In her letter to the Watford Observer last week Helen Brown makes four points to campaigners for a new hospital on a new site:

1. The need for urgency: time not money is the key criteria and the trust’s responsibility is to secure improvements as quickly as possible

2. Identification of key cost drivers in the latest estimates

3. The longer time frame of a new site does not relate to construction

4. Those who say a new clear site would be cheaper and quicker are simply wrong

Each of these points illustrates some basic erroneous thinking/approach employed by the trust since 2017.

Perhaps Ms Brown’s strongest assertion is the need for urgency. In her statement “that time and not money is the key criteria” there is no mention of the fact that the Government, via its agencies, has at least twice in recent years instructed the trust to present proposals that reduce capital costs below circa £600m, thereby contradicting her and making value for money a key criteria which also include the annual running costs.

The ‘independent programme’ produced by Royal Free Property Services was fundamentally different from the current 120,000sq m triple tower proposal. The trust’s own professional team assesses that the construction period required is 52 months, a year longer. (Ms Brown appears to have overlooked this.) When it comes to the reasons for the escalating costs, by far the biggest factor is the increase in built area, most of which results from the additional lift shafts required (fireman's lifts, public lifts and operational lifts) when building towers, and also the cost of installing the services required in such tall buildings.

Add to this inflation rates and the current exceptional escalation in the price of building materials. And surely the trust is not considering providing a hospital without a digital infrastructure?

In 2019/2020 the trust forecast that main construction would start in April 2022. The latest projection is that the outline business case (OBC) will not be submitted until late 2022 or early 2023. Referring to the programme included in the planning application and assuming the OBC will be submitted in October 2022, this would suggest that main construction could start in late 2024, and the move to the new hospital could optimistically commence in early 2028. This, again, hardly suggests that Ms Brown’s topmost criterion of urgency is the key factor.

In the trust’s recent meetings it has become clear that two options are being considered: the preferred option (Triple Towers) and a mixture of refurbishment and some new buildings. Neither option represents ‘value for money’, nor do they fulfil her benchmark of ‘urgency’.

So why isn’t the trust considering the solution that is being successfully developed by Harlow - a new build on a clear site?

My professional experience and recent research into hospital capital and revenue costs suggests to me that I am not simply wrong, as Ms Brown implies, and I would be interested to understand how her experience qualifies her to make such a statement. I doubt that her professional team echoes her assertion.

Clive Birch

Project Management and Construction Consultant