the cessation of the project, and with attendant fanfare, the then Minister for Economic Affairs, accompanied by police and media, sought to recover items procured for the hospital but stored off-site. The publicity stunt created the illusion that the items were stored in unauthorized areas. Since that time, there has been no public accounting of the “recovered items.” One may have assumed that with the items now in hand construction would recommence. Instead, three years after stoppage, in 2019, work on a new facility began.
The public was never informed of the estimated date of completion; neither the estimated cost. What is known is that the new construction, notwithstanding the claim that it was 70% completed, did not have completed electricals, air-conditioning lines, or medical gasses. The cumulative expenditure on the new construction was more than on the first. And yet, it was not at a more advanced stage of completion.
In June 2016, at least $27 million was available to complete the hospital. Whether that sum would have been sufficient is debatable. However, in August 2021 there were no funds available to work on the hospital. These are some of the issues that must be considered when debating or attempting to apportion blame for where we are regarding SJH.