DHB Covid upgrades underway, but building supply woes remain

Source: 1News

Work is quickly getting underway to upgrade hospitals around the country, but some DHBs say supply chain issues and labour shortages may pose challenges.

Auckland City Hospital.

It comes as hospitals nationwide prepared for a potential Omicron outbreak in the community. Current modelling predicted the number of Covid-19 patients in hospital on any given day could peak at about 190.

Peak hospitalisation rates in the Delta outbreak reached 93, with hospitals around Auckland bearing most of the brunt.

Justine White, Auckland DHB’s chief financial officer, told 1News they had already completed work in two wards at Auckland City Hospital. Both were now regularly used to treat people with Covid-19.

She said the DHB had also begun almost all of its next stage of improvements, which received $6.34 million in Government funding, in December. This included converting eight existing beds and two resuscitation bays in the children’s ED into nine negative-pressure isolation rooms. The DHB would also turn an eight-bed shared room into six individual rooms.

“We’re currently aiming to complete these works by mid-2022. The timeframe for the works is somewhat dependent on contractor availability and supply logistics,” White said.

Canterbury DHB also anticipated it could also face “some challenges” with planned upgrades because of “ongoing global shipping and supply constraints”.

Dr Rob Ojala, executive director of infrastructure at the DHB, said things were otherwise progressing well, and work was on track to be done by winter this year.

In Canterbury, a new negative-pressure ICU ward with 12 beds is being constructed adjacent to the current ICU in Christchurch Hospital. It is expected to cost $12 million.

Ojala said the DHB currently had 54 negative-pressure rooms across its region, 38 of which were in Christchurch Hospital. It had also recently upgraded an area in the hospital in case of a significant Covid-19 outbreak.

The projects form part of the Government’s announcement in mid-December last year that $644 million would be used to fund improvements in 36 facilities throughout the country.

Once complete, the programme would provide 23 new beds in ICU and high dependency units nationwide. Additionally, the DHB would change 355 existing beds into isolation or negative-pressure environments.

The country continues to face a long-term shortage of health staff, however.

Academic: Hard to know when supply chain issues would improve

John Tookey, professor of construction management at AUT, said last year’s building supply challenges, in addition to skilled labour shortages, had not eased.

He said it came down to a lack of supply of both locally-sourced and internationally-sourced building materials.

“Globally, we’ve seen a contraction in total shipping capacity that’s out there in the marketplace. We’re seeing a global supply chain crisis, a lot of it related to getting products out of China but also all sorts of other countries as well.”

Tookey said Covid-19 had also encouraged more “consolidation”, meaning fewer ships with less volume were coming to New Zealand.

As for the capacity to produce things locally, he said many New Zealand companies had been offshoring their activities for years before the pandemic.

“At the same time, we're seeing an increase in demand in the construction industry as a whole.”

He said it was hard to tell when things would return to something resembling pre-pandemic times.

“When you cut stuff, it's easy to cut it. It’s much harder to lay it on,” Tookey said.

“What tends to happen is that your cost base goes down when you take off unprofitable shipping. As a result, the cost of everything else increases. If you take them out of service, costs reduce. So far, so good.

“The problem is, what's the point at which you lay on additional capacity to be able to meet the demand?”

He said it was also “impossible to say” when skilled labour shortages would begin to be filled while there was uncertainty around the border.

“There’s no easy way out. The effects of Covid will be with us for years to come … and the building industry is going to be one of those that are going to be hit,” Tookey said.

“What we will inevitably do is feel our way forward very slowly, gradually, providing additional capacity if it proves continuous and sustainable. We will seek to expand imports from overseas to make up the shortfall in terms of certain materials.

“I can also see that we could end up fast-tracking skilled people through the immigration process when the border restrictions are lifted.”

A spokesperson for Health Minister Andrew Little said it was widely-known that Covid-19 had been disrupting supply in a range of areas. She said the upgrade projects were an operational matter that fell under DHBs’ responsibilities.

Other upgrades also in progress

Waitematā DHB, which covers the north and west of Auckland, has begun constructing two isolation rooms in North Shore Hospital’s ICU, up from its existing two.

A spokesperson said the project was expected to be finished by March.

The hospital was also converting eight elective surgery beds to increase surge ICU capacity, with completion slated for between July and September. It brought the cost of the upgrades to North Shore Hospital to $5.5 million.

For $1.75 million in Waitakere Hospital, the DHB is also adding two isolation rooms in the maternity ward, converting a 22-bed ward to treat Covid-19 patients, and segregating its ED entrances for non-Covid and Covid patients. That’s also expected to be completed by March.

In Counties Manukau DHB for the east and south of Auckland, 39 beds across Middlemore Hospital will be turned into a mix of isolation rooms and negative-pressure rooms. Some will also be partitioned.

Some of those upgrades were expected to be finished as early as March.

In early January, Tauranga Hospital completed three months of work to re-purpose its orthopaedic ward for patients with Covid-19.

Bay of Plenty DHB’s chief medical officer Dr Luke Bradford said the ward, which has 24 beds, would have additional oxygen supply and improved air management.

“It means that as we go through the year and we learn to live with Covid-19 in the community as case numbers rise, we will be able to care for those with Covid in a way that keeps them safe, enhances the care of patients and their whānau, and improves safety for staff,” Bradford said.