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Queensland Health

Gold Coast University HospitalBusiness Case

September 2008

Gold Coast University Hospital Business Case 30 September 2008

Queensland HealthGold Coast University Hospital

September 2008

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Contents

1 Executive summary 1 1.1 Preamble 1 1.2 Project Background and key elements of the Health Service Plan 3 1.3 Project site, design and facilities 8 1.4 Proposed procurement method 17 1.4.1 Description of the proposed procurement process 18 1.4.2 Indicative Project Resources 18 1.5 Risk adjusted nominal project costs 19 1.6 Affordability analysis 22 1.7 Capital cost comparison with a reference case 24 1.7.1 Qualitative assessment of the Proposed Delivery Model 26 1.8 Public interest 27 1.8.1 Planning issues 27 1.8.2 Environmental issues 28 1.8.3 Cultural Heritage and Native Title Issues 28 1.8.4 Key workforce and employment issues 29 1.8.5 Employment issues associated with construction of the facility 30 1.8.6 Stakeholder issue management 30 1.8.7 Communication strategy 30

2 Background 31 2.1 Project background 31 2.1.1 Project decisions 31 2.1.2 Health Service Plan 32 2.1.3 Precinct site 34 2.1.4 Proposed hospital site 35 2.2 Project objectives 36 2.3 Purpose of the Business Case 38 2.3.1 Refinement of the Business Case 38 2.4 Scope of the Business Case 39 2.4.1 Interrelated Projects 39

3 Service needs definition 42 3.1 Introduction 42 3.2 Existing health services 42 3.2.1 Public hospital facilities 42 3.2.2 Community health services 44 3.2.3 Other health related services 45 3.3 Demand for health services 45 3.3.1 Demographic profile 45 3.3.2 Other demand factors 46 3.3.3 Health service needs 46 3.4 Health services plan 47 3.4.1 Proposed role of Gold Coast University Hospital 47 3.4.2 Proposed Delivery Model 48 3.4.3 Clinical service requirements 49



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3.4.4 Clinical support services 52 3.5 Planned GCUH utilisation rates 53 3.6 Interim demand management strategy 54 3.6.1 Proposed strategies 55 3.6.2 Cost implications 55 3.7 Future use of existing health services 56 3.7.1 Southport campus 56 3.7.2 Robina Hospital 56 3.7.3 Other community /care centres 56 3.7.4 Integration with State wide health service planning 57 3.7.5 Integration with northern NSW health service planning 58

4 Project description 60 4.1 Introduction 60 4.2 Site description 60 4.2.1 Precinct site 60 4.2.2 Hospital site 61 4.2.3 Site features 62 4.2.4 Site acquisition 62 4.3 Proposed Delivery Model and PDP preferred option 64 4.4 Design process 72 4.4.1 Design principles 73 4.4.2 Design features 73 4.4.3 Interior design 73 4.5 Facilities description 75 4.5.1 Facility layout 76 4.5.2 Building layout 76 4.5.3 Future proofing 78 4.5.4 Future Private Hospital facility 81 4.5.5 Private sector involvement 81 4.6 Accommodation 81 4.6.1 Development of accommodation schedules 81 4.6.2 Schedule of accommodation 82 4.7 Clinical services 83 4.7.1 Division of Family, Women and Children 83 4.7.2 Division of Mental Health 85 4.7.3 Division of Medicine 85 4.7.4 Division of Surgery and Critical Care 86 4.7.5 Division of Community, Allied, Rehabilitation and Aged Services 87 4.7.6 Division of Medical Services 88 4.7.7 Division of Pathology 88 4.8 Non-Clinical service divisions 89 4.9 Operational and support services 89 4.10 FF&E requirements 90 4.11 Information technology 90 4.12 Education 91 4.13 Environmental Sustainable Design (ESD) 92 4.14 Transport and roads infrastructure 93 4.14.1 External Road access 93 4.14.2 Internal Road access 94 4.14.3 Other transport modes 94



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4.15 Car park facilities 95 4.15.1 Procurement approach 95 4.15.2 Car parking tariff 96 4.16 Facilities management services 96 4.16.1 Building maintenance 96 4.16.2 External cleaning 98 4.16.3 Grounds maintenance 98 4.16.4 Utilities management service 98 4.16.5 Helpdesk and associated management services 99 4.17 Single bed allowances 99 4.17.1 Studies supporting single beds 100 4.17.2 Benefits of increased single-bed 100 4.17.3 Cost impacts 102 4.17.4 Decision to increase the proportion of Single Beds 103

5 Proposed procurement method 104 5.1 Proposed procurement method 104 5.2 Description of the proposed procurement process 105 5.3 Commercial principles 109 5.3.1 General risk allocation 109 5.3.2 Performance bonding (security) 110 5.3.3 Liquidated damages 110 5.3.4 Defects liability period 110 5.3.5 Foreign Currency Exchange Risks 110 5.3.6 Insurance 111 5.3.7 Price 111 5.3.8 Termination provisions 111 5.3.9 Maintenance and facility management 112 5.4 Advantages and disadvantages – (Managing Contractor Guaranteed

Construction Sum) 112 5.5 Proposed Project Plan 114 5.5.1 Indicative Project Resources 114 5.5.2 Indicative Procurement Timetable 114

6 Project cost estimates 116 6.1 Key infrastructure components 116 6.2 Gold Coast University Hospital contractor capital costs 116 6.2.1 Contractor raw capital costs 117 6.2.2 Escalation adjustment 117 6.2.3 Risk adjustment 119 6.2.4 Transferred risk adjustment 119 6.2.5 Retained risk adjustment 120 6.2.6 Total contractor capital costs 121 6.3 Project development costs 122 6.3.1 Project development raw costs 122 6.3.2 Escalation adjustment 123 6.3.3 Project development capital costs risk adjustment 124 6.3.4 Total project development costs 125 6.4 Total project capital costs 125 6.5 Facility maintenance and management costs 126 6.5.1 Facility maintenance and management – raw cost 126



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6.5.2 Escalation adjustment 126 6.5.3 Facility maintenance and management costs – transferred risk

adjustment 127 6.5.4 Facility maintenance and management costs – retained risk adjustment 127 6.5.5 Average annual facility maintenance and management costs 127 6.5.6 Total facility maintenance and management costs over 20 years 128 6.6 Clinical and support service costs 128 6.6.1 Clinical and support services – casemix costing methodology 131 6.6.2 Clinical and support services – labour analysis methodology 131 6.6.3 Clinical and support services – raw costs from 2012/13 to 2016/17 132 6.6.4 Escalated costs 133 6.6.5 Depreciation expense 134

7 Affordability 135 7.1 Introduction 135 7.2 Capital budget 135 7.2.1 Methodology 135 7.3 Estimated capital expenditure 136 7.4 Committed capital funding 137 7.5 Affordability analysis of capital expenditure 137 7.6 Recurrent budget 138 7.6.1 Methodology 138 7.7 Estimated recurrent expenditure 139 7.8 Committed recurrent funding 140 7.9 Affordability analysis of recurrent expenditure 141

8 Capital cost comparison with government budget and reference case budget 143

8.1 Announced Capital Cost budget (August 2006) 143 8.2 Updated Announced Capital Cost budget (July 2008) 144 8.3 Government approved capital cost budget - escalation calculations 144 8.4 Need for a Reference Case 145 8.5 Proposed Reference Case 146 8.6 Comparative analysis of the Reference Case with the Proposed Delivery

Model 148 8.6.1 Increased risk adjustment 149 8.6.2 Increased ratio of single beds 149 8.6.3 Statutory Requirements 150 8.6.4 Environmentally Sustainable Design Initiatives 150 8.6.5 Furniture Fixtures & Equipment 150 8.6.6 High level variations table 153 8.7 Potential capital cost offsets to fund the affordability gap 153

9 Evaluation of the Proposed Delivery Model 158 9.1 Possible evaluation approaches 158 9.1.1 Cost benefit analysis 158 9.1.2 Cost effectiveness analysis 158 9.2 Qualitative assessment of Proposed Delivery Model 159 9.2.1 Project objective: Service delivery and care 159 9.2.2 Project objective: People 160



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9.2.3 Project objective: Site access and egress 161 9.2.4 Project objective: Future proof and flexible 161 9.2.5 Project objective: Teaching and research 162 9.2.6 Project objective: Business continuity 163 9.2.7 Government commitment, policy and objectives 163 9.2.8 Project objective: Stakeholder relationships 164

10 Public interest 166 10.1 Planning, environment, cultural heritage and native title 166 10.1.1 Planning Issues 166 10.1.2 Environmental Issues 169 10.1.3 Cultural Heritage and Native Title Issues 170 10.2 Employee, employment and skills issues 171 10.2.1 Workforce profile 171 10.2.2 Key Workforce and Employment Issues 174 10.2.3 Employment Issues Associated With Construction of the Facility 175 10.3 Stakeholder Issue Management 177 10.3.1 Health related stakeholder consideration 177 10.3.2 Broader Community Stakeholders 181 10.4 Communication Strategy 186 10.4.1 Purpose of the Communication Strategy 187 10.4.2 Communication objectives 187 10.4.3 Community Strategy Action Plan 188 10.5 Accountability and transparency 188 10.5.1 Communication principles 190 10.5.2 Public access and equity 190

A Glossary 192

B Raw costs inputs 194

C Risk analysis methodology 201 C.1 Introduction 201 C.2 Objectives 201 C.3 Risk valuation methodology 201 C.4 Monte Carlo analysis 203 C.5 Risk matrix 204 C.6 Risk quantification reconciliation with previous Business Case 211

D Gold Coast Hospital Car Park Report 213

E Space allocation benchmarking 275

F Financial model inputs and results 281

G Space area reconciliation 303

H Updated beds and treatment places schedule 305



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I Definition of Key Procurement Stages 312

J Managing Contractor procurement paper 317

K ESD initiatives summary 335

L Interim Demand Management Strategy – 2008/09 proposals 337


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Gold Coast University Hospital Business Case 30 September 2008 1

1 Executive summary

1.1 Preamble On 18 August 2006, the Queensland Government announced an election commitment to the development of a new tertiary hospital. The announcement stated that “a 750 bed Gold Coast University Hospital will be built adjacent to Griffith University by the end of 2012 – two years ahead of time”. The brief explained that a smaller (500 bed) hospital was originally planned for 2014 however growing pressure on existing staff and resources coupled with rapid growth had fast-tracked the project.

A number of other key decisions have already been made regarding the proposed Hospital facility:

• The procurement model - The Cabinet Budget Review Committee in April 2007 determined that the current Business Case for the GCUH would not consider an option for delivery of the hospital as a Private Finance Initiative/Public Private Partnership. Queensland Health and the Department of Public Works endorsed the selection of the ‘Managing Contractor Guaranteed Construction Sum’ as the proposed procurement method for the Gold Coast University Hospital in April 2007. This decision was made after extensive consultation with Tier 1 (major) contractors given the current unprecedented level of construction activity in the building and civil infrastructure areas. The decision to procure based on a Managing Contractor methodology was primarily driven by the need to gain certainty of access to satisfactory construction resources (further advantages and disadvantages of this model is described in Section 5). This method has been the primary method of procurement by Queensland Health over the past decade.

• Project site – In relation to identification of the preferred site of the Hospital, press articles quoted former Premier Peter Beattie as saying “As is the normal process, detailed studies by the Office of Urban Management have found that while the original site [off Smith Street] was more than adequate for the project, there is the potential to avoid spending more than an additional quarter of a billion dollars with this alternative site [Parklands Drive]". Mr Beattie was also reported as saying the new location would allow for more flexibility in how the Hospital campus grew, and deliver an improved flight path for emergency helicopters away from local residents1.

Purpose of the Business Case

This Business Case is to be submitted to CBRC at the end of the Schematic Design phase for endorsement. It has been written to assist the decision making process by providing further information in relation to key aspects of the proposed Gold Coast University Hospital (GCUH) project. The aim of this Business Case is to provide an understanding of the reasonability of the option chosen to deliver the GCUH and the cost of the project compared with budgeted funding. To meet this aim this Business Case:

• summarises the Proposed Delivery Model for the GCUH Project as defined in the Project Definition Plan (PDP). The Proposed Delivery Model has been developed to achieve the clinical and support service requirements identified in the GCUH Health Service Plan

• summarises the procurement method and procurement process going forward

1 Source: Australian Associated Press, 22 August 2007


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• describes the project site and outlines the site issues that still need to be resolved

• describes the key elements of the Health Service Plan prepared for the GCUH and the interface between GCUH and provision of regional health services

• calculates the risk-adjusted capital and operating cost estimates for the Proposed Delivery Model

• reconciles the capital cost estimate for the Proposed Delivery Model with the announced capital budget for the project, and

• highlights the public interest assessment that has been completed for the project including stakeholder analysis, employment issues and environmental and cultural heritage issues.

There are also a number of health service plans that impact the Business Case, such as the Gold Coast Health Service District Health Service Plan, inter-state Joint Planning, and various specific service plans.

Project Objectives

The Project objectives were developed at a Value Management Workshop conduct in January 2007. The Project objectives include:

Service delivery and care • Create a patient-focussed health system that encourages innovative models of care

delivered in a major teaching hospital.

• Deliver operational efficiency, optimising the use of people and resources, capable of achieving health service planning targets and sustaining service levels into the future.

• Promote evidence-based design to create an environment that enhances patient safety, patient outcomes and clinical excellence.

• Ensure ability to function in a post-disaster environment.

• Enhance amenity for users of the site including consideration of carparking, retail, co-located private hospital.

People • Support attraction and retention of well-trained, committed and motivated staff.

Site access and egress • Provide clear points of site access and egress ensuring the efficient movement of

public/staff, emergency and service vehicles in and around the site.

• Maximise integration of developing public transport infrastructure to the new Hospital.

Future proof and flexible • Encourage flexible design and infrastructure capable of adapting to new technologies

(clinical, information and operational) and emerging trends in clinical practice, models of care and changes in government policy, legislation and standards.


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Teaching and research • Promote an active learning environment, providing appropriate facilities for teaching and

research within clinical areas, and between the GCUH and its key education and research partners.

Stakeholder relationships • Encourage a collaborative constructive relationship between the new Hospital and

stakeholders including education and research partners, local community, and communities of interest.

• Minimise impact and disruption to the surrounding community during construction.

• The new Hospital is part of a network of services including “district-wide” service.

Business continuity • Achieve a successful relocation to the new Hospital with no interruption to the ongoing

delivery of services.

Government commitment, policy and objectives • Procure a new major teaching hospital which delivers value for money to the State, within

budget and other parameters as agreed by the State.

• Achieve State sustainability policies/objectives, including greenhouse gas and peak energy reduction, water conservation and waste minimisation.

• Maximise benefits of collocation opportunities – with university, private hospital and other services.

Project Budget

The proposed budget for the GCUH of $1.23 billion was subsequently announced in a number of press releases and was also included in the South East Queensland Infrastructure Plan and Program (SEQIPP) 2007-2026 at $1.23 billion. Then in July 2008, the Government revised the Gold Coast University Hospital Project capital cost budget to $1,549 million (July 2008 dollars). This Updated Announced Capital Cost budget contained a number of additional scope items including site acquisition, Medical and Dental School and additional surrounding infrastructure.

1.2 Project Background and key elements of the Health Service Plan Background

The population of the Gold Coast makes it the sixth largest city in Australia and is currently experiencing rapid growth. Over the next two decades to 2026 the Gold Coast region is projected to experience population growth at an average annual rate of 2.4%2 – one of the fastest growing population areas in Queensland.

The Gold Coast Health Service District (GCHSD) currently provides public hospital services from two sites:

• Gold Coast Hospital Southport Campus (Southport) – a major regional referral hospital which provides a range of specialist and sub-specialist services

2 Source: Planning Information and Forecasting Unit, Department of Local Government, Planning, Sport and Recreation, August 2007.


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• Gold Coast Hospital Robina Hospital (Robina) – which provides general medical and surgical, rehabilitation, sub-acute and mental health services for the local area.

However, many of their clinical and clinical support services have now reached capacity, and significant accommodation shortages are impacting their ability to meet current and growing service demands. Between the period 2004/05 and 2016, day only activity is expected to increase by 135%, and overnight activity is expected to increase by 74% over the same period3.

In addition to a rapidly growing population, the age profile of the GCHSD places a high demand on health services. In 2006, the District’s proportion of people aged 65 and over was 13.7%, compared to 12% for the State, and is projected to increase to 19.6% over the next two decades. This will place further stress on the existing facilities.

As part of a detailed planning exercise by the Queensland Government to address the future health needs of the Gold Coast, it was determined that a new tertiary hospital be developed to complement other health services on the Gold Coast.

Role of the GCUH

The GCUH will replace the existing Gold Coast Hospital at Southport and is intended to take on the role of major tertiary referral hospital for the GCHSD and Northern New South Wales. The key tertiary services include cancer, cardiac, neurosciences, and neonatal services; and key clinical support services include medical imaging, pharmacy, pathology, emergency, and general amenity services.

This Business Case has been developed on the assumption that the new GCUH will fully absorb the current operations of the Gold Coast Hospital Southport campus and that the Southport site will not operate as a major hospital post commissioning of the GCUH. The future of the Southport site will be subject to an economic and functionality assessment.

The inpatient role of Robina is to complement and extend the specialist acute and tertiary role of the GCUH. Following planned upgrades for an additional 180 beds by 2009, Robina will function as a 364 bed major hospital.

Key services

The future model of service developed by the GCHSD addresses the growth predicted for the Gold Coast and surrounding areas. The model proposes:

• the strengthening of community based health services through the development of a range of health precincts and community centres across the Gold Coast

• a growth in general hospital based services via expanding the number of available public hospital beds

• establishing a range of super speciality services at the GCUH to provide improved access to these types of services to the GCHSD residents.

Broadly, the GCUH will provide a range of acute inpatient services and related super-speciality services required for such a population. There would be a phased introduction of services with service demands and workforce availability dictating the timing of the introduction of services.

3 Source: GCHSD Health Service Plan February 2007


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Integration with health service planning

Current planning for the GCUH takes place within a hierarchy of planning instruments that are designed to ensure a coordinated and integrated approach is undertaken in planning the delivery of health services. Queensland Health has developed the State-wide Health Services Plan 2007 – 2012 to provide an overarching vision with key objectives of improving access to safe and sustainable health services and better meeting people’s needs across the health continuum. The Southern Area Health Service4 (SAHS) Plan 2007-12 provides direction for reform and development of health services in the Southern Area, in line with the broader objectives. Associated with this plan are a series of cluster and Health Service District plans that project health service utilisation and which articulate strategies for responses by specific service networks, including delineation of roles of facilities, identification of cross-district issues and opportunities for improved integration of services.

Consistent with this approach, the GCHSD developed the Gold Coast Health Service District Master Plan in 2005 following a consultation process. This plan has subsequently been reviewed to provide specific plans for the GCUH, Robina Hospital and the Robina Health Precinct. The GCUH Health Services Plan has been based upon a close cooperation between the GCHSD and the teams currently developing specific State-wide plans. As far as practicable, the GCUH plan directly reflects the concepts under development in the following planning processes:

• Cancer Services State-wide Plan

• Community Health Review

• Cross Border Planning Study

• Hardes Projection Data (based on the latest population census)

• Mental Health State-wide Plan

• NICU State-wide Plan

• Oral Health State-wide Plan

• Rehabilitation Services State-wide Plan

• Renal services State-wide Plan

• Southern Corridor Plan

• Intensive Care Services State-wide Plan, and

• Medical Imaging Services State-wide Plan – due 2009.

The GCUH will act as a tertiary referral facility with limited super-specialist services with the District still required to refer a limited number of patients to Brisbane for very low volume / high cost / highly specialised interventions or interstate for an even more limited subset of patients at

4 On 1 September 2008, the Area/District structure within Queensland Health was significantly reformed. A fundamental element of the reform process was the redistribution of Area Health Service functions to Districts and Queensland Health Corporate Office. Areas including the Southern Area Health Service have been replaced by a flatter District structure. The numbers of Districts have been reduced from 20 to 15. The new structure will allow District CEOs to report directly to the Director-General, improving communication channels and responsiveness and allowing greater District autonomy in boosting performance standards and accountability.


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Nationally Funded Centres. Over time, the GCUH may develop a limited number of services which have a State-wide referral role, receiving referrals from all other Queensland Districts and Northern NSW. The GCUH will also provide a supportive hub role for selected services from the Logan Health service District. Currently this role will be limited to renal services.

Within the GCHSD, the GCUH will form part of an integrated network of health facilities encompassing Robina Hospital; Robina Health Precinct and a variety of Community Based Services primarily at Palm Beach, Bundall and Helensvale, as well as a number of outreach clinics; and Carrara Health Service, providing subacute care. Within this network, the GCUH will provide higher-level support services such as intensive care, trauma management and neonatal care. For these services the role of the facility will be to support the State-wide availability of capacity and act as an integrated part of a network in peak periods of stress.

In relation to services provided by the private sector, planning for the GCUH and Robina Hospital expansion are based on the assumption of private sector growth in bed capacity is similar to that of the public sector services. Accordingly, the incorporation of the strategy for the collocation of a private hospital on the GCUH site is designed to facilitate that growth. The collocation of the private hospital will also provide opportunity for the development of synergistic relationships between the public and private sector for shared services. A land area of 40,000m2 has been provided for a future Private Hospital facility, preliminary discussions are already underway with private operators, and a detailed market sounding process will commence in early 2008.

Integration with northern NSW health service planning

A Joint Planning Study has been established by the NSW and Queensland governments to ensure an integrated approach to service planning and delivery for the residents of the north coast of NSW and the southern region of the Gold Coast. Some of the key assumptions that have been identified by this joint study process to guide service planning include:

• public sector expansion and changes will predominantly be in response to demand associated with projected population growth and ageing

• Lismore Base and The Tweed Hospitals will remain rural referral hospitals providing a range of Level 4 and 5 services (NSW Role Delineation). Therefore, services such as specialty paediatrics, neurosurgery, organ transplantation, and cardiothoracic surgery will continue to be provided by hospitals located in Queensland (Gold Coast or Brisbane), the Hunter region or metropolitan Sydney. Given the travel distances to the Hunter and Sydney, it is expected that the majority of NSW residents in the far north coast will be referred to Queensland

• in Queensland, the private sector will increasingly focus on developing day-only services. With the exception of John Flynn and Pindara Private Hospitals, private sector providers have indicated that they are not planning to significantly increase capacity generally to meet population growth and ageing

• over the next five years, both John Flynn and Pindara Private Hospitals have indicated major planned expansion: John Flynn anticipates bed increases of 48, while Pindara Private has advised of bed increases of 209

• no change to the private supply pattern or capacity on the NSW far north coast is expected during the planning horizon

• no planned reversal of private inpatients is expected from NSW private hospitals to public hospitals.


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These assumptions have been further developed to forecast patient flows by specific clinical type and have been incorporated in the GCUH Health Service Plan.

Project completion and transition planning The GCUH is expected to be completed by December 2012, but only 83% operational within the first year of operation. During the first year of operation of GCUH, staff and resources from Southport Hospital will be transferred to GCUH, and the Southport Hospital will correspondingly be closed.

GCUH will not be fully operational until 2015. This is due to a range of resource constraints such as the availability of appropriately skilled and experienced clinical and support staff, as well as the time that is needed to develop super speciality services not previously provided by the GCHSD.

To address the resourcing and timing issues, a transition strategy is to be implemented whereby a phased or ‘ramp up’ process will be applied to gradually bring the facility up to 100% operational capability. Queensland Health is currently in the process of developing these detailed transition plans.

The Gold Coast Health Service District Interim Demand Management Strategy 2008-2012 (IDMS), submitted in November 2007, proposes a range of integrated strategies to partially meet the growing local demand prior to the opening of the GCUH. A separate Business Case seeking funding approval for the IDMS will be considered as part of the upcoming budgetary process. The IDMS strategy and funding requirements is discussed further in Section 3.6. However, the IDMS is not considered as part of the project capital or recurrent budget analysis or affordability analysis in this Business Case.

Interrelated Projects An overview of the interrelated projects that will impact either the development of the GCUH and/or efficient operation of the facility is provided in the following table.

Table 1.1 Interrelated Projects Project High level description Responsibility Cost Estimate

Interim Demand Management Strategy (IDMS)

The IDMS proposes a range of integrated strategies that maximises capacity within the GCHSD in order to partially meet the growing local demand prior to the opening of the GCUH.

Queensland Health

Capital costs of $66.6m over the 4 year period

2007/08 – 2010/11 was considered as part of the 2008/09 budget process,

with $8.2m allocated in 2007/08 for Coomera

land purchase and $1.4m in 2008/09 for expansion

of the Emergency Department at Southport.

Surrounding road network upgrades

Smith Street and Olsen Avenue are the two major thoroughfares linking to the GCUH. Upgrades to these roads and to other roads that surround the GCUH site are proposed.

Department of Main Roads

The estimated cost of the Surrounding Road

Network Upgrades is in the range of $215 million to $360 million (based on advice from Department

of Main Roads).


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Project High level description Responsibility Cost Estimate

Rapid Transit Project

It proposed that the Gold Cost Rapid Transit (GCRT) system will provide a station servicing Griffith University and the GCUH. Construction of this station is included in the first stage of the GCRT project which is scheduled to be completed by 2012, however the system will not become operational immediately. Queensland Transport will provide bus arrangement to service the hospital until the GCRT is operational.

Queensland Transport

The estimated capital cost of the Gold Coast

Rapid Transit system is $1.67 billion (as per

SEQIPP 2008-2026). This estimate relates to

the development of a rapid transit system

extending from Helensvale to

Coolangatta. However, the project is likely to be

delivered in several stages.

Car Parking facilities

It is proposed that a total of 3,000 car parking bays be constructed to cater for the needs of staff and visitors to the new Hospital. It is proposed that the 3,000 spaces will be provided in two separate car parks facilities.

Queensland Health

Private sector procurement. EOI phase

completed. RFP phase to commence soon.

Provision of Utilities to the site

Negotiations are currently underway with Energex for provision of a new zone substation, and with Gold Coast City Council (and Gold Coast Water) for water and waste services. These will be provided to the district and will not be costed to the GCUH project.

Queensland Health, Energex, Gold Coast Water / Gold Coast City Council

To be determined

Source: Queensland Treasury, Department of Infrastructure and Planning and Queensland Health

1.3 Project site, design and facilities Project Site

The Hospital development is part of a 130 hectare site referred to as the “Gold Coast Hospital and Knowledge Precinct”. The Precinct is located on the western edge of Southport on the Gold Coast, approximately 4km west of the Southport CBD and 36km north of Tweed Heads. The proposed site for the Hospital will occupy approximately 18.1 hectares of the Precinct land, directly opposite the Griffith University site. The site is boarded by Parklands Drive and Olsen Avenue and is currently being acquired by Queensland Health with assistance from the Department of Infrastructure. An aerial photo of the site is shown below.


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Figure 1.1 GCUH proposed site

Source: Project Definition Plan

The recommendation to locate GCUH on the northern site was based on the following key features:

• health service delivery will be enhanced through improved access and egress to the site, as indicated by Department of Main Roads (DMR), through better accommodation from all directions with the Northern site providing better reliability

• better potential for expansion of GCUH over time

• more timely integration of road works with the opening of GCUH in 2012 and significant cost savings in excess of $260m in the supporting road infrastructure whilst providing improved access and better operability.

Site acquisitions

Within the proposed GCUH footprint there are existing organisations currently operating that will be affected by the Hospital development. Key acquisitions and funding of relocation costs (where appropriate) will include land occupied by Griffith University’s Medical and Dental School, the Church of Christ, Salvation Army, Greyhound Racing Authority, and Southport Lawn Cemetery.

Proposed Delivery Model

As part of the development of the Project Definition Plan, five technical delivery models were developed for consideration (which are described in greater detail in Section 4). The five technical delivery models were then assessed against the Project objectives to select the preferred technical delivery model which is referred to as the Proposed Delivery Model. The


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evaluation process, scoring against the Project objectives and the selection of the preferred delivery model is discussed in more detail in Section 4.3.

Project design features

To meet the requirements of the GCUH Health Service Plan, the Hospital will feature the following key attributes:

• A compact solution, which is designed over nine levels and located in a parkland setting.

• A compact footprint which allows for future expansion.

• The potential for clear ‘way-finding’ with the principle of having short travel distances to lift cores. The distance between the front entrance and the central lift core is less than 60 metres.

• Use of site topography to separate by level the key entrances points for visitors, patients and services (i.e. main entrance, Emergency Department entrance and the loading docks).

• A dedicated car park to be accessed by the Caner Centre via the South block basement level.

• Direct and discrete connections between the Emergency Department and the Mental Health Unit, which also has a dedicated entrance.

• Designed with departmental stacking, which responds to its Model of Care.

The philosophy for the interior design is to create a comfortable and healing environment for patients, their families and carers, and incorporates the qualities of friendliness, safety, privacy and fun where appropriate.

Furthermore the overall design has incorporated future proofing principles including an expansion allowance for 90,000m2 of gross floor area (total potential area in excess of 250,000m2), which could increase the beds from 750 to approximately 1,000. The potential future expansion can occur without impeding access to the facility by the public, patient, visitors, staff or those supplying the facility with the goods and services during the operation of the facility.

As part of the expansion allowance, a land area of 14,000m2 has been provided for a future Private Hospital facility. A tender process to select a private operator for the site is currently underway with six organisations registering Expressions of Interest.

The layout of the facilities is shown in the figures below.


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Figure 1.2 Perspective showing view from South West

Source: GCUH Architecture

Figure 1.3 Perspective showing view from North East



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Accommodation design and benchmarking

Accommodation design was developed with reference to Australasian Health Facility Guidelines (AHFG) and through a benchmarking exercise. A series of user group meetings and discussions were also conducted to inform the development process.

Reference was made to several documents and guidelines including the following:

• GCUH Health Service Plan

• Queensland Health’s Queensland Health Capital Works Guidelines

• Queensland Health’s Queensland Health Clinical Services Capability Framework for Public and Licensed Private Health Facilities, version 2 July 2005.

• Australasian Health Facility Guidelines, November 2006.

• Department of Human Services, Victoria Hospital Project Planning Benchmark 2003, as detailed for Level 6 hospitals

• Queensland Health recommendations for single rooms

• Environmentally Sustainable Design initiatives.

Furthermore the following factors and statutory requirements were also incorporated:

• Additional floor space area associated with new Statutory Requirements (including Disability Discrimination Act, Occupational Health and Safety Act, and Building Code of Australia)

• Queensland Health policy to move from average provision of 25% single bed rooms to 75% single bed rooms

• Introduction of Environmentally Sustainable Design initiatives (plant and equipment)

• Increased provision of high-cost medical equipment.

The accommodation design was benchmarked against comparative Australian hospitals:

• Queensland: Royal Brisbane and Women’s Hospital, Princess Alexandra Hospital, The Prince Charles Hospital and the Townville Hospital

• Victoria: Royal Melbourne Hospital, the Alfred Hospital, the new Royal Children’s Hospital (based on the PDP), Monash Medical Centre and Austin Hospital

• New South Wales: the Royal Prince Alfred Hospital and the proposed Redevelopment of the Royal North Shore Hospital (based on PDP)

• South Australia: Royal Adelaide Hospital and the proposed Marjorie Jackson Hospital (based on PDP)

• Western Australia: Fiona Stanley Hospital (based on PDP).

The resulting bed and floor space profile is detailed in the table below.

Table 1.2 GCUH Floor Space Requirements and Benchmarking


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Division

Day beds

Bed Altern-atives

Over night beds

Treat-ment

places

Consul-ting

rooms

Gross Area m2

Bench-mark

Area m2

Comments

Generic inpatient unit - - 400 1 13 19,057 18,648 The increase in area (2%)

compared to the benchmark can be explained by a greater allowance for single bed rooms, shared eduction and training areas, and a decentralised model of care for allied health areas.

Division of Medicine 14 97 76 115 115 24,473 22,887 The increase in area (7%)

compared to the benchmark reflects a higher proportional of single rooms and the inclusion of shared service areas.

Division of Surgery and Critical Care Services

40 - 50 39 11 16,032 14,376 The increase in area (11%) compared to the benchmark can be attributed to the increased size of interventional rooms in line with current international standards, and the collocation of the Anaesthetics department within this cluster.

Division of Family, Women & Children

20 - 124 26 39 14,018 11,499 The increase in area (22%) compared to the benchmark can be explained by a greater allowance for single bed rooms, and inclusion of ambulatory care as part of this cluster.

Division of Medical Services

- - - 28 - 5,923 5,143 The increase in area (15%) compared to the benchmark can be explained by inclusion of satellite imaging services with emergency and ambulatory care areas, and equipment such as PET.

Division of Mental Health & ATODS

- - 72 - - 5,817 5,895 The decrease in area (1%) compared to the benchmark is immaterial.

Division of Community, Allied, Rehabilitation and Aged Services

- - 28 99 10 7,359 6,502 The increase in area (13%) compared to the benchmark can be explained by additional services not included in benchmark hospitals, such as the Rehabilitation Unit and Therapy Area.


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Division

Day beds

Bed Altern-atives

Over night beds

Treat-ment

places

Consul-ting

rooms

Gross Area m2

Bench-mark

Area m2

Comments

Division of Pathology - - 8 - 5,039 6,360 The decrease in area

(20%) compared to the benchmark can be explained by the centralised provision of specialised pathology services for the region by the Royal Brisbane and Women's Hospital.

Education & Research - - - - - 3,871 4,125 The decrease in area (6%)

can be explained through the ability to integrate and utilise education, library, and research facilities at Griffith university.

Corporate Services, amenities and retail

- - - - - 16,556 16,318 The difference to the benchmark is immaterial.

Total 74 97 750 316 188 118,109 111,753

Travel space

17,380

Plant space

27,673

Main atrium

1,200

Total Gross Area

164,362

Source: GCUH Technical Advisor, DLA, GCUH Architecture Notes: See Appendix H for updated beds / treatment places schedule, and Appendices E and G for benchmarking and area schedule.

Education and Research Facilities

The future teaching facilities will be developed in collaboration with the university sector. A spatial allowance has been made for hospital-based research, where all such dry research undertaken by the various Clinical Departments is to be conducted.

Environmental Sustainable Design (ESD)

The project team is endeavouring to provide a sustainable hospital capable of accreditation as a four star Greenstar facility, within the original Project Definition Plan ESD budget allocation of $82 million (nominal)5. A detailed description of the ESD initiatives is provided in Appendix K.

Transport infrastructure

General vehicle access to the Hospital site is to be provided from the Smith Street end of Parklands Drive and from Olsen Avenue. Upgrades to Smith Street and Olsen Avenue, and other roads that surround the GCUH site, are proposed. These upgrades will be managed by the Department of Main Roads.

5 $47 million (July 2008 dollars excluding managing contractor fee, professional fees and risk adjustments)


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Bicycles and motorcycle facilities will also be provided. Bicycle parking for visitors and couriers designed to meet the Queensland Cycle Strategy, will be located in convenient and safe locations and protected from adverse weather conditions.

The Queensland Government has identified the proposed Gold Coast Rapid Transit (GCRT) System as a priority project in SEQIPP with a cost estimate of $1.67 billion. The GCRT system will be of significant benefit to the Hospital, providing an alternate mode of transport for bringing patients, staff, visitors and students to the Precinct and the Hospital. Queensland Transport is planning the development of the GCRT project and has indicated a station servicing Griffith University and the GCUH is a priority for the project. Construction of this station is included in the first stage of the project. Queensland Transport advise that the rapid transit construction works adjoining the new hospital can be completed by December 2012, however the GCRT will not be operational by this time. Queensland Transport will provide bus arrangements to service the hospital until the GCRT is operational.

Car park facilities

It is proposed that the car parking facilities required for the GCUH will be separately procured through a Build Own Operate and Transfer (BOOT) process (i.e. where a private sector consortium will build, own, finance and operate the facility for an agreed concession term, at the end of the concession term ownership will be transferred back to Queensland Health), and Queensland Health is currently running a competitive tender process to select the BOOT partner.

The car parking facilities will provide a minimum of 3,000 spaces in two separate vertical structures, with the East Car Park to be completed by August 2010 to ensure sufficient parking for construction workers and commissioning of the hospital. More information on the car parking facilities is provided in Section 4.15 and Appendix D.

Facility management services

Queensland Health is considering the possibility of entering into a Facilities Management contract with a Managing Contractor and/or a nominated third party provider. The specialist provider would provide certain facilities management services over a 20 year operational phase, commencing upon completion of construction of the GCUH. Collecting like elements into the overall ambit of responsibility of a facilities manager should result in better initial installation or choice of plant and or equipment. Alternatively, these services could be managed by a facilities manager within Queensland Health, with some outsourcing to third parties through supply agreements.

Single bed allowances

The profile of the GCUH, being a major tertiary / super-speciality hospital for South East Queensland, together with other planned tertiary hospitals for the region, prompted an investigation by Queensland Health’s Capital Works & Asset Management Branch (CW&AMB) into the optimal proportion of single beds to multiple beds.

In November 2007, the Capital Works & Asset Management Committee (EMT – inc Strategic Reference Committee Qld Health Major Hospital Projects) endorsed that the planning for the three major hospital projects (including the GCUH Project) were to proceed on the basis of the following proportion of single bed rooms:


September 2008


• 100% single rooms for critical care areas, mental health, immuno-compromised and infectious patients.

• 80% single rooms for high acute ward environments.

• 60% single rooms for variable acuity medical wards.

• 30% single rooms for Rehabilitation wards.

Noting that the room sizes will vary from 24m2 (critical care), to 15-18m2 (high/variable acuity) to 12m2 (mental health). Queensland Health is also undertaking some further analysis of the recurrent costing associated with the increased amount of the single bed rooms. Applying these principles has increased the single bed ratio from current Queensland allowances of 25% to 75%. The increase in proportion of single rooms together with the increase in room sizes results in a requirement for an additional space of 5,123 m2.

The proposed single bed allocation for the GCUH is consistent with worldwide trends. In Australia, the Royal Children’s Hospital in Melbourne is planning for 80-90% single bed rooms, while the Fiona Stanley Hospital in WA has recommended 83% inpatient single bed rooms plus 100% single-bed rooms in ICU, short stay and mental health units.

Benefits of increased single bed rooms include:

• Improved infection control with annual savings through effective isolation estimated between $0.25 to $1 million per 100,000 population.

• Reduction in clinical errors.

• Reduction in patient falls and injuries.

• Evidence it results in a shorter length of stay. International studies such as a study undertaken in the UK6 estimated that the average length of stay of non-hospital acquired infection patients was 7.6 days compared to hospital acquired infection patients of 21.7 days.

• Increased patient privacy and overall satisfaction.

The capital cost of this increase required $35.6m in nominal terms, and less than 2% of the Proposed Delivery Model Capital Cost Estimate. Additional recurrent operating costs (for lifecycle capex, utilities and internal cleaning costs) have been estimated by the technical advisers to be an additional $1.7m per annum (in 2007 dollars) which is less than 2.5% of the annual average Facilities Maintenance and Management estimate. An impact analysis of recurrent cost is currently being developed by Queensland Health.

Queensland Health believes when considering the marginal relative cost of this decision to the overall budget, that the qualitative (and quantitative) evidence presented in this Business Case together with the results of the recurrent cost study is sufficient to validate the policy position.

Further information on the proportion of single beds in the proposed facility is discussed further in Section 4.17. 6 R.Plowman, N Graves, M.A.S. Griffin, J.A. Roberts, A.V. Swan, B Cookson and L. Taylor: The rate and cost of hospital acquired infections in patients admitted to selected specialties of a district general hospital is England and the national burden imposed. Journal of Hospital Infection 2001 47:198-209.


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1.4 Proposed procurement method The decision making process in relation to the selection of the proposed procurement approach for the GCUH has been completed separately to this Business Case process. The Cabinet Budget Review Committee in April 2007 determined that the current Business Case for the GCUH would not consider an option for delivery of the hospital as a Private Finance Initiative/Public Private Partnership.

In determining the preferred procurement method, the Department of Public Works (DPW) undertook extensive consultation with Tier 1 (major) contractors given the current unprecedented level of construction activity in the building and civil infrastructure areas. There are currently nine Tier 1 Building Contractors servicing the Queensland market. Consultation in early 2007 included formal meetings between DPW’s Deputy Director General (Works) and Director Contracts and the CEO level of each of the major contractors.

This consultation resulted in the decision to tailor procurement strategies to attract an appropriate tender market for the major projects. These strategies have included key factors that contractors noted as important to be attracted to the State Government building works, including:

• A general registration of interest in early 2007 to encourage forward planning of projects to enable contractors to better plan for undertaking government work.

• A more specific Expression of Interest in April 2007 based on the 14 Government building contracts known to be going to tender within the next 18 months to 2 years. The Expressions of Interest were scored by an evaluation team and contractors ranked by score for each project. The interest in the project, the ranking order, an acceptable level of score, projects won at tender and eligibility under the DPW PQC system were factors in determining the final select tender list.

• Agreement with industry to a Managing Contractor form of contract well known to industry but including provision for early contractor involvement to enable contractors to not only provide value adding services to the project, but also to enable the contractors to secure the required supply-chain resources early (e.g. trade subcontractors).

Queensland Health and the Department of Public Works endorsed the selection of the Managing Contractor Guaranteed Construction Sum as the proposed procurement method for the GCUH in April 2007. The proposed advantages given for the selection of the procurement method included:

• The appointment of the Managing Contractor at an early stage ensures that, in a period of unprecedented construction activity in the building and civil infrastructure areas, the project has certainty of construction resources.

• Provides a greater degree of price certainty – once the Guaranteed Construction Sum is agreed between parties.

• Allows Queensland Health to commence work on the project quickly and easily – as not all issues need to be resolved prior to the appointment of the Managing Contractor.

• Reduces Queensland Health’s exposure to design and construction risks – as the risks are transferred to the Managing Contractor.

A more detailed description of the advantages and disadvantages of the proposed procurement method are provided in Section 5.4 and Appendix J.


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The Managing Contractor Guaranteed Construction Sum is also the procurement method that has predominantly been used by Queensland Health to undertake major capital works over the past decade.

1.4.1 Description of the proposed procurement process

In delivering the project with the Managing Contractor Guaranteed Construction Sum procurement method there are three further distinct phases to be completed following the completion of the Master Plan and the Project Definition Plan, including:

• development of the Schematic Design Process completed by the Project Team including a Building Consultant and the appointment of a Managing Contractor to proceed to the next stage of the procurement process

• the Managing Contractor undertaking the Design Development process and producing a Guaranteed Construction Sum (GCS) Offer. The GCS Offer is assessed and upon agreement of acceptable terms is submitted to the Cabinet Budget Review Committee for consideration and approval. This phase may include early works packages

• the Managing Contractor undertaking construction work, commissioning work and all other design work and documentation work not completed in the previous phase.

The three phases and the key tasks to be completed in each phase are outlined in the following table.

Table 1.3 Procurement phases

1. Schematic Design and MC appointed

2. Agree GCS and obtain approval

3. Construction process

The Project Team & Building Consultant (BC):

• Complete the Schematic Design.

• Finalise the draft Contractual Terms for Managing Contractor (MC) Contract.

• Prepare revised Project Capital Budget.

The Project Team:

• Prepares the Request for Tender Documentation for the MC and conducts the process.

• Provides updated Business Case (e.g. revised Capital Budget) to CBRC for endorsement.

• Appoints the MC to complete Developed Design and submit proposal including GCS.

The Project Team and MC:

• Complete the Developed Design for the facility.

The MC:

• Engages consultants.

• Prepares GCS.

• Submits proposal including GCS to Project Team

The Project Team:

• Reviews the MC’s proposal and if required further negotiates price and terms.

• Seeks approval from Queensland Health to accept the offer.

The MC and the Project Team:

• Complete the Construction Documentation (Project Team reviews).

• Completes construction of the facility (Project Team reviews and makes progress payments to MC).

• Complete decanting into the new facility.

• Complete the defects liability period for the facility (Project Team reviews).

Source: Project Services

A more detailed description of the three phases is provided at Section 5.2. Section 5.3 also provides a summary of the key commercial principles of the draft Managing Contractor Contract.

1.4.2 Indicative Project Resources

The following table provides a preliminary indication of the project resources (i.e. Queensland Health employees and external consultants) required through to completion of the project. The


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table provides a breakdown of the resources into the key procurement stages going forward and also by resource classification.

Table 1.4 Indicative Project Resources for the GCUH Project

Resource Type Schematic Design

Detailed Design

Construction Documentation

Construction Defects Period

Queensland Health (Major Projects & Gold Coast Team)

19.5 19.5 19.5 24.5 14.0

Project Managers 9.0 9.0 8.0 7.8 6.5 Architects 46.0 52.0 75.0 57.0 9.0 Engineering 42.0 51.5 63.0 18.0 4.0 Quantity Surveyors 4.0 4.0 4.0 4.0 Programming 4.0 4.0 4.0 4.0 Procurement and Principal Representative

3.5 5.0 5.2 6.2 3.0

Commercial & Financial 1.0 Building Consultant 11.0 Total (People) 140.0 145.0 178.7 121.5 36.5 Managing Contractor 37.0 94.0 184.0 4.0 Source: Queensland Health, Project Services, Building Consultant

An indicative timetable for the GCUH Project is also provided at Section 5.5.

1.5 Risk adjusted nominal project costs In order to derive the total project costs, the raw construction, project development, facility maintenance and management costs have been estimated by the technical advisers and have been adjusted to include allowances for escalation and risk. In addition, Queensland Health has estimated clinical and support services costs using its casemix and labour analysis costing methodologies.

Escalation

The raw construction costs, managing contractor fees, professional fees, statutory fees and project development costs have been escalated from the cost base date of 1 July 2008 in accordance with the rates in the following table.

Table 1.5 Capital cost escalation rates

Items Escalation rate 2008/09 2009/10 2010/11 2011/12 2012/13 Construction costs, MC fees, novated professional fees and statutory fees 8.0% 7.0% 6.0% 6.0% 5.0%

Source: DLA

Queensland Health costs and FF&E costs have been escalated from the cost base date of 1 July 2008 at 4.0% p.a. and other project development costs at the rates in the following table.


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Table 1.6 Project development costs escalation rates

Items Project Development Cost Escalation Rates 2008/09 2009/10 2010/11 2011/12 2012/13 Commissioning / decanting / QH Costs 4.0% 4.0% 4.0% 4.0% 4.0% Professional Fees 4.0% 4.0% 4.0% 4.0% 4.0% Public art allowance 4.0% 4.0% 4.0% 4.0% 4.0% Site acquisition 0.0% 0.0% 0.0% 0.0% 0.0% Additional infrastructure 8.0% 7.0% 6.0% 6.0% 5.0% Medical and dental school 8.0% 7.0% 6.0% 6.0% 5.0% Source: Queensland Health and DLA

Escalation rates have been applied to the capital costs in accordance with a capital cost profile (S-curve) provided by the technical advisers.

Facility maintenance and management costs (recurrent costs) all of which have a cost base date of 1 July 2007 have been escalated at 4.0% with respect to labour components and 3.2% for other components.

Further details on the escalation rates used are contained in Appendix B.

Risk adjustment

The purpose of the risk adjustment is to provide a more accurate estimate of the project’s out-turn costs by quantifying the potential cost impact of individual project risks on a probability-weighted basis. The methodology used to quantify the risks was to workshop high, medium and low risk impacts and associated probabilities and then determine the weighted average value of the risks. In addition, a Monte Carlo simulation was performed to assess the probability distribution of the aggregate risk outcomes. Further details on the risk adjustment methodology and the risk curves are detailed in Appendix C.

Quantified risk values have been indicatively allocated into transferred and retained risk components based on the Managing Contractor procurement method chosen by Queensland Health.

Project capital costs

The following table summarises the project’s total nominal risk-adjusted capital costs for the entire project (i.e. the Contractor Capital Costs and Project Development Capital Costs). These costs have been calculated by adjusting the raw capital costs provided by the technical advisers for escalation and risk adjustments.

Table 1.7 Capital Cost Estimate – Proposed Delivery Model

Total project capital costs Proposed Delivery ModelNominal $M

Generic Inpatient Unit 178.41 Education & Research 28.27 Division of Medicine 242.46 Division of Surgery & Critical Care 169.06 Division of Family, Women & Children 114.79 Division of Mental Health & ATODS 40.30


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Division of Community, Allied Health Aged & Rehabilitation Services 50.92 Division of Medical Services 106.78 Division of Pathology 55.23 Corporate Services, Amenities and Retail 134.79 Engineering and Travel 249.75 Central Plant Etc 244.01 ESD Initiatives 90.26 External Works 84.41 Total Contractor capital cost 1,789.43

Project development capital costs 318.86

TOTAL PROJECT CAPITAL COSTS 2,108.30 Included escalation 341.45 Included transferred risk 42.27 Included retained risk 106.64 Note: Total capital costs include adjustments for escalation, transferred and retained risk. Source: Queensland Health, DLA cost assumptions and KPMG Financial Model

Project recurrent costs

The following table shows the estimated clinical and support services costs (other than facilities management costs estimated below) from commissioning of the new GCUH until full operations in 2015-16. The estimates are based on the casemix costing methodology and assume expansion from 624 overnight beds in 2012-13 to 750 overnight beds by 2015-16 in accordance with the draft Queensland Health Bed Transition Strategy. The recurrent costs have also been estimated for 2015-16 using Queensland Health’s labour analysis methodology and were equivalent to the costs estimated on a casemix basis.

Table 1.8 Clinical & Support Services Recurrent Costs, excluding facilities management costs

Forecast Costs 2012-13$M

2013-14$M

2014-15 $M

2015-16$M

Clinical and Support Services 442.1 483.5 525.5 581.7 Source: Queensland Health Note: All costs are in nominal dollars.

Further information on the Clinical and Support Services Recurrent Cost is provided in Section 6.6.

The average annual escalated and risk-adjusted Facilities Management costs are shown in the table below. The risk adjustment based on a Managing Contractor delivery model resulted in and average 10.3% transferred risk adjustment.

Table 1.9 Facility Management and Maintenance Recurrent Cost Estimate (Average Annual)

Cost Category – operating at full capacity Proposed Delivery Model

Nominal $M Routine Building and Plant maintenance 25.82 Grounds maintenance costs 0.70


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Nominal $M Cleaning 0.67 Helpdesk 0.71 Utilities 26.57 Subtotal 54.47 Lifecycle Building Maintenance 25.29 Total facility maintenance and management costs 79.76 Note: The above costs include adjustments for escalation, transferred and retained risk Theses costs are average annual cost over 20 years Source: Queensland Health

Further information on the Clinical and Support Services Recurrent Cost is provided in Section 6.5.

1.6 Affordability analysis The affordability analysis determined the gap between proposed expenditure and committed funding by comparing:

• the annual cost and estimated total cost of capital expenditure on the GCUH with the Government’s announced funding commitment (July 2008), and

• the annual recurrent expenditure on the GCUH with existing funding based on 2006-07 activity levels at the Gold Coast Hospital.

Capital cost affordability

The capital expenditure is calculated on a risk adjusted and escalated basis. The announced capital budget of $1.549 billion (July 2008 dollars) has been escalated based on the escalation rates in Table 6.3 and an S-curve for total project capital costs. The resulting gap is shown in the tables below. The gap is explained in the section 1.7.

Table 1.10 Affordability of Proposed Delivery Model

Est. Total

Cost $m 2007-08

$m 2008-09

$m 2009-10

$m 2010-11

$m 2011-12

$m 2012-13

$m Proposed Delivery Model Capital Expenditure

2,108.30 31.14 148.05 347.83 546.10 707.20 327.98

Committed Capital Funding

1,868.54 29.57 121.71 306.58 485.82 637.06 287.80

Capital affordability surplus / (deficit)

(239.76) (1.57) (26.34) (41.25) (60.28) (70.13) (40.18)

Source: Queensland Health, KPMG Financial Model Note: Costs are in nominal dollars

A number of potential capital cost offsets initiatives which may reduce the affordability gap are listed in Section 8.7.

Recurrent cost affordability

The estimated recurrent expenditure prior to commissioning of the GCUH is based on budgeted Gold Coast Hospital expenditure of $249.8 million for 2007-08 plus supplementation under the


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“More Beds for Hospitals” program amounting to $7.3 million in 2007-08 and $14.5 million in subsequent years. No allowance has been made for potential funding under the Interim Demand Management Strategy or other possible growth funding in the future that is not currently approved.

The following table shows the affordability comparison in real and escalated terms between the existing recurrent funding level and recurrent expenditure under the Proposed Delivery Model.


2007-08

2008-09

2009-10

2010-11

2011-12

2012-13

2013-14

2014-15

2015-16

2007-08 dollars Projected overnight bed numbers 480 480 480 480 480 624 683 716 750 Expenditure on Preferred Delivery Model ($m real) 257.0 264.3 264.3 264.3 264.3 393.1 431.7 450.1 477.5 Committed Funding ($m real) 257.0 264.3 264.3 264.3 264.3 458.2 459.1 459.9 461.1 Real Expenditure Surplus / (Deficit) 0.0 0.0 0.0 0.0 0.0 65.1 27.4 9.8 (16.4) Nominal dollars Escalated value of Proposed Delivery Model ($m nominal) 257.0 269.2 279.3 289.8 300.7 464.8 529.7 572.8 630.2 Escalated value of Committed Funding ($m nominal) 257.0 269.2 279.3 289.8 300.7 506.3 522.8 543.5 565.5 Total nominal recurrent surplus / (deficit) ($m ) 0.0 0.0 0.0 0.0 0.0 41.4 (6.9) (29.3) (64.7) Source: Queensland Health

In 2007-08 dollars, the table shows a funding surplus of $65.1 million in 2012/13 which reduces to a small deficit of $16.4 million by 2015/16. These results reflect the following key factors:

• In forecasting recurrent expenditure, Queensland Health has assumed continuation of Gold Coast Hospital acuity levels and reduced occupancy levels for the additional beds at GCUH in order to ensure that recurrent expenditure is affordable within available funding under the More Beds for Hospitals program by 2015/16. For the GCUH to function at the higher acuity level identified in the Health Service Plan or to have higher activity levels and occupancy rates, the recurrent funding would need to be reassessed and increased.

• Additional funding in 2012-13 under the More Beds for Hospitals program is provided in nominal dollars (hence the total funding is partly in 2007-08 dollars and partly in 2012-13 dollars).

• Additional funding under the More Beds for Hospitals program assumes 750 beds will be available in 2012-13 compared to the 624 beds assumed by Queensland Health under the Bed Transition Strategy in that year (rising in subsequent years to 750 beds by 2015-16).

In nominal dollars, the table shows a funding surplus of $41.4 million in 2012/13 which reduces to a deficit of $64.7 million by 2015/16. This affordability gap is greater than the deficit in real


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terms (2007-08 dollars) primarily because, as noted above, the latter deficit includes a component of nominal funding under the More Beds for Hospitals program.

1.7 Capital cost comparison with a reference case It is understood that the Announced Capital Budget in August 2006 of $1.23 billion was developed based on the following assumptions:

• that the Gold Coast University Hospital is a 750 bed tertiary referral hospital with the costs broadly based on the Townsville Hospital which is also a tertiary referral hospital

• a total gross floor area of 144,000 m2

• a Managing Contractor procurement model with broadly similar risk allocation was used for the procurement of the Townsville Hospital, and

• the announced budget is as at August 2006 (i.e. real August 2006 dollars). It is assumed that the escalation included in the table in section 8.1 relates to the escalation from the date of completion of the Townsville hospital to the date of the Announced Capital Budget in August 2006.

These broad assumptions, combined with the absence of a detailed schedule of areas, mean that it is difficult to determine the mix and level of services that the Announced Capital Budget would provide. Consequently, the Announced Capital Budget is an insufficient basis for meaningful comparisons with the Proposed Delivery Model. In order to address this problem, it has been necessary to develop a suitable Reference Case and estimate that:

• Provides clarity about the underlying assumptions through development of a detailed schedule of areas and associated cost plan; and

• Is based on similar assumptions to the Announced Capital Budget concerning facility standards and consequently reconciles to the Announced Capital Budget in terms of its aggregate cost.

Accordingly, a Reference Case has been developed to reflect facility standards that may have been assumed in, or can reasonably be associated with, the Announced Capital Budget to permit analysis of the main factors that account for the difference in cost associated with the Proposed Delivery Model. The Reference Case is based on a schedule of areas that is consistent with delivering the level and mix of services required by the Health Service Plan. Consequently, the Reference Case will deliver essentially the same service outputs in terms of activity levels as the Proposed Delivery Model.

Nevertheless, there are some significant differences between the Reference Case and the Proposed Delivery Model in terms of service outcomes as a result of differences in facility standards and equipment levels, as detailed below. In addition, the cases differ in terms of their reliability of delivery because of differential provision for project risks.

It is emphasised that the Reference Case has not been developed as a viable delivery solution and it would not be able to be delivered because it fails to achieve certain statutory standards and does not reflect essential requirements for the GCUH, such as FF&E levels appropriate for the super-specialty services at the hospital.


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Reference Case

While the Announced Capital Cost Budget is not explicit as to the facility standards that have been assumed, the stated gross floor area of 144,000 m2 provides a reasonable guide. A Reference Case has been established involving a schedule of areas which assumes application of the revised Health Facility Guidelines and with reference to Townsville. The Reference Case would require a gross floor area of 148,476 m2 which is comparable to, but slightly higher than, the gross floor area assumed in the Announced Capital Cost Budget.

Comparison of the Reference Case to the Proposed Delivery Model capital cost estimate

The following table provides a comparison between the Reference Case and the Proposed Delivery Model capital cost estimate. It clearly identifies the items that have increased the Proposed Delivery Model capital cost above the escalated announced budget.

Table 1.12 Reconciliation of the Announced Capital Cost, Reference Case and Proposed Delivery Model

Items Amount $M

Adjustments$M

Comments

Announced Capital Budget (August 2006)

1,230.4 Capital budget announced in August 2006

Escalation from August 2006 to December 2007

84.0 Escalation adjustment to bring the Announced capital budget to the base date dollars (i.e. 10 months at 5.4%p.a. escalation rate)

Additional scope (December 2007) 170.0 Site acquisition, medical and dental school, additional infrastructure were added to the project scope

Escalation from December 2007 to 1 July 2008

64.6 Escalation adjustment to bring Announced Capital Budget and additional scope items to base date dollars (1 July 2008)

Updated Announced Capital Budget 1,549.0 In July 2008, the Government revised the capital cost budget to $1,549m in July 2008 dollars.

Escalation to commissioning (nominal) 319.54 Escalation of the updated announced budget with the same escalation rates and construction curve as the Proposed Delivery Model.

Total Escalated Announced Capital Budget (nominal)

1,868.5 The escalated announced budget is comparable with the Proposed delivery model

Reference Case Reference Case (nominal) 1,868.54 The Reference Case is based on a

floor space of approx. 148,000m2. The Reference Case includes the current AHFG and VHFG and a risk contingency


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Items Amount $M

Adjustments$M

Comments

Risk adjustment (nominal) 10.0 This is the difference between the reference case risk contingency and the Proposed Delivery Model risk adjustment. The risk adjustment in the Proposed Delivery Model has been based on a detailed risk assessment and is considered appropriate for this project taking into account the stage in the procurement process and the relative certainty/uncertainty about significant cost items.

Single rooms (nominal) 38.4 This is the additional cost to reference case budget in relation to the proportion of single beds at approximately 25% and the Proposed Delivery Model which has approximately 75%

Statutory requirements - additional space (nominal)

76.2 This is the difference between the reference case floor space for statutory requirements and the Proposed Delivery Model

ESD - plant and equipment (nominal) 82.0 This is the difference between the reference case budget with respect to ESD plant & equipment and the Proposed Delivery Model estimate which is targeting a 5 star rating

FF&E (nominal) 42.1 This is the difference between the reference case budget for FF&E and the Proposed Delivery Model which assumes a high level of speciality care

Adjusted Reference Case (nominal) 2,117.2 This is the Reference Case with the additional costs for the items that differ between the Reference Case and the Proposed Delivery Model

Proposed Delivery Model Proposed Delivery Model (nominal) 2,108.3 Source: Queensland Health, GCUH Architecture, DLA and KPMG Financial Model

Further information on the comparative analysis of the Reference Case and the Proposed Delivery Model and the reasons for the variation in costs are detailed in Section 8.

1.7.1 Qualitative assessment of the Proposed Delivery Model

The Queensland Government’s Project Assurance Framework requires that, in preparing a Business Case for Government consideration, agencies should use Cost Benefit Analysis (CBA), or Cost Effectiveness Analysis (CEA) if appropriate, to demonstrate that the project option recommended in the Business Case will optimise value for money in its use of resources.

CBA is used to assess the impact of a project on the economic welfare of the community. It involves the comprehensive identification and estimation of project costs and benefits, including external social and environmental impacts, to rank project options according to their net economic benefit. However, CBA is not generally used in the evaluation of hospital projects because of the difficulty of reliably valuing significant benefits of reduced morbidity and mortality in the community.


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CEA is used for projects where benefits can be identified but it is not possible to value them in monetary terms. Instead, benefits are expressed in terms of outcome statistics such as number of hospital beds. CEA is an appropriate methodology in principle for evaluation of the GCUH project and could be applied in assessing options for delivering 750 beds which, while an input measure, represent a convenient proxy for the predominant outcomes of the project. However, CEA has not been applied for the following reasons:

• In the development of the Project Definition Plan and related user consultation processes, Queensland Health has developed a single option, described in this Business Case as the Proposed Delivery Model, for progressing the project.

• As noted in Section 1.7, this business case has developed a Reference Case to reflect facility standards that may have been assumed in, or can reasonably be associated with, the Announced Capital Cost budget to permit analysis of the main factors that account for the difference in cost associated with the Proposed Delivery Model. The Reference Case was not developed as a viable delivery solution and it would not be able to be delivered because it fails to achieve certain statutory standards and does not reflect essential requirements for the GCUH.

• The factors that account for the differences between the Reference Case and the Proposed Delivery Model have been separately costed and evaluated in Chapter 8; evaluation of the Reference Case and Proposed Delivery Model in a CEA framework would not add any further information or analysis.

Based on the factors discussed above, the proposed approach for evaluating the Proposed Delivery Model is a qualitative assessment against the project objectives. This approach is undertaken in Section 9 of this report.

1.8 Public interest The Business Case presents the public interest assessments for the project in Section 10. It addresses the following topics:

• environmental, planning, cultural heritage and native title

• employee, employment and skills issues

• stakeholder considerations

• communication strategy

• accountability and transparency.

The following section provides a high level summary of the findings contained in Section 10.

1.8.1 Planning issues

In accordance with the requirements of the Integrated Planning Act 1997 (IPA), a Ministerial designation of land at Southport to facilitate the construction and operation of the proposed GCUH has been implemented (approved by the Health Minister on 1 August 2008). The proposed Ministerial Designation will facilitate the future development and growth of the site as the Gold Coast’s regional health precinct, primarily through the delivery of the GCUH. The effect of the designation is that the development of the site for the designated community infrastructure and service will be exempt from the local government’s planning scheme. However, the requirements of all State and Federal legislation must be met and consideration should be given to the provisions of the local planning scheme.


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1.8.2 Environmental issues

Existing site hydrology and flooding: Gold Coast City Council’s flood mapping indicates that the site is not vulnerable to flooding, however the site is listed as being susceptible to stormwater issues. It is recommended that a stormwater management plan is prepared for the development. Due care will be required during design of any new buildings to ensure the development area has adequate freeboard from the flow path and surface flows are adequately drained away from the building platform. Standard best practice controls are to be implemented during construction to minimise potential impacts on stormwater quality.

Topography and geotechnical characteristics: The site’s topography is not expected to cause any significant issues with the proposed hospital design and ultimate construction. However, it is recommended that consideration of dispersivity of site soils is established during site geotechnical investigations to ensure appropriate erosion and sediment control measures are implemented during construction and operation of the facility to protect nearby sensitive stormwater receptors.

Existing vegetation and habitats: Gold Coast City Council’s on-line mapping shows that no specific vegetation protection orders exist for the site. However, Council does provide ‘protected vegetation’ status to all vegetation on freehold land with a girth of 40 centimetres or more at a height of 1.3 metres. On-line mapping also indicates that the western side of Lot 188 is affected by ‘significant remnants’ within the Conservation Strategy overlay and the eastern side of Lot 458 appears to be affected by the ‘bushland mosaics’ designation within Council’s Conservation Strategy. Both allotments are mapped as containing existing 1994 remnant vegetation (and other natural systems).

After reviewing all options, including legislative and planning options, it was proposed that a regulation or series of regulations under s.109 of the State Development and Public Works Organisation Act 1971 (SDPWO Act) be made, directing the Coordinator-General to undertake works to facilitate the project (Works Regulation). Legal advice has been obtained which concluded that the Integrated Planning Act does not apply to exercise of the Coordinator-General’s powers under the SDPWO Act, therefore the use of Works Regulations will avoid potential difficulties associated with vegetation issues.

Site contamination and waste management: The sites are not listed on the Environmental Protection Agency’s Environmental Management Register or Contaminated Land Register.

Air and acoustic quality: There are no residential properties located immediately adjacent to the site. Some residences are located within 500 metres to the north, west and south of the proposed site. Consideration of potential amenity impacts, including nuisance from increased traffic, noise and lighting, on these nearby residences must be considered and managed during the design, construction and operational phases of the facility. Additional consideration should be given to the access and egress routes taken by emergency vehicles, including helicopter flight paths. Potential noise and air quality impacts on the site users from road traffic and other site activities should also be considered during design of the facility.

1.8.3 Cultural Heritage and Native Title Issues

The sites are not listed on the Queensland Heritage Register or the National Heritage Register databases, however a Memorial Tree is noted on the site survey within Lot 496.

Lot 496 on WD6012 and Lot 458 on WD6223 are held under freehold tenure and as such Native Title is unlikely to apply, however this has not been investigated. The greater Gold Coast


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region is subject to a claim by the Turrbal People (Federal Court file no. QUD6196/98; Tribunal no. QC98/26) and as such Native Title may still exist on Lot 497 on WD6012 with leasehold tenure and Lot 188 on WD6012 as a reserve.

Advice received from Queensland Health indicates that Native Title exists over Lot 188 on WD6012 and that a Native Title assessment is to be conducted shortly. The area of land affected by Native Title will either require an Indigenous Land Use Agreement or an Acquisition of Native Title by the State.

1.8.4 Key workforce and employment issues

The key work force issues for the proposed GCUH Project that need to be addressed as part of the development of the project include:

• Recruitment, retention and retraining: Ability to make key future appointments to clinical services at the GCUH facility. The proposed strategies to recruit, retrain clinicians, nurses and support staff include:

- The establishment of links with the existing and emerging university health programs to maximise consequent recruitment.

- Plan for student clinical education within overall staffing numbers so that local recruitment is enhanced.

- Establish links with local high schools and VET sector for recruitment of support clinical staff and support non-clinical staff.

These strategies will also need to recognise and focus on the additional workforce requirement due to the increased number of staff members entering the retirement age or close to retirement age.

• Potential inclusion of the facility management and maintenance into Managing Contractor Contract: Queensland Health is currently investigating the potential benefits of including the facility management and maintenance into the contract for the Managing Contractor. The benefits may include a more whole of life design.

The affected staff under this proposal primarily include the Building, Engineering and Maintenance (BEMS) Staff and Grounds / Gardens Staff.

Strategies for managing major organisational change and contracting out are clearly articulated in the Qld Public Health Sector Certified Agreement [No 6] 2005 [sections 4.1 and 6.2] and the Queensland Health Building Engineering and Maintenance Services Certified Agreement (No 3) 2006 [section 7.3]. Both agreements require early consultation with unions and detailed discussion prior to going to tender or entering into any binding legal agreement.

• Work practice changes: The scope of services for the new hospital and the ability to transition staff from acute to community contexts as population health initiatives and changes in models of care take effect will necessitate significant changes to current workforce practices. To effectively undertake the work practice changes, the Gold Coast Workforce Planning Committee will require buy in and input from clinician and support services planning groups. However, clinical groups have been affected by recent changes at the systemic level in Queensland Health and may be reluctant to engage in further change.


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Strategies to address these employment issues are being developed through a Strategic Workforce Planning Committee including representatives of GCHSD. In addition strategies are being developed at a corporate level to address consistent practices and processes affecting the major Hospital developments. These strategies will include direct negotiation with Unions at a whole of Queensland Health level to establish processes for local negotiation and development of change management strategies.

1.8.5 Employment issues associated with construction of the facility

A project of this magnitude will offer considerable opportunities for employment, either as direct employment during the construction phase of the project, or indirectly via the employment of those providing goods and services as inputs to the project. It has been estimated by the building consultant that during the construction phase of the Hospital, 2,200 to 3,000 full time equivalents will be required over three years.

1.8.6 Stakeholder issue management

Several stakeholder groups will be impacted by the proposed GCUH project and the broader precinct development. These groups and the respective project issues affecting them are discussed in Section 10.3 under the following headings:

• Health related stakeholder consideration: Consultation in relation to the health related issues has been undertaken by a number of means including Stakeholder Advisory Committee, ‘Lean Thinking’ initiatives, Service Planning Groups and Executive Service Planning Groups. The health related stakeholder considerations, issues and consultation is addressed in Section 10.3.1.

• Broader community stakeholder consideration: Consultation in relation to the precinct has been facilitated through the Precinct Master Planning. The main stakeholders affected and their issues are described in the Section 10.3.2.

1.8.7 Communication strategy

A Communication Strategy has been developed and was approved in October 2007 for the GCUH Project. The strategy provides the overarching strategic direction for communication relating to the development and construction stages of the GCUH. It will provide guidance towards branding, public relations, community engagement, and stakeholder relations activities. It is intended that the strategy provides communication support throughout the lifetime of the project stages, including master planning, schematic design, design development, tender, construction, practical completion and opening.

The Communication Strategy objectives and key messages are further detailed in Section 10.4.


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2 Background This section of the Business Case provides an overview of the proposed Project and the work undertaken to date in planning for the Gold Coast University Hospital Project (GCUH or the Hospital).

In particular this section provides information on the following issues:

• background information on the Project including summaries of the key decisions made by the Queensland Government in regard to the Project

• project objectives

• purpose and scope of the Business Case

• structure of the Business Case.

2.1 Project background The population of the Gold Coast makes it the sixth largest city in Australia and is currently experiencing rapid growth. This population growth, together with the Gold Coast’s ageing population profile, means the future demand for quality health care services will continue to increase.

As part of a detailed planning exercise by the Queensland Government to address the future health needs of the Gold Coast, it was determined that a new tertiary hospital be developed to complement other health services on the Gold Coast.

2.1.1 Project decisions

Prior to the development of this Business Case a series of decisions were made in relation to the Project including the following:

Queensland Government announces plans to build a new tertiary hospital

On 18 August 2006 the Queensland Government announced an election commitment to the development of a new tertiary hospital. The announcement stated that “a 750 bed Gold Coast University Hospital will be built adjacent to Griffith University by the end of 2012 – two years ahead of time”. The brief explained that a smaller (500 bed) hospital was originally planned for 2014 however growing pressure on existing staff and resources coupled with rapid growth had fast-tracked the Project.

The announcement described the co-location of the university with the tertiary hospital as creating an ideal environment for research and training of future doctors, nurses and allied health professionals. The service priorities were identified as cancer and cardiac services, neurosciences, trauma and neonatal intensive care.

The South East Queensland Infrastructure Plan and Program (SEQIPP) 2007-2026 discloses an investment of $1.23 billion (2006 dollars) for the GCUH.

In July 2008, the Government revised the capital cost budget for the Gold Coast University Hospital Project to $1.549 billion (July 2008 dollars).


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Proposed Site for the GCUH

In relation to identification of the preferred site of the Hospital, press articles quoted then-Premier Peter Beattie as saying “As is the normal process, detailed studies by the Office of Urban Management have found that while the original site [off Smith Street] was more than adequate for the Project, there is the potential to avoid spending more than an additional quarter of a billion dollars with this alternative site [Parklands Drive]". Mr Beattie was also reported as saying the new location would allow for more flexibility in how the Hospital campus grew, and deliver an improved flight path for emergency helicopters away from local residents7.

In response to whether the new preferred site would impact the 2012 delivery date, Health Minister Stephen Robertson was reported in the press as saying "Queensland Health and the Department of Infrastructure will begin consultation with Griffith University, Gold Coast City Council, the Salvation Army, the Church of Christ and the Parklands Trust. The Premier and I have assured Gold Coast MPs there will be no delay in the delivery of the Gold Coast University Hospital. It will be delivered by late 2012 as per our 2006 election commitment8.

The Procurement Model

The Cabinet Budget Review Committee in April 2007 determined that the current Business Case for the GCUH would not consider an option for delivery of the hospital as a Private Finance Initiative/Public Private Partnership. Queensland Health and the Department of Public Works endorsed the selection of the ‘Managing Contractor Guaranteed Construction Sum’ as the proposed procurement method for the Gold Coast University Hospital in April 2007. This decision was made after extensive consultation with Tier 1 (major) contractors given the current unprecedented level of construction activity in the building and civil infrastructure areas. The decision to procure based on a Managing Contractor methodology was primarily driven by the need to gain certainty of access to satisfactory construction resources (further advantages and disadvantages of this model is described in Section 5 and Appendix J). This method has been the primary method of procurement by Queensland Health over the past decade.

2.1.2 Health Service Plan

The GCUH Health Service Plan (GCUH HSP) – version 3.1 was finalised in January 2008 but will continue to be updated as further information becomes available. However, the general space and services proposed are not anticipated to change going forward.

The GCUH HSP was developed from the original Master Plan of Health Services prepared by the Gold Coast Health Service District (GCHSD) clinicians and health services managers in October 2005. This earlier plan critically evaluated the adequacy of the District’s services and facilities and made recommendations regarding future facility requirements.

The GCUH will replace the existing Gold Coast Hospital at Southport and is intended to take on the role of major tertiary referral hospital for the GCHSD and Northern New South Wales. The GCUH HSP describes the model of service and clinical relationships for each of the Hospital’s departments, and provides a detailed description of all clinical and clinical support services planned for the GCUH. The key tertiary and clinical support services include the following:

7 Source: Australian Associated Press, 22 August 2007 8 Source: Gold Coast Sun, 29 August 2007


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Tertiary services

It is proposed that GCUH will adopt the role of the primary tertiary referral hospital for GCHSD and northern New South Wales by providing a range of patient-centred acute inpatient services (including mental health) and the associated specialist ambulatory care services for the catchment population. This will be supported by commensurate clinical support and corporate support services.

GCUH will offer a public health care environment that:

• delivers health care services in the safest and most efficient manner by:

- clustering services to create critical mass and foster clinical collaboration and communication

- enhancing access to services by streamlining the patient flows

- optimising the available skilled workforce, and

- providing opportunities for staff development through continuous access to education and research

• provides a therapeutic setting for the delivery of health services by:

- adopting Evidence-Based Design (EBD) principles, and

- utilising the crime prevention through environmental design (CPTED) principles, and

• fosters transitional research in key health areas.

The new tertiary services will include:

• Cancer Services – including a cancer care centre providing care for patients needing access to haematology, oncology, radiation oncology, nuclear medicine and palliative care

• Cardiac Services – including pacemaker service, cardiac catheter service, ambulatory heart failure program, cardiac rehabilitation services and cardiac surgery

• Neurosciences Services – including neurosurgical services and stroke unit

• Neonatal services – including a tertiary neonatal intensive care service and a level 3 neonatal surgery

• Trauma Services – including a dedicated trauma service.

To support the full implementation of the tertiary services, the facility will develop advanced training roles in conjunction with the universities, advanced education sectors and professional bodies. The tertiary nature of the facility will enable graduates to gain the broadest range of skills and experience and enable them to complete the highest levels of training required in many clinical areas.


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The GCUH is able to maximise these training and development roles due to its physical proximity to Griffith University and the Knowledge Precinct, and to Bond University which is within close transit distance.

Another primary role of any tertiary medical institution is to support clinical research by virtue of the employment of the most highly specialised staff in each clinical field. This again will be supported by the proximity of Griffith University and Bond University.

Clinical support service

In order to provide the tertiary services a range of clinical support services are required including:

• medical imaging

• ward based pharmacy service

• pathology, including autologous bone marrow transplant service

• emergency department and intensive care / high dependency unit

• suitable amenities and retail space to support a 750 overnight bed teaching hospital.

2.1.3 Precinct site

The Hospital development is part of a 130 hectare site referred to as the “Gold Coast Hospital and Knowledge Precinct”. The Precinct is located on the western edge of Southport on the Gold Coast, approximately 4km west of the Southport CBD and 36km north of Tweed Heads. Figure 1 below shows the general precinct area, which currently contains a variety of uses including the Griffith University (Gold Coast campus), Parklands Showgrounds, community facilities, the Church of Christ, the Salvation Army, football clubs, residential development, school, parks and industrial uses.


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Figure 2.1 Gold Coast Hospital and Knowledge Precinct


2.1.4 Proposed hospital site

The proposed site for the Hospital will occupy approximately 18.1 hectares of the Precinct land, directly opposite the Griffith University site. The site is boarded by Parklands Drive and Olsen Avenue and is currently being acquired by Queensland Health with assistance from the Department of Infrastructure. An aerial photo of the site is shown below in figure 2.


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Figure 2.2 GCUH proposed site


Preferred site location

In 2007, the State identified the northern site (being the northern end of the Precinct) as the preferred site for the new hospital. The key features that support location of the GCUH on the northern site are:

• enhanced health service delivery through improved access and egress to the site, as indicated by DMR, through better accommodation from all directions with the Northern site providing better reliability

• better potential for expansion of GCUH over time

• more timely integration of road works with the opening of GCUH in 2012 and significant cost savings in excess of $260m in the supporting road infrastructure whilst providing improved access and better operability.

2.2 Project objectives In February 2007 Queensland Health facilitated a Value Management Workshop for the GCUH Project. The purpose of the workshop was to bring together the Project stakeholders, team members and advisors to build a shared understanding about the Project’s vision and to agree a set of Project objectives. The Project objectives developed at the workshop are as follows:


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Service delivery and care • create a patient-focussed health system that encourages innovative models of care

delivered in a major teaching hospital

• deliver operational efficiency, optimising the use of people and resources, capable of achieving health service planning targets and sustaining service levels into the future

• promote evidence-based design to create an environment that enhances patient safety, patient outcomes and clinical excellence

• ensure ability to function in a post-disaster environment

• enhance amenity for users of the site including consideration of car parking, retail, co-located private hospital.

People • support attraction and retention of well-trained, committed and motivated staff

Site access and egress • provide clear points of site access and egress ensuring the efficient movement of

public/staff, emergency and service vehicles in and around the site

• maximise integration of developing public transport infrastructure to the new Hospital

Future proof and flexible • encourage flexible design and infrastructure capable of adapting to new technologies

(clinical, information and operational) and emerging trends in clinical practice, models of care and changes in government policy, legislation and standards

Teaching and research • promote an active learning environment, providing appropriate facilities for teaching and

research within clinical areas, and between the GCUH and its key education and research partners

Stakeholder relationships • encourage a collaborative constructive relationship between the new Hospital and

stakeholders including education and research partners, local community, and communities of interest

• minimise impact and disruption to the surrounding community during construction

• ensure new Hospital is part of a network of services including “district-wide” service

Business continuity • achieve a successful relocation to the new Hospital with no interruption to the ongoing

delivery of services

Government commitment, policy and objectives • procure a new major teaching hospital which delivers value for money to the State, within

budget and other parameters as agreed by the State

• achieve State sustainability policies/objectives, including greenhouse gas and peak energy reduction, water conservation and waste minimisation


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• maximise benefits of collocation opportunities – with university, private hospital and other services.

2.3 Purpose of the Business Case This Business Case has been developed taking into consideration Queensland Health and Queensland Government guidelines for the preparation of Business Cases (e.g. “Value for Money Framework” and the Draft “Business Case Development Guidance Material – Achieving Value for Money in Public Infrastructure and Service Delivery”).

This Business Case has been written to assist the decision making process by providing further information in relation to key aspects of the proposed Gold Coast University Hospital (GCUH) Project. The aim of this Business Case is to provide an understanding of the reasonability of the option chosen to deliver the GCUH and the cost of the Project compared with budgeted funding. To meet this aim this Business Case:

• summarises the Proposed Delivery Model for the Gold Coast University Project as defined in the Project Definition Plan (PDP). The Proposed Delivery Model has been developed to achieve the clinical and support service requirements identified in the GCUH Health Service Plan.

• summarises the procurement method and procurement process going forward

• describes the Project site and outline the site issues that still need to be resolved

• describes the key elements of the Health Service Plan prepared for the GCUH and the interface between GCUH and provision of regional health services

• calculates the risk adjusted capital and operating costs estimates for the Proposed Delivery Model

• reconciles the capital cost estimate for the Proposed Delivery Model with the announced capital budget for the Project and Reference Case

• highlights the public interest assessment that has been completed for the Project including stakeholder analysis, employment issues and environmental and cultural heritage issues.

As only one option is being considered by Queensland Health it has not been possible to measure the ‘value for money’ of this option using a Cost Effectiveness Analysis (CEA), instead the option has been assessed based on benchmarking, a qualitative assessment against Project objectives, and a reconciliation to the announced budget for the hospital.

2.3.1 Refinement of the Business Case

This Business Case, together with the business cases for the proposed Sunshine Coast Hospital and Queensland Children’s Hospital, will be submitted for consideration by the State in September 2008. The intention of this joint submission approach is to ensure that the technical, financial and commercial considerations for the Projects are considered collectively for the three Projects. However, it is noted that the submission timeframe is in advance of detailed design work being undertaken for the GCUH and final costing and contract award. As a result, the definition of facilities, scope of services, Project costs and Project risks presented at this stage of the Business Case are preliminary only.


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2.4 Scope of the Business Case The primary focus of the Business Case is on the Proposed Delivery Model for the Gold Coast University Project as defined in the Project Definition Plan (PDP). In particular, the Business Case provides the following information:

• key features of the Health Service Plan for the GCUH and the Interim Demand Management Strategy (Section 3)

• proposed GCUH Project description including the site, services and facilities (Section 4)

• managing Contractor procurement method including definition of the key stages, indicative timetable and key commercial principles (Section 5)

• total Project outturn cost including escalation and risk adjustments (Section 6)

• affordability assessment including both capital and recurrent budget analysis (Section 7)

• comparison of the capital cost estimate for the Proposed Delivery Model with the announced capital cost for the Project (Section 8)

• evaluation of the Proposed Delivery Option against the Project objectives (Section 9)

• public interest assessment (Section 10).

The Business Case builds on the previous work already completed in relation to the Project. The Business Case has been prepared in conjunction with Queensland Health, Department of Public Works (Project Services), Treasury, Department of Infrastructure and Planning, Department of Premier and Cabinet, Davis Langdon Australia, Capital Insight, GCUH Architecture, Connell Wagner, SKM, S2F and KPMG.

2.4.1 Interrelated Projects

Although the focus of this Business Case is predominantly on the Proposed Delivery Model, there are a number of other interrelated Projects that will impact either the development of the GCUH and/or efficient operation of the facility. An overview of these inter-related Projects is provided in the following table:

Table 2.1 Overview of inter-related Projects



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Interim Demand Management Strategy (IDMS)

The IDMS proposes a range of integrated strategies that maximises capacity within the GCHSD in order to partially meet the growing local demand prior to the opening of the GCUH.

Queensland Health

Capital costs of $66.6m over the 4 year period

2007/08 – 2010/11 was considered as part of the 2008/09 budget process,

with $8.2m allocated in 2007/08 for Coomera

land purchase and $1.4m in 2008/09 for expansion

of the Emergency Department at Southport.

Surrounding road network upgrades

Smith Street and Olsen Avenue are the two major thoroughfares linking to the GCUH. Upgrades to these roads and to other roads that surround the GCUH site are proposed.


The estimated cost of the Surrounding Road

Network Upgrades is in the range of $215 million to $360 million (based on advice from Department

of Main Roads).

Rapid Transit Project

It proposed that the Gold Cost Rapid Transit (GCRT) system will provide a station servicing Griffith University and the GCUH. Construction of this station is included in the first stage of the GCRT Project which is scheduled to be completed by 2012, however the system will not become operational immediately. Queensland Transport will provide bus arrangements to service the hospital until the GCRT is operational.

Queensland Transport

The estimated capital cost of the Gold Coast

Rapid Transit system is $1.67 billion (as per

SEQIPP 2008-2026). This estimate relates to

the development of a rapid transit system

extending from Helensvale to

Coolangatta. However, the project is likely to be

delivered in several stages.

Car Parking facilities

It is proposed that a total of 3,000 car parking bays be constructed to cater for the needs of staff and visitors to the new Hospital. It is proposed that the 3,000 spaces will be provided in two separate car parks facilities.

Queensland Health

Private sector procurement. EOI phase

completed. RFP phase to commence soon.

Provision of Utilities to the site

Negotiations are currently underway with Energex for provision of a new zone substation, and with Gold Coast City Council (and Gold Coast Water) for water and waste services. These will be provided to the district and will not be costed to the GCUH Project.

Queensland Health, Energex, Gold Coast Water / Gold Coast City Council

To be determined

Source: Queensland Treasury, Department of Infrastructure and Planning and Queensland Health

While this Business Case does provide high-level information on each of these Projects, it does not inform the decision making process for these Projects. However, a CEOs Committee was established in January 2007 to coordinate the supportive infrastructure required for an


September 2008


effectively functioning new hospital. The CEOs Committee consists of the Director-Generals of the Departments of Health, Infrastructure & Planning, Main Roads, Public Works and Transport as well as the Under Treasurer of the Department of Treasury to ensure that the inter-linkages between the hospital construction, land acquisition and approvals, Precinct planning, road upgrades and transport requirements achieve a whole-of-government solution. Through monthly meetings of the CEOs Committee, the inter-related Projects are defined with indicative estimates and coordination issues discussed in order for the respective agencies to develop their proposals for submission to CBRC.


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3 Service needs definition

3.1 Introduction The GCUH Health Service Plan January 2007 (GCUH HSP) provides a detailed description of all clinical and clinical support services planned for the GCUH. The purpose of this section is to reference the key elements of the GCUH HSP including the demand for new and expanded tertiary health services in the Gold Coast Health Service District (GCHSD or the District), and to describe the services proposed for the GCUH. A brief description of the existing health services available in the GCHSD and future uses for these facilities post commissioning of the GCUH is also presented.

3.2 Existing health services 3.2.1 Public hospital facilities

The GCHSD currently provides public hospital services from five sites:

• Gold Coast Hospital Southport Campus (Southport) – a major regional referral hospital which provides a range of specialist and sub-specialist services

• Robina Hospital (Robina) – provides general medical, surgical, rehabilitation, sub-acute and mental health services

• Gold Coast Surgery Centre – the first stand alone Elective Surgery Facility in Queensland Health. Gold Coast Health Service District has taken over the lease of the Allamanda Surgicentre opposite the Gold Coast Hospital Southport Campus to provide day only activity as an interim measure until 2014. After 2014, it is planned to move services to GCUH

• Gold Coast Health Service District’s twenty bed palliative care unit, located on Level 2 of the Pacific Private Building, opposite the Gold Coast Hospital Southport Campus. This service will relocate to the expanded Robina Hospital in 2010/11

• new Carrara Health Centre which provides subacute care to the Gold Coast community. When fully commissioned this 63 bed facility will provide quality patient rehabilitation and aged services (recurrent funding is only available in 2008/09). These beds are required beyond the opening of GCUH to meet District Projected bed demand.

Available bed numbers across these five public hospitals is presented in the following table. There are no beds associated with the Gold Coast Surgery Centre. Bed occupancy across the District has seasonal peaks and troughs and in the general wards ranged from 96% on average in July to 86% on average in September 2007/08.

Table 3.1 Available overnight beds in public hospitals within GCHSD, as at June 2008

Hospital Overnight beds Mental Health Total beds Southport (including palliative care) 428 44 472 Robina 114 96* 210 Carrara 15 0 15 Total 557 140 697 Source: GCHSD Key Activity Report FY 2008 *Note: Bed alternates for same day surgery, oncology day unit, renal dialysis, cardiac catheter laboratory, transit lounge etc have not been included. 43 non acute mental health beds have been included in the bed numbers but should be considered separately.


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The following hospital services are currently provided at the five hospital sites.

Table 3.2 Existing services at Southport, Robina and Carrara

Hospital services Southport (Including Surgicentre and Pacific Private)

• Medical and Surgical Services • Emergency Medicine • Intensive Care • General Medicine • Cardiology • Nephology (including renal dialysis) • Rehabilitation • Geriatrics • Oncology • Haematology • Neurology • Endocrinology • Gastroenterology • Respiratory • Infectious Diseases • Paediatrics

• General Surgery • Urology • ENT • Ophthalmology • Orthopaedics • Neurosurgery • Vascular Surgery • Plastics Surgery • Paediatric Surgery • Obstetrics • Gynaecology • Palliative Care • Psychiatry • Anaesthetics • Medical Education

Carrara • Subacute Rehabilitation • Subacute Aged Care Robina • Chemotherapy/Oncology Day Unit

• Intensive Care / Coronary Care • Medical/Surgical • Mental Health Services • Outpatients Department • Palliative Care

• Perioperative Services • Rehabilitation Services • Renal Dialysis • Gynaecology • Child Health

Source: Queensland Health website

The Southport campus was opened in the 1960s. Since this time the site has been heavily developed. However, many of its clinical and clinical support services have now reached capacity, and significant accommodation shortages are impacting its ability to meet current and growing service demands. This has necessitated the expansion of services within the Southport Precinct to encompass leases in Private facilities and the use of Carrara for patients who require less supportive infrastructure in provision of their care.

The Robina campus recently underwent a $40 million major refurbishment incorporating an Emergency Department, Intensive Care Unit and a new Renal Unit. Upgrades to support services including pharmacy, medical imaging, medical records, pathology and allied health were also part of the Project. A further upgrade of Robina Hospital to be completed in 2010 will see the facility expanded as a major secondary Hospital which will include a total of 364 overnight beds.


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In 2007/08 GCHSD hospitals (Robina and Southport) provided care for 69,846 admissions. Of all of the admissions to the District’s public hospitals, 88% of these hospital admissions were for GCHSD residents. The remaining 12% of admissions were for other Queenslanders (7.2%) and non Queensland residents (4.9%). From previous studies, GCHSD residents primarily access services outside the District for tertiary level services that are currently not available in the public sector on the Gold Coast including cardiac surgery, radiation oncology, trauma services and neonatal intensive care.

Table 3.3 All admissions by campus from 1/7/2007 - 30/6/2008

Admissions by campus Robina Southport Total % of total

admissions GCH residents 16,032 45,422 61,454 88.0%

Other QLD Districts - residents 1,217 3,786 5,003 7.2%

Non QLD residents 548 2,841 3,389 4.9%

Total admissions 17,797 52,049 69,846 100.0% Source: Queensland Health Data is split by the admissions residential area.

On 1 September 2008, the Area/District structure within Queensland Health was significantly reformed. A fundamental element of the reform process was the redistribution of Area Health Service functions to Districts and Queensland Health Corporate Office. Areas including the Southern Area Health Service have been replaced by a flatter District structure. The numbers of Districts have been reduced from 20 to 15. The new structure will allow District CEOs to report directly to the Director-General, improving communication channels and responsiveness and allowing greater District autonomy in boosting performance standards and accountability.

3.2.2 Community health services

The District is currently developing a Community Health Services Plan to determine the extent of community services that the GCUH will require to function at the planned acuity level and the additional capital and recurrent funding required to support such a plan. The Plan will describe District services that are primarily provided throughout the GCHSD from three main locations at Palm Beach, Bundall and Helensvale.

Historically there has not been significant investment in community health services. As a consequence, these services have a relatively small critical mass and limited potential to make a significant impact on hospital avoidance (post acute care and secondary intervention) without a future commitment to additional services.

As part of the 2006 election commitments, capital funding has been allocated for a Health Precinct to be located at Robina which is due for completion in late 2010 (the first phase of the Robina Health Precinct does not fully meet the Health Service Plan for Robina Precinct requirements. No funds have been identified for Stage 2 development). Additional Health Precincts may be developed in other locations such as Southport and Coomera, and existing community health centres at Palm Beach and Nerang may be expanded or refurbished. $8.2 million was allocated in the 2007/08 budget for acquisition of land at Coomera for a future Health Precinct.


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3.2.3 Other health related services

Other health related services available in the Gold Coast region include five private hospitals, the Queensland Ambulance Service, non-government home and community care providers (such as Blue Care) and residential aged care facilities.

3.3 Demand for health services 3.3.1 Demographic profile

The demand for health services is driven by broader population trends, particularly growth and changes in age profile. The main source of population growth on the Gold Coast is attributed to migration from other parts of Australia which in turn influences the age structure and economic base of the GCHSD. Population growth continues to place pressure on the GCHSD to provide quality health services to a growing demand base.

Gold Coast population and age profile

Over the next two decades to 2026 the Gold Coast region is projected to experience population growth at an average annual rate of 2.4%9 – one of the fastest growing population areas in Queensland. Its estimated resident population as at 2006 was 507,439 and is projected to reach 634,03510 by 2016, representing an increase of 25%.

This level of population growth is estimated to significantly impact Gold Coast public hospital admissions. Between the period 2004/05 and 2016, day only activity is expected to increase by 135%, and overnight activity is expected to increase by 74% over the same period11.

In addition to a rapidly growing population, the age profile of the GCHDS places a high demand on health services. In 2006, the District’s proportion of people aged 65 and over was 13.7%, compared to 12% for the State, and is projected to increase to 19.6% over the next two decades. The median age of the Gold Coast by 2026 is projected to be 41 years, consistent with the Queensland average12.

The correlation between social disadvantage and poorer health status requiring higher proportions of health services is well documented. In relation to the Gold Coast, it has a level of social disadvantage and disability relatively equal to Queensland as a whole. There are pockets of wealth across the Gold Coast interspersed with areas of significant social disadvantage. Compared to the rest of Queensland, there are significantly less people in the most socioeconomic disadvantaged quintile (7.3% of GCSHD compared to 20% for Queensland) and in the most advantaged quintile (15.3% compared to 20% of Queensland)13.

Transient population

The Gold Coast City Council advises that at any one time there are more than 50,000 people holidaying in the Gold Coast. This number swells to over 100,000 in the Christmas period. Many

9 Source: Planning Information and Forecasting Unit, Department of Local Government, Planning, Sport and Recreation, August 2007. 10 Source: Planning Information and Forecasting Unit, Department of Local Government, Planning, Sport and Recreation, August 2007 11 Source: GCHSD Health Service Plan February 2007 12 Source: Planning Information and Forecasting Unit, Department of Local Government, Planning, Sport and Recreation, August 2007 13 Source: GCHSD Health Service Plan February 2007


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of these people seek emergency and other health services from the GCHSD whilst holidaying. This transient population increase is not included in population projections.

Tertiary flows

Demand for health services at public hospitals is also likely to increase due to population growth in areas surrounding the GCHSD. A proportion of patients from growth areas such as the Tweed Shire and areas beyond Coomera requiring tertiary services are likely to be referred to public hospitals in the GCHSD.

Flows from Queensland to New South Wales

The flow of residents from the GCHSD catchment area to the far north coast hospitals in NSW for acute inpatient health services has increased from 5,167 in 2003/04 to 6,716 in 2005/06, which represents a 30% increase in activity over the three years. Some of the key areas of patient flows from Queensland are for non-specialty medicine and surgical treatments including cardiology and orthopaedics. Other services provided include gynaecology, respiratory medicine, gastroenterology, with the biggest inpatient inflow being for obstetrics.

Flows from New South Wales to Queensland

In 2004-05 there were 4,765 separations in Queensland public hospitals for residents of the northern NSW area. Of these inflows 1,277 were to Gold Coast hospitals and most of the remainder 3,488, were to Brisbane metropolitan hospitals (Prince Charles, Royal Brisbane and Women’s, Princess Alexandra, Royal Brisbane, Royal Children’s, Mater Health Services). While many of the inflows to Brisbane metropolitan hospitals are for tertiary services, for example Neurosurgery and Cardiothoracic Surgery, there are substantial flows to these hospitals for district level services such as General Surgery and Medicine, Oncology, Haematology and Respiratory Medicine.

3.3.2 Other demand factors

Along with population growth factors, the following factors are likely to impact on the demand for health services:

• improvements in medicine: Breakthroughs in treatments and the introduction of new medical and surgical procedures into the profession will lead to an increase in demand for such services.

• technology changes: Ongoing technology changes, for example medical imaging equipment improvements, provide a wider and better service offering than previously available to the public.

• other: Changing disease profiles and incidence rates are likely to impact the demand for health services.

• increase in aged population in the 75 years plus category

• impact of increased range and complexity of tertiary services

• lack of private sector growth in service capacity in line with population growth and current service share.

3.3.3 Health service needs

The main health problems facing the GCHSD population relate to chronic disease. Leading causes of death and illness are coronary heart disease, stroke, chronic obstructive pulmonary


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disease, depression and lung cancer. Among the older population, this list is extended to include Alzheimer and other dementias, diabetes and colorectal cancer.

The major impacts of growth in demand for overnight beds relates to sub-acute care (rehabilitation, geriatrics and palliative care), orthopaedics, cardiology and acute psychiatry. For day only care, the major impacts relate to renal dialysis, diagnostic cardiology, endoscopy, chemotherapy and other day surgery.

In addition to the GCHSD addressing demand for these types of health problems, the Tertiary Services Plan October 2004 for GCHSD identifies the need to develop a range of much needed tertiary services and non-clinical services to support the development of super-specialist services.

3.4 Health services plan The future model of service developed by the GCHSD addresses the growth predicted for the Gold Coast and surrounding areas. The model proposes:

• the strengthening of community based health services through the development of a range of Health Precincts and Community Centres across the Gold Coast. Funding sources are in large part yet to be identified. The 2008/09 budget allocated $900,000 for Community Based Rehabilitation and the Robina Health Precinct Stage 1 has received capital funding to relocate existing services

• a growth in general hospital based services via expanding the number of available public hospital beds

• establishing a range of super speciality services at the GCUH to provide improved access to these types of services to the GCHSD residents. The proposed super speciality services are Emergency services, Maternity services, Haematological malignancy and Medical Oncology.

The GCUH HSP finalised in January 2008, provides a comprehensive documentation of the current and proposed services, models of care and clinical relationships for the new GCUH. This plan will continue to be updated as further information becomes available such as state-wide planning documents currently under development which may impact on the GCUH service delivery. Accordingly the GCUH HSP will be continually reviewed to ensure its on-going consistency with state-wide directions. However, it is anticipated that the general space and services proposed in the HSP will not change going forward.

This section presents an overview of the new tertiary and expanded services of significance that are proposed for the new GCUH. A brief description of the associated clinical support services is also presented. A detailed analysis of all services can be found in the GCUH Health Service Plan January 2008.

3.4.1 Proposed role of Gold Coast University Hospital

The GCUH is intended to take on the role of tertiary referral hospital for the GCHSD and Northern New South Wales. Broadly, the GCUH will provide a range of acute inpatient services (including mental health) and specialist ambulatory care services, 24 hour emergency and trauma service and the clinical support services required to support these. Details of the new and expanded services are discussed further in section 3.4.3.


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To undertake this role, both the capacity and the level of specialist services will be required to increase, with a number of tertiary referral services required to be established. Additional clinical and support staff will be required to create viable and sustainable services.

The District has planned services on the basis of an integrated network of hospital and community locations. The GCUH service has been predicated on the availability of the Community Health Precincts to support a significant volume of ambulatory activity offsite. This was on the basis that these services can be delivered in the community with a relatively lower infrastructure cost. Without the development of the Precincts, the long term implications for the GCUH are that these services will be required to be located on site (as while ambulatory, they are essential to care delivery), resulting in a future loss of capacity.

The following table summarises the proposed movements of services between facilities in the District.

Table 3.4 GCUH Proposed bed profile

Year Description 2010/11 Palliative Care services move from Pacific Private Hospital to Robina Hospital,

increasing bed numbers to 364. 2011/12 No changes. 2012/13 Most services at Gold Coast Hospital (Southport) transfer to Gold Coast University

Hospital, increasing bed numbers to 624. Carrara Facility remains, but currently does not have recurrent funding from 2009/10.

2013/14 Gold Coast University Hospital bed numbers increase to 683, 2014/15 Gold Coast Surgery Centre services move to Gold Coast University Hospital, increasing

bed numbers to 716. 2015/16 Gold Coast University Hospital bed numbers increase to 750. Source: Queensland Health Notes: (1) Renal dialysis, ATODS and District Executive Services do not transfer to GCUH in 2012/13. The locations of these services are yet to be determined, but could potentially include the Southport Health Precinct and existing offices east of Little High Street, Southport. (2) The lease arrangement for the Gold Coast Surgery Centre expires in 2014, but has the option of 2 x 2 year extensions.

3.4.2 Proposed Delivery Model

The Proposed Delivery Model has been developed to meet the requirements of the GCUH HSP. This section outlines the bed profile and services to be provided by the Proposed Delivery Model.

Proposed bed profile

The GCUH will absorb the present role of Southport as the major referral hospital and provider for acute care services for the GCHSD. The announcement by the Queensland Government for the GCUH to provide 750 overnight beds represents a significant increase from existing bed numbers at Southport. The proposed bed profile is presented in the following table.

Table 3.5 GCUH Proposed bed profile


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Unit No. of overnight beds

No. of same day beds

No. of alternative beds

Generic inpatient unit: Medical inpatient beds 180 - - Surgical inpatient beds 220 - - Division of medicine: Inpatient cancer unit # 56 - Emergency medicine short stay observation unit

20 - -

Day oncology/haematology - - 29 Cardiac Catheter Labs - - 18 Ambulatory services - 14 20 Others - - 30 Division of surgery and critical care: Intensive care / High Dependency Unit 50 - - Interventional suite, same day - 40 - Division of family, women and children: Obstetric services 48 10 - Neonatal intensive care 44 - - Paediatric services 32 - - OPD and ambulatory services - 10 - Division of mental health and ATODS* Adult inpatient unit 72 - - Day therapy unit - - - Division of community, allied health, rehabilitation and aged services: Acute rehabilitation 28 - - Total No. of beds 750 74 97 Source: Queensland Health Notes: # incl. palliative care 6 beds * Alcohol, Tobacco and Other Drugs Service (ATODS). See Appendix H for updated beds / treatment places schedule

3.4.3 Clinical service requirements

The proposed development of tertiary services at the GCUH is based on the projected population growth for the GCHSD and related super-speciality services required for such a population. There would be a phased introduction of services with service demands and workforce availability dictating the timing of introduction of services. The new tertiary and expanded services include:

• Cancer Services

• Cardiac Services

• Neurosciences Services

• Neonatal Services


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• Trauma Services.

In order for these services to be developed to the proposed level, a range of clinical support services improvements will also be required.

An overview of each of the services listed above is described further in the following sections. A more detailed analysis of all clinical and non-clinical support services is contained in the GCUH HSP.

3.4.3.1 Cancer services

Current services

The GCHDS Cancer Service runs a large and growing ambulatory treatment program as well as managing acute inpatients. The Southport campus currently provides cancer screening, early detection, diagnosis, treatment, palliative and management services. It is a high growth service with increasing demand from initial access through to follow up post treatment.

Cancer services at Southport are severely constrained by lack of space with limited capacity to expand inpatient beds (currently 18). There are also problems in relation to access to outpatient clinics, office space and facilities for multidisciplinary case conferences and related meetings.

Other service issues include: lack of multidisciplinary care, difficultly in accessing medical imaging services, delays in receiving test results, lack of adolescent cancer services, and transport problems arising from some medical oncology and radiotherapy services being provided at different hospitals.

Proposed new services

To support the new model of cancer care proposed for the GCHSD, a comprehensive Cancer Centre will be established at the GCUH. The provision of Radiation Oncology which is not currently provided publicly in the Gold Coast Health Service District will enable the District to provide an integrated comprehensive Cancer Centre approach to the treatment of cancer for patients of the District and far north New South Wales. The new PET scanner will also enable more highly specialised diagnostic and treatment services. The service will expand to create capacity and develop a service which is conducive to recruitment and retention which has not been possible at the current location. The Cancer Centre will provide a more specialist multi-disciplinary service to manage common cancers as well as rare cancers and specialised interventions. Services to be located in the Cancer Centre will include: super-specialist services, an integrated haematology/oncology inpatient unit, radiotherapy suite, palliative care services, satellite pharmacy and conferencing and teaching facilities. A total of 56 overnight beds and 29 bed alternatives will be provided.

A range of other cancer related services accessed outside the Cancer Centre will also be provided.

3.4.3.2 Cardiac services

Current services

Cardiac care operates as a level 3 sub-speciality service at Southport. In addition to providing a District service, referrals are received from cardiac patients residing in Northern NSW. The service has the highest projected growth rate within the division of medicine and is a high bed-


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day consuming specialty. There is currently a lack of acute cardiac inpatient beds and lack of ambulatory programs including cardiac rehabilitation and heart failure management. Currently the Southport and Robina campuses have no cardiac surgery capacity, with all public patients referred to Brisbane for treatment.


The future cardiac service will offer super-speciality services in acute cardiac management and cardiac intervention at a zonal level and will accept referrals from northern NSW. The GCUH campus will offer:

• expanded inpatient cardiology services including increased interventional facilities and cardiac beds

• Chest Pain Assessment unit (CPA) – as part of the Medical Assessment Unit co-located with the emergency department and managed by the cardiology department, the CPA will rapidly assess and treat potential cardiac patients presenting to the ED

• expanded pacemaker services will be expanded to meet population demand

• enhanced ambulatory services – including a heart failure management program, cardiac rehabilitation services and outpatient clinics.

It is proposed that the GCUH cardiothoracic surgery department will provide a comprehensive adult service to the GCHSD and will be accredited for advanced training with the Royal Australasian College of Surgeons.

The new cardiothoracic surgery service will establish:

• dedicated beds for the treatment of cardiothoracic and thoracic surgical patients, staffed by a dedicated multi-disciplinary team

• protocols for the management of cardiothoracic patients.

3.4.3.3 Neonatal intensive care

Current services

The Special Care Nursery (SCN) at Southport provides specialist medical and nursing care for premature and sick neonates, however, neonatal intensive care services are not available. The SCN is a 20-bed unit, equipped to provide intensive respiratory, circulatory support and stabilise neonates prior to retrieval to a tertiary centre (usually Brisbane). There are demands on the capacity of the two tertiary neonatal services in South East Queensland and the nursery at the Mater Mother’s Hospital is frequently closed for transfers or retrievals.

Proposed services

The GCHSD has an annual birth rate (public and private) of 5,500 births per year and current estimates of births in Northern NSW are 5,000 per year. To service the demand of the local population as well as acting as a tertiary referral centre for Northern NSW, it is proposed to establish a level 3 neonatal intensive care nursery at the new GCUH, including 10 neonatal intensive care unit beds and 34 special care nursery inpatient beds.

The Neonatal Intensive Care Service has been planned as an integral part of the Statewide Plan for neonatal services, in line with accepted benchmarks. As a part of the Statewide


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network, the Gold Coast Service will serve the local catchment including northern New South Wales and work in close cooperation with the Brisbane tertiary centres. The Gold Coast as such may provide overflow capacity when Brisbane and or Townsville have peak periods.

3.4.3.4 Neurosciences


The new neuroscience service will provide a full range of services for the management of neurosurgical and neurological conditions.

The GCUH will provide a combined neurology/acute stroke/ rehabilitation inpatient unit for the management of patients with strokes and complicated or acute neurological disorders. The combined unit will provide flexibility in accommodating changes in demand for stroke and neurology patient beds. Acute stroke and neurology rehabilitation services will also be provided.

3.4.3.5 Trauma services


The new Trauma Service for the District and Northern New South Wales will form an integral part of the Statewide Plan for Trauma services, in line with accepted benchmarks. As a part of the Statewide network, the Gold Coast Service will serve the local catchment including northern New South Wales and work in close cooperation with the Brisbane tertiary centres.

The helipad is an important element of supportive infrastructure to enable high level trauma care. There will also be 10 dedicated high dependency beds collocated with neurosurgery to ensure adequate care.

3.4.4 Clinical support services

In order for the GCUH to provide the new tertiary and expanded services, a range of clinical support service improvements will also be required. A selection of key support services are described in the following sections.

3.4.4.1 Medical Imaging services Current services

The Medical Imaging Department (MID) at Southport offers a full range of diagnostic and interventional services. The department has a good range of modern equipment, but has significant problems with floor space, excessive demand and staffing, and critical services such as CT and MRI services suffer from significant waiting times. In addition, the MID does not have a RIS or PACS system which has adverse effects on workflow, accuracy, patient safety and cost-effectiveness.

Proposed new services To enable timely access to emergency, diagnostic and interventional radiography services, it is proposed that the GCUH medical imaging services be expanded particularly through: additional general radiology rooms and interventional fluoroscopy units; an increase in MRI units and CT scanners; additional nuclear medicine units; a PET/CT; and a RIS/PACS system to support a diagnostic imaging service throughout the District.


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3.4.4.2 Teaching and Research

The GCUH will be the principal teaching hospital of the Griffith University and Bond University medical schools. The collocation of the Hospital and Griffith University provides a unique opportunity to build a contemporary teaching hospital where the public is able to benefit from synergies between providing clinical services, teaching and research. To ensure the continued close integration of teaching activities between the Hospital and the Griffith University, the University’s existing Medical and Dental School will be relocated from its present location at Southport to University land opposite the GCUH.

The model ensures that teaching of health care professionals, both undergraduate and postgraduate levels, is enmeshed within the Hospital service setting. Educational facilities will be embedded in clinical service areas, together with proximate learning facilities that support staff and students such as library, auditoriums, seminar rooms and collocated learning and research hubs.

In addition, research facilities including clinical trials space and translational research involving patient and staff participation linked to clinical service areas is planned. Bench research is to be collocated in university buildings.

3.4.4.3 Other clinical support services

Other clinical support services to be expanded include the following:

• The emergency services at the new GCUH will operate as a major tertiary Emergency Department (ED) and provide State wide multi-trauma services. It is expected to form a central transfer/referral point for tertiary referrals south of Brisbane and from Northern New South Wales.

The ED services will be enhanced through additional resuscitation and treatment bays, special care and short stay beds, and fast-track spaces. A new helipad for trauma and other retrievals and transfer will also be provided.

• Expanded pharmacy services will be established to cater for the introduction of super-speciality services. Emergency department based pharmacy reviews will be introduced, together with increased involvement in cancer services and research activities and automation at ward level to improve medication safety.

• The intensive care unit and high dependency unit will have an expanded bed capacity to cope with increases in demand for critical services.

• A broad range of corporate support services (including administration services, library services and conference facilities and so on), staff and public amenities and retail services to support the new 750-bed hospital will also be provided.

3.5 Planned GCUH utilisation rates The GCUH is not expected to be fully operational from December 2012. This is due to a range of resource constraints such as the availability of appropriately skilled and experienced clinical and support staff, as well as the time that is needed to develop super speciality services not previously provided by the GCHSD. To address the resourcing and timing issues, a transition strategy is to be implemented whereby a phased or ‘ramp up’ process will be applied to gradually bring the facility up to 100% operational capability. In the years prior to the GCUH


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becoming operational, an Interim Demand Strategy will also be adopted (as outlined in section 3.6 below).

Queensland Health is in the process of developing detailed transition plans for the GCUH, however this information is unlikely to be completed prior to submission of this Business Case. An indicative ramp-up profile based on a draft transition strategy is shown in the following table.

Table 3.6 GCUH utilisation profile

2012/13

Year 1 2013/14

Year 2 2014/15

Year 3 2015/16

Year 4 % beds operational

83% 91% 95% 100%

No. of overnight beds operational 624 683 716 750

Services not at full bed capacity

• Cancer (low acuity)

• Cancer (high acuity)

• Obstetrics • Neonatal IC • ICU / HDU • Gastroenterolo

gy and Gastrointestinal Surgery

• Orthopaedic/ Trauma Surgery

• General Surgery

• Cardiothoracic Surgery

• Vascular Surgery

• Cancer (low acuity)


• Neonatal IC • ICU / HDU • Gastroenterolo



• General Surgery

• Cardiothoracic Surgery

• Vascular Surgery


• Neonatal IC • ICU / HDU • Gastroenterolo



-

Source: Queensland Health, Draft bed transition strategy 2008 to 2016_v Aug 2008

A more detailed Transition Strategy will be completed in early 2009 after release of updated activity projections and more fully developed workforce plans.

3.6 Interim demand management strategy The Gold Coast Health Service District Interim Demand Management Strategy 2008-2012 (IDMS) proposes a range of integrated strategies that maximises capacity within the GCHSD in order to partially meet the growing local demand prior to the opening of the GCUH. This involves creating capacity across the Continuum of Care, including a range of Community and Hospital Based Programs.

The Gold Coast Health Service District Interim Demand Management Strategy 2008-2012 is a dynamic document which is currently undergoing review in terms of contemporary relevance and trend. Ongoing review will be a feature of the strategy.


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A Concept Brief for Funding Proposal in relation to the IDMS has been prepared by the GCHSD and submitted to CBRC for funding approval in 2008 where service delivery gaps remain. The IDMS funding requirements and deliverables from the funding submission 2008/09 are attached as Appendix L.

3.6.1 Proposed strategies

Accommodation pressures and service growth

To accommodate demand in the medium to long term, Robina Redevelopment, Robina Health Precinct and the GCUH are proposed for development. Additionally, the purchase of land at Coomera has been finalised to facilitate the development of health facilities. This will assist in the management of the long term demand for community and hospital based services in the GCHSD. In the short to medium term, a solution is required to support the maintenance of services to meet existing demand.

All key clinical and support services are projected to be under significant pressure and each service requires solutions that address community, ambulatory and inpatient aspects of care. The IDMS addresses these issues by creating packaged strategies relocating a number of non clinical services and creating additional clinical capacity at the Gold Coast Hospital (Southport). Each Division has developed a highly prioritised list of strategies that involve a combination of growth in community services, decanting of non-clinical services from clinical space and associated capital refurbishment and utilisation of private sector capacity.

Proposed strategies

Proposed strategies, in order of priority involve:

• expansion and redesign of the Gold Coast Hospital (Southport) emergency department

• opening of an additional three intensive care beds at Gold Coast Hospital (Southport)

• extended surgical and associated support services including extended theatre session hours at Southport, increased utilisation of surgical capacity at Robina, and a stand alone day surgery facility

• specialist and private practice outpatient service development package including reconfiguration of specialist outpatients to improve work conditions, leasing of additional consulting rooms and leasing of alternative space for existing administration offices

• community and ambulatory services to support the demand management strategy by focussing on chronic disease management, rehabilitation, hospital avoidance and diversionary programs.

• expanded community medical packages and associated support services for the District.

3.6.2 Cost implications

Preliminary estimates of the capital and recurrent cost implications of the IDMS are presented in the following table. Budget priorities for the current financial year are currently being finalised.

Table 3.7 IDMS preliminary cost implications

Cost component 2008/09

$m 2009/10

$m 2010/11

$m 2011/12

$m Controlled Equity (Capital) 9.6 7.1 10.4 0


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Cost component 2008/09

$m 2009/10

$m 2010/11

$m 2011/12

$m Controlled Appropriation (Operating Revenue) 41.7 77.8 80.6 83.8 Source: Queensland Health (Funding Submission) Note: 2008/09 includes $8.15m required in 2007/08 for Cara Land purchase

3.7 Future use of existing health services The proposed longer-term service configuration for the GCHSD focuses most tertiary level services at the GCUH, with inpatient network linkages to Robina and other public hospitals (e.g. Tweed Hospital) and surrounding private hospital facilities.

3.7.1 Southport campus

This Business Case has been developed on the assumption that the new GCUH will fully absorb the current operations of the Gold Coast Hospital Southport campus west of Little High St (i.e. hospital based services). The Southport site will not operate as a major hospital post commissioning of the GCUH, however some community health facilities may be provided on the site interim to their placement in the proposed Southport Health Precinct. The future of the Southport site will be subject to an economic and functionality assessment. This assessment will identify options for future use and disposal. It anticipated that this assessment will be completed late in 2008.

The timing for the availability of the site will be dependent on the relocation into the proposed Southport Health Precinct of the community service particularly Renal services that currently occupy the site.

The Southport Hospital site East of Little High St, will continue to be utilised for District Executive Services post commissioning of the GCUH.

3.7.2 Robina Hospital

The inpatient role of Robina is to complement and extend the specialist acute and tertiary role of the GCUH. Following planned upgrades for an additional 180 beds by 2009, Robina will function as a 364 bed major hospital.

3.7.3 Other community /care centres

The Gold Coast Health Service District (GCHSD) is developing a plan for Community Based Services in 2008, for the next five years and more broad strategies for the next 10 years.

It is intended that the GCHSD community based services will be physically located in major precincts at Robina, Southport and in the longer term Coomera, and the related satellite community health centres of Palm Beach, Nerang (Early Years Centre), and Helensvale (until Coomera is commissioned). The long term role of the Bundall Community Health Services relates to the ability for the future Precincts to accommodate administrative functions, existing clinical functions and enable service growth to meet population demand. Priority in the Precincts will be given to clinical service provision and Bundall has been identified as the centralised location for administrative functions should the Precincts not be able to accommodate these roles in addition to existing and new clinical roles.

These services will be aligned primarily to Robina Hospital or Gold Coast University Hospital as well as the needs of the catchment populations.


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The models of care planned into the new GCUH and the Robina Hospitals expansions are predicated on the development of those community based Health Precincts.

There is a Government commitment of $26.1M for the Robina Health Precinct which is included in the South East Queensland Infrastructure Plan and Program. This precinct is anticipated to be commissioned in 2010.

Currently there is no capital funding commitment to the proposed Health Precinct expansion program for the GCHSD.

Carrara health facility

The District acquired a residential aged care facility in November 2007, which has the capacity to provide approximately 63 additional sub acute bed capacity. The facility will progressively open during 2008/09.

3.7.4 Integration with State wide health service planning

Current planning for the GCUH takes place within a hierarchy of planning instruments that are designed to ensure a coordinated and integrated approach is undertaken in planning the delivery of health services. Queensland Health has developed the State-wide Health Services Plan 2007 – 2012 to provide an overarching vision with key objectives of improving access to safe and sustainable health services and better meeting people’s needs across the health continuum. The Southern Area Health Service (SAHS) Plan 2007-12 provides direction for reform and development of health services in the Southern Area, in line with the broader objectives. Associated with this plan are a series of cluster and Health Service District plans that Project health service utilisation and which articulate strategies for responses by specific service networks, including delineation of roles of facilities, identification of cross-district issues and opportunities for improved integration of services.

Consistent with this approach, the GCHSD developed the Gold Coast Health Service District Master Plan in 2005 following a consultation process. This plan has subsequently been reviewed to provide specific plans for the GCUH, Robina Hospital and the Robina Health Precinct. The GCUH Health Services Plan has been based upon a close cooperation between the GCHSD, SAHS and the teams currently developing specific State-wide plans. As far as practicable, the GCUH plan directly reflects the concepts under development in the following planning processes:

• Cancer Services State-wide Plan – published 2008

• Community Health Review – due 2008/09

• Cross Border Planning Study – due 2008

• Hardes Projection Data (based on the latest population census) – due 2008

• Mental Health State-wide Plan – published 2008

• NICU State-wide Plan – published 2008

• Oral Health State-wide Plan – due 2008

• Rehabilitation Services State-wide Plan – published 2008

• Renal services State-wide Plan – published 2008


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• Southern Corridor Plan – due 2008

• Intensive Care Services State-wide Plan – due 2008/09

• Medical Imaging Services State-wide Plan – due 2009.

The GCUH will act as a tertiary referral facility with limited super-specialist services. The District will still be required to refer a limited number of patients to Brisbane for very low volume / high cost / highly specialised interventions or interstate for an even more limited subset of patients at Nationally Funded Centres. Over time, the GCUH may develop a limited number of services which have a State-wide referral role, receiving referrals from all other Queensland Districts and Northern NSW. The GCUH will also provide a supportive hub role for selected services from the Logan Health Service District. Currently this role will be limited to renal services.

Within the GCHSD, the GCUH will form part of an integrated network of services encompassing Robina Hospital, Robina Health Precinct,and a variety of Community Based Services primarily at Palm Beach, Bundall and Helensvale, as well as a number of outreach clinics, with Carrara Health Service providing subacute care. Within this network, the GCUH will provide higher-level support services such as intensive care, trauma management, and neonatal care. For these services the role of the facility will be to support the State-wide availability of capacity and act as an integrated part of a network in peak periods of stress.

In relation to services provided by the private sector, planning for the GCUH and Robina Hospital expansion are based on the assumption of private sector growth in bed capacity similar to that of the public sector services. Accordingly, the incorporation of the strategy for the collocation of a private hospital on the GCUH site is designed to facilitate that growth. The collocation of the private hospital will also provide opportunity for the development of synergistic relationships between the public and private sector for shared services. A footprint of 14,000m2 has been provided for a future Private Hospital facility.

3.7.5 Integration with northern NSW health service planning

A Joint Planning Study has been established by the NSW and Queensland governments to ensure an integrated approach to service planning and delivery for the residents of the north coast of NSW and the southern region of the Gold Coast. Some of the key assumptions that have been identified by this joint study process to guide service planning include:

• public sector expansion and changes will predominantly be in response to demand associated with projected population growth and ageing

• Lismore Base and The Tweed Hospitals will remain rural referral hospitals providing a range of Level 4 and 5 services (NSW Role Delineation). Therefore, services such as specialty paediatrics, neurosurgery, organ transplantation, and cardiothoracic surgery will continue to be provided by hospitals located in Queensland (Gold Coast or Brisbane), the Hunter region or metropolitan Sydney. Given the travel distances to the Hunter and Sydney, it is expected that the majority of NSW residents in the far north coast will be referred to Queensland

• in Queensland, the private sector will increasingly focus on developing day-only services. With the exception of John Flynn and Pindara Private Hospitals, private sector providers have indicated that they are not planning to significantly increase capacity generally to meet population growth and ageing

• over the next five years, both John Flynn and Pindara Private Hospitals have indicated major planned expansion: John Flynn anticipates bed increases of 48, while Pindara Private has advised of bed increases of 209. In addition the Allamanda Private Hospital has


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announced in mid 2008 that it will become a 352-bed facility in the next three years, with a two-stage expansion that included 100 extra private beds

• no change to the private supply pattern or capacity on the NSW far north coast is expected during the planning horizon

• no planned reversal of private inpatients is expected from NSW private hospitals to public hospitals.

These assumptions have been further developed to forecast patient flows by specific clinical type and have been incorporated in the GCUH Health Service Plan.


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4 Project description

4.1 Introduction This section of the Business Case provides a description of the Project. It summarises the key features of the Project as described in the Project Definition Plan (PDP) and as developed for the Schematic Design. The following aspects of the Project are described in this section:

• proposed site location and site definition, boundary and road networks, key features of the site and required acquisitions

• evaluation of alternative technical delivery models and the selection of the preferred delivery model

• design principles adopted in the development of the building facilities and proposed building layout

• accommodation floor space for each of the clinical divisions and the proposed single-bed allowances

• overview of the clinical services and various support services

• environmental Sustainable Design principles incorporated and implementation process

• transport and road infrastructure

• car park facilities

• provision of facilities management services

• single beds analysis.

4.2 Site description 4.2.1 Precinct site

The hospital development is part of a 130 hectare site referred to as the “Gold Coast Hospital and Knowledge Precinct”. The Precinct is located on the western edge of Southport on the Gold Coast, approximately 4km west of the Southport CBD and 36km north of Tweed Heads. The major connector route to the Precinct is Smith Street which provides access to Southport and other centres on the Gold Coast. The regional centres of Helensvale, Biggera Waters/Harbour Town, Southport and Nerang currently form a ring around the Precinct with over 2km separation distances generally.

Figure 4.1 below shows the general Precinct area, which currently contains a variety of uses including the Griffith University (Gold Coast campus), Parklands Showgrounds, community facilities, the Church of Christ, the Salvation Army, football clubs, residential development, school, parks and industrial uses. In order to implement the total development plan, a number of site acquisitions from some of these organisations will need to be made. More detailed information on these acquisitions are provided in a sub-section below.


September 2008


Figure 4.1 Gold Coast Hospital and Knowledge Precinct


4.2.2 Hospital site

The proposed site for the Hospital will occupy approximately 18.1 hectares of the Precinct land, directly opposite the Griffith University site at Parkwood on the Gold Coast. The site is bordered by Parklands Drive and Olsen Avenue. An aerial photo of the Hospital site is shown below (figure 4.2).


September 2008


Figure 4.2 GCUH proposed


4.2.3 Site features

The proposed site is generally undulating rising from levels of RL10.0 in the valleys to RL27.0 at the highest point. Grades vary from 1:3 at the steepest point (adjacent to the greyhound and harness racing track).

The site contains remnant vegetation primarily at the corner of Parklands Drive and Olsen Avenue, and to the east of a line joining the high points and north of the existing Church of Christ site and extending almost to the bottom of the valley to the east. A cleared area exists to the northwest opposite a lawn cemetery.

Views and aspects will vary with the differing levels and undulations of the site. Views out into parklands settings are proposed from all lower patient occupied levels at various points in their journey. There are views across the treed canopy of the University to the south and a green belt to the north. The west offers distant views to the mountains of the Gold Coast Hinterland.

4.2.4 Site acquisition

The relevant site acquisitions for the Project are being undertaken by Queensland Health with assistance from the Department of Infrastructure.

Within the proposed GCUH footprint there are existing organisations currently operating that will be affected by the Hospital development. The main organisations directly impacted by the GCUH development, and the necessary land acquisition requirements are described below.


September 2008


Griffith University

The construction of the new GCUH will require the relocation of the University’s Medical and Dental School which is currently adjacent to the existing Gold Coast Hospital at Southport. Relocation is necessary to ensure continued close integration of teaching activities between the Hospital and the University. Queensland Health and Griffith University have agreed that the new facility will be located on University land.

Church of Christ

The Church of Christ is a freehold land owner located to the south of the lawn cemetery, central to the proposed location of the Hospital. In addition to church services, it undertakes a range of activities on their premises such as child care related functions, provision of off-street parking for Griffith University students, crisis and relationship counselling, student support services largely for international students, theological education and youth programmes for surrounding State Schools.

Church of Christ has agreed to relocate to a portion of a site currently owned by Griffith University on the southern side of Smith Street, subject to a number of conditions including the acquisition of freehold title to the area in question, and funding for a temporary child care facility on the Parklands Showground site.

Salvation Army

The Salvation Army currently occupies land in trust from the Queensland Government on the proposed hospital site. A warehouse/distribution service for its district is operated from this site, as well as the Fairhaven Rehabilitation Centre offering detoxification services relating to drug and alcohol addictions.

The Salvation Army is currently being assisted with relocation to new premises with adequate space to allow for expansion of their accommodation and drug rehabilitation services. A warehouse facility at Molendinar has been purchased by Queensland Health and leased to the Salvation Army. The Fairhaven Rehabilitation Centre is currently being assisted with relocation to new premises.

The Greyhound Racing Authority and the Harness Racing Association

The Parklands Gold Coast Trust currently manages land in trust from the Queensland Government upon which leases have been granted to Greyhound Racing Authority and the Harness Racing Association. The land currently utilised as a greyhound track and associated car park are within the footprint of the GCUH. An alternative venue for greyhound racing has been identified. The Greyhound Racing Authority is scheduled to vacate in September 2008.

Southport lawn cemetery

The Lawn Cemetery is 12.4 hectares in size and is located in the north-western corner of the proposed GCUH hospital site. The Gold Coast City Council, as trustees of the cemetery, have agreed to supply surplus land for the GCUH.


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4.3 Proposed Delivery Model and PDP preferred option In order to decide on the Proposed Delivery Model for the Project, the Project Team assessed five technical delivery options (Options A to E) based on a high-level multi-criteria options assessment against the Project Objectives.

Description of Options

For the purposes of evaluating the options put forward for the PDP, the Project Team selected the following five options as a representative overview of the development process (each of the five options are illustrated and described in the following section).

Figure 4.3 Option A

Option A (Buildings of 6 to 8 levels):

This option is a linear concept with main entrance close to Parklands Drive, a transit stop at the high points in Parklands Drive, a Northern Road boundary (now known as the Hospital Boulevard), an Eastern Road boundary (now known as Hospital Street East), with the future Private Hospital site to the east of Eastern Road, and future expansion to the northeast and southeast.


September 2008


Figure 4.4 Option B

Option B (Buildings of 6 to 8 levels):

This option is a linear concept with main entrance close to car parking and the transit stop at the high points in Parklands Drive, a Northern Road boundary and an Eastern Road boundary. The future Private Hospital site is to the east of Eastern Road, and future expansion to the north and east.


September 2008


Figure 4.5 Option C

Option C (Buildings 8 Levels):

This option is a linear concept developed on east–west and north–south pedestrian axis/spines with the hospital entry plaza located in the southwest sector, the ward blocks in the southern and western sectors and the diagnostic and treatment block in the northeast sector. The east-west spine is linked to the car parks at either end of the site and the north-south spine links the main entry to emergency and mental health. Links to pathology and education, the private hospital and university occur off these spines. Connectivity with ‘green spaces’ is achieved between the pedestrian spines and the ward blocks. The Private Hospital is positioned in the southwest sector.


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Figure 4.6 Option D

Option D (Buildings 10 levels):

This option is a ‘vertically stacked/compact plan form’ with an L-shaped diagnostic and treatment block plan form. Vertical circulation nodes are at arrival at the main entrance and in choice of direction east and north along the spines. The compact plan leaves more space for future expansion and replacement with minimal intrusion into parklands. The Private Hospital is positioned in the southwest sector.


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Figure 4.7 Option E

Option E (Preferred Option) This option is a ‘vertically stacked/compact plan form’ with an L-shaped diagnostic and treatment block plan form. Vertical circulation nodes are at arrival at the main entrance and in choice of direction east and north along the spines. The compact plan leaves more space for future expansion and replacement with minimal intrusion into parklands. This option is a development of Option D, with the Private Hospital and Education/Pathology in new locations. Assessment of Options The Project Team assessed the options by scoring each of the options against the Project objectives, the following scoring system was used in the assessment:

5 Exceeds objective 4 More than meets objective 3 Meets objective 2 Partially meets objective 1 Does not meet objective


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Table 4.1 Assessment of options

Project Objectives Total Score Option A

Option B

Option C

Option D

Option E

Service Delivery and Care 1 Create a patient-focused health system that

encourages innovative models of care delivered in a major teaching Hospital

4 4 4 4 4

2 Deliver operational efficiency, optimising the use of people and resources, capable of achieving Health Service planning targets and sustaining service levels into the future

2 2 2 4 4

3 Promote evidence based design to create an environment that enhances patient safety, patient outcomes and clinical excellence

4 4 4 4 4

4 Ensure ability to function in a post-disaster environment

4 4 4 4 4

5 Enhance amenity for users of the site including consideration of car parking, retail and co-located private hospital

4 4 4 4 4

People 6 Support attraction and retention of well trained,

committed and motivated staff 3 3 3 4 4

Site Access and Egress 7 Provide clear points of site access and egress ensuring the efficient movement of public/staff, emergency and

service vehicles in and around the site (Criteria as follows) General Access 2 2 3 4 4 Optimum access at Hospital Front Door 1 1 4 4 5

8 Maximise integration of developing public transport infrastructure to the new hospital

3 3 4 4 4

Future Proof and Flexible 9 Encourage flexible design and infrastructure

capable of adapting to new technologies (clinical and information) and emerging trends in clinical practice, models of care and changes in government policy, legislation and standards

3 3 3 4 4

Teaching and Research 10 Promote an active learning environment,

providing appropriate facilities for teaching and research within clinical areas and between the Gold Coast University Hospital and its key education and research partners

4 4 3 3 5

Business Continuity 11 Achieve a successful relocation to the new

hospital with no interruption to the ongoing delivery of services

Note 1 Note 1 Note 1 Note 1 Note 1

Stakeholder Relationships 12 Encourage a collaborative constructive

relationship between the new hospital and stakeholders including education and research partners, local community and communities of interest



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Project Objectives Total Score Option A

Option B

Option C

Option D

Option E

13 Minimise impact and disruption to the surrounding community during construction


14 The new hospital is part of a network of services including: 'District Wide' service


Government Commitment, Policy and Objectives 15 Procure a new major teaching Hospital which delivers value for money to the State, within budget and other

parameters as agreed by the State (Criteria as follows) Capital Cost 3 3 4 4 4 Recurrent Cost 2 2 2 4 4 Timing 4 4 4 4 4

16 Achieve State sustainability policies/objectives including greenhouse gas and peak energy reduction, water conservation and waste minimization

2 3 4 4 4

17 Maximise benefits of co-location opportunities - with University, private hospital and other services (Criteria as follows)

Co-location with Griffith University 4 4 3 3 4 Co-location with Private Hospital 2 2 4 4 3 Co-location with other services 3 3 4 4 3 Integration with Precinct Master Plan 2 2 4 4 4 Project Objectives Total Score 56 57 67 74 76 Ranking 5 4 3 2 1 Source: Queensland Health PDP Report Note 1: Objectives 11-14 were not assessed as design objectives.

Preferred Option

As a result of the assessment Option E gained the highest score and also achieved the best fit to the required Model of Care. The next closest option (Option D) was very similar to Option E but did not allow for the same level of potential future expansion and did not address the teaching and research object as well.

The following image indicates the Project Definition Plan / Master Plan concept.


September 2008


Figure 4.8 Preferred option concept

The image below shows the current axonometric view of the schematic design of the GCUH.


September 2008


Figure 4.9 Schematic design image

The development of the GCUH design from Project Definition Phase to Schematic Design has been in accordance to the Project design principles and vision. The development of the design has seen the following changes:

• the building has 9 storey levels, with an integrated service tunnel now at the basement level in lieu of below the Basement floor level

• clinical support building has been further articulated to maximise natural light and to frame the entrance and atrium to the hospital

• western and southern inpatient unit buildings have been modified to reflect the revised bed numbers per Inpatient Unit (IPU). The southern IPU building has been slightly elongated to provide two 28 bed units per floor, while the western IPU building remains with two 24 bed units per floor. The revised bed configuration has reduced the number of floors to the western IPU building

• revised ground levels along Parklands Drive have enabled the Discharge Lounge and Loan Equipment area to be located on the Basement level of the Southern IPU Building. This also provides a secure corridor link to lifts from the on grade Cancer Car Parking area to Chemotherapy and Radiotherapy areas.

4.4 Design process The design of the GCUH commenced in July 2007 with the commissioning of a design team, GCUH Architecture (PDT, STH and Hassell). The design team consists of Health Planners, Health Architects and Design Architects as well as Interior Designers, Landscape Architects and Urban Planners.


September 2008


The design of the facility has been developed in order to address the Project objectives described in section 2.2. To meet these objectives and to incorporate stakeholder interests, a series of workshops and presentations occurred that progressively developed the design principles.

4.4.1 Design principles

The design principles applied to the development of the Hospital include the following:

• ensure ease of access from public and private transport

• provide a campus of linked areas within the site that allow for future flexibility options

• provide separate definition and identity for each area with in the site

• provide clinical and operational services to all precincts and their departments separately without interruption or access to adjacent precincts or departments

• maximise visual connection with the parklands setting from all areas

• minimise travel distances for staff, patients and visitors within and between areas

• ensure intuitive and clear way-finding between each area

• operate areas independently

• maximise the sharing of support facilities between areas.

4.4.2 Design features

To meet the requirements of the GCUH Health Service Plan, the Hospital will feature the following key attributes:

• a compact solution, which is designed over nine levels and located in a parkland setting

• a compact footprint which allows for future expansion

• the potential for clear ‘way-finding’ with the principle of having short travel distances to lift cores. (The distance between the front entrance and the central lift core is less than 60 metres)

• use of site topography to separate by level the key entrances points for visitors, patients and services (i.e. main entrance, Emergency Department entrance and the loading docks)

• a dedicated car park to be accessed by the Cancer Centre via the South block basement level

• direct and discrete connections between the Emergency Department and the Mental Health Unit, which also has a dedicated entrance

• designed with horizontal and vertical integration of clinical services, which responds to its Model of Care.

4.4.3 Interior design

The philosophy for the interior design is to create a comfortable and healing environment for patients, their families and carers and incorporate the qualities of friendliness, safety, privacy and fun where appropriate. The overall result should be of a non-institutional, people-friendly


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character that gives children, families/carers, public and staff positive surroundings in which to experience healthcare.

Key interior design features

Patient areas will embody the same key health planning features as are characteristic of a therapeutic environment – privacy, control, choice and comfort. Patient privacy and confidentiality is paramount, and consulting rooms and treatment rooms must be planned so that a patient on a couch or bed cannot be seen from the doorway to the room. The design should also incorporate features that enable effective nurse supervision.

Emphasis will be paid to the clarity of circulation patterns, demarcation and signage of departments, and articulation of public spaces. Internal treatments will acknowledge the Parklands setting whilst remaining functional, timeless and durable.

Patient waiting areas will be located to take advantage of natural light and outdoor views. Separate play areas for children and adolescents are to be collocated, with chair groupings in clusters for discretion and privacy. Public areas including circulation areas are to be designed for the display of artwork. Artefacts celebrating past history should be displayed appropriately, as should donor boards and relocated sculptures.

Staff lounges and other staff-specific areas are to be treated as breakout spaces providing relief from high-stress work environments.

Lighting along walls and wall fixtures should be used to the maximum extent possible to reduce glare and provide areas of interest for patients, many of whom are transported horizontally. The use of indirect lighting is encouraged where appropriate.

Security must be dealt with as unobtrusively as possible, particularly at the main entrance, and the triage area in the emergency department.


September 2008


Figure 4.10 Atrium images

Atrium view to northwest Southeast view to atrium


4.5 Facilities description The GCUH will provide super speciality, tertiary services for the population of South East Queensland, extending into Northern New South Wales and will comprise of the following key facilities:

• acute tertiary hospital with 750 overnight beds, 74 same day beds and 97 same day bed alternatives

• comprehensive Cancer Care centre

• Family, Women’s and Children’s cluster

• acute mental health inpatient cluster

• pathology and education facility with pedestrian links to a new Medical School, future library and Medical research facilities

• car parking facilities for 3,000 car parking spaces

• opportunity for co-located private hospital and specialist medical consulting facilities

• Central Energy facility

• opportunity for Child Care Centre and Carer/relatives accommodation.

As a major teaching hospital, GCUH will be associated with both Griffith and Bond Universities and will provide academic and research support for Medical, Nursing and Allied Health students.

To support the clinical services, there will be a range of administrative, general and staff support services for not only the GCUH campus, but other campuses within the Gold Coast Health Service District.


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4.5.1 Facility layout

Figures 4.11 and 4.12 provide an overview of the facilities layout.

Figure 4.11 Perspective showing view from South West


Figure 4.12 Perspective showing view from North East


4.5.2 Building layout

Figure 4.13 shows the proposed hospital buildings with the major components being clinical, family, women’s and children, cancer, accident and emergency, and mental health.


September 2008


Figure 4.13 Building layout


In order to minimise horizontal travel distances and provide clear ‘way-finding’ the GCUH will be designed over nine levels as follows:

• the lowest level, referred to as the Basement, includes the Hospital’s loading docks together with its Operational Services Department (i.e. kitchen, stores, linen and waste handling) plus Biomedical Engineering and Clinical Resource Unit

• the Lower Ground Floor, the Ground Floor and the First Floor will deal primarily with all Ambulatory Care Services and include Emergency and Allied Health Services, Medical Imaging and Nuclear Medicine and Pharmacy.

− South wing of the inpatient block will house the Radiotherapy Unit, Day Chemotherapy/Haematology Unit and Cancer Services outpatient and at Level 1 the two Cancer Care Services Inpatient units of 29 beds each are located. The Paediatric Services are located on Ground Floor

− there will be a direct link to the Mental Health Unit at both the Lower Ground Floor and the Ground Floor. There will also be provision for future links through to the proposed Private Hospital and public car parking. The Hospital’s main entrance will be located on the Ground Floor

• the next level, the Second Floor, will include the Interventional Suites, the Birthing Unit and two Inpatient Units together with some Pathology Units. There will be a direct link to the car park and the proposed Private Hospital from this level


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• the remaining levels include support units such as the Sterilising Department, ICU, NICU, Cardiac Catheter Labs and Clinical Measurement and Rehabilitation Therapy areas. In addition to the Inpatient Units located on the Second Floor of the south and west wings, additional Inpatient Units, including Obstetrics inpatient units and the Cardiology/Coronary Care Unit are located on the Third, Fourth, Fifth and Sixth Floors

• plant is located on the seventh floor and the helipad located on the rooftop.

4.5.3 Future proofing

Master planning principles

The Hospital Master Plan has a design philosophy that includes an effective expansion strategy, and a replacement strategy.

The future expansion is planned to occur without impeding access to the facility by the public, patient, visitors, staff or those supplying the facility with the goods and services during the operation of the facility.

The Hospital will be modified or expanded to meet the requirements of changes in medical technology, case mix and demand that will occur over the life of the facility.

Capacity

The new hospital is planned to occupy approximately 165,000m2 of gross floor area. The Health Service Plan provides the short to medium term and long term implications for the Health services to be provided at the new hospital and the most likely areas of expansion, such as Cancer Care Services. The stage 2 expansion master plan is shown in figure 4.14.

Spatial allowance for future expansion

There has been provision for an expansion area of 90,000m2 of gross floor area provided as extensions/additions or as new buildings, bringing the possible gross floor area to be in excess of 250,000m2, which could increase the number of beds from 750 to approximately 1,000.

To accommodate a changing and growing hospital over a multiple of 25-year life cycles, adequate plant capacity and spare space will be provided for future growth.

World’s best practice indicates a site area of 20 hectares is appropriate. The current site area is 18.5 hectares, the net usable area of which is only 14.5ha due to road reserves and cut off land. It is recommended that the current site be expanded from an area of 18.5 hectares to 20 hectares.

Figures 4.14 and 4.15 below highlight the additional proposed expansion area. It is Queensland Health's intention to apply for additional land (referred to as stage 2) as part of the revised Precinct Master Plan review which is scheduled for the last quarter of 2008.


September 2008


Figures 4.14 and 4.15 Future expansion plans


September 2008




September 2008


4.5.4 Future Private Hospital facility

As part of the expansion allowance, a land area of 1.4 hectares has been provided for a future Private Hospital facility. Expressions of interest from private health care providers have been called and discussions are currently underway with private health owners/operators. A strategy is being put in place to consider timing, interface, and other issues.

4.5.5 Private sector involvement

A retail consultant is to be engaged to assist with potential private sector involvement in utilising approximately 1,000m2 of commercial space, for purposes such as a newsagency, bank, ATMs, florist, pharmacy and gymnasium.

4.6 Accommodation 4.6.1 Development of accommodation schedules

The schedule of accommodation was developed with reference to Australasian Health Facility Guidelines (AHFG) and through a benchmarking exercise. A series of user group meetings and discussions were also conducted to inform the development of the schedules of accommodation.

The proposed area allocation components of the Hospital were benchmarked against comparable tertiary/quaternary teaching health facilities nationally and internationally, as well as standards and regulations, relevant College of Medicine guidelines and local, national and international trends towards the health needs of the Hospital’s specific client group.

The schedules of accommodation were developed with reference to several documents and guidelines including the following:

• GCUH Health Service Plan

• Queensland Health’s Queensland Health Capital Works Guidelines

• Queensland Health’s Queensland Health Clinical Services Capability Framework for Public and Licensed Private Health Facilities, version 2 July 2005

• Australasian Health Facility Guidelines, November 2006

• Department of Human Services, Victoria Hospital Project Planning Benchmark 2003, as detailed for Level 6 hospitals

• Queensland Health recommendations for single rooms

• Environmentally Sustainable Design initiatives.

Although several sources of information are available to guide the development of accommodation schedules, the information is not entirely suited to the profile of the GCUH and its designation as an educational and training facility. For example, AHFG considers 19 departments only and does not fully reflect the needs of tertiary level hospitals, while the Victorian Department of Human Services guidelines mainly relate to level 4 Role Delineation only.

In order to substantiate the design outcomes a benchmarking exercise was conducted based on reference facilities. This is detailed further in this section.


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4.6.2 Schedule of accommodation

Table 4.2 presents the floor space allocations and number of overnight beds for each of the organisational groupings. Benchmarking information is provided further below.

Table 4.2 GCUH proposed floor space areas

Division

Same day

beds

Same day bed

altern-atives

Over night beds

Treatment places

Consulting rooms

Gross Area m2

Generic Inpatient Unit - - 400 1 13 19,057 Division of Medicine 14 97 76 115 115 24,437 Division of Surgery and Critical Care Services

40 - 50 39 11 16,032

Division of Family, Women & Children

20 - 124 26 39 14,018

Division of Medical Services - - - 28 - 5,923 Division of Mental Health - - 72 - 5,817 Division of Community, Allied, Rehabilitation and Aged Services

- - 28 99 10 7,359

Division of Pathology - - 8 - 5,039 Education & Research - - - - - 3,871 Corporate Services, amenities and retail

- - - - - 16,556

Total 74 97 750 316 188 118,109 Travel space 17,380 Plant space 27,673 Main atrium 1,200 Total Gross Area 164,362 Source: GCUH Technical Advisor, DLA Notes: 1. Accommodation places provided by DLA, 4 September 2008. 2. Gross areas provided by DLA, 16 September 2008. 3. Total Gross Area excludes Unenclosed Covered Area of 1,377m2. See Appendix H for updated beds / treatment places schedule, and Appendix G for benchmarking and area schedule.

Benchmarking

The benchmarking exercise involved examination of comparative Australasian hospitals including the following:

• Queensland: Royal Brisbane and Women’s Hospital, Princess Alexandra Hospital, The Prince Charles Hospital and the Townville Hospital

• Victoria: Royal Melbourne Hospital, the Alfred Hospital, the new Royal Children’s Hospital (based on the PDP), Monash Medical Centre and Austin Hospital

• New South Wales: the Royal Prince Alfred Hospital and the proposed Redevelopment of the Royal North Shore Hospital (based on PDP)

• South Australia: Royal Adelaide Hospital and the proposed Marjorie Jackson Hospital (based on PDP)


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• Western Australia: Fiona Stanley Hospital (based on PDP).

The following factors and statutory requirements have been incorporated in this exercise:

• additional floor space area associated with new Statutory Requirements (including Disability Discrimination Act, Occupational Health and Safety Act and Building Code of Australia);

• Queensland Health policy to move from average provision of 25% single bed rooms to 75% single bed rooms (discussed further in Section 4.17);

• introduction of Environmentally Sustainable Design initiatives (plant and equipment)

• increased provision of high-cost medical equipment.

Appendix E contains further benchmarking data and detailed explanations for the differences between the proposed GCUH space allocations and the benchmarks. In general the GCUH has relatively larger space allowances due to:

• the mix of single beds to multiple beds (this is discussed later in this section), and the associated increase in circulation requirements

• the integration of education, training and research facilities incorporated into the wards

• the model of care and preferred location of services. (For example the anaesthetics department being located with the surgical cluster {in benchmark facilities this forms part of central administration}, the inclusion of rehabilitation inpatient units and therapy areas that are not part of the comparative hospitals, and the decentralised nature of pharmacy services.)

4.7 Clinical services A brief overview of each of the clinical services to be provided by the GCUH service divisions, their space considerations and benchmarks are presented in the following sections.

4.7.1 Division of Family, Women and Children

The following table shows the space allowance and comparison to the benchmark for this clinical service. The increase in area compared to the benchmark can be explained by a greater allowance for single bed rooms, and inclusion of ambulatory care as part of this cluster.

Table 4.3 Area comparison with benchmark – Division of family, women and children

Division Gross Area m2 Benchmark Area m2 Difference % Division of Family, Women and Children 14,018 11,499 21.9% Source: GCUH Architecture

Obstetrics unit

The delivery suite/birthing centre will support all women from low risk to high-risk pregnancies, including those that require tertiary level care. The delivery suite and birthing centre will comprise ten delivery rooms, two high care rooms (including one to function as a HDU bed room), and a six room-birthing centre. A dedicated obstetric theatre will be required in the operating suite.


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The Family, Women and Children (FWC) Services provides the full range of services including the following inpatient services:

• Antenatal Care

• Delivery Services

• Antenatal / Postnatal Inpatient Unit

• private facility for labouring women outside room

• clinical administration

• clinical support services

• Teaching and Research.

Neonatal intensive care unit

It is proposed to establish a Level 3 Neonatal Intensive Care Nursery at the new GCUH to bring the total inpatient capacity for neonatal services to 15 Level 3 neonatal cots and 40 Level 2 Special Care cots by 2016.

Paediatric unit

The Paediatric Service will be designed in accordance with the concept of family focus and developmentally supportive areas and patient free areas. The design of the unit will take into consideration the family centre focus nature of the service and include appropriate features to enhance family relationships and functions within a hospital environment. It is comprised of:

• Level 2 Paediatric Inpatient Unit of 32 beds

• Paediatric Intensive Care Unit of 2 beds, within the Adult Intensive Care Unit

• same day unit for medical and surgical patients (10 beds)

• clinical administration

• clinical support services


• admission ward for surgical subspecialty.

Family, Women’s Clinical – outpatients

Family Women’s and Children’s Ambulatory Care services will be provided as a dedicated unit within the new hospital providing care to women and children separate to the specialist outpatient department.

Services to be provided include:

• Antenatal Care

• Paediatric Services

• Gynaecology Out Patients Service

• Clinical administration


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• FWC Divisional Executive

• Clinical support services


4.7.2 Division of Mental Health

The following table shows the space allowance and comparison to the benchmark for this clinical service. The difference is immaterial.

Table 4.4 Area comparison with benchmark – Division of mental health

Division Gross Area m2 Benchmark Area m2 Difference % Division of Mental Health 5,817 5,895 -1.3% Source: GCUH Architecture

The following mental health services are proposed for the GCUH:

• Acute Adult Inpatient Care service – 72 beds

• ECT Suite

• Ambulatory Day programs accessible to both inpatients and community clients

• capacity for specialty inpatient services including mother and baby, eating disorders and mood disorders to be accommodated as required from existing adult bed complement.

• Adult, Child and Youth Consultation Liaison Services

• outpatient clinics including adult C/L, multidisciplinary eating disorders and paediatric diabetes

• research and teaching programs

• capacity for intake assessment

• general acute areas with capacity for close observation

• a Psychiatric Intensive Care Unit

• capacity for sub specialty unit – Mother baby, eating disorders, neuropsychology, mood disorders.

There will be an easily identified entry to the Mental Health Unit with access to drop off and car parking. Patients and visitors will be provided with a clear route from the Emergency Department that is not through public spaces. A separate police and ambulance entrance will provide discreet access to the units.

4.7.3 Division of Medicine

The following table shows the space allowance and comparison to the benchmark for this clinical service. The difference reflects a higher proportion of single rooms and the inclusion of shared service areas.


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Table 4.5 Area comparison with benchmark – Division of medicine

Division Gross Area m2 Benchmark Area m2 Difference % Division of Medicine 24,437 22,887 6.8% Source: GCUH Architecture

The Division of Medicine is comprised of inpatient accommodation, ambulatory care/outpatient facilities, and interventional and procedural units. It encompasses the following specialty units:

• Cancer Services

• Neurology/Neuroscience

• Endocrinology/Diabetes Centre

• Infectious Diseases/Immunology/Rheumatology

• Cardiology

• Respiratory Medicine, including Sleep studies

• Dermatology

• Gastroenterology

• Renal Medicine including Acute Renal Dialysis Unit

• General Medicine

• Ambulatory Care

• Day Medical Procedures Unit

• Medical Assessment Unit, including Chest Pain Investigation

• Teaching and Research

• Aged Care Services.

4.7.4 Division of Surgery and Critical Care

The following table shows the space allowance and comparison to the benchmark for this clinical service. The increase in area compared to the benchmark can be attributed to the increased size of interventional rooms in line with current international standards, and the collocation of the Anaesthetics department within this cluster (compared to the benchmark where it generally sits in clinical administration).

Table 4.6 Area comparison with benchmark – Division of surgery and critical care

Division Gross Area m2 Benchmark Area m2 Difference % Division of Surgery and Critical Care 16,032 14,376 11.5% Source: GCUH Architecture


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The Division of Surgery and Critical Care includes the following departments:

• Department of Anaesthetics and Pain Management. This department will provide services to both GCUH and Robina Hospital including a comprehensive Acute Pain Management Service (which also manages patients not involved in the operative suite), a separate Chronic Pain Service, anaesthesia services for other areas, such as medical imaging.

• Department of Surgery.

- Surgical Specialties Services. The Surgical Specialties provides the full range of acute and elective surgical services including inpatient, ambulatory care, interventional and procedural services.

- Surgical Specialties Outpatients

- Orthopaedic and Trauma Services. This service will provide the full range of acute and elective orthopaedic services including a major joint replacement program and orthopaedic trauma surgery. It will have an active participation in rehabilitation.

• Infusion Therapy Services

• Intensive Care Unit. The proposed model of care for the Intensive Care Unit (ICU) is based the co-location of Intensive Care Unit and High Dependency Unit, with horizontal or direct vertical access to Operating Suite, and direct access to the Emergency Department, Helipad, Cardiac Interventional Unit and inpatient units.

• Interventional Suite

• The Central Sterilising Department. This department is responsible for the collection, cleaning, packaging, sterilisation, storage and distribution of re-useable instruments and equipment.

4.7.5 Division of Community, Allied, Rehabilitation and Aged Services

The following table shows the space allowance and comparison to the benchmark for this clinical service. The increase in area compared to benchmark can be explained by additional services provided including orthotics, transitional care services and clinical education and training areas.

Table 4.7 Area comparison with benchmark – Division of community, allied, rehabilitation and aged services

Division Gross Area m2 Benchmark Area m2 Difference % Division of Community, Allied, Rehabilitation and Aged Services

7,359 6,502 13.2%


Allied Health

To enhance the GCUH model of care, the Allied Health units will be co-located. These include:

• Clinical Psychology

• Clinical Dietetics

• Occupational Therapy

• Physiotherapy


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• Social Work, with office located on each inpatient level.

• Speech Pathology

• Teaching & Research.

Other allied health units such as audiology, podiatry, orthotics and prosthetics will be located with other clinical service departments.

Community Health

A Health Promotion Unit will be located within the front foyer of the Hospital, with ease of access for staff, patients and visitors. The Health Promotion’s model is based on similar models of service provided by like hospitals.

4.7.6 Division of Medical Services

The following table shows the space allowance and comparison to the benchmark for this clinical service. The increase in area compared to the benchmark can be explained by the inclusion of satellite imaging services with emergency and ambulatory care areas, and equipment such as PET.

Table 4.8 Area comparison with benchmark – Division of medical services

Division Gross Area m2 Benchmark Area m2 Difference % Division of Medical Services 5,923 5,143 15.2% Source: GCUH Architecture

The Division of medical services will provide medical imaging and pharmacy services.

• Medical Imaging. The Medical Imaging Department (MID) of GCUH will provide a comprehensive radiology service, including diagnostic and interventional services for inpatients and outpatients of all hospital departments. These services are provided on an elective and emergency basis.

Services will be primarily provided in the MID with a mobile service provided to intensive care, the operating suite and inpatient units, as required. Satellite imaging will be located in Emergency Department, Ambulatory Care, and Family/Women/Children’s services.

• Pharmacy. Pharmacy services will include, but not be limited to, clinical pharmacy activities relating to inpatients and ambulatory patients, drug distribution to inpatients and ambulatory patients, IV additive service, cytotoxic preparation service, provision of medicines information, clinical trial management, education and training, and research.

4.7.7 Division of Pathology

The following table shows the space allowance and comparison to the benchmark for this clinical service. The decrease in area compared to the benchmark can be explained by more limited range of services and extent of pathology services planned for GCUH compared to benchmark facilities. Certain specialised pathology services for the region can be delivered from the Royal Brisbane and Women's Hospital which has a large pathology unit in line with the benchmark (for a central provision facility).


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Table 4.9 Area comparison with benchmark – Division of pathology

Division Gross Area m2 Benchmark Area m2 Difference % Division of Pathology 5,039 6,360 -20.8% Source: GCUH Architecture

The division of pathology will provide the following services:

• Clinical Chemistry, Microbiology, Haematology, Anatomical Pathology and Transfusion Medicine. These will be provided by the Pathology Queensland Gold Coast laboratory, which will operate out of the GCUH and service the pathology needs of the Gold Coast District Health Service.

• Mortuary. The major post-mortems studies for south-east Queensland are to be undertaken at the new GCUH facility.

The decrease in area (21%) compared to the benchmark is due to certain specialised pathology services for the region being delivered centrally from the Royal Brisbane and Women’s Hospital, with remaining pathology services being provided from the GCUH standalone pathology unit.

4.8 Non-Clinical service divisions Space considerations and benchmarks for each of these divisions are presented in the following table.

Table 4.10 Area comparison with benchmark – non-clinical services

Division Gross Area m2

Benchmark Area m2

Difference %

Comments

Generic inpatient unit 19,057 18,648 2.2% The increase in area compared to the benchmark can be explained by a greater allowance for single bed rooms, shared eduction and training areas, and a decentralised model of care for allied health areas.

Eduction and Research 3,871 4,125 -6.2% The decrease in area can be explained through the ability to integrate and utilise education, library, and research facilities at Griffith university.

Corporate services, amenities, and retail

16,556 16,318 1.5% The difference is immaterial.


4.9 Operational and support services The GCUH will provide a full range of operational services as required for a tertiary hospital facility. Accommodation spaces will be allocated to all operational services including, but not limited to:

• Gold Coast University administration


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• Operational services – including housekeeping and waste management, portages, security services, ID production, linen services and mail room

• Public amenities – including a main foyer with 24 hour reception services, interview facilities, lost property pastoral care department; links to retail services

• Staff facilities – including recreation rooms, medical officer rooms

• Environmental services

• Food services – kitchen

• Information Technology (IT)

• Clinical information services and medical records.

4.10 FF&E requirements The process of determining FF&E requirements for the GCUH will require a number of staged approaches. The following bodies of work will need to be undertaken over the coming years to clarify requirements. These include, but are not limited to:

• Completion of room data sheets (currently 90% complete)

• Identification of high capital value equipment (i.e. MRIs, CT Scanners, etc.) which has been completed

• Condition assessments on existing equipment at the Gold Coast Hospital which has been completed and will be ongoing

• Development of a Strategic Procurement Plan to achieve value for money principles.

4.11 Information technology Information technology provisions will be critical services for delivery of health services for the GCUH Project. Information technology (IT) will be integrated into the Project and fundamental to the delivery of improved patient care and efficiency of health services.

The ICT system will cater for high bandwidth applications including:

• Picture Acquisition and Communication Systems (PACS)

• Telemedicine

• Video conferencing.

Communications to staff will be enhanced with wireless technologies including:

• Wireless telephony

• Radio paging

• UHF radio.

Digital technologies that will interface with patients include:


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• IT TV systems

• Information kiosks

• Public information displays

• Patient queuing system.

Critical health care ICT technology that will be catered for include:

• Patient (nurse) call systems

• IP master clock system

• Patient monitoring systems.

There is the potential for some or all of these IT services to be provided, operated and maintained by a third party IT provider. This can have advantages in terms of cost certainty, risk transfer and cost efficiency through provision of service by providers who focus on these services as part of their core business.

4.12 Education The future teaching facilities will be developed in collaboration with the university sector. Teaching will be embedded within the Hospital setting together with proximate teaching and research. Education areas will include:

• 240 seat lecture theatre

• two 120-150 seat lecture theatres

• one conference room, two seminar rooms and four tutorial rooms

• OH&S Training and Staff Development facilities

• Computer Learning Centre

• Clinical Training Service including Clinical Skills Laboratory and training rooms.

Research

A spatial allowance has been made for hospital-based research, where all such dry research undertaken by the various Clinical Departments is to be conducted.

Queensland Academy of Health and Medical Science

The development of the $43.5 million Queensland Academy of Health and Medical Science opened for the 2008 academic year and will ultimately accommodate 450 students from Years 10-12. The Academy will provide students with the opportunity to combine their senior schooling with tertiary studies, focused on health and allied industries, offered by Griffith University.

The Academy is funded by the Queensland Government in partnership with Griffith University and is to be located within the Griffith University southern campus expansion area on 2.36 hectares of land, bounded to the north by the proposed Smart Water Research Facility, the Griffith University Student Housing Village to the south and bushland to the west.


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4.13 Environmental Sustainable Design (ESD) An ESD working group has been established within Queensland Health Major Projects to determine appropriate strategies and objectives for hospital development projects currently underway.

In parallel with the ESD Working Group, the GCUH Project Team progressed their ESD design for the GCUH Project in order to meet program timescales.

As a starting point, the GCUH Project Definition Plan identified that the Project team would design for a non-accredited Green Building Council of Australia 4-Star Green Star equivalent rating with the aspiration for the 5-Star rating if budget permits. During the course of Scheme Design, studies performed by the GCUH Project team identified a number of options aspiring to a sustainable outcome which were costed for the GCUH Project. Some of the options and outcomes investigated are as follows. The options were provided in 2 parts; Formally Accredited Design, and Non-accredited Self-assessed Design.

The cost estimates for each option presented below are Project costs including managing contractor fees, professional fees and risk adjustments.

Formally Accredited Design An accredited design approach has the benefit of formal and independent recognition (with the GBCA) for the implementation of environmentally sustainable initiatives, the use of cutting edge technologies and the application of sustainable building practices. Independent accreditation would showcase the ability and will of the Queensland Government to preserve the environment and at the same time not only deliver a modern healthcare and education facility but a high-grade environmentally sustainable workplace for future generation of healthcare professionals. Formal accreditation further serves as proof of achievement of a national benchmark increasingly gaining national and international recognition among industry leaders, governments, local and global community. Option 1: Four Star Green Star $65.8m Option 2: Five Star Green Star $92.9m

Non-Accredited – Self-assessed Design The current approach is to use the draft tool as a guideline only without accreditation. Option 3: Four Star Green Star $63.7m Option 4: Five Star Green Star $90.8m Note: Above figures are capital cost estimates and are inclusive of professional and managing contractor fees, and contingency as at July 2007 but are exclusive of escalation


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Budget allowance Currently, the Project team is endeavouring to provide a sustainable hospital consistent with Option 1 (accredited four star rating),which equates to $82 million nominal14. A detailed description of the ESD initiatives is provided in Appendix K. The GCUH Project team believe that it is possible to achieve a sustainable hospital that is in line with community expectations, an appropriate response to greenhouse gas emissions issue, is in line with Queensland Health policy guidelines, and will assist in meeting staff aspirations. The Project will, however, be ‘registered’ with Greenstar in order to, in the first instance, create dialogue with the GBCA and to influence the outcomes of development of future versions of the Healthcare tool to ensure regional and geographical issues for future hospitals in Queensland are addressed. If market forces reduce ESD initiative costs sufficiently and it becomes possible to achieve an accredited Greenstar rating within the assigned budget, then this could be pursued.

4.14 Transport and roads infrastructure SKM has been appointed to conduct an overall site transport study and analyse car-parking requirements.

4.14.1 External Road access

General vehicle access to the Hospital site is to be provided from the Smith Street end of Parklands Drive and from Olsen Avenue. Additional vehicular access is to be provided from Musgrave Avenue following road upgrades planned by the Department of Main Roads (DMR) to Smith Street and Olsen Avenue (DMR is the road network owner and manager of these two major thoroughfares).

Upgrades to Smith Street and Olsen Avenue, and other roads that surround the GCUH site, are proposed at an estimated funding cost of $250 million. The proposed road upgrades consist of the following projects:

• upgrading of the existing Smith Street Connection Road/Labrador-Carrara Road (Olsen Avenue) grade separated interchange

• construction of new Smith Street Connection Road/Parklands Drive (eastern end) grade separated interchange

• construction of a signalised at grade intersection at Tonga Place at an estimated cost of $7m

• preferably (but not essential) an improved more directional left-turn off Labrador-Carrara Road (Olsen Ave) into the western end of Parklands Drive at an estimated cost of $1m

• preferably (but not essential) an improved more directional left-turn lane off Labrador - Carrara Road (Olsen Ave) into Southport - Nerang Road at an estimated cost of $1m

• non-signalised at grade intersection from the Hospital to connect to Musgrave Avenue to provide an additional low-usage ambulance and emergency vehicle access point to the surrounding local road network at an estimated cost of $1m

14 Or $47m (excluding managing contractor fees, professional fees and risk adjustments)


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• new Hospital Boulevard signalised intersection on Olsen Avenue

• upgraded Parklands Drive signalised intersection on Olsen Avenue

• Smith Street / Olsen Avenue interchange upgrade

• new Smith Street / Parklands Drive interchange.

DMR are currently updating and refining the road upgrade costs required for the GCUH in line with developments on the master planning for the Precinct and hospital site.

4.14.2 Internal Road access

The Hospital site traffic and transport plan will include the location and specification of the following accesses:

• between the Hospital and Parklands Drive

• between the Hospital and the proposed Hospital Boulevard

• between the surrounding road network and car parking areas.

• between the emergency department and surrounding road network, from all approaches

• between the surrounding road network and pick-up and set-down locations.

Access to the emergency department shall be clearly signed from each approach direction. A minimum of three separate emergency access routes are proposed.

All new roads, intersections, driveways, access paths, etc. within the identified boundary of the GCUH (refer to section 2.1.4) will be constructed and funded as part of this Project. This includes the extension of Melia Court to the proposed Hospital Boulevard but excluded is the new intersection of Olsen Avenue and Hospital Boulevard and the first section of Hospital Boulevard from Olsen Avenue to the next intersection. This scope of work will be designed, funded and constructed by the Department of Main Roads as agreed by the CEOs committee.

4.14.3 Other transport modes

In addition to general vehicle access, other transport facilities will be provided for:

Bicycle facilities

Bicycle facilities shall be provided to meet the objectives of the Queensland Cycle Strategy. End-of-trip cycle facilities are to be fully integrated including secure undercover cycle parking, personal lockers, shower and change facilities. Cycle parking for visitors and couriers will be located in convenient and safe locations and protected from adverse weather conditions.

Motorcycles

Motorcycle parking zones will be provided to meet anticipated demand. As an incentive to reduce car driver trips to the Hospital, the master plan will assess the potential for separate undercover parking areas for small scooters.

Public transport facilities.

The Queensland Government has identified the proposed Gold Coast Rapid Transit (GCRT) System as a priority Project in SEQIPP with a cost estimate of $1.67 billion. This Project is a


September 2008


major public transport ‘spine’ linking the Gold Coast rail line at Helensvale to Griffith University and Southport, and then following the coastline to Broadbeach and ultimately to Coolangatta. On 22 August 2008, the Minister for Transport, Trade, Employment and Industrial Relations noted the outcomes of the preliminary business case to date, which lean towards light rail as the preferred mode and Project delivery being staged, with priority given to the section from Griffith University to Broadbeach. The GCRT system will be of significant benefit to the Hospital, providing an alternate mode of transport for bringing patients, staff, visitors and students to the Precinct and the Hospital.

Queensland Transport is planning the development of the GCRT Project and has indicated a station servicing Griffith University and the GCUH is a priority for the Project. Construction of this station is included in the first stage of the Project. Queensland Transport advise that the rapid transit construction works adjoining the new hospital can be completed by December 2012, however the GCRT will not be operational by this time. Queensland Transport will provide bus arrangement to service the hospital until the GCRT is operational. A joint working group, facilitated by DIP, involving Queensland Health, Queensland Transport, GCCC and Griffith University is negotiating a whole of government outcome for the public transport interface within the hospital and university precinct.

Other public transport facilities will be incorporated in order to support the public transport components of the Precinct Framework. This will include pedestrian access between the proposed rapid transit stations and proposed bus stops on Parklands Drive.

4.15 Car park facilities 4.15.1 Procurement approach

As part of the initial business case, a car parking financial analysis was prepared in November 2007 discussing the proposed options for delivery of the car parking facilities. A copy of this report is located in Appendix D.

Queensland Health subsequently decided to procure the car parking facilities required for the GCUH under a Build Own Operate and Transfer (BOOT) style procurement process.

The car parking facilities comprise a minimum of 3,000 spaces in two separate vertical structures (the East and West Car Park), with the East Car Park to be completed by August 2010 to ensure sufficient parking is available for construction workers and commissioning of the hospital.

The lease term is expected to be between 20 and 25 years.

Queensland Health has commenced the competitive tender process to select the BOOT partner. The BOOT partner is proposed to be responsible for the operation and maintenance of all car parking spaces allowing for optimisation of operating costs across all car parks.

Expression for Detailed EOI closed on 25 August 2008. Queensland will release RFP documentation in September with RFP anticipated to close in November 2008 and contractual close targeted for March/April 2009.


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4.15.2 Car parking tariff

The staff car parking rates need to be agreed between Queensland Health and the private operator/consortium. The car parking financial analysis undertaken in November 2007 indicated that the car park facilities are unlikely be delivered at zero cost to Queensland Heath without car parking tariffs applicable to staff and visitors being increased by between 20% and 30% as compared to current parking rates applicable for staff working at the Royal Brisbane Hospital and Princess Alexandra Hospital.

4.16 Facilities management services Queensland Health is considering the possibility of entering into a Facilities Management contract with a Managing Contractor and/or a nominated third party provider. The specialist provider would provide certain facilities management services over a 20 year operational phase, commencing upon completion of construction of the GCUH. Collecting like elements into the overall ambit of responsibility of a facilities manager should result in better initial installation or choice of plant and or equipment.

Alternatively these services would be managed by a facilities manager within Queensland Health, with some outsourcing to third parties through supply agreements. The Queensland Health Strategic Working Group for Industrial Relations is in the process of assessing the industrial relation issues pertaining to this opportunity and is expected to provide feedback in late 2008.

The following services are proposed for inclusion in either a facilities management contract or within the remit of a facilities management group provided by Queensland Health:

• building maintenance

• grounds maintenance responsibility

• external cleaning

• utilities Management

• facilities Management helpdesk and associated management services.

4.16.1 Building maintenance

Facilities management will provide a comprehensive building maintenance service on a full “lifecycle” basis. The service will cover all facilities on the GCUH campus and will include “Group 1” equipment items such as heating, ventilation and air conditioning plant, lifts, and fixtures and fittings, which could be within a Managing Contractor’s remit. Equipment items in “Group 2” and “Group 3” would generally be acquired, maintained and replaced by Queensland Health in accordance with conventional maintenance arrangements.

Queensland Health will prepare a specification setting out its requirements in relation to the following building maintenance services:

• maintenance planning

• planned and preventative maintenance

• programmed replacement maintenance


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• statutory maintenance, testing, auditing and certification

• reactive maintenance

• condition-based survey.

Maintenance planning

The facilities manager will be required to prepare monthly and annual maintenance plans setting out the activities and rosters to be implemented over the relevant period in various parts of the facility. The plans will reflect the requirements of condition based surveys, planned and preventative maintenance activities and programmed replacement maintenance. In addition, the facilities manager may be required to prepare five-year plans setting out the programmed replacement maintenance to be carried out over the period. Under a Managing Contractor arrangement the facilities manager would also be required to prepare maintenance manuals comprehensively setting out the detailed information and procedures essential to effective management of the maintenance services.

Planned and preventative maintenance

The facilities manager will be required to perform preventative and condition-based maintenance and associated testing and inspection services. Under a Managing Contractor arrangement the facilities manager would need to provide scheduled maintenance activities to ensure that all elements within the facilities meet certain specified minimum condition standards.

Programmed replacement maintenance

The facilities manager will be responsible for replacing facility components in accordance with a pre-agreed program reflecting appropriate component life-cycles.

Statutory maintenance, testing, auditing and certification

The facilities manager will be responsible for carrying out maintenance, testing, auditing and certification to ensure the facilities comply with applicable laws and with the requirements of the facility maintenance plans. This may include, for example, maintenance and testing of back-up generators, emergency lighting, fire systems, and some communications systems.

Reactive maintenance

The facilities manager will provide a reactive maintenance service to rectify any damage, defects or other faults in the facilities. The facilities manager must carry out the reactive maintenance to ensure that the facilities comply with minimum condition standards determined by Queensland Health. Under a Managing Contractor arrangement comprehensive specifications would be set out with response and rectification times and other requirements that must be met in relation to different types and severity of building and equipment failure.

Condition-based survey

The facilities manager will generally be required to carry out a condition based survey of the facilities at least every five years to record elements that do not comply with the minimum maintenance standards and to describe the maintenance program that is necessary to implement all necessary repair, replacement and refurbishment activities.


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4.16.2 External cleaning

The facilities manager will be required to carry out a programmed clean of external surfaces of the facility on an annual basis. Under a Managing Contractor arrangement the facilities manager would develop a manual detailing the procedures to be followed to carry out the cleaning to comply with minimum standards that will be specified by Queensland Health.

4.16.3 Grounds maintenance

The facilities manager will be responsible for maintenance of the campus grounds including lawns and gardens, internal roads, pathways and other paved areas, external lighting, furniture and other elements of external infrastructure. The service will not include maintenance of the car parks which will be provide by a private car park operator under a separate BOOT contract.

The service will involve reactive maintenance and planned and preventative maintenance of the Hospital grounds. Under a Managing Contractor arrangement the facilities manager would be required to provide an operating manual detailing how it will provide the services to meet minimum standards that will be set out in the service specification provided by Queensland Health.

4.16.4 Utilities management service

The facilities manager will be responsible for ensuring the continuous provision of the following utilities to the facilities:

• electricity

• gas

• fuel oil

• water

• sewerage

• surface water, stormwater and in-ground water disposal.

The facilities manager will be required to maintain supply from the relevant utilities meter and to ensure that adequate capacity is provided to supply the requirements of the GCUH under foreseeable operating conditions. The service will include:

• undertaking all testing, cleaning and maintenance, including complying with any reasonable requirements of the utility provider

• providing and ensuring backup systems are continually operational and there is no interruption in the provision of emergency backup systems

• complying with policies for energy management and energy conservation

• developing and implementing contingency plans for addressing and minimising the affect of the possible loss of one or more Utilities

• providing adequate sub-metering to support Queensland Health’s utilities reporting requirements, including any arrangements that are entered into by the parties to share the risk of energy consumption.


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Under a Managing Contractor arrangement, Queensland Health could transfer a level of energy volume risk to the facilities manager to incentivise the Managing Contractor to implement energy efficient designs and building management systems and to actively promote energy conservation measures during the term of the operations contract.

4.16.5 Helpdesk and associated management services

The facilities manager will be required to establish a helpdesk which will operate 24 hours per day, 7 days per week and to be the primary point of communication for all requests regarding the delivery of facilities management services. In particular, the helpdesk will accept notification of faults and complaints relating to the facility management services, coordinate facilities management responses to service failures and provide a system for logging and reporting calls, service failures, incidents, work orders and a range of other relevant information.

The helpdesk will be required to use appropriate software applications to support the above functions. In particular, the software application will be required to support performance monitoring and to generate a monthly performance report which will support the monthly invoice and will calculate the level of any payment abatements that are applicable because of service failures.

Queensland Health’s service specification may require the facilities manager to undertake a range of management services that are complementary to its facilities management services. These management services may include activities such as quality assurance; disaster, fire and emergency management; employee training; occupational health, safety and rehabilitation; risk management and similar activities.

4.17 Single bed allowances The profile of the GCUH, being a major tertiary / super-speciality hospital for South East Queensland, together with other planned tertiary hospitals for the region, prompted an investigation by Queensland Health’s Capital Works & Asset Management Branch (CW&AMB) into the optimal proportion of single beds to multiple beds.

In November 2007, the Capital Works & Asset Management Committee (EMT – inc Strategic Reference Committee Qld Health Major Hospital Projects) endorsed that the planning for the three major hospital projects (including the GCUH Project) were to proceed on the basis of the following proportion of single bed rooms:

• 100% single rooms for critical care areas, mental health, immuno-compromised and infectious patients

• 80% single rooms for high acute ward environments

• 60% single rooms for variable acuity medical wards


It should be noted that the room sizes will vary from 24m2 (critical care), to 15-18m2 (high/variable acuity) to 12m2 (mental health). Queensland Health is also undertaking some further analysis of the recurrent costing associated with the increased amount of the single bed rooms.


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Applying these principles has increased the single bed ratio for inpatient units from current Queensland allowances of 25% to between 71% and 75%. Along with an increase in the proportion of single bed rooms, the Queensland Health recommended single room size for the GCUH is an increase from the current AHFG room size of 15m2 to 16.5m2. The increase in proportion of single rooms together with the increase in room sizes results in a requirement for an additional space of 5,123 m2.

Increasing the number of single-bed rooms will also have an impact on other rooms and spaces within the Hospital, for example, circulation areas will increase from the standard 32% to 40%. A ‘pod’ ward design with decentralised staff stations and supplies is also proposed.

4.17.1 Studies supporting single beds

The significant increase in single-beds to multi-beds is based on the findings and recommendations of the CW&AMB investigation that reviewed over 150 evidence based research studies. Of particular relevance to the investigation were recent studies undertaken by the European Health Property Network UK (2004), and the American Institute of Architects (2006). The Fiona Stanley Hospital Assessment of the use of single patient rooms (August 2007) was also used as a key reference for the study.

The CW&AMB literature review identified a strong body of opinion which suggests that an increase in provision of single-bed rooms will help to improve performance and reduce costs simultaneously, by decreasing the risks of adverse clinical events and increasing operational efficiencies. These findings are discussed further in the sections below.

The proposed single bed allocation for the GCUH is consistent with worldwide trends. In Australia, the Royal Children’s Hospital in Melbourne is planning for 80-90% single bed rooms, while the Fiona Stanley Hospital in WA has recommended 83% inpatient single bed rooms plus 100% single-bed rooms in ICU, short stay and mental health units.

Recent studies conducted in Australia and internationally (particularly Europe and the United States) provide strong arguments for an increase in the proportion of single-bed rooms. Studies recommend that decisions for the optimal single-bed ratio should reflect the population profile of the Hospital and clinical service mix. Accordingly, a tertiary teaching hospital will have a higher preferred single-bed ratio compared to secondary and community hospitals.

The findings of these studies point to a number of benefits for increasing the number of single patient rooms and these are summarised below. However, potential risks should also be acknowledged including the creation of public and clinical expectations of single rooms, potential for increased staffing costs and possible shift in demand from privately insured patients.

4.17.2 Benefits of increased single-bed

4.17.2.1 Infection control

It is estimated that around 35% of healthcare-associated infections are acquired from other inpatients. The associated cost to Queensland hospitals is estimated to be around $2.8 million per 100,000 population per year. The proximity of patients in a multi-bed environment and staff behaviour leading to person to person transmission (e.g. contact by hands) have been cited as contributing to the spread of infections. The risk of infection has been found to increase in higher acuity settings as there is a greater proportion of immuno-compromised patients. An


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increase in multi-resistant pathogens and ageing population are seen as risks to infection control.

Evidence based design studies have found that the provision of single patient rooms contributes to lowering the incidences of hospital acquired infections. Reasons include better protection against airborne pathogen transmission by enabling isolation of patients; restricting pathogen transmission by direct contact; and encouraging culture change toward hand washing. There are of course a range of important factors to controlling infection rates including an appropriate design to re-enforce behavioural change.

The annual potential savings through effective isolation of infectious patients in single-bed rooms is estimated at between $0.25 to $1 million per 100,000 population.

4.17.2.2 Reduction in clinical errors

Medication dispensing errors have been found to increase with noise distractions and interruptions typically associated with multi-bed rooms. Multi-patient rooms often necessitate patient transfers and this is another source of medication error due to delays, communication discontinuities among staff and loss of information for example.

4.17.2.3 Reduction in patient falls and injuries

Patient falls is the second highest cost associated with adverse events in hospitals in the United States. Additional costs result from extended lengths of stay, morbidity, mortality and litigation. Improved single-bed room visibility, designs that encourage a presence of family and carers and decentralised staff stations help to increase surveillance and therefore reduce patient fall incidents.

4.17.2.4 Shorter length of stay

Single bed rooms can also contribute to shortening length of stay periods. International studies (for example Ulrich et al., 200415) indicate that the physical environment strongly impacts hospital-acquired infection rates and that evidence-based design measures (including climate and sunlight influences) play a key role in shortening hospital stays. Other international studies have attempted to estimate the impact on the length of stay of patients that have hospital acquired infections (HAI).

In particular, a study undertaken in the UK16 estimated that the average length of stay of non-HAI patients was 7.6 days compared to HAI patients of 21.7 days. The reduction in length of stay provides for a greater capacity for the facility in terms of population it can serve and hence net reduction in overall health costs for the district.

4.17.2.5 Patient impacts

The GCUH design principles embrace a positive healing environment. Single-bed rooms create a more therapeutic environment which provide patients with more control and choice over their environment, thereby reducing stress levels and improving healing. Increased patient privacy and patient satisfaction are further benefits of the single-room concept.

15 Ulrich, R.S., Zimring, C., Joseph, A., Quan, X., and Choudhary, R. (2004). The role of the physical environment in the hospital of the 21st century: A once-in-a-lifetime opportunity. 16 R.Plowman, N Graves, M.A.S. Griffin, J.A. Roberts, A.V. Swan, B Cookson and L. Taylor: The rate and cost of hospital acquired infections in patients admitted to selected specialties of a district general hospital is England and the national burden imposed. Journal of Hospital Infection 2001 47:198-209.


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4.17.3 Cost impacts

4.17.3.1 Capital cost impacts

The following table shows the impact of the additional 5,123 m2 on the Proposed Delivery Model Capital Cost Estimate of $38.4 million in nominal dollar terms.

Table 4.11 Additional space due to increase single rooms (by planning unit)

Additional space due to single rooms Planning Unit Floor Space (m2) Nominal $M Generic Inpatient Unit 1,940 14.5 Division of Medicine 240 1.8 Division of Surgery and Critical Care Services 375 2.8 Division of Family, Women & Children 620 4.6 Division of Mental Health & ATODS 360 2.7 Division of Community, Allied, Rehabilitation and Aged Services

240 1.8

Sub total 3,775 28.3 Travel 604 4.5 Plant 744 5.6 Total increase in area 5,123 38.4 Source: GCUH Architecture, DLA

4.17.3.2 Facilities cost impact

The facilities management additional operating cost of the increased single bed space allocation is shown in the following table in 1 July 2007 terms.

Table 4.5 Additional facility cost associated with increased single beds

Facilities management cost category July 2007 dollars($ 000)

Annualised life cycle costs 899 Annual electricity, gas and water costs 497 Internal Cleaning 307 Total recurrent costs 1,703 Source: Source: DLA Notes:

1 Life cycle costs (LCC) includes a capex and opex component. The capex component is the annualised cost of replacement or renewal items of a capital nature. The opex component includes all mandatory and non-mandatory maintenance and outgoings.

2 LCC excludes internal portage, internal cleaning and waste management

3 LCC costs includes help desk, external cleaning to the facades and grounds and for a Facility Manager.

4.17.3.3 Other recurrent costs

An impact analysis of other recurrent costs associated with the increase in single beds is currently being developed by Queensland Health. However, this information will not be finalised until after the submission of this Business Case. It is understood that the analysis will include the impact on staffing levels and the potential recurrent cost savings impact.


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Staffing levels

Initial research by the CW&AMB indicates that the levels of nursing staff is not expected to be significantly impacted as a result of increasing the proportion of single-bed rooms. This is primarily due to the following assumptions:

• The proposed new ‘pod’ ward design is implemented with appropriate designs to increase visibility into patient rooms (e.g. increased use of glass) together with decentralised staff and supplies stations.

• Staff workloads will continue to be allocated via a patient-nurse dependency system.

• Various international studies support the initial findings by the CW&AMB in relation to minimal staffing levels impacts. In particular, the Fiona Stanley Hospital Business Case (August 2007) cites the following studies:

“Heindrich et al. (2004) reported that in hospitals that adopted single patient room concept, combined with adequate decentralised nursing bases and supplies, staffing ratio did not increase, and in fact marginally declined. Chaudhury and colleagues (2003) observed that although monitoring of patients and staffing was initially considered somewhat problematic in both single and double rooms, the multiple advantages (e.g. control over infection transmission, flexibility for families, less medication and diet errors, suitability for confidentiality, faster recovery rate, etc.) rapidly outweighed the initial concerns. The same study reported that staff efficiency was found to be greater in single patient rooms. Moreover, there are currently no published peer-reviewed studies indicating an increase in staffing requirements linked with single patient rooms.”

Extracted from the Fiona Stanley Hospital Business Case (August 2007)

Recurrent cost impact savings

The initial research conducted by the CW&AMB suggests that these should decrease due to better infection control and potential reductions in adverse clinical events. Single patient rooms have been associated with a more efficient environment to achieve improved bed utilisation, shorter lengths of stay and reduced patient transfers leading to reduced recurrent costs.

As noted earlier a detailed cost impact analysis is currently being undertaken by Queensland Health and this will include a recurrent cost savings analysis. In relation to savings through effective isolation of infectious patients, the GCHSD has initially estimated these savings to be in the range of $0.25m - $1.0m.

4.17.4 Decision to increase the proportion of Single Beds

The capital cost of this increase required is $35.6m in nominal terms, and less than 2% of the Proposed Delivery Model Capital Cost Estimate. Recurrent additional operating costs are $1.7m and less than 2.5% of the annual average Facilities Maintenance and Management estimate. An impact analysis of recurrent cost savings (matching the benefits outlined above) is currently being developed by Queensland Health. It is noted that the policy position of Queensland Health will only be confirmed once the recurrent cost studies currently underway are completed.

Queensland Health believes when considering the marginal relative cost of this decision to the overall budget, that the qualitative (and quantitative) evidence presented in this Business Case together with the results of the recurrent cost study is sufficient to validate the policy position.


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5 Proposed procurement method This chapter of the Business Case provides information on the selected procurement method for the GCUH Project. In particular it describes:

• the selection of the proposed procurement method

• definition of the proposed procurement method

• key commercial principles of the proposed procurement method

• proposed project plan including indicative timetable and resources.

5.1 Proposed procurement method The decision making process in relation to the selection of the proposed procurement approach for the GCUH has been completed separately to this Business Case process. The Cabinet Budget Review Committee in April 2007 determined that the current Business Case for the GCUH Project would not consider an option for delivery of the hospital as a Private Finance Initiative/Public Private Partnership.

In determining the preferred procurement method, the Department of Public Works (DPW) undertook extensive consultation with Tier 1 (major) contractors given the current unprecedented level of construction activity in the building and civil infrastructure areas. There are currently nine Tier 1 Building Contractors servicing the Queensland market. Consultation in early 2007 included formal meetings between DPW’s Deputy Director General (Works) and Director Contracts and the CEO level of each of the major contractors.

This consultation resulted in the decision to tailor procurement strategies to attract an appropriate tender market for the major projects. These strategies have included key factors that contractors noted as important to be attracted to the State Government building works, including:

• a general registration of interest in early 2007 to encourage forward planning of projects to enable contractors to better plan for undertaking government work

• a more specific Expression of Interest in April 2007 based on the 14 Government building contracts known to be going to tender within the next 18 months to 2 years. The Expressions of Interest were scored by an evaluation team and contractors ranked by score for each Project. The interest in the Project, the ranking order, an acceptable level of score, projects won at tender and eligibility under the DPW PQC system were factors in determining the final select tender list.

• agreement with industry to a Managing Contractor form of contract well known to industry but including provision for early contractor involvement to enable contractors to not only provide value adding services to the Project, but also to enable the contractors to secure the required supply-chain resources early (e.g. trade subcontractors).

The key stakeholders for the GCUH Project (Queensland Health, DPW, Treasury, Department of Infrastructure and Planning) in March 2007 participated at a number of procurement analysis workshops which considered a range of procurement methods for the Project including Alliancing, Design, Construction and Maintenance and Managing Contractor and hybrids of these three methods. The participants at the workshop identified a number of advantages for the Managing Contractor method.


September 2008


Queensland Health and the DPW endorsed the selection of the Managing Contractor Guaranteed Construction Sum as the proposed procurement method for the GCUH in April 2007. The proposed advantages given for the selection of the procurement method included:

• the appointment of the Managing Contractor at an early stage ensures that, in a period of unprecedented construction activity in the building and civil infrastructure areas, the Project has certainty of construction resources

• provides a greater degree of price certainty – once the Guaranteed Construction Sum is agreed between parties

• allows Queensland Health to commence work on the Project quickly and easily – as not all issues need to be resolved prior to the appointment of the Managing Contractor

• reduces Queensland Health’s exposure to design and construction risks – as the risks are transferred to the Managing Contractor.

The Managing Contractor Guaranteed Construction Sum is also the procurement method that has predominantly been used by Queensland Health to undertake major capital works over the past decade. Further details on the advantages and disadvantages of the Managing Contractor procurement model are provided in Section 5.4.

5.2 Description of the proposed procurement process In delivering the Project with the Managing Contractor Guaranteed Construction Sum procurement method there are three further distinct phases to be completed following the completion of the Master Plan and the Project Definition Plan, including:

• the development of the Schematic Design phase completed by the Project Team including a Building Consultant and the appointment of a Managing Contractor to proceed to the next stage of the procurement process.

• the Managing Contractor undertaking the Developed Design phase and producing a Guaranteed Construction Sum (GCS) Offer. The GCS Offer is assessed and upon agreement of acceptable terms the Managing Contractor is appointed. This phase will include early works packages.

• the Managing Contractor undertaking construction work, commissioning work and all other design work and documentation work not completed in the previous phase.

The three phases and the key tasks to be completed in each phase are outlined in the following table.

Table 5.1 Key procurement phases




The Project Team & Building Consultant (BC):

• complete the Schematic Design

• finalise the draft Contractual Terms for Managing Contractor (MC) Contract

• prepare revised Project Capital Budget

The Project Team:

The Project Team and MC:

• complete the Developed Design for the facility

The MC:

• engages consultants

• prepares GCS

• submits proposal including GCS to Project Team

The MC and the Project Team:

• complete the Construction Documentation (Project Team reviews)

• completes construction of the facility (Project Team reviews and makes progress payments to MC)

• complete decanting into the


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• Prepares the Request for Tender Documentation for the MC and conducts the process

• Provides updated Business Case (e.g. revised Capital Budget) to CBRC for endorsement

• Appoints the MC to complete Developed Design and submit proposal including GCS

The Project Team:

• Reviews the MC’s proposal and if required further negotiates price and terms

• Seeks approval from Queensland Health to accept the offer

new facility

• Complete the defects liability period for the facility (Project Team reviews)


Phase 1 - Schematic Design and the appointment of the Managing Contractor

A Building Consultant has been appointed as part of the consultant team to complete the Project Definition Plan and Schematic Design. The role of the Building Consultant in the development of the Schematic Design is to provide key subcontractors’ input into the design stages, allowing (amongst other benefits), resources and industry production rate constraints to be factored into the overall Project planning as well as value management and constructability advice.

Appointment of the Building Consultant

Two construction companies were asked to formally tender for the Project role as the Building Consultant. The two construction companies were Bovis Lend Lease and John Holland.

In tendering for this consultancy, tenderers submitted a proposal which contained fees for undertaking the services and they also addressed specific non-price selection criteria including their proposed resources, experience and capacity to provide consultancy design advice in the development of the Project Definition Plan and Schematic Design.

The tendered proposals were evaluated and Bovis Lend Lease was selected as the Building Consultant.

Other major consultants employed for the Project include:

• Project Manager

• Quantity Surveyor

• Programmer

• Principal Consultant and Architect

• Services Engineers

• Civil and Structural Engineers.

As part of the Schematic Design phase the proposed Capital Estimate is further refined by taking into account the additional design work and technical studies completed.

The contractual terms and conditions of the Managing Contractor Contract are finalised during this phase. Managing Contractor tenderer(s) will be required to tender:


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• fees to undertake the works including management fees, off site overheads, profit, onsite overheads and consultant fees

• proposed resources to complete the design and construction of the facility including proposed personnel and their capacity and commitment to the Project

• experience of the organisation and personnel proposed

• methodology for the construction of the proposed facility.

One or more tenderers may be invited to tender for the role of the Managing Contractor. While the Building Consultant role is only to the end of the Schematic Design, there is an intention the Building Consultant will be invited to submit a tender for the role of Managing Contractor. However, there is no contractual requirement for this to occur. The State can invite only the Building Consultant to submit a proposal or alternatively can invite other organisations not including the Building Consultant to submit proposals. The Building Consultant shall be invited to tender for the Managing Contractor role as a single select tenderer.

The Project Team will also provide an updated Business Case to the Cabinet Budget Review Committee which will contain the revised capital estimate. CBRC endorsement of the Business Case will provide the basis for a request to Governor-in-Council for funding approval for the endorsed Project sum.

The Project Team will evaluate the proposal received from the Building Consultant to act as Managing Contractor and will make a recommendation.

The State will then appoint the Managing Contractor to proceed with the Developed Design process and the preparation of a Guaranteed Construction Sum Offer.

For the remaining phases of the Project, the Project Manager, Quantity Surveyor and Programmer will provide audit role services. All of the other consultants’ commissions with the State will end and they will be engaged by the Managing Contractor for the Developed Design Process and subsequent stages.

To meet the predetermined completion date of December 2012, a Prior Works contract has been implemented. The Building Consultant was asked to tender on a medium works contract that will be rolled into the Managing Contractor contract as early works. The significant scope of works in the Prior Works contract is bulk earthworks, demolition and fencing.

Phase 2 – Agree Guaranteed Construction Sum and obtain approval to proceed (Developed Design)

The Managing Contractor will work with the Project Team to undertake the Developed Design phase. The Developed Design phase will result in a design that has been developed to the stage where the scope, spatial requirements, functionality and quality standards of the Project are sufficiently detailed to allow the Project to be costed and constructed with a suitable degree of certainty. Where approved, documentation and construction of early works packages may also be undertaken.

Based on the work completed in the Developed Design phase and earlier work, the Managing Contractor will prepare a Guaranteed Construction Sum Offer. The Guaranteed Construction Sum is the maximum price payable to perform construction work for the proposed Project. The


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Managing Contractor will then submit to the State the Guaranteed Construction Sum as part of a ‘GCS Offer’ for consideration. The ‘GCS Offer’ will include:

• a Guaranteed Construction Sum

• a time for Practical Completion

• documentation identifying the design upon which the Guaranteed Construction Sum is based, including a revised Project Brief whereby any changes from the original Project Brief are clearly shown

• an elemental cost plan

• the Managing Contractor’s proposed trade package breakup and estimate for each trade package.

On behalf of the State, the GCS Offer shall in the first instance be reviewed by the Project Team (i.e. Principal’s Representative, Project Director, Project Manager, Audit Quantity Surveyor and Audit Programmer). The State has the option of either rejecting or accepting the GCS Offer. If the GCS Offer is considered acceptable (i.e. consistent with the funding allocation approved by Governor-in-Council) then the Project Team will seek approval from Queensland Health to accept the GCS Offer.

However, if the GCS Offer is considered unacceptable then the following options are available:

• further negotiate, with the Managing Contractor, the Guaranteed Construction Sum, scope of work and/or terms and conditions of the contract until an acceptable outcome is achieved

• terminate the Managing Contractor Contract. The State may then invite other organisation to submit GCS Offers based on the documents that have been produced through the Schematic Design and Developed Design phases. The State will then assess the submitted GCS Offers and again has the option to either accept or reject the GCS Offer.

Upon acceptance of a GCS Offer, contractual close is reached and the Project proceeds to the next phase of procurement (i.e. Construction Documentation and Construction).

Phase 3 – Construction Process

Upon acceptance of the GCS Offer the Managing Contractor will be responsible for the completion of the design and construction of the Gold Coast University Hospital and associated infrastructure. If facilities management is also incorporated into the contract then the Managing Contractor will provide these services for the length of the contract term. The major tasks to be completed during this phase include:

• completion of the Developed Design and Construction Documentation process. This task is completed by the Managing Contractor and includes the finalisation of the design documents and work packages. The Project Team will review and monitor the Construction Documentation

• construction of the facility. The Managing Contractor will be responsible for the management of the construction process and the Project Team will review and monitor construction and also administer the contract. During the construction process the State will make progressive payments to the Managing Contractor for the construction of the Project


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• commissioning of the facility. The Managing Contractor will complete the predetermined commissioning tests required for the facility. The Project Team will monitor the commissioning process

• decanting into the new facility. The decanting process will include the transfer of predetermined furniture, fixtures, plant, equipment, records, staff and patients from the existing Southport campus to the new facility. The decanting process is likely to be conducted on a progressive basis

• completion of the Defects Liability Period. The Defects Liability Period is a set period of time in which the Managing Contractor has to be available to quickly and efficiently resolve any defects that appear. The Managing Contractor contract will include provisions where a level of security (e.g. retention of money or performance bonds) is held by the State until the Defects Liability Period is satisfactorily completed.

5.3 Commercial principles The final contract terms and conditions of the Contract are finalised. These terms and conditions were developed in parallel with the design process. A ‘Draft Managing Contractor Two Stage Design and Construction Management Contract’ was provided in the Building Consultant’s tender documents as a guide and the final contract is similar. The contract for this Project is a Managing Contractor Design and Construction Management Stage One with option for Stage Two (Negotiated Guaranteed Construction Sum). The key commercial principles included in the Managing Contractor contract documents are discussed below.

5.3.1 General risk allocation

The Managing Contractor warrants to the Principal that the Managing Contractor has investigated and satisfied itself of the adequacy and suitability of the GCS offer Project brief and the contract to enable the Managing Contractor to perform all of the work under the contract without limitation in accordance with the Contract. In particular the Managing Contractor warrants the sufficiency of the Guaranteed Construction Sum.

In general terms the Project risks are transferred from the State to the Managing Contractor following acceptance of the ‘GCS Offer’ and the high level proposed allocation of risks is shown in the following table:

Table 5.2 High-level risk allocation

Risk Managing Contractor

State

Design and documentation Actual cost of construction Scope changes Inadequate Project brief or GCS offer brief Wet weather Latent conditions as defined in the contract Defective design Authority approvals Escalation Fit for intended purpose


September 2008


Risk Managing Contractor

State

Defective workmanship Industrial (site specific) Principal delays Managing Contractor in decision making Delay in delivery of Group 2 and Group 3 FF&E Labour shortage Subcontractor default Environmental Noise, dust and nuisances Performance warranties Consultant performance Statutory changes Source: Project Services

A more detailed risk matrix is provided in Appendix C to this Business Case, which includes a description of the identified risks, their proposed allocation, a mitigation strategy and an indicative quantification.

5.3.2 Performance bonding (security)

It is proposed that the Managing Contractor will be required to provide security and retention moneys. All security provided by the Managing Contractor shall be in the form of either cash or an approved unconditional undertaking given by an approved financial institution or insurance company.

During Stage two, the proposed amount of retention moneys or security in lieu of retention moneys is 10% of each progress payment up to a limit of 5% of the Guaranteed Construction Sum. At Practical Completion it is anticipated that the amount of retention moneys or security is reduced to 50%. Following the issue of the Final Certificate, the remaining retention moneys or security is released.

5.3.3 Liquidated damages

Queensland Health and Department of Public Works have agreed that Liquidated Damages clauses will not be included in the contract. However there is a maximum liability of the Managing Contractor to the Principal for costs and damages for failure to reach Practical Completion of the Works within a reasonable time. The limit is $50million.

5.3.4 Defects liability period

The Defects Liability Period is 12 months. However, a 24 months Defects Liability Period will apply to nominated plant / services.

5.3.5 Foreign Currency Exchange Risks

The Contract will allow for variations in rates of foreign exchange and duty. The Managing Contractor has to nominate, prior to Stage Two of the Contract, those goods from overseas that will be subject to foreign exchange and duty. The Contract provides a formula for adjusting the values of overseas goods.


September 2008


5.3.6 Insurance

Insurance provisions for the Contract are being finalised. A Principal Arranged Insurance Program is being implemented and a current State Government contract is being extended for this Project. Insurances that may be required are as follows:

• insurance against loss or damage to the Works.

• public liability and third party insurance

• professional indemnity insurance

• insurance of employees.

Appropriate levels of insurance will be determined during the tender of the Managing Contractor.

5.3.7 Price

The Guaranteed Construction Sum is the maximum price that may be payable by the Principal to the Managing Contractor to perform all construction work, as adjusted in accordance with the provisions of the Contract. Construction work excludes onsite overheads, off site overheads, design work and documentation work.

This contract allows for a construction bonus which is applied when the final Actual Construction Sum is less than the adjusted Guaranteed Construction Sum. The Managing Contractor receives a 20% bonus on the difference to a maximum 2% of the Actual Construction Sum.

In developing the Contract, discussions were held with the Building Consultant to assist in ascertaining appropriate commercial terms for the contract. The Managing Contractor shall engage key subcontractors for Stage One to advise on design and costs and will tender approximately 75% of trade packages for the GCS Offer.

5.3.8 Termination provisions

The contract includes a number of instances where termination may occur:

• substantial breach of Contract by either the Managing Contractor or State

• insolvency

• frustration

• rejection of Guaranteed Construction Sum offer

• at the Principal’s sole discretion.

Where there is a substantial breach of contract by the Managing Contractor, the State may take out of the hands of the Managing Contractor the whole or part of the work remaining to be completed or may terminate the Contract. The Managing Contractor’s exposure is not limited to just costs and damages.

Where there is a substantial breach of contract by the State, the Managing Contractor may suspend the whole or any part of the work under the Contract. This may end in termination. The Managing Contractor shall be entitled to recover any damages.


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Where the Managing Contractor becomes insolvent, the State may take out of the hands of the Managing Contractor the whole or part of the work remaining to be completed or may terminate the Contract. Termination may also occur if the Contract becomes frustrated. The State shall pay the Managing Contractor for work completed and incurred. The State may take possession of drawings, specifications and other information.

Under the contract, the Managing Contractor submits a GCS offer. The State may accept the Managing Contractor’s GCS offer or reject the Managing Contractor’s GCS offer. If the Managing Contractor’s GCS offer is rejected by the State, the State may terminate the Contract. The State may also go to tender with any of the documents that have been produced. If the Managing Contractor has not submitted a GCS offer within the nominated time frame then there is a substantial breach.

The State may at any time at its sole discretion and without obligation to act reasonably, by written notice to the Managing Contractor terminate the Contract. The State shall pay the Managing Contractor for work completed and incurred. The State may take possession of drawings, specifications and other information. The State shall not be liable to the Managing Contractor for any cost, loss, expense or damage incurred by the Managing Contractor including without limitation compensation for loss of profits.

5.3.9 Maintenance and facility management

As previously addressed in section 4.16, some maintenance and facility management services are currently being investigated by Queensland Health to determine the extent that maintenance and facility management may be included within the contract of a Managing Contractor.

To achieve this, Queensland Health in conjunction with the Department of Public Works have engaged a facilities management consultant to work with the Asset Management Unit of Queensland Health to determine a set of key performance indicators (KPIs) for maintenance levels/activities that can be used across all health facilities.

In addition to this, Bovis Lend Lease (BLL) in its role as Building Consultant, has engaged a separate facilities management consultant to review the adequacy of the Schematic Design report in relation to whole of life considerations. This consultancy has been extended to include the production of the necessary documentation to allow BLL to tender and appoint (notionally) two facilities management providers to work with the design team throughout the Detailed Design phase of the Project. The intent of this is to then allow the two facilities management providers to submit, for Queensland Health’s consideration, a fully costed proposal at the end of the Detailed Design phase for long term or extended maintenance of the facilities.

5.4 Advantages and disadvantages – (Managing Contractor Guaranteed Construction Sum) The following table identifies potential advantages and disadvantages associated with this approach.


September 2008


Table 5.3 Managing Contractor – Guaranteed Construction Sum Advantages and disadvantages

Managing Contractor – Guaranteed Construction Sum Key Advantages Key Disadvantages

• provides a greater degree of price certainty – once the Guaranteed Construction Sum is agreed between parties

• allows Queensland Health to commence work on the Project quickly and easily – as not all issues need to be resolved prior to the appointment of the Managing Contractor

• reduces Queensland Health’s exposure to design and construction risks – as the risks are transferred to the Managing Contractor

• the appointment of the Managing Contractor at an early stage ensures that, in a period of unprecedented construction activity in the building and civil infrastructure areas, the Project has certainty of construction resources.

• the Guaranteed Construction Sum for the Project is not competitively tendered but rather a negotiation between the State and the Managing Contractor – this may result in a price premium to the State

• the time saved by commencing early can be lost if the Managing Contractor fails to submit an acceptable ‘GCS Offer’ and the procurement process is delayed – leading to a delay in delivery of the Project.


Mitigation strategies for the Managing Contractor Guaranteed Construction Sum procurement method disadvantages include:

• Where the State believes the ‘GCS Offer’ does not offer value for money then the State has the options to:

- further negotiate, with the Managing Contractor, the Guaranteed Construction Sum, scope of work and/or terms and conditions of the contract until an acceptable outcome is achieved

- terminate the Managing Contractor Contract. The State may then invite other organisations to submit ‘GCS Offers’ based on the documents that have been produced through the Schematic Design and Developed Design phase (provided tenderers are available). The State will then assess the submitted ‘GCS Offers’ and again has the option to either accept or reject the ‘GCS Offer’.

• Where there is a delay to the Project due to the Managing Contractor failing to submit an acceptable ‘GCS Offer’ then the State may be forced to re-tender the Project. However, as the State owns all of the work completed by the Managing Contractor then the re-tendering process should be relatively short (approximately 3 to 4 months). The Project Team needs to ensure that any negotiations to the ‘GCS Offer’ with the Managing Contractor are not protracted and are terminated if sufficient progress is not being made.

• The effectiveness of the mitigation strategy may be reduced if substantial early works packages are undertaken prior to the acceptance of the ‘GCS Offer’.

Attached as Appendix J is a paper prepared by the Department of Public Works, explaining the rationale for using the Managing Contractor Guaranteed Construction Sum procurement strategy for the Gold Coast University Hospital.


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5.5 Proposed Project Plan The proposed Project Plan for the procurement, design and development are outlined in the following section. The Project Plan includes:

• list of the key resources (including consultants) required to execute the Project Plan

• an indicative timetable.

A high level description of the key procurement stages is provided in Appendix I.

5.5.1 Indicative Project Resources

The following table provides a preliminary indication of the Project resources (i.e. Queensland Health employees and external consultants) required through to completion of the Project. The table provides a breakdown of the resources into the key procurement stages going forward and also by resource classification.

Table 5.4: Indicative Project Resources

Resource Type Schematic Design

Developed Design


Construction Defects Period

Queensland Health (Major Projects & Gold Coast Team)

19.5 19.5 19.5 24.5 14.0

Project Managers 9.0 9.0 8.0 7.8 6.5 Architects 46.0 52.0 75.0 57.0 9.0 Engineering 42.0 51.5 63.0 18.0 4.0 Quantity Surveyors 4.0 4.0 4.0 4.0 Programming 4.0 4.0 4.0 4.0 Procurement and Principal Representative

3.5 5.0 5.2 6.2 3.0

Commercial & Financial 1.0 Building Consultant 11.0 Total (People) 140.0 145.0 178.7 121.5 36.5 Managing Contractor 37.0 94.0 184.0 4.0 Source: Queensland Health, Project Services, Building Consultant

5.5.2 Indicative Procurement Timetable

The following indicative Gantt chart shows the current forecast for significant procurement dates with regard to the key procurement stages.


January 2008


Figure 5.1 Procurement timetable

Source: Queensland Health


September 2008


6 Project cost estimates This section outlines the total cost of the Proposed Delivery Model, including the Managing Contractor Construction Cost, Queensland Health Project Development Costs, estimated annual clinical and support services costs and facility maintenance and management costs proposed for transfer to the contractor under a long-term operations contract. The section includes:

• a list of the project costs that are included in, and excluded from, the Project’s capital cost estimates

• contractor raw capital costs and project development raw capital costs under the Proposed Delivery Model

• escalation and risk adjustments to the capital costs

• total project capital costs

• annual facility maintenance and management costs

• annual clinical and support service costs

• depreciation expenditure associated with the project assets.

6.1 Key infrastructure components The following table describes the key infrastructure components that are included in, and those that are excluded from, the Project’s Capital Cost Estimate:

Table 6.1 Summary description of the Project infrastructure

Infrastructure included in Project Estimate Infrastructure excluded from Project Estimate Hospital buildings (165,000 m2) Car Park Costs Fixtures, fittings, furniture and equipment Griffith University Footbridge Demolition and site works External Road Upgrades Managing Contractor fees, statutory charges External Utility Service Upgrades Roads and other external infrastructure within the site boundary

Queensland Health procurement costs, professional fees & public art allowance

Site acquisition & relocation of existing facilities Griffith University Medical and Dental School Additional infrastructure Note: Additional infrastructure refers to additional external site infrastructure not included in the original scope of work. Source: Queensland Health

A more detailed description of the project is contained within section 4.

6.2 Gold Coast University Hospital contractor capital costs In order to develop the total capital cost for the Project, the following adjustments are made to the raw capital costs:


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• escalation adjustments

• transferred and retained risk adjustments.

This section identifies the value of the raw capital costs and the value of each of the above adjustments to provide an estimate of the total project capital cost.

6.2.1 Contractor raw capital costs

Queensland Health has developed the raw capital costs for the project in conjunction with various technical advisers, in particular Capital Insight, Davis Langdon Associates (DLA), Connell Wagner, SKM, S2F, GCUH Architecture and Project Services. The raw capital costs are summarised in the following table:

Table 6.2 Contractor raw capital costs

Items Proposed Delivery Model

$M Generic Inpatient Unit 134.72 Education & Research 21.31 Division of Medicine 184.36 Division of Surgery & Critical Care 128.38 Division of Family, Women & Children 86.56 Division of Mental Health & ATODS 30.40 Division of Community, Allied Health Aged & Rehabilitation Services 38.37 Division of Medical Services 82.35 Division of Pathology 41.83 Corporate Services, Amenities and Retail 101.79 Engineering and Travel 187.75 Central Plant etc 183.40 ESD Initiatives 67.84 External Works 63.44 Raw capital cost 1,352.51 Note: All costs are at the base date 01July 2008. Source: Queensland Health, DLA

Appendix B outlines the methodology and assumptions used to develop the raw capital costs.

6.2.2 Escalation adjustment

The project’s nominal capital costs have been calculated by adjusting the raw capital costs provided by the technical advisers for construction cost escalation.

The raw construction costs, managing contractor fees, professional fees and statutory fees have been escalated from the cost base date of 1 July 2008 at the rates in the following table, in accordance with assumptions agreed between DLA and the technical advisers on the Sunshine Coast Hospital and Queensland Children’s Hospital projects.


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Table 6.3 Capital cost escalation rates

Items Escalation rate 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 Construction costs, MC fees, novated professional fees and statutory fees 0.0% 8.0% 7.0% 6.0% 6.0% 5.0%

Source: DLA

Further details on the escalation rate are contained in Appendix B. The escalation rates have been applied to the raw costs in accordance with the following capital cost profile (S-curve) provided by the technical advisers.

Figure 6.1 S-curve profile of the Gold Coast University Hospital

S-curve raw capital cost

0.00%10.00%20.00%30.00%40.00%50.00%60.00%70.00%80.00%90.00%

100.00%

Jun-0

7

Oct-07

Feb-08

Jun-0

8

Oct-08

Feb-09

Jun-0

9

Oct-09

Feb-10

Jun-1

0

Oct-10

Feb-11

Jun-1

1

Oct-11

Feb-12

Jun-1

2

Oct-12

Feb-13

Jun-1

3

%

The following table summarises the nominal project capital costs (i.e. the raw project costs adjusted for escalation) for the Project assets.

Table 6.4 Contractor Nominal capital costs

Items Escalation $M Proposed Delivery Model $M

Generic Inpatient Unit 27.41 162.13 Education & Research 4.38 25.69 Division of Medicine 35.97 220.33 Division of Surgery & Critical Care 25.25 153.64 Division of Family, Women & Children 17.75 104.32 Division of Mental Health & ATODS 6.23 36.63 Division of Community, Allied Health Aged & Rehabilitation Services

7.90 46.27


September 2008



Division of Medical Services 14.69 97.03 Division of Pathology 8.36 50.19 Corporate Services, Amenities and Retail 20.70 122.49 Engineering and Travel 39.21 226.96 Central Plant etc 38.34 221.74 ESD Initiatives 14.18 82.02 External Works 13.26 76.70 Nominal Capital Costs 273.63 1,626.15 Note: All costs are in nominal dollars. Source: Queensland Health

6.2.3 Risk adjustment

The purpose of the risk adjustment is to provide a more accurate estimate of the project’s out-turn costs by quantifying the potential cost impact of individual project risks on a probability-weighted basis. The methodology used to quantify the risks is detailed in Appendix C. The proposed risk allocation contained in the draft Managing Contractor Contract (as advised by DPW) was assumed to allocate the quantified risk values into transferred and retained risk components.

6.2.4 Transferred risk adjustment

Transferred risks are risks that are transferred to the Managing Contractor under the proposed contract approach (i.e. if a transferred risk eventuates, the consequences will be borne by the Managing Contractor, including any cost impacts).

The following table details the mean value of the transferred risk adjustment in percentage and nominal dollar terms. The value of the transferred risk adjustment is added to the raw nominal capital costs to calculate the nominal capital cost adjusted for transferred risks. The transferred risks have been dissected in the table between risks which would primarily cause a delay to the project, with consequent impacts on cost escalation and certain time-based costs (e.g. Managing Contractor overheads), and risks that would lead to increases in project costs.

Table 6.5 Transferred risk adjustment

Items Proposed Delivery Model$M

Post Contract - Delay risks Building certificate delayed 2.39

Industrial action 0.80

Materials shortage 2.07

Breach of OH&S standards 0.89

6.14 Post-contract - Cost risks Escalation estimate inadequate 12.75

Non-compliance with PDP/Schematics 2.72

Detailed design error 0.74

Estimating error 17.96


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Items Proposed Delivery Model$M

Default of major sub-contractor 0.95

Shortage of labour (MC) 10.53

Change in law 0.16

45.82

Total capital cost transferred risk adjustment ($M) 51.97 % of total nominal Contractor Capital cost 3.20% Note: The transferred risk adjustments were based on a number of risk workshops. All risks are in nominal dollars. Source: Queensland Health – Risk Workshops

The transferred risks associated with the GCUH capital costs are discussed in more detail in Appendix C.

A detailed risk assessment (including quantification) was completed as part of the previous Gold Coast University Hospital Business Case and a reconciliation of the changes to the risk adjustments from the last Business Case including the rationale for the changes are provided in Appendix C.

6.2.5 Retained risk adjustment

Retained risks are risks that are retained by the State under the proposed contract approach (i.e. if a retained risk eventuates, the consequences will be borne by the State, including any cost impacts). The retained risk component has been dissected into two categories, as follows:

• risks that, if they eventuate, would lead to an increase in the level of Managing Contractor costs that are passed through to the State - these are listed in this section.

• risks that, if they eventuate, would lead to an increase in Project Development costs incurred by Queensland Health - these are listed in section 6.3.3.

The following table details the mean value of the retained risk adjustment in percentage and nominal dollar terms. The value of the retained risk adjustment is added to the transferred risk adjusted nominal capital cost to calculate the total risk adjusted nominal capital cost. The retained risks have been dissected in the table between delay risks and cost risks. These categories have been further dissected into risks that could occur prior to a contract being signed with the Managing Contractor and after a contract is signed with the Managing Contractor (the timing reflects the timing of occurrence of the risk, not the consequential impact on expenditures).

Table 6.6 Government retained risk adjustment


$M Pre contract - Delay risks Site access problems 12.20 GCS negotiations protracted 10.45 Contract drafting delayed 1.23


September 2008



$M 23.88 Pre contract - Cost risks Future proofing 2.81 Planning approval additional costs 0.13 Negotiations with MC fail, retender required 13.39 Escalation provision inadequate 2.25 Capital costs underestimated 35.17 53.75 Post contract - Delay risks Building certificate delayed 1.59 Equipment selection delayed 1.08 Default of MC 1.04 Materials shortage 0.52 Principal delays decision making 4.83 Commissioning delay – Energex substation 0.12 9.18 Post-contract - Cost risks Adverse geotechnical conditions 4.80 Non-compliance with PDP/Schematics 0.68 Equipment selection delayed 0.59 Client minor variations 15.54 External infrastructure upgrade required 0.50 Default of MC contractor 1.91 Change in law 0.49 24.51 Total capital cost retained risk adjustment ($M) 111.32 % of total nominal Contractor Capital cost 6.85% Note: The retained risk adjustments were based on a number of risk workshops. All risks are in nominal dollars. Source: Queensland Health – Risk Workshops

The retained risks associated with the GCUH capital costs are discussed in more detailed in Appendix C.


6.2.6 Total contractor capital costs

The following table summarises the estimated total Contractor nominal capital costs. These costs have been calculated by adjusting the raw capital costs provided by the technical advisers for escalation, transferred and retained risk adjustments.


September 2008


Table 6.7 Capital Costs – Gold Coast University Hospital


$M Generic Inpatient Unit 178.41 Education & Research 28.27 Division of Medicine 242.46 Division of Surgery & Critical Care 169.06 Division of Family, Women & Children 114.79 Division of Mental Health & ATODS 40.30 Division of Community, Allied Health Aged & Rehabilitation Services 50.92 Division of Medical Services 106.78 Division of Pathology 55.23 Corporate Services, Amenities and Retail 134.79 Engineering and Travel 249.75 Central Plant etc 244.01 ESD Initiatives 90.26 External Works 84.41

Total Contractor related capital cost 1,789.44 Note: Total capital costs include adjustments for escalation, transferred and retained risk adjustments. This table include retained risks even though they will not form part of the Total Contractor Price. Source: Queensland Health

6.3 Project development costs The project development costs included all costs incurred by Queensland Health in planning and procuring the project other than sums paid to the Managing Contractor. This section of the report summarises the adjustments for escalation and risk that have been made to the project development capital costs provided by the technical advisers.

6.3.1 Project development raw costs

Queensland Health has developed the raw capital costs for the project in conjunction with various technical advisers, in particular, Capital Insight, Davis Langdon, Connell Wagner, SKM, S2F, GCUH Architecture and Project Services. The project development raw capital costs are summarised in the following table:

Table 6.8 Raw project development costs

Item Proposed Delivery Model$M

Commissioning / decanting / QH Costs 31.00 Professional Fees 55.02 Public Art Allowance 2.00 Site acquisition 52.20 Additional infrastructure 62.20 Medical and dental school 62.20 Project Development Raw Costs 264.62


September 2008


Item Proposed Delivery Model$M

Notes (1) All costs are at the base date 01 July 2008. (2) Additional infrastructure refers to additional external site infrastructure not included in the original scope of work. Source: Queensland Health, DLA

More information on the raw project development cost is provided in Appendix B.


The escalation rates that apply to the project development capital costs are set out in the following table.

Table 6.9 Project development costs escalation rates

Items Project Development Cost Escalation Rates 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 Commissioning / decanting / QH Costs 0.0% 4.0% 4.0% 4.0% 4.0% 4.0% Professional Fees 0.0% 4.0% 4.0% 4.0% 4.0% 4.0% Public art allowance 0.0% 4.0% 4.0% 4.0% 4.0% 4.0% Site acquisition 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% Additional infrastructure 0.0% 8.0% 7.0% 6.0% 6.0% 5.0% Medical and dental school 0.0% 8.0% 7.0% 6.0% 6.0% 5.0% Source: Queensland Health and DLA

The escalation rates have been applied to the project development capital cost from the cost base date of 1 July 2008 in accordance with the expenditure profile in the following graph:

Figure 6.2 Project development cost – expenditure profile

S-curve project development capital cost

0.00%10.00%20.00%30.00%40.00%50.00%60.00%70.00%80.00%90.00%

100.00%

Jun-0

7

Oct-07

Feb-08

Jun-0

8

Oct-08

Feb-09

Jun-0

9

Oct-09

Feb-10

Jun-1

0

Oct-10

Feb-11

Jun-1

1

Oct-11

Feb-12

Jun-1

2

Oct-12

Feb-13

Jun-1

3

%


September 2008


The nominal Project development costs (i.e. the raw costs adjusted for escalation) are summarised in the following table:

Table 6.10 Nominal project development costs


Commissioning / decanting/QH Costs 2.99 33.99 Professional Fees 4.18 59.20 Public Art Allowance 0.36 2.36 Site acquisition 0.00 52.20 Additional infrastructure 13.66 76.26 Medical and dental school 16.16 78.76 Total nominal project development capital costs 37.35 302.76

Notes (1) All costs are in nominal dollars. (2) Additional infrastructure refers to additional external site infrastructure not included in the original scope of work. Source: Queensland Health

6.3.3 Project development capital costs risk adjustment

The following table identifies the mean value of the risk retained by Queensland Health in percentage and nominal terms – retained risks being those risks not fully transferred to the private sector.

Table 6.11 Project Development Cost - retained risk adjustment

Retained risk adjustment Proposed Delivery ModelNominal $M

Pre contract - Cost risks Early works require modification 0.11 Medical school escalation not separately funded 7.50 Inadequate site acquisition budget 3.00 10.61 Post-contract - Cost risks Delay due to shortage of labour resulting extended use of Southport facilities 0.80

Inadequate resourcing (decanting) 4.20 Southport facility not secured adequately following decant to GCUH 0.49

5.49 Total project development cost retained risk adjustment 16.10 % of total nominal project development cost 5.32% Note: The retained risk adjustment for the Project are based on a Managing Contractor procurement approach. Source: Risk workshops

The project development risks associated with the GCUH capital costs are discussed in more detailed in Appendix C.


September 2008



6.3.4 Total project development costs

The following table summarises the total nominal risk adjusted project development capital costs. These costs have been calculated by adjusting the raw capital costs provided by the technical advisers for escalation and retained risk adjustments.

Table 6.12 Total Project Development Costs – Gold Coast University Hospital


Nominal $M Total nominal project development capital costs 318.86

Note: Total capital costs include project development raw capital costs plus adjustments for escalation and retained risk. Source: Queensland Health

6.4 Total project capital costs The following table summarises the project’s total nominal risk adjusted capital costs for the entire project (i.e. the Contractor Capital Costs and Project Development Capital Costs). These costs have been calculated by adjusting the raw capital costs provided by the technical advisers for escalation and risk adjustments.

Table 6.13 Total Project Capital Costs – Gold Coast University Hospital


Generic Inpatient Unit 178.41 Education & Research 28.27 Division of Medicine 242.46 Division of Surgery & Critical Care 169.06 Division of Family, Women & Children 114.79 Division of Mental Health & ATODS 40.30 Division of Community, Allied Health Aged & Rehabilitation Services 50.92 Division of Medical Services 106.78 Division of Pathology 55.23 Corporate Services, Amenities and Retail 134.79 Engineering and Travel 249.75 Central Plant Etc 244.01 ESD Initiatives 90.26 External Works 84.41

Total Contractor capital cost 1,789.43


September 2008



Project development capital costs 318.86

TOTAL PROJECT CAPITAL COSTS 2,108.30 Note: Total capital costs include adjustments for escalation, transferred and retained risk. Source: Queensland Health

6.5 Facility maintenance and management costs The estimate of the project’s facility maintenance and management costs is an aggregate of the raw facility maintenance and management costs, escalation and a transferred and retained risk adjustment. The paragraphs that follow outline the contribution of these components to the project’s total facility maintenance and management costs.

6.5.1 Facility maintenance and management – raw cost

The estimated raw average annual facility maintenance and management costs of the project are contained in the following table and are based on an assumed 20 year operations contract from completion of the new GCUH.

Table 6.14 Average Annual Facility Maintenance and Management Raw Costs


Average Annual Cost ($M) Routine Building and Plant maintenance 15.89 Grounds maintenance costs 0.35 Cleaning 0.34 Helpdesk 0.35 Utilities 14.96 Lifecycle Building Maintenance 12.01 Total facility maintenance and management costs 43.90 Note: All costs are in base date (01 July 2007) dollars. Source: Queensland Health


The escalation rates that apply to the facility maintenance and management costs vary depending on the individual cost component. The following table identifies the escalation rates that have been applied to facility maintenance and management costs all of which have a cost base date of 1 July 2007:

Table 6.15 Facility Maintenance and Management Costs Escalation Rates

Cost Category Escalation rate Routine building and plant maintenance 3.20% Routine building maintenance - labour component 4.00% Grounds maintenance 4.00% Cleaning 4.00% Helpdesk 4.00% Utilities 3.20%


September 2008


Cost Category Escalation rate Lifecycle Building Maintenance 3.20% Source: Queensland Health

6.5.3 Facility maintenance and management costs – transferred risk adjustment

The following table identifies the transferred risk adjustment for facility maintenance and management costs.

Table 6.16 Facility maintenance and management transferred risk adjustment

Facility maintenance and management transferred risk Proposed Delivery Model Transferred risk adjustment (%) 10.6% Note: The above facility maintenance and management costs transferred risk adjustment is the average risk adjustment over the 20-year operating period under the Managing Contractor procurement method. Source: Queensland Health – Risk Workshop

6.5.4 Facility maintenance and management costs – retained risk adjustment

The following table details the retained risk adjustment for facility maintenance and management costs. The small valuation of this risk adjustment reflects shared risks and the fact that the operations risk analysis has focussed on transferred risks which are relevant to estimating the potential cost of the operations contract. The analysis has not attempted to cost retained risks during the operations phase including the significant risks associated with clinical service delivery.

Table 6.17 Facility Maintenance and Management Costs - Retained risk adjustment

Facility maintenance and management retained risk Proposed Delivery Model

Retained risk adjustment 0.03%

Note: The above facility maintenance and management costs retained risk adjustment is the average risk adjustment over the 20-year operating period under the Managing Contractor procurement method. Source: Queensland Health – Risk Workshop

The operating and maintenance risks associated with the GCUH are discussed in more detail in Appendix C.


6.5.5 Average annual facility maintenance and management costs

The average annual facility maintenance and management risk adjusted nominal operating costs are shown below:


September 2008


Table 6.18 Average annual facility maintenance and management nominal costs


Nominal $M Routine Building and Plant maintenance 25.82 Grounds maintenance costs 0.70 Cleaning 0.67 Helpdesk 0.71 Utilities 26.57 Subtotal 54.47 Lifecycle Building Maintenance 25.29 Total facility maintenance and management costs 79.76 Note: The above costs include adjustments for escalation, transferred and retained risk Theses costs are average annual cost over 20 years Source: Queensland Health

The assumptions, inclusions and exclusions adopted in generating the above raw costs are detailed in Appendix B.

6.5.6 Total facility maintenance and management costs over 20 years

The total nominal operating costs for facilities maintenance and management over 20 years, including a transferred and retained risk adjustment, is approximately $1,595 million. The following chart graphs the profile of the nominal facility maintenance and management costs over 20 years of operations.

Figure 6.3 Total nominal facility maintenance and management costs for 20 years

Nominal risk adjusted facility maintenance and management costs

0.0020.0040.0060.0080.00

100.00120.00140.00160.00180.00200.00

2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033Year ending

$m

Routine Building & Plant maintenance Grounds maintenance costs CleaningHelpdesk Utilities Lifecycle Building MaintenanceTransferred risk Retained risk

6.6 Clinical and support service costs This section summarises the Clinical and Support Services costs for the GCUH. The costs have been estimated using the following methodologies:


September 2008


Casemix costing

Queensland Health has used the casemix costing methodology to estimate total recurrent costs. The methodology involves an estimate of activity (number of cases) within Diagnostic-Related Groups (DRGs) and costs this activity based on acuity levels (cost weights per case) applicable to each DRG. Queensland Health’s Resource Management Practice Statement 2007/08 requires that all Business Cases use casemix to determine revenue requirements (funding) for spending initiatives. However, casemix can also be used to estimate expenditure and is appropriate in the context of a new hospital because there is no basis to assume that expenditure at GCUH will be more or less efficient than the benchmark level assumed in the casemix cost weights.

In applying the casemix methodology Queensland Health has been responsible for all calculations and assumptions, including the following key assumptions:

• initial capacity of 624 beds in 2012/13 rising to 750 beds over 4 years in accordance with the Bed Transition Strategy, discussed in section 6.6.3, below

• bed occupancy of 80% for general inpatient beds in 2012/13, moving to 82% by 2015/16 and 73% for critical care beds in 2012/13, declining to 68% by 2015/16. 85% bed occupancy for general inpatients is normally used when determining inpatient utilisation rates. To keep within the allocated funding when the facility has all inpatient bed available in the fourth year, an average bed occupancy rate of 82% has been applied. For critical care services, bed occupancy is usually 75% and for these services the overall utilisation rate as beds are brought online changes from 73% in 2012/13 to 68% by 2015/16

• average lengths of stay based on benchmark hospitals (Royal Brisbane Hospital, Princess Alexandra Hospital and Gold Coast Hospital) and Queensland averages, as appropriate for each DRG. The assumptions concerning average length of stay have not been adjusted for the potential impact of increased use of single beds. However, a general indication of this potential impact is provided in Section 4

• acuity levels (factors used to weight the mix and number of cases in a DRG and reflecting the resource intensity of that DRG relative to the average cost per case) based on current levels at Gold Coast Hospital and Princess Alexandra Hospital (e.g. Neurosurgery) and Royal Brisbane & Womens Hospital (e.g. NICU)

• a cost of $3,800 per case (i.e. for a standard case with an acuity factor of 1), reflecting the Queensland casemix funding provision in 2007/08 dollars.

Queensland Health has adopted the assumptions of Southport acuity levels (acuity factors based on Princess Alexandra and Royal Brisbane would be more representative of the Health Services Plan requirements) and reduced occupancy levels for the additional beds at GCUH in order to ensure that recurrent expenditure is affordable within available funding under the More Beds for Hospitals program by 2015/16, when all 750 overnight beds will be available. Further detail on the affordability analysis is provided in section 7.9.

The casemix costing methodology includes all clinical services with the following exceptions:

• Community health services. These services are expected to be provided from community health hubs outside the GCUH.

• Commonwealth programs. These programs are assumed to be fully supported by Commonwealth funding and therefore budget neutral.


September 2008


• Emergency Department. A fixed supplementary payment of $15 million per year has been assumed, based on expenditure at Princess Alexandra Hospital.

• Radiation therapy. The recurrent estimate includes provision for three linear accelerators, costed at $17 million per year, based on expenditure at Princess Alexandra Hospital.

• Clinical education. The recurrent estimate for clinical education has been costed at $21.0 million per year and has been extrapolated from the proportion of the current Gold Coast District budget allocated to clinical education.

The casemix methodology has been used to estimate the cost of the ramp up in activity at the GCUH between 2012/13 and 2015/16 under the Bed Transition Strategy.

Labour analysis

Queensland Health has used its labour analysis template to calculate total recurrent costs. All assumptions underpinning the analysis have been developed by Queensland Health and include assumptions relating to bed occupancy levels and patient acuity that have been necessary to ensure that the cost estimates are affordable within available funding (in a similar fashion to the casemix methodology outlined above). The labour analysis methodology involves an estimate of the labour (Full Time Equivalents, or FTEs) required to provide the planned activity levels. It involves the following basic steps:

• Information about patient numbers, type and acuity level is used to estimate nursing staff hours per patient day based on standard ratios established under the Queensland Health Business Planning Framework.

• Once nursing staff numbers are determined, other labour categories are estimated on a pro rata basis with a relevant benchmark hospital (in this case Gold Coast Hospital was used).

• Total FTE numbers are used to calculate total employee costs including on-costs and back-fill rates (for annual leave, etc) using the terms and conditions from the latest enterprise bargaining agreements.

• The goods and services costs are calculated as a proportion of labour costs based on experience with a relevant benchmark hospital (in this case Gold Coast Hospital was used).

Queensland Health’s Resource Management Practice Statement 2007/08 requires that all Business Cases use the labour cost template to determine expenditure for new projects and other initiatives. The labour analysis methodology has been used as a cross-check on the accuracy of the casemix methodology for the GCUH operating at full capacity (i.e. 750 beds in 2015/16).

Benchmark costing of maintenance and utilities

DLA has estimated the cost of building and equipment maintenance, utilities consumption and related costs that may be included within the proposed long-term Facilities Maintenance and Management contract. This approach has been necessary to permit a more accurate estimate than is possible with the casemix and labour cost methodologies, particularly in relation to major periodic maintenance costs which are typically under-estimated in conventional hospital budgets. The casemix and labour cost methodologies each include a component of maintenance and utilities costs and these costs have therefore been removed from each of


September 2008


these methodologies to avoid double-counting with the separate estimate of expected costs under the proposed Facilities Maintenance and Management contract.

6.6.1 Clinical and support services – casemix costing methodology

The following table shows the Clinical and Support Services costs in 2007/08 dollars for the first year of full operations, 2015/16, as calculated using the casemix methodology. Repair and maintenance and utilities costs have been excluded from the total cost as these costs are calculated separately in section 6.5. The amount deducted is based on Queensland Health advice as to the portion these costs comprise of the standard casemix unit price.

Table 6.19 Casemix costing of clinical and support services (excluding maintenance and utilities) for 201516 (in 2007/08 dollars)

Clinical Services Overnight Beds

Same-Day

Beds

Bed Alternatives

2015-16Cost $M

Medical Inpatient beds 196 - - Surgical Inpatient beds 192 - - Education & Research - - - Division of Medicine 68 14 97 Division of Surgery & Critical Care 50 40 - Division of Family, Women & Children 124 20 -

Division of Mental Health & ATODS 72 - -

Division of Community, Allied Health Aged & Rehabilitation Services

48 - -

Division of Medical Services - - - Special Grants Own Source Revenue Total 750 74 97 441.1 Source: Queensland Health Note: Costs are in 2007/08 dollars

6.6.2 Clinical and support services – labour analysis methodology

The following table shows the Clinical and Support Services costs in 2007/08 dollars for the first year of full operations, 2015/16, as calculated using the labour analysis methodology. Repair and maintenance and utilities costs have also been excluded from the total cost as these costs are calculated separately in section 6.5.

Table 6.20 Labour analysis costing of clinical and support services (excluding maintenance and utilities) for 2015/16 (2007/08 dollars)

Expense item FTEs 2015-16 Cost $M

Medical Officers 480.0 91.0 Visiting Medical Officers 17.7 6.8 Professional/Technical Officers 356.7 29.6 Nurses 1,561.5 132.1 Executive Officers(DES,DSO) 2.2 0.3 Administration Officers 431.9 23.0


September 2008


Expense item FTEs 2015-16 Cost $M

Operational Officers 472.1 25.2 Total Labour 3,322.1 308.2 Goods and Services 132.9 Total 441.1 Source: Queensland Health Note: Costs are in 2007/08 dollars

Queensland Health has compared the estimated total labour cost at GCUH with two major Brisbane tertiary hospitals, for benchmarking purposes. This analysis is summarised in the following table.

Table 6.21 Comparison of estimated labour costs at GCUH relative to benchmark tertiary hospitals (2007/08 dollars)

Hospital FTEs Cost $M Avg cost per FTE

$’000/FTE GCUH (921 beds and bed alternates) 3,322 308.2 92.8 Benchmark Tertiary Hospital (901 beds and bed alternates) 4,573 465.6 101.8 Benchmark Tertiary Hospital (1,042 beds and bed alternates) 5,347 518.2 96.9 Source: Queensland Health Note: (1) Costs are in 2007/08 dollars (2) GCUH FTEs and cost excludes maintenance & utilities (3) Benchmark Tertiary Hospital includes whole of district services

6.6.3 Clinical and support services – raw costs from 2012/13 to 2016/17

The following table shows the Clinical and Support Services costs from commencement of operations in 2012/13 to 2016/17. The ramp up of operations at the GCUH is based on the Queensland Health Bed Transition Strategy 2008 to 2016 which includes additional activity planned under the Interim Demand Management Strategy.

The Interim Demand Management Strategy assumes that the existing 654 beds in the Gold Coast Health Service District in 2007/08 will increase to 952 beds by 2011/12, including:

• 63 subacute beds through purchase of a nursing home at Carrara, allowing backfill of 37 acute medical beds and 26 acute surgical beds at Southport and Robina

• 35 mental health beds at Robina including 16 available through sourcing additional accommodation at the private Palm Beach Currumbin Clinic

• 29 subacute beds through leasing space at Pacific Private until 2012/13

• 6 additional ICU beds at Southport to alleviate demand across the Southern Area

• 3 additional cancer beds and 1 cardiac bed at Southport

• 180 beds with opening of Robina Stage 2 in 2011/12.

By 2011/12 Queensland Health expects to have 364 beds at Robina, 63 beds at Carrara and 44 Community Care Units. Fully opening 750 beds at GCUH in 2012/13 would provide total


September 2008


capacity in the district of 1,221 beds. Demand in that year is projected to be at least 1,009 beds, giving a surplus of up to 212 beds.

Queensland Health’s Bed Transition Strategy recommends that 624 overnight beds should be provided at the GCUH when it is commissioned in 2012/13. This projection is higher than the minimum number of 538 beds that must be commissioned to maintain a neutral bed balance and takes into account:

• indications that 2001 census projections are low

• high levels of bed occupancy in the Gold Coast Hospital relative to appropriate levels in the new GCUH

• the need to smooth out expansion following commissioning of the new hospital to enable a matching with new service model development and supportive infrastructure

The overnight bed numbers are projected to increase to 683 beds in 2013/14, 716 beds in 2014/15 and 750 beds in 2015/16. The main strategies determining the mix of beds that will be expanded over this four year period are summarised below.

• a maximum of 17 Intensive Care Unit (ICU) beds are expected to be available at Southport prior to the opening of GCUH when it is planned to open 34 ICU beds (i.e. an extra 17 beds). Given the time required to recruit the necessary staff, expansion will then occur at the rate of 6 beds in 2013/14, 4 beds in 2014/15 and 6 beds in 2015/16

• thirty Special Care and Neonatal Intensive Care beds will open in 2012/13 (additional 8 beds) and will expand by 5 beds in 2013/14 and 4 beds in 2014/15

• two cancer wards of 16 beds each will open in 2012/13 with a further 8 beds opened in each successive year

• forty maternity beds will be opened in 2012/13 and, assuming current birth rates, an additional 8 beds will be opened in 2013/14.

The annual recurrent costs of this ramp up program have been determined based on the casemix costing methodology and are shown in the following table, excluding expected costs under the Facilities Maintenance and Management contract.

Table 6.22 Clinical and support services – raw costs for 2012/13 to 2016/17 (2007/08 dollars) excluding facilities maintenance costs.

2012-13$M

2013-14$M

2014-15 $M

2015-16$M

Clinical and Support Services 374.4 394.7 413.4 441.1 Source: Queensland Health Note: All costs are in 2007/08 dollars

6.6.4 Escalated costs

The following table shows the annual recurrent costs of the ramp up program in nominal dollars. Escalation of casemix costs has been estimated on the basis of Queensland Health advice that the standard casemix cost per case comprises approximately 66% labour, 20% supplies and 14% equipment and other expenses. The labour component has been escalated at 4% per


September 2008


annum, the non-labour component at 3.2%, in accordance with assumptions advised by Queensland Treasury and Queensland Health.

Table 6.23 Clinical and support services – escalated costs for 2012/13 to 2016/17, excluding facilities maintenance costs.

2012-13$M

2013-14$M

2014-15 $M

2015-16$M

Clinical and Support Services 442.1 483.5 525.5 581.7 Source: Queensland Health Note: All costs are in nominal dollars.

6.6.5 Depreciation expense

In accordance with Queensland Health accounting policies, capitalised costs include the contracted value of the acquisition plus costs incidental to the acquisition such as project planning and procurement costs and all directly attributable costs incurred to bring the asset to a state where it is ready for use, except for training costs which are expensed as incurred. Queensland Health does not recognise facilities procured under BOOT-type agreements as assets. Consequently, the car parks proposed to be included in a BOOT contract will not be assets of Queensland Health and will not incur a depreciation expense.

Assets (other than land and artworks) are depreciated on a straight-line basis from the time of acquisition or, in respect of work in progress, from the time an asset is completed. Any material expenditure that increases the originally assessed capacity or service potential and/or useful life of an asset is capitalised and the new depreciable amount is depreciated over the remaining useful life of the asset to the department.

For each class of depreciable assets, the following depreciation rates are used:

Class Depreciation Rates

• Buildings 3.33%

• Land Improvements 2.50%

• Plant and Equipment 5.0% - 20.0%

The total annual depreciation expense has been estimated based on dissecting the total, escalated, risk-adjusted project cost into building and plant and equipment components and depreciating the former at 3.33% and the latter at 5%. The results are summarised in the following table.

Table 6.22 Annual depreciation expense

Asset

Initial value ($M)

Annual Depreciation expense ($M)

Buildings 1,653.2 54.6 Plant & Equipment 455.1 22.8 Source: Queensland Health


September 2008


7 Affordability

7.1 Introduction This section assesses the affordability of the Proposed Delivery Model for the GCUH in capital and recurrent expenditure terms. In particular, the affordability analysis determines the gap between proposed expenditure and committed funding by comparing:

• the annual cost and estimated total cost of capital expenditure on the GCUH with the Government’s announced funding commitment

• the annual recurrent expenditure on the GCUH with existing funding based on 2006/07 activity levels at the Gold Coast Hospital.

The capital expenditure is calculated on a risk adjusted and escalated basis. The announced capital funding of $1.549 billion in July 2008 dollars is escalated on the same basis to allow for cost increases over the construction period.

The recurrent expenditure at the new GCUH is estimated on the basis of bed numbers required under Queensland Health’s preliminary Bed Transition Strategy and using the casemix costing methodology. Services proposed for transfer to a private sector operator under a long-term facilities management contract are costed on a risk-adjusted basis. Committed recurrent funding is assessed on the basis of existing expenditure, with no allowance for growth funding in 2007/08 or future years.

7.2 Capital budget 7.2.1 Methodology

The capital affordability analysis in sections 7.3 to 7.5 below will compare the capital expenditure under the Proposed Delivery Model with the capital funding approved by the Government in July 2008 to determine the extent of any affordability gap.

Inclusions and exclusions

Expenditure on the Proposed Delivery Model reflects the cost estimates developed in Chapter 6 and, in particular, the various cost items shown as included and excluded from the project in table 6.1.

The following table summarises the planned funding arrangements for the various items that are excluded from the Preferred Delivery Model.

Table 7.1 Exclusions from the affordability analysis

Excluded item Funding External infrastructure e.g. road upgrades, utilities upgrades

Funding is provided outside the project by Department of Main Roads and utilities providers.


September 2008


Excluded item Funding Car-parks Funding for car-parks is being addressed in a

separate business case. If procured under a BOOT arrangement, the capital costs will be privately financed under a long-term concession to a private car park operator. Costs for any basement or early car parks may be included in the Managing Contractor contract and, if so, would be funded by Queensland Health on an interim basis until the cost is recouped through an upfront payment from the private car park operator.

Interim Demand Management Strategy Capital works on Southport Campus

Funding is being addressed in a separate business case.

Source: Queensland Health, Department of Infrastructure and Planning

Escalation

Escalation has been applied to July 2008 construction costs based on the rates and S-curve as described in section 6.3.2 to derive a total “end-cost” estimate. The Government’s funding commitment of $1.549 billion in July 2008 dollars has been escalated to end cost terms assuming the same escalation rates and S-curve as the Proposed Delivery Model.

Risk adjustment

The Proposed Delivery Model includes valuation of transferred risks and retained risks. The calculation of the risk adjustment is described in Appendix C.


7.3 Estimated capital expenditure Table 7.2 sets out the estimated capital expenditure on the Proposed Delivery Model in each year of the project from commencement in June 2007 to completion in 2012. Managing Contractor costs and Queensland Health costs amount to $1,320 million, and $279 million, respectively, in raw (non-risk-adjusted) terms and excluding escalation. Transferred and retained risk adjustments amount to $146 million or 9.2% of the total capital cost in real (i.e. July 2008) terms17. Escalation amounts to $434 million. The annual expenditure cash flow until completion of the facilities is based on the construction “S-curve” set out in Section 6.

Table 7.2 Proposed Delivery Model: estimated capital expenditure

Est. Total

Cost $m 2007-08

$m 2008-09

$m 2009-10

$m 2010-11

$m 2011-12

$m 2012-13

$m Managing Contractor costs

1,352.21 0.00 55.65 263.36 375.49 462.07 195.94

Queensland Health costs 265.42 30.88 67.17 21.82 49.11 64.38 32.06

17 The risk adjustment in the following table is expressed in real terms to permit affordability analysis in real and escalated terms. The risk values therefore differ from those indicated in Section 6 in nominal dollar terms.


September 2008


Est. Total

Cost $m 2007-08

$m 2008-09

$m 2009-10

$m 2010-11

$m 2011-12

$m 2012-13

$m Transferred risk adjustment

42.27 0.00 1.28 7.74 11.20 13.02 9.03

Retained risk adjustment 106.64 0.26 19.33 17.07 23.85 28.51 17.63 Escalation 341.45 0.00 4.61 37.85 86.43 139.23 73.32 Total capital expenditure

2,108.00 31.14 148.05 347.83 546.10 707.20 327.98

Source: Queensland Health, DLA, KPMG Financial Model, Risk Matrix Note: Costs other than Escalation and Total capital expenditure are in July 2008 dollars.

7.4 Committed capital funding The Government has announced capital funding of $1.549 billion in July 2008 dollars and has committed to construct the new 750 bed GCUH by December 2012. The announced funding budget has been treated as exclusive of any allowance for cost escalation and that the funding budget for this Business Case has been escalated to ensure adequate provision for cost increases over the construction period. The Announced Government Capital Budget has been escalated based on the escalation rates in Table 6.3 and an S-curve for total project capital costs.

Table 7.3 Committed Capital Funding inclusive of escalation

Est. Total

Cost $m 2007-08

$m 2008-09

$m 2009-10

$m 2010-11

$m 2011-12

$m 2012-13

$m Construction costs 1,549.00 29.57 117.59 273.02 406.51 504.02 218.29 Escalation 319.54 0.00 4.12 33.55 79.31 133.05 69.51 Total funding 1,868.54 29.57 121.71 306.58 485.82 637.06 287.80 Source: Queensland Health Note: Construction costs are in July 2008 dollars.

7.5 Affordability analysis of capital expenditure The estimated total cost of the Proposed Delivery Model is $240 million higher than existing committed funding, in escalated (“end cost”) terms. The annual affordability gap is highest in the years of peak expenditure for the project, reaching $70 million in 2011/1218.

The explanation and justification for the difference between the Proposed Delivery Model and committed funding is provided in Section 8.

18 The annual affordability gap as a proportion of annual expenditure varies over the period because of differences in the calculation of escalation for the expenditure and funding cashflows. In particular, the Proposed Delivery Model is based on different s-curves for raw construction costs and project risks whereas the funding cashflow is based solely on escalation of the announced budget in accordance with the construction s-curve.


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Table 7.4 Affordability of Preferred Delivery Model

Est. Total

Cost $m 2007-08

$m 2008-09

$m 2009-10

$m 2010-11

$m 2011-12

$m 2012-13

$m Proposed Delivery Model Capital Expenditure

2,108.30 31.14 148.05 347.83 546.10 707.20 327.98

Committed Capital Funding

1,868.54 29.57 121.71 306.58 485.82 637.06 287.80

Capital affordability surplus / (deficit)

(239.76) (1.57) (26.34) (41.25) (60.28) (70.13) (40.18)

Source: Queensland Health, KPMG Financial Model Note: Costs are in nominal dollars

Section 8.7 also identifies a range of capital cost offset initiatives which may reduce the affordability gap.

7.6 Recurrent budget The following paragraphs describe the methodology used to develop the estimates of annual expenditure on clinical and support services, incorporating a ramp up in activity following commissioning of the GCUH based on Queensland Health’s Bed Transition Strategy and including adjustments for escalation and risk.

7.6.1 Methodology

Recurrent expenditure for the Proposed Delivery Model has been estimated using the casemix funding methodology which will be used to determine hospital funding in Queensland hospitals from 2008/09 onwards. The methodology is described in section 6.6 together with the labour analysis methodology which has been used as cross-check for accuracy on the GCUH in 2015/16 when the hospital is expected to be operating with 750 overnight beds.

Support services proposed for inclusion in a 20-year operations contract have been costed separately by DLA, as described in section 6.6. The estimates include a capital replacement component which is included in the capital expenditure estimates from commissioning of the GCUH and a routine maintenance component which is included in the recurrent expenditure estimates. In addition, DLA has estimated the cost of electricity, gas and water in the new facilities as well as the cost of the other minor services proposed for inclusion in the operations contract, namely, grounds maintenance, external cleaning and provision of a helpdesk and associated management services.

Transition Strategy

Queensland Health’s Interim Demand Management Strategy plans for increased activity within the Gold Coast Health Service District between 2007/08 and 2011/12. This strategy is separate from the GCUH Business Case and is the subject of a separate submission to the Queensland Government for funding in the State Budget to be announced in June 2008. The projected expenditure under this strategy (for Operating Revenue), amounting to $68.4 million in 2008/09 and rising to $83.3 million in 2012/13, is not included in this affordability analysis which assumes that expenditure over the period to 2012/13 is based on 2006/07 activity levels. The annual amount of capital expenditure sought for the Interim Demand Management Strategy is contained in Table 3.5.


September 2008


Following commissioning of the GCUH, recurrent expenditure is projected to increase in line with the bed numbers planned under Queensland Health’s Bed Transition Strategy, as outlined in section 6.6.3. The overnight bed numbers are projected to increase to from 624 beds in 2012/13 to 683 beds in 2013/14, 716 beds in 2014/15 and 750 beds in 2015/16. Expenditure corresponding to these bed numbers has been estimated using the casemix costing methodology, with some adjustments for occupancy levels.

Escalation

Escalation of casemix costs has been estimated in accordance with the methodology outlined in section 6.6.4 based on assumptions advised by Queensland Treasury and Queensland Health.

Risk adjustment

A risk adjustment has been applied to the maintenance and related services proposed for transfer to the private sector under an operations contract as determined in Queensland Health risk workshops. The calculation of the risk adjustment follows the methodology outlined in Appendix C. The risk quantification has been confined to the services proposed for transfer to the private sector and all other components of the recurrent estimate (e.g. clinical costs) have not been risk-adjusted.

7.7 Estimated recurrent expenditure The estimated recurrent expenditure prior to commissioning of the GCUH is based on budgeted Gold Coast Hospital expenditure of $249.8 million for 2007/08 plus supplementation under the “More Beds for Hospitals” program amounting to $7.3 million in 2007/08 and $14.5 million in subsequent years. As noted above, additional expenditure of $14.2 million has been funded in 2008/09 for the following initiatives:

• Gold Coast Surgery Centre - $9.985 million

• ICU (3 beds, PYE) - $2.100 million

• Emergency Department expansion - $1.200 million

• Community Based Rehab Team - $0.900 million.

Including the above and other future planned but unfunded initiatives, additional expenditure will increase to $78.9 million in 2011/12, but this is the subject of a separate funding approval and is not included in this analysis.

Table 7.5 Estimated recurrent expenditure

2007-08

2008-09

2009-10

2010-11

2011-12

2012-13

2013-14

2014-15

2015-16

Projected overnight bed numbers 480 480 480 480 480 624 683 716 750 Clinical services and support services (excluding Operations contract services from commissioning of GCUH) ($m 2007/08) 257.0 264.3 264.3 264.3 264.3 374.4 394.7 413.4 441.1


September 2008


2007-08

2008-09

2009-10

2010-11

2011-12

2012-13

2013-14

2014-15

2015-16

Operations contract services (including risk adjustment) ($m 2007/08) 0.0 0.0 0.0 0.0 0.0 18.7 37.0 36.7 36.4 Escalation ($m) 0.0 4.9 15.0 25.5 36.4 71.8 98.0 122.7 152.7 Total recurrent expenditure ($m nominal) 257.0 269.2 279.3 289.8 300.7 464.8 529.7 572.8 630.2 Source: Queensland Health Note: Costs other than Escalation and Total Recurrent Expenditure are in 2007/08 dollars

Recurrent expenditure under the Proposed Delivery Model for clinical and ancillary services (but excluding operations contract services) in 2012/13 has been estimated by Queensland Health at $374.4 million (in 2007/08 dollars). Queensland Health has assumed that 624 overnight beds will be available from completion of the GCUH in December 2012 and that expenditure to operate these beds will be required for the whole of 2012/13 to cope with start-up costs.

7.8 Committed recurrent funding The committed recurrent funding is based on budgeted expenditure at the Gold Coast Hospital at Southport of $249.8 million in 2007/08 plus supplementation under the “More Beds for Hospitals” program amounting to $7.3 million in 2007/08, with an annual effect of $14.5 million in subsequent years, plus $192 million in 2012/13 (in 2012/13 dollars). No allowance has been made for potential funding under the Interim Demand Management Strategy or other possible growth funding in the future that is not currently approved.

Funding for escalation of the More Beds for Hospitals program is based on the fixed provision for escalation contained in the program for the period up to and including the first year that additional funding is provided. The existing Gold Coast Hospital funding level (and increments of More Beds for Hospitals escalation funding, once provided in 2007/08 and 2012/13) has been escalated in the forward years using the same methodology described in section 7.6.1 to escalate casemix expenditures.

Table 7.6 Committed Recurrent Funding – Southport service transfer and GCUH More Beds for Hospitals Program

2007-08

2008-09

2009-10

2010-11

2011-12

2012-13

2013-14

2014-15

2015-16

Projected overnight bed numbers 480 480 480 480 480 750 750 750 750 Gold Coast Hospital funding in 2007/08 ($m 2007/08 ) 229.9 229.9 229.9 229.9 229.9 229.9 229.9 229.9 229.9 More Beds for Hospitals Program ($m 2007/08) 7.3 14.5 14.5 14.5 14.5 206.6 206.6 206.6 206.6 Own Source Revenue ($m 2007/08) 19.8 19.8 19.8 19.8 19.8 21.7 22.6 23.4 24.6 Estimated funding for cost escalation ($m nominal) 0.0 4.9 15.0 25.5 36.4 48.1 63.7 83.6 104.4


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2007-08

2008-09

2009-10

2010-11

2011-12

2012-13

2013-14

2014-15

2015-16

Total recurrent funding ($m nominal) 257.0 269.2 279.3 289.8 300.7 506.3 522.8 543.5 565.5 Source: Queensland Health Note: Funding other than Escalation and Total Recurrent Funding is in 2007/08 dollars

7.9 Affordability analysis of recurrent expenditure The following table compares projected expenditure under the Proposed Delivery Model with the existing committed funding level in terms of both current prices and escalated prices.


2007-08

2008-09

2009-10

2010-11

2011-12

2012-13

2013-14

2014-15

2015-16

2007/08 dollars Projected overnight bed numbers 480 480 480 480 480 624 683 716 750 Expenditure on Preferred Delivery Model ($m real) 257.0 264.3 264.3 264.3 264.3 393.1 431.7 450.1 477.5 Committed Funding ($m real) 257.0 264.3 264.3 264.3 264.3 458.2 459.1 459.9 461.1 Real Expenditure Surplus / (Deficit) 0.0 0.0 0.0 0.0 0.0 65.1 27.4 9.8 (16.4) Nominal dollars Escalated value of Proposed Delivery Model ($m nominal) 257.0 269.2 279.3 289.8 300.7 464.8 529.7 572.8 630.2 Escalated value of Committed Funding ($m nominal) 257.0 269.2 279.3 289.8 300.7 506.3 522.8 543.5 565.5 Total nominal recurrent surplus / (deficit) ($m ) 0.0 0.0 0.0 0.0 0.0 41.4 (6.9) (29.3) (64.7) Source: Queensland Health

In 2007-08 dollars, the table shows a funding surplus of $65.1 million in 2012/13 which reduces to a small deficit of $16.4 million by 2015/16. These results reflect the following key factors:

• As indicated in section 6.6, in forecasting recurrent expenditure, Queensland Health has assumed continuation of Gold Coast Hospital acuity levels and reduced occupancy levels for the additional beds at GCUH in order to ensure that recurrent expenditure is affordable within available funding under the More Beds for Hospitals program by 2015/16. For the GCUH to function at the higher acuity level identified in the Health Service Plan or to have higher activity levels and occupancy rates, the recurrent funding would need to be reassessed and increased.

• Additional funding in 2012-13 under the More Beds for Hospitals program is provided in nominal dollars (hence the total funding is partly in 2007-08 dollars and partly in 2012-13 dollars).


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• Additional funding under the More Beds for Hospitals program assumes 750 beds will be available in 2012-13 compared to the 624 beds assumed by Queensland Health under the Bed Transition Strategy in that year (rising in subsequent years to 750 beds by 2015-16).

In nominal dollars, the table shows a funding surplus of $41.4 million in 2012/13 which reduces to a deficit of $64.7 million by 2015/16. This affordability gap is greater than the deficit in real terms (2007-08 dollars) primarily because, as noted above, the latter deficit includes a component of nominal funding under the More Beds for Hospitals program.


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8 Capital cost comparison with government budget and reference case budget This section of the Business Case provides an analysis of the Project’s capital cost estimate (Proposed Delivery Model Capital Budget contained in section 6 and 7) against the Government’s Announced Capital Budget. In particular, this section addresses the following related topics:

• the amount of the Announced Capital Budget (August 2006) and a breakdown of the cost components of the budget

• the amount of the Updated Announced Capital Budget (July 2008) and a breakdown of the additional capital cost components and escalation included and the updated budget

• development of a Reference Case (including budget) based on standards likely to have been assumed in the Announced Capital budget to provide a basis for detailed comparison with the Proposed Delivery Model

• the major areas of difference between the Proposed Delivery Model capital cost budget and the Reference Case budget

• a list of potential capital cost offsets that have been identified for the Project including indicative values.

8.1 Announced Capital Cost budget (August 2006) On 18 August 2006, the Queensland Government announced an election commitment for the development of a new tertiary hospital. The announcement stated that “a 750 bed Gold Coast University Hospital will be built adjacent to Griffith University by the end of 2012 – two years ahead of time”. The brief explained that a smaller (500 bed) hospital was originally planned for 2014, however, growing pressure on existing staff and resources, coupled with rapid growth, had fast-tracked the project.

The proposed budget for the GCUH of $1.23 billion was subsequently announced in a number of press releases and was also included in the South East Queensland Infrastructure Plan and Program (SEQIPP) 2007-2026 at $1.23 billion.

The Announced Capital Budget and the high level components that make up the budget are contained in the following table.

Table 8.1 GCUH Announced Capital Budget (August 2006)

GCUH Announced Capital Budget – Basis of the Budget Calculation Components Total $M Building Costs 456.00 Siteworks and external works 45.00 Central Energy Building 85.00 Escalation 240.00 MC Fees 146.00


September 2008


GCUH Announced Capital Budget – Basis of the Budget Calculation Components Total $M Consultants Fees 81.00 Contract Contingency 34.00 Statutory Charges 4.69 Professional Audit Fees 6.70 Clerks of Works 1.01 Procurement Management Fees 1.68 Q Health Costs 84.00 Artwork 1% 11.76 Project Reserve 33.60 Total Cost (based on GFA of 144,000m2) 1,230.44 Source: Queensland Health / Project Services Note: All dollars are real as at August 2006

8.2 Updated Announced Capital Cost budget (July 2008) In July 2008, the Government revised the Gold Coast University Hospital Project capital cost budget to $1,549 million (July 2008 dollars). This Updated Announced Capital Cost budget contained a number of additional scope items including site acquisition, Medical and Dental School and additional surrounding infrastructure.

Table 8.2 GCUH Updated Announced Capital Budget (July 2008)

Description Hospital Budget ($M)

Additional Scope ($M)

Total Budget ($M)

Approved Budget as at August 2006 $1,230 - $1,230 Escalation from August 2006 to December 2007 (16 mths, 6.8% escalation)

$84 - $84

Site Acquisition (December 2007) - $50 Medical and Dental School (December 2007) - $60 Additional Surrounding Infrastructure (December 2007)

- $60 $170

Escalation – December 2007 – 1 July 2008 (4.4%) $58 $7 $65 Approved Budget as at 1 July 2008 $1,372 $177 $1,549 Source: Queensland Health and DLA Note: All dollars are real dollars at the date specified

8.3 Government approved capital cost budget - escalation calculations In the following table the Announced Government Capital Budget has been escalated based on the escalation rates in Table 6.3 and an S-curve for total project capital costs to reach a nominal end-cost budget of $1,868.54 million.


September 2008


Table 8.3 GCUH Announced Capital Budget – Escalation Calculations

GCUH Announced Capital Budget – Escalation Calculations

Element Escalation Rate $M Announced Budget as at Base Date of 1 July 2008 (Real Dollars)

1,549.00

Plus escalation to commissioning based on agree escalation rates and the DLA construction curve

2008-2009 = 8% per annum

2009-2012 = 7%,6%,6%,5% per annum

DLA construction curve

319.54

Total Announced Budget in Nominal Dollars 1,868.54 Source: Escalation rates based on report from Quantity Surveyors for the three current health projects, Construction Curve provided by DLA

The Government Approved Capital Budget in nominal dollars of $1,868.54 million can be compared with the Proposed Delivery Model Capital Cost Estimate, as calculated in Section 6 of this report, of $2,108.30 million in nominal dollars.

8.4 Need for a Reference Case It is understood that the Announced Capital Budget ($1,230 million in August 2006 dollars) was developed based on the following assumptions:

• that the Gold Coast University Hospital is a 750 bed tertiary referral hospital with the costs broadly based on the Townsville Hospital which is also a tertiary referral hospital

• a total gross floor area of 144,000 m2

• a Managing Contractor procurement model with broadly similar risk allocation to the Townsville Project

• the estimated budget is as at August 2006 (i.e. real August 2006 dollars). It is assumed that the escalation included in the table in section 8.1 relates to the escalation from the date of completion of the Townsville hospital to the date of the Announced Capital Budget in August 2006.

These broad assumptions, combined with the absence of a detailed schedule of areas, mean that it is difficult to determine the mix and level of services that the Announced Capital Budget would provide. Consequently, the Announced Capital Budget is an insufficient basis for meaningful comparisons with the Proposed Delivery Model. In order to address this problem, it has been necessary to develop a suitable Reference Case and budget that:

• provides clarity about the underlying assumptions through development of a detailed schedule of areas and associated cost plan; and

• is based on similar assumptions to the Announced Capital Budget concerning facility standards and consequently reconciles to the Announced Capital Budget in terms of its aggregate cost.


September 2008


Accordingly, a Reference Case has been developed to reflect facility standards that may have been assumed in, or can reasonably be associated with, the Announced Capital Budget to permit analysis of the main factors that account for the difference in cost associated with the Proposed Delivery Model. The Reference Case is based on a schedule of areas that is consistent with delivering the level and mix of services required by the Health Service Plan. Consequently, the Reference Case will deliver essentially the same service outputs in terms of activity levels as the Proposed Delivery Model.

Nevertheless, there are some significant differences between the Reference Case and the Proposed Delivery Model in terms of service outcomes as a result of differences in facility standards and equipment levels, as detailed below. In addition, the cases differ in terms of their reliability of delivery because of differential provision for project risks.

It is emphasised that the Reference Case has not been developed as a viable delivery solution and it would not be able to be delivered because it fails to achieve certain statutory standards and does not reflect essential requirements for the GCUH, such as FF&E levels appropriate for the super-specialty services at the hospital.

8.5 Proposed Reference Case While the Announced Capital Cost Budget is not explicit as to the facility standards that have been assumed, the stated gross floor area of 144,000 m2 provides a reasonable guide. The following table shows a series of area schedules that have been developed to determine the Reference Case. The table shows the following for comparative purposes (in columns from left to right):

• the total gross floor area required for the Proposed Delivery Model of 165,000 m2 dissected by planning unit

• the total gross floor area of the existing Townsville Hospital of 55,715 m2, dissected by planning unit. The Townsville Hospital was the last major tertiary hospital to be constructed and was used as the benchmark in developing the Announced Capital Cost Budget

• the floor space that would have been required for the Proposed Delivery Model excluding the impact of the revised Health Facility Guidelines, increased provision of single beds, and new statutory requirements. This area amounts to 122,095 m2, and represents the floor space required to deliver the 750 beds and mix of services required for the Proposed Delivery Model at standards (AHFG, single beds and statutory) that are comparable to those prevailing when the Townsville Hospital was constructed

• the floor space that would have been required for the Proposed Delivery Model including the impact of the revised Health Facility Guidelines but excluding increased provision of single beds and new statutory requirements

• the floor space that would have been required for the Proposed Delivery Model including the impact of the revised Health Facility Guidelines and increased provision of single beds but excluding the new statutory requirements


September 2008


• the floor space that would have been required for the Proposed Delivery Model including the impact of the revised Health Facility Guidelines, increased provision of single beds and the new statutory requirements (in effect, corresponding to the Proposed Delivery Model).

Table 8.4 Floor space reconciliation

Comparable Townsville area (m2)

Planning Unit

Proposed Delivery

Model (m2)

Existing Townsville

375 bed (m2)

750 bed with old

guideline

+ AHFG VHFG

+ Single rooms

+Statutory

require Generic inpatient unit 19,057 6,904 15,820 17,043 18,983 18,983 Division of Medicine 24,437 10,119 21,952 26,102 26,342 26,342 Division of Surgery and Critical Care Services 16,032 5,672 12,418 14,527 14,902 14,902

Division of Family, Women & Children 14,018 5,001 9,674 10,988 11,608 11,608

Division of Medical Services 5,923 2,228 5,100 5,858 5,858 5,858

Division of Mental Health & ATODS 5,817 2,146 4,952 5,582 5,942 5,942

Division of Community, Allied, Rehabilitation and Aged Services

7,359 2,672 5,554 6,425 6,665 6,665

Division of Pathology 5,039 1,181 3,888 4,493 4,493 4,493 Education & Research 3,871 2,281 3,866 3,866 3,866 3,866 Corporate Services, amenities and retail 16,556 6,192 12,095 14,513 14,513 14,513

Total 118,109 44,396 95,319 109,399 113,174 113,174 Travel space 17,380 17,504 18,108 18,108 Plant space 27,673 21,573 22,317 22,318 Main atrium 1,200

13,319 26,776

Statutory Requirements 10,445 Total Gross Area 164,362 57,715 122,095 148,476 153,599 164,045 Notes: (1) Under AHFG and VHFG an allowance of 20% has been applied based on changes to the 1992 Guidelines applied at the time of constructing Townsville (2) Statutory Requirements includes DDA, BCA, OH&S and ESD. An allowance of 6.8% has been applied based on recent PPP projects in Victoria and New South Wales Source: GCUH Architecture, Townsville PDP

On the basis of this analysis, a Reference Case has been established involving a schedule of areas which assumes application of the revised Health Facility Guidelines and would require a gross floor area of 148,476 m2 which is comparable to, but slightly higher than, the gross floor area assumed in the Announced Capital Cost Budget (August 2006) of 144,000 m2.

A cost plan has been developed for the Reference Case and is summarised in the following table. The total nominal risk-adjusted cost of the Reference Case equates to the Updated Announced Capital Budget (July 2008) because the risk adjustment has been used as a balancing item. This approach is considered reasonable because the amount of the risk adjustment (approximately $170 million) is 11.9% of the capital cost and is comparable to the level of risk contingencies assumed for the Proposed Delivery Model.


September 2008


This approach means that there is a different proportion of risk in the Reference Case budget compared to the Announced Capital Budget (August 2006) where the contingency amounts to 5.5% of the capital cost (as contained in table 8.1). This contingency is relatively low and the treatment of risk is just one of a number of assumptions that are unclear in relation to the Announced Capital Budget (August 2006), necessitating the development of the Reference Case.

Table 8.5 Capital Cost Estimates for Reference Case and Proposed Delivery Model

Items

Reference Case Capital Cost

$M

Proposed Delivery Model Capital Cost

$M Generic Inpatient Unit 119.18 134.72 Education & Research 21.04 21.31 Division of Medicine 183.60 184.36 Division of Surgery & Critical Care 112.88 128.38 Division of Family, Women & Children 68.00 86.56 Division of Mental Health & ATODS 28.82 30.40 Division of Community, Allied Health Aged & Rehabilitation Services 33.38 38.37 Division of Medical Services 71.77 82.35 Division of Pathology 36.59 41.83 Corporate Services, Amenities and Retail 88.42 101.79 Engineering and Travel 159.13 187.75 Central Plant, etc. 165.51 183.40 ESD Initiatives 0.00 67.84 External Works 75.02 63.44 Raw capital cost 1,163.33 1,352.51 Raw Project Development Costs 86.34 88.02 Additional scope items (Site Acquisition, Additional Infrastructure and Medical School) 177.40 177.40 Total Raw Capital Costs (July 2008) 1,427.08 1,617.93 Escalation 272.04 310.98 Risk adjustment 169.42 179.38 Total Nominal Risk Adjusted Cost 1,868.54 2,108.30 Note: All amounts are in July 2008 dollars except escalation, risk adjustment and total nominal risk adjusted cost, which are in nominal dollars. Source: Reference Case Capital Cost provided by DLA, Proposed Delivery Model Capital Cost based on assumptions provided by DLA and KPMG Financial Model

8.6 Comparative analysis of the Reference Case with the Proposed Delivery Model A number of factors have been identified that explain the difference between the estimated cost of the Proposed Delivery Model and the Reference Case budget. These factors are discussed in the following sub-sections and relate to:

• increased provision for risks relative to conventional project allowances for contingencies (albeit relatively small);


September 2008


• Queensland Health policy to move from average provision of 25% single bed rooms to approximately 75% single bed rooms;

• additional floor space area associated with new/revised Statutory Requirements (including Disability Discrimination Act, Occupational Health and Safety Act and Building Code of Australia);

• introduction of Environmentally Sustainable Design initiatives (plant and equipment); and

• increased provision of FF&E (high-cost medical equipment).

8.6.1 Increased risk adjustment

The following table shows that the risk adjustment in the Proposed Delivery Model is more than the risk adjustment included in the Reference Case. As the Schematic Design and a number of detailed technical studies have been completed for the Proposed Delivery Model the risk adjustment has now been reduced. This reduction is a result of some risks materialising and therefore included in the raw cost rather than being a contingency and other risks have been avoided or failed to eventuate.

Table 8.6: Additional cost due to risk adjustment

Risk Adjustment Element Nominal $M Risk adjustment included in the Reference Case 169.42 Risk adjustment included in the Proposed Delivery Model 179.38 Difference between the two estimates 9.96 Source: Queensland Health risk workshops

The risk adjustment for the Proposed Delivery Model has been based on detailed identification and valuation of project risks as described in Section 6 and Appendix C of this report.

8.6.2 Increased ratio of single beds

In November 2007, the Capital Works & Asset Management Committee (EMT – inc Strategic Reference Committee Qld Health Major Hospital Projects) endorsed that the planning for the three major hospital projects (including the GCUH Project) was to proceed on the basis of the following proportion of single bed rooms:

• 100% single rooms for critical care areas, mental health, immuno-compromised and infectious patients

• 80% single rooms for high acute ward environments

• 60% single rooms for variable acuity medical wards


Noting that the room sizes will vary from 24m2 (critical care), to 15-18m2 (high/variable acuity) to 12m2 (mental health). Queensland Health is also undertaking some further analysis of the recurrent costing associated with the increased amount of the single bed rooms. Applying these principles has increased the single bed ratio from current Queensland allowances of 25% to 75%. The increase in proportion of single rooms together with the increase in room sizes


September 2008


results in a requirement for an additional space of 5,123 m2. The following table shows the increased floor area and cost of this additional space on the Proposed Delivery Model estimate.

Table 8.7 Additional space due to single rooms

Additional space due to single rooms Planning Unit Floor Space (m2) Nominal $M Generic Inpatient Unit 1,940 14.5 Division of Medicine 240 1.8 Division of Surgery and Critical Care Services 375 2.8 Division of Family, Women & Children 620 4.6 Division of Mental Health & ATODS 360 2.7 Division of Community, Allied, Rehabilitation and Aged Services

240 1.8

Sub total 3,775 28.3 Travel 604 4.5 Plant 744 5.6 Total increase in area 5,123 38.4 Source: GCUH Architecture, DLA

8.6.3 Statutory Requirements

The new Statutory Requirements (including Occupational Health and Safety, Building Code of Australia, Disability Discrimination Act, etc) are estimated to add a further 10,445m2 to the required floor space and also include additional costs associated with a façade and insulation required by BCA.

Table 8.8 Statutory requirements

Statutory Requirements Element Nominal $M Total funding for additional Statutory Requirements 76.2 Source: GCUH Architecture, DLA

8.6.4 Environmentally Sustainable Design Initiatives

The following table provides an estimate of the additional cost of plant and equipment associated with Environmentally Sustainable Design Initiatives. Currently, the project team is endeavouring to provide a sustainable hospital consistent with an accredited four star rating. A detailed description of the ESD initiatives is provided in Appendix A.

Table 8.9 Environmentally Sustainable Design Initiatives (plant and equipment)

Environmentally Sustainable Design Initiatives Requirements Element Nominal $M Additional capital cost for ESD plant and equipment 82.0 Source: GCUH Architecture, DLA

8.6.5 Furniture Fixtures & Equipment

The allowance for furniture, fittings and equipment (FF&E) in the Proposed Delivery Model estimate is $42.1 million higher than the allowance in the Reference Case budget, as shown in the following table. This difference reflects a higher level of FF&E in the Proposed Delivery


September 2008


Model as a proportion of the total capital estimate, relative to the level in the Reference Case which is based on the Townsville Hospital. The estimated FF&E requirement at GCUH will be subject to further review, including incorporating the results of an audit of FF&E at the existing Southport campus to determine the equipment that may be transferred to GCUH.

Table 8.10: Additional FF&E requirements

Furniture, Fixtures and Equipment Element Nominal $M FF&E included in the Reference Case 152.5 FF&E included in the Proposed Delivery Model 194.6 Difference between the two estimates 42.1 Source: GCUH Architecture, DLA

The increased FF&E provision in the proposed Gold Coast University Hospital compared to the Townsville Hospital (and therefore the Reference Case) reflects the higher role delineation associated with the Gold Coast University Hospital and the consequent need for additional high-cost medical equipment. The following table compares the role delineation of the existing Gold Coast Hospital (GCH) with the proposed Gold Coast University Hospital and the current Townsville Hospital. The Gold Coast University Hospital will require a number of super-specialty services that are not present at Townsville. It should be noted that the Royal Brisbane Hospital, which represents a more appropriate benchmark hospital for the Gold Coast University Hospital in terms of services and role levels, has a similar percentage of FF&E as a proportion of its capital cost as the Proposed Delivery Model.

Table 8.11: GCUH role levels relative to GCH and Townsville Hospital

2006/07 2016 Current Clinical Department GCH GCUH Townsville Core Clinical Services Emergency Services [1] 3 Super-Specialist 3 Endoscopy Services 3 3 3 Maternity Services 3 Super-Specialist 3 Supporting Clinical Services Anaesthetic Services 3 3 3 Coronary Care Services 2 3 3 Diagnostic Imaging 2 3 3 Intensive Care Unit (Adult) 3 3 3 Intensive Care Unit (Paediatric) N/A 3 [2] N/A Interventional Radiology 1,2,3 1,2,3 1,2,3 Neonatal Services 2 3 3 Nuclear Medicine 2 2,3 3 Operating Suite Services 3 3 3 Pathology 3 3 3 Pharmacy 3 [3] 3 [4] 3 Surgical Sub-Specialties Breast surgery 3 3 Burns 2 2 Cardiothoracic surgery N/A 3 N/A Colorectal surgery 3 3


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2006/07 2016 Current Clinical Department GCH GCUH Townsville Ear, nose and throat surgery 3 3 3 Endocrine surgery N/A 3 N/A Gastrointestinal surgery 3 3 3 General surgery 3 3 3 Gynaecology 3 3 3 Head and neck surgery 2 3 Hepato-biliary and pancreas 2 3 Maxillofacial surgery 3 3 Neurosurgery 3 3 3 Ophthalmology 3 3 3 Orthopaedic surgery 3 3 3 Paediatric surgery 3 3 3 Plastic and reconstructive 3 3 3 Podiatric surgery N/A 3 Trauma N/A 3 Urology 3 3 3 Vascular surgery 3 3 3 Medical Sub-Specialties Cardiology 3 3 3 Clinical genetics (medical) Primary 3 Primary Clinical haematology 2 3 3 Clinical immunology Primary 3 Dermatology 2 3 2 to 3 Endocrinology 3 3 3 Gastroenterology 3 3 3 General paediatrics 2 2 2 Geriatrics 3 3 2 to 3 Hepatology 3 3 Infectious diseases 3 3 3 Internal medicine 3 3 Neurology 3 3 3 Rehabilitation medicine 2 3 3 Renal medicine 3 3 3 Rheumatology 1 3 Sleep medicine N/A 3 3 Thoracic medicine 3 3 3 Cancer and Palliative Care Haematological malignancy 3 Super-Specialist 3 Medical oncology 3 Super-Specialist 3 Palliative care 2 3 3 Radiation oncology N/A 3 3 Surgical oncology 3 3 3


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2006/07 2016 Current Clinical Department GCH GCUH Townsville Notes: Where no indication of service is defined, this is due to the lack of definition of the Service at Townsville based on the Townsville Hospital PDP documentation Source: GCUH Architecture

8.6.6 High level variations table

As noted in Section 8.3 above, the Reference Case is based on the Australian Health Facility Guidelines and the Victorian Health Facility Guidelines but otherwise reflects standards and conditions that prevailed in relation to construction of the Townsville Hospital. The following table summarises the impact on the Reference Case of the other factors discussed above, specifically, the increased provision for risk, the increased proportion of single rooms, increased Statutory Requirements and increased provision for FF&E. Together, these factors amount to $248.7 million and they substantially explain the additional cost of the Proposed Delivery Model compared to the Reference Case.

Table 8.12: Summary of cost differences between the Reference Case and Proposed Delivery Model

Additional costs ($000)

Category (Nominal $)

Proposed Delivery

Model ($M)

Reference Case

Budget ($M)

Risk Adjust-ment

Single Room

Statutory Require-

ments Space

ESD Plant & Equip FF&E

Reference Case plus additional costs ($M)

Total Capital Cost 2,108.3

Total Capital Cost

1,868.5 10.0 38.4 76.2 82.0 42.1 2,117.2

Source: GCUH Architecture, DLA Note: All costs are in nominal dollars.

8.7 Potential capital cost offsets to fund the affordability gap The estimated total cost of the Proposed Delivery Model is $240 million higher than existing committed funding, in escalated (“end cost”) terms as contained in Table 7.4.

The following table identifies potential cost offset initiatives which may reduce the affordability gap, which is the difference between the capital cost estimate of the Proposed Delivery Model and the committed funding, as specified in the Updated Announced Capital Cost (July 2008).


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Table 8.13 Potential Cost Offset Initiatives

Potential Cost Offset Initiatives for the Gold Coast University Hospital

Proposed cost offset initiative

Estimate of potential cost

offset

Rationale for cost offset initiative

Risks associated with achieving the cost offset

initiative

Sale of Southport site (West of Little High Street)

$60 million (July 2008)

Escalation is based on CPI assuming the land is sold in 2013/14 (CPI is

likely to be a conservative

escalation index)

$69 million (nominal)

Offsetting the sale of an existing asset for the funding of a new asset is a standard saving initiative.

An indicative high level valuation has been completed by QH which resulted in a $60 million estimate.

State Valuation Services is currently preparing a formal highest and best use valuation report for the Southport Hospital. This valuation report is to be available by mid October 2008.

Revenues are subject to rezoning approval for residential development, Council requirements (for floor space ratios, site coverage, setbacks, height restrictions, etc), building demolition / remediation, market risk at time of sale for proposed use and the relocation of any additional QH activities off the site.

The timing of the sale will be post the capital expenditure for the Project and will therefore still have budgetary impact in the years in which capital is expended.

Revenues could be significantly higher or lower than the estimate provided.

Commonwealth funding for oncology facilities


No escalation is assumed

QH has submitted an application for Commonwealth funding for the GCUH Oncology facilities (construction and FFE costs) as part of the Australian Healthcare Agreement negotiations.

A fully cost estimate of the Oncology Facilities was forwarded to the Commonwealth as part of the application.

The Commonwealth funding application was made in July 2008.

The amount of any potential offset will depend on the success of the Commonwealth funding application.


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offset



initiative

Reduction in FF&E and ICT


Escalation is based on FFE escalation

rate and will postpone

expenditure in 2012


A reduction in the FF&E / ICT budget may be achieved through greater re-use of existing equipment (i.e. transfer of equipment from the Southport Hospital).

Estimate is subject to audit of existing FF&E to confirm suitability for re-use.

Private hospital collocation


Escalation is based on CPI and it is

assumed that the private hospital payment will be paid in 2012/13


The GCUH site includes a 14,000m2 provision for a collocated private hospital to meet expected growth in private sector bed capacity as assumed in the GCUH and Robina hospital expansion plans. Expressions of Interest have been called from potential private hospital developers.

This amount is intended to be an upfront contribution by the successful private operator to QH as a contribution towards the infrastructure that has been developed as part of the Project.

This upfront contribution is not a payment for the purchase of the land (i.e. QH is not selling the land and it is intended that a rent stream will be paid by the private operator).

QH’s ability to charge an upfront payment for the private hospital land and infrastructure will depend on the level of private sector interest and the investors ability to pay an upfront contribution based on viability of the private hospital. The payment of an upfront contribution may also result in a reduction to the ongoing rental stream to be paid by the private operator.

Six private sector organisations registered formal Expressions of Interest in the Private Hospital. The proposed procurement process for the private hospital is planned to be completed by early 2009.

The timing of the upfront contribution will potentially not align with the capital expenditure for the Project and could therefore still have budgetary impact in the years in which capital is expended.


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offset



initiative

Deferred fit-out (“shelling”) of critical care, surgery and paediatrics spaces


Escalation is based on construction

escalation rate and assumes deferment

of expenditure at the mid point of

construction


Shelling is feasible for 4 operating rooms, 20 ICU beds, 24 surgery beds, 14 paediatric beds.

Shelling is defined as structural completion of the areas but with no final flooring, ceiling, internal walls, lighting and FFE completed.

Fit-out expenditure would be required during ramp-up phase as beds are opened.

Deferment of FFE will ensure that the latest equipment can be procured and that the equipment does not deteriorate prior to use.

Dependent on policy view concerning timing of capital budget constraint (Saving is achieved during construction phase but is offset by fit-out expenditure when ramp-up phase to 750 beds is undertaken).

Shelling is a cost deferment as the costs will eventually have to be incurred. It is likely that completing the construction fit-out at a later date will result in more expensive outcome.

If the deferred fit-out is treated as cost not included in the Project capital cost budget then an additional source of funding will be required for the deferred capital costs.

Remove 1,000m2 of gym space for rehabilitation services





construction


Gym capacity can be reduced while retaining an option to complete if required at a later date.

The area will be constructed but will be shelled. Shelling is defined as structural completion of the areas but with no final flooring, ceiling, internal walls, lighting and FFE completed.

Subject to health planner’s review as to service needs during ramp-up phase.

If the deferred fit-out is treated a cost offset and not included in the Project capital cost budget then an additional source of funding will be required for the deferred capital costs.


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offset



initiative

Outsourcing of commercial kitchen space for cafeteria





construction


The private sector will be responsible for the capital costs associated with the fit-out of the cafeteria / kitchen facilities.

As part of the Project the area will be constructed but will be shelled. Shelling is defined as structural completion of the areas but with no final flooring, ceiling, internal walls, lighting and FFE completed. The private sector will then pay for the fit out.

Subject to viability of private sector delivery.

The upfront fit out may result in a lower rental stream from the private sector tenant.

Private sponsorship and naming rights


Private sector and community organisations may make donations or other contribution to equipment or facilities.

Requires significant promotional activity and there is uncertainty over timing of revenues relative to expenditure.

Radiotherapy (private sector provision of equipment and service)

This option is only available if the application for funding from the Commonwealth for the Oncology Facility is unsuccessful.

$20 million

Escalation is based on FFE escalation

rate and will postpone

expenditure in 2012


Services to non-admitted patients can potentially be provided cost-effectively by the private sector who are able to recoup costs through the MBS rebate and a small out of pocket component. The MBS payment also includes a capital recovery component.

The level of out of pocket expenses may be included in negotiations as part of the lease arrangements.

Proposed savings are based on equipment costs, not building costs. It is assumed that QH

Private providers may require financial incentives to commence services in parallel with commissioning of the GCUH.

Requires the Commonwealth support for radiotherapy in the local area.

There will be some costs in contracting small volumes of inpatient activity.

There is also the potential to obtain an ongoing rental stream for private sector use of QH building space (recurrent saving).

Source: Queensland Health


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9 Evaluation of the Proposed Delivery Model

9.1 Possible evaluation approaches The Queensland Government’s Project Assurance Framework requires that, in preparing a Business Case for Government consideration, agencies should use Cost Benefit Analysis (CBA), or Cost Effectiveness Analysis (CEA) if appropriate, to demonstrate that the project option recommended in the Business Case will optimise value for money in its use of resources. The Queensland Government has issued Cost-Benefit Analysis Guidelines to assist agencies in conducting CBA and CEA.

9.1.1 Cost benefit analysis

CBA is used to assess the impact of a project on the economic welfare of the community. It involves the comprehensive identification and estimation of project costs and benefits, including external social and environmental impacts, to rank project options according to their net economic benefit. Economic valuation of costs and benefits involves adjustments for market distortions, such as tax and subsidies, and the estimated valuation of inputs and outputs not traded in the market, such as lives saved. CBA is not generally used in the evaluation of hospital projects because of the difficulty of reliably valuing significant benefits of reduced morbidity and mortality in the community.

9.1.2 Cost effectiveness analysis

CEA is used for projects where benefits can be identified but it is not possible to value them in monetary terms. Instead, benefits are expressed in terms of outcome statistics such as number of hospital beds. Only one benefit is used as a measure of effectiveness and therefore the predominant benefit of the project needs to be identified. Project options are valued only in terms of costs in achieving the measured predominant benefit. The CEA will therefore determine the least cost option for achieving a particular outcome but it will not show whether benefits outweigh costs.

CEA is an appropriate methodology in principle for evaluation of the GCUH project and could be applied in assessing options for delivering 750 beds which, while an input measure, represent a convenient proxy for the predominant outcomes of the project. However, CEA has not been applied for the following reasons:

• in the development of the Project Definition Plan and related user consultation processes, Queensland Health has developed a single option, described in this Business Case as the Proposed Delivery Model, for progressing the project

• as noted in section 8.3, this Business Case has developed a Reference Case to reflect facility standards that may have been assumed in, or can reasonably be associated with, the Announced Capital Cost budget to permit analysis of the main factors that account for the difference in cost associated with the Proposed Delivery Model. The Reference Case was not developed as a viable delivery solution and it would not be able to be delivered because it fails to achieve certain statutory standards and does not reflect essential requirements for the GCUH, such as FF&E levels appropriate for the super-specialty services at the Hospital

• the factors that account for the differences between the Reference Case and the Proposed Delivery Model have been separately costed and evaluated in Chapter 8; evaluation of the Reference Case and Proposed Delivery Model in a CEA framework would not add any further information or analysis.


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Based on the factors discussed above, the proposed approach for evaluating the Proposed Delivery Model is a qualitative assessment against the project objectives. This approach does not evaluate the Reference Case because, as noted above, it is not considered to be a viable delivery option. Nevertheless, it is appropriate to summarise in this section the main outcomes or benefits that are associated with each of the factors identified in Section 8 that explain the difference between the Reference Case and the Proposed Delivery Model.

9.2 Qualitative assessment of Proposed Delivery Model The following section qualitatively assesses the Proposed Delivery Model against the project’s objectives set out in Chapter 2. Each project objective is reviewed in turn and a short commentary is provided which describes how the Proposed Delivery Model seeks to achieve the stated objective.

9.2.1 Project objective: Service delivery and care • create a patient-focussed health system that encourages innovative models of care

delivered in a major teaching hospital

• deliver operational efficiency, optimising the use of people and resources, capable of achieving health service planning targets and sustaining service levels into the future

• promote evidence-based design to create an environment that enhances patient safety, patient outcomes and clinical excellence

• ensure ability to function in a post-disaster environment

• enhance amenity for users of the site including consideration of car parking, retail, co-located private hospital.

Assessment of Proposed Delivery Model

The Proposed Delivery Model achieves the Queensland Government’s commitment to the development of a 750-bed major tertiary teaching hospital. It will also offer the full range of super-specialist clinical and support services described in the GCUH Health Service Plan. The evidence based design principles of the Proposed Delivery Model will enable the Hospital to offer a supportive patient/family-centred environment where patients and their families and carers experience excellence in all aspects of health service.

The Master Plan has developed a clustering approach towards the delivery of clinical services and support services as follows:

• clustering of acute care services, sub-acute services and acute services clinical support

• clustering of acute mental health inpatient services

• clustering of family, women and children services

• clustering of education, research and pathology

• clustering of offices centrally in close proximity to clinical areas.

The design principles described earlier in Section 4.3. support this clustering approach and the desire to minimize travel distances, provide clear ‘way-finding’ and ease communication between departments. For example, acute services and ambulatory care services are primarily located on the first five levels of the hospital building (basement through to level 2) with direct links to mental health, the proposed private hospital and public car parking. The remaining four


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levels include support units and additional inpatient units. (The building layout is described further in Section 4.4).

As discussed in Section 4.16, evidence based local and international studies suggest that the adoption of a relatively high proportion of single-bed rooms, together with ‘pod’ ward designs, will be a key contributing factor towards enhancing patient safety (e.g. reducing the number of patient falls) and patient outcomes (e.g. improved satisfaction levels, shorter lengths of stay) and thereby improving operational efficiency.

The configuration of the Hospital under the Proposed Delivery Model allows sufficient space within the site for the development of suitable amenities and support services including a 3,000 car parking facility, retail opportunities, private hospital and medical consulting suites and child care facilities (it is noted that provision of these facilities is outside the scope of the Proposed Delivery Model).

The proposed site and configuration promotes easy patient access and movement into and around the facility. For example, it is proposed that:

• the Rapid Transit station will be located at the front door of the hospital

• the planned “Hospital Street” allows good access for traffic, emergency vehicles to the hospital main entry, car park and associated functions

• pedestrian access spines link the book end car parks, mental health and the wider precinct on simple grid system providing clarity for access

• core hospital facilities will be located along a right angled internal street with a walking distance to lift nodes within 50 meters of each other.

The Proposed Delivery Model will also provide a central energy facility on-site to ensure the Hospital’s essential utilities can function in a post-disaster environment.

9.2.2 Project objective: People • Support attraction and retention of well-trained, committed and motivated staff.


Competition for skilled clinical and nursing staff is a challenge for all health service providers in Australia and the GCUH is expected to face similar challenges, particularly following commissioning when there is a significant increase in service activity. Queensland Health’s Bed Transition Strategy envisages a progressive ramp-up in activity over a four year period to manage the recruitment process while meeting projected service demand.

In addition, the Proposed Delivery Model develops the Hospital to exceptional clinical, teaching and support services standards that are expected of a modern major tertiary hospital. Given the profile of the Hospital facilities, its clinical service offerings and designation as a leading teaching hospital, it is more than likely to attract and retain well-trained, committed and motivated staff.

The Hospital’s proposed location within the Knowledge Precinct, the ease of access to the facility and on-site amenities such as car-parking, child care facilities and retail outlets, are a few examples of the many features the Proposed Delivery Model offers towards attracting appropriately skilled staff.


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The Hospital’s close association with the Griffith University, Bond University and other higher educational institutions, as well as the re-location of the Medical and Dental School to Griffith University land, are further reasons the Proposed Delivery Model is likely to achieve the project’s ‘people’ objective.

9.2.3 Project objective: Site access and egress • provide clear points of site access and egress ensuring the efficient movement of

public/staff, emergency and service vehicles in and around the site

• maximise integration of developing public transport infrastructure to the new Hospital.


Key design principles of the Proposed Delivery Model include ease of access from public and private transport, and the concept of intuitive and clear ‘wayfinding’ between buildings. The Proposed Delivery Model features a series of linking spines throughout the Hospital site in order to promote efficient travel. These vehicle and pedestrian links provide access to car parking facilities, green spaces, associated hospital services and wider precinct neighbours including the University, proposed Private Hospital and Child Care Centre. A series of proposed external road upgrades by the Department of Main Roads to the network surrounding the Hospital will provide clear points of access and egress to the site.

The Department of Main Roads and Queensland Transport are communicating with the GCUH project team to inform the design of the Gold Coast Rapid Transit station which will service the University and the GCUH. Construction of this station is scheduled to be completed in 2012 in line with completion of the Hospital.

9.2.4 Project objective: Future proof and flexible • encourage flexible design and infrastructure capable of adapting to new technologies

(clinical, information and operational) and emerging trends in clinical practice, models of care and changes in government policy, legislation and standards.


The GCUH Health Service Plan addresses the short to medium as well as long term implications for health services and includes assessments of the most likely areas of expansion, such as Cancer Care Services. Accordingly, the Hospital’s Master Plan has a design philosophy that considers flexibility of internal layout and an effective expansion strategy. Some of the key design principles for flexibility and expansion include:

• to ensure that the building structure, construction and provision of building services can be easily modified to respond to change and expansion

• to ensure that critical zones, including but not limited to the Emergency Department, Medical Imaging, Operating Suite, Ambulatory Care and Cancer Care services can expand in the future without disrupting ongoing operational activity

• to provide core infrastructure in locations which will not obstruct change or expansion and which will continue to provide ‘back bone’ services and access throughout the life of the building

• to provide convenient access to building services that could require change or expansion in the future.


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The Proposed Delivery Model includes a spatial expansion allowance of 90,000m2 of gross floor area to enable extensions or new buildings to be added. This additional floor space could increase bed numbers from 750 to approximately 1,000 to cope with future demand (such an increase would be subject to usual feasibility analysis and approvals) and would bring the total gross floor area to 255,000m2. Adequate plant capacity will also be provided by the Proposed Delivery Model to accommodate the changing requirements of the Hospital over a 25 year period.

The decision by Queensland Health to increase the proportion of single-bed rooms from current standards of 25% up to approximately 75% means the Proposed Delivery Model is well positioned to keep pace with this emerging trends in Australia and internationally.

The use of single rooms has been debated extensively and the increased ratio of single rooms has been selected as it delivers the following advantages:

• improved flexibility of ward utilisation on a day to day basis

• improved flexibility of ward utilisation in terms of future reconfiguration of use (future proofing)

• improved infection control

• increased privacy, dignity and independence

• increased space around the bed

• reduced staff injuries

• encouragement of therapeutic activity

• reduced recovery time

• reduced adverse clinical errors.

9.2.5 Project objective: Teaching and research • promote an active learning environment, providing appropriate facilities for teaching

and research within clinical areas, and between the GCUH and its key education and research partners.


Under the Proposed Delivery Model, the Hospital will be located at the northern end of the Knowledge Precinct. One of the key benefits of this location is the ability to closely integrate teaching and research activities between the Hospital and University. The co-location of the proposed Private Hospital with the GCUH will also complement the teaching and research activities of the Hospital.

To address the teaching and research project objective, the Proposed Delivery Model embeds teaching activities within the Hospital setting together with proximate teaching and research. In particular the education areas will include the following:


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• 240 seat lecture theatre

• two 120-150 seat lecture theatres

• one conference room, two seminar rooms and four tutorial rooms

• OH&S Training and Staff Development facilities

• Computer Learning Centre

• Clinical Training Service including Clinical Skills Laboratory and training rooms.

A spatial allowance has been made for hospital-based research, where all dry research undertaken by the various Clinical Departments is to be conducted. The teaching and research spaces at the hospital will provide capacity to build relationships not only with Griffith University but with Bond University and other higher educational institutions.

To ensure the integration between the new Hospital and Griffith University continues, the parties have agreed that the existing Medical and Dental school will be relocated to University land. A footbridge over Parklands Drive will achieve connectivity with the GCUH (this aerial link is not part of the Proposed Delivery Model scope).

9.2.6 Project objective: Business continuity • achieve a successful relocation to the new Hospital with no interruption to the

ongoing delivery of services.


The Proposed Delivery Model is expected to meet the opening date for the Hospital of December 2012. This on-time delivery will facilitate a smooth transition from the hospital services at Southport and existing Interim Demand Management Strategies, as well as assisting in implementation of the Transition Plans without unexpected delay. Queensland Health is in the process of developing a detailed transition plan for the Hospital, however current indications are that a ‘ramp up’ approach will be adopted to introduce services in line with service demand and workforce availability. The Proposed Delivery Model is planned to be fully operational by 2015. The Southport facility is planned to be decommissioned following the commissioning of GCUH in 2013.

9.2.7 Government commitment, policy and objectives • procure a new major teaching hospital which delivers value for money to the State,

within budget and other parameters as agreed by the State.


The selection of a procurement option for the Proposed Delivery Model was subject to a decision making process separate to the development of this Business Case. Through that process it was determined that the best value for money procurement approach for the project would be Managing Contractor GCS form of contract.

The original capital cost budget announced by the Queensland Government for the 750-bed GCUH was $1,230 million (August 2006 dollars). A further announcement by the Government in July 2008 revised the Gold Coast Hospital Capital Cost Budget to $1,549 million (July 2008 dollars). Applying the same escalation rates and construction works profile assumed for the Proposed Delivery Model the Updated Government Approved Capital Cost Budget is $1,846.54 million (nominal dollars).


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The cost planning analysis for the Proposed Delivery Model results in a capital cost of $2,108.30 million in nominal dollars. This project cost exceeds the original budget by $240 million. As discussed, in Section 8, the Announced Capital Budget does not provide sufficient information to permit meaningful comparison with the Proposed Delivery Model. Consequently, a Reference Case has been established which delivers essentially the same level and mix of service outputs as the Proposed Delivery Model but for the same capital cost as the Announced Capital Budget. The main differences between the Reference Case and the Proposed Delivery Model have been discussed in section 8.

The sections emphasise that the Reference Case is not a viable delivery solution because it fails to achieve certain statutory standards and does not reflect essential requirements for the GCUH, such as FF&E levels appropriate for the super-specialty services at the hospital. In addition, it is not a robust and reliable costing because it contains an inadequate provision for project risks. The risk adjustment for the Proposed Delivery Model has been based on detailed identification and valuation of project risks as described in Section 6 and Appendix C of this report and is considered appropriate for this project taking into account the current early stage in the procurement process and consequent uncertainty about significant cost items.

If the Queensland Government approves the estimated capital cost for the Proposed Delivery Model, then Queensland Health would have a sustainable basis to progress the project to deliver the full range of services required by the Health Services Plan, recognising that further design changes after Queensland Government endorsement of the estimate should be managed within the overall raw construction cost.


The Proposed Delivery Model seeks overall ESD performance in compliance with non accredited 4 Star rating consistent with industry benchmarking. In addition to Green Star rating, several benchmarks and targets will be used for individual ESD topics. The ESD targets identified by the working group are based on Queensland Health’s Sustainability Guidelines and the benchmarks set out in the Green Star Healthcare Pilot scheme. These documents have formed the basis of a Green Plan which identifies specific ESD initiatives and targets for the Hospital. Targeted ESD areas include energy efficiency, water efficiency, thermal comfort, PVC reduction and waste minimisation.

• maximise benefits of collocation opportunities – with university, private hospital and other services.


The hospital will be located within the Knowledge Precinct to enable it to integrate its teaching and research functions with those of the Griffith University. In addition, the GCUH site includes an area of 14,000m2 which has been set aside for a future private hospital development. Discussions are underway with private hospital proponents and a strategy is being developed to consider the appropriate timing of the private capacity and its relationship with the GCUH.

9.2.8 Project objective: Stakeholder relationships • encourage a collaborative constructive relationship between the new Hospital and

stakeholders including education and research partners, local community, and communities of interest

• minimise impact and disruption to the surrounding community during construction

• the new Hospital is part of a network of services including “district-wide” service.


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A “Relationship Agreement” has been negotiated between the Griffith and Bond Universities and the GCHSD agreeing to a process for the development of shared services between the parties on the GCUH site and across the District. In addition, detailed discussions have been held with Griffith University relating to the Master Planning of the GCUH to ensure synergy and connectivity is established between the two facilities in the delivery of teaching and research programs.

The Gold Coast City Council (GCCC) has been involved in the Precinct Master Planning coordinated through the Department of Infrastructure. In addition, the GCCC is represented on the Project’s Stakeholder Advisory Committee. This committee includes community representatives and has been established to advise the District and Project Team on proposed services as well as design matters such as accessibility and way finding. It is allied to a range of other strategies that are being pursued by the District to engage health consumers under the Helping Consumers Connect Plan and to ensure opportunities for community participation in facility planning.

The GCUH will form part of an integrated network of services within the GCHSD, encompassing Robina Hospital, Robina Health Precinct, and a variety of Community Based Services primarily at Palm Beach, Bundall and Helensvale, as well as a number of outreach clinics; with Carrara Health Service providing subacute care. Within this network, the GCUH will provide higher-level support services such as intensive care, trauma management and neonatal care. For these services the role of the facility will be to support the State-wide availability of capacity and act as an integrated part of a network in peak periods of stress.


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10 Public interest This chapter of the Business Case presents the public interest assessments for the project. It addresses the following topics:

• environmental, planning, cultural heritage and native title

• employee, employment and skills issues

• stakeholder considerations

• communication strategy

• accountability and transparency.

10.1 Planning, environment, cultural heritage and native title Proposed Precinct and Site

The wider precinct is essentially bounded by the extent of Griffith University land to the south, Olsen Avenue to the west, sporting clubs, private development and open space to the North, and Musgrave Hill Primary to the East. In total the precinct is approximately 130 hectares which consists of approximately 58 hectares north of Parklands Drive, 26 hectares between Parklands Drive and Smith Street and 46 hectares south of Smith Street.

The site is located within a large parcel of land under the ownerships of the Department of Tourism, Racing and Fair Trading and Churches of Christ in Queensland.

The site for the Gold Coast University Hospital consists of four separate lots or part there of:

• Lot 458 on WD6223 (part) is currently owned by the Department of Tourism, Racing and Fair Trading and contains showgrounds, a dog track and a harness track.

• Lot 497 on WD6012 is currently leased by the Salvation Army for a drug and alcohol rehabilitation centre.

• Lot 188 on WD6012 (part) is held in trust by the Gold Coast City Council for use as a cemetery.

• Lot 496 on WD6012 is currently owned and occupied by the Churches of Christ Queensland.

10.1.1 Planning Issues

Ministerial Designation

In accordance with the requirements of the Integrated Planning Act 1997 (IPA), a Ministerial designation of land at Southport to facilitate the construction and operation of the proposed Gold Coast University Hospital has been implemented (approved by the Health Minister on August 1 2008). The Ministerial Designation will facilitate the future development and growth of the site as the Gold Coast’s regional health precinct, primarily through the delivery of the Gold Coast University Hospital. The effect of the designation is that the development of the site for the designated community infrastructure and service will be exempt from the local government’s


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planning scheme. However, the requirements of all State and Federal legislation must be met and therefore consideration was given to the provisions of the local planning scheme.

The present designation is only over the land required for the proposed hospital. Project Services’ Town Planning Unit prepared an Initial Assessment Report on behalf of Queensland Health to provide information in the assessment of the Ministerial Designation for community infrastructure, Gold Coast University Hospital. Gold Coast City Council on line planning scheme information indicates that Lots 188, 496, and 497 are all listed within the planning scheme as ‘community purposes’. Lot 458 is predominantly zoned as ‘private open space’, with a small area zoned as ‘community purposes’.

The IPA prescribes the way in which Ministerial Designations can be undertaken. The Integrated Planning and other Legislation Amendment Act 2003 (IPOLA Act) makes changes to the IPA and in particular, procedures for designation of land for community infrastructure. The IPA, Section 2.6.7 prescribes that a Minister, before designating land for community infrastructure, must be satisfied that for development, the subject of the proposed designation:

• adequate environmental assessment has been carried out

• in carrying out environmental assessment under paragraph (a), there was adequate public consultation

• adequate account has been taken of issues raised during the public consultation.

In terms of development under the IPA the designation will be undertaken in accordance with Section 2.6 and Schedule 5 of the Act, the Integrated Planning Regulation 1998, and the Guidelines ‘About Environmental Assessment’ and ‘Public Consultation Procedures for Designating Land for Community Infrastructure’.

The Ministerial Designation, under the IPA Section 2.6.1 for the purpose of Community Infrastructure, of the Gold Coast University Hospital site at Southport includes:

(a) aeronautical facilities;

(d) community and cultural facilities, including child-care facilities, community centres, meeting halls, galleries and libraries;

(g) emergency services facilities;

(f) educational facilities;

(h) hospitals and associated institutions; and

(r) storage and works depots and the like including administrative facilities associated with the provision or maintenance of the community infrastructure mentioned above.

It is intended that the community purposes undertaken at the site will be provided through:

• facilities for the provision of medical care and/or treatment of sick or injured persons

• facilities for scientific, forensic and medical research and testing services

• educational facilities for training of persons engaged or to be engaged in the delivery of those services, with libraries, and similar facilities to encompass training requirements

• administrative, storage and maintenance facilities as necessary to support the delivery of those purposes


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• social and public support functions including car parking, conference facilities and commercial activities and alliances that are in support of the community infrastructure.

Steps taken in completing the Ministerial Designation The six steps for the Ministerial Designation process included:

Step 1: Initial Assessment Report (prepared by Project Services). A Preliminary Environmental Review Report has also been completed.

Step 2: Initial Consultation carried out in early 2007. A Communication Strategy for the project was developed in October 2007, further details on the communication strategy is provided in Section 10.4.

Step 3: Finalisation of Initial Assessment Report – March 2008

Step 4: Public Notification and Second Consultation - public notification and consultation occurred in late March to late April 2008.

Step 5: Preparation of the Final Report for Minister – May 2008.

Step 6: Minister’s Consideration of the Final Report - final endorsement August 2008

Other planning issues that were considered include:

• The proximity of the site to the State controlled road (Olsen Avenue) may also require development applications to be referred to Main Roads.

• Environment related State legislation which may need to be sought through the Integrated Development Assessment System including:

- clearing of native vegetation

- environmentally relevant activities associated with the operations of the facility (e.g. crude oil or petroleum storage and fuel burning associated with emergency generators, on site water or waste water treatment, heliport).

• It is also recommended that formal town planning advice is obtained to confirm development approval requirements.

Works Regulation

Previously, the project had been at risk of delay due to a number of planning, land tenure and vegetation clearance constraints. After reviewing all options, including legislative and planning options, it was proposed that a regulation, or series of regulations, made under s.109 of the State Development and Public Works Organisation Act 1971 (SDPWO Act) be made, directing the Coordinator-General to undertake works to facilitate the project (Works Regulation).

Legal advice was obtained from Mark Hinson SC about the interaction between the undertaking of works under the SDPWO Act and IPA. Mr Hinson concluded that IPA did not apply to the exercise of the Coordinator-General’s powers and functions under the SDPWO Act. Mr Hinson also noted that, to the extent another person exercises powers under the SDPWO Act not as the agent of the Coordinator-General (such as a local body undertaking works directed to be undertaken under s.100 of the SDPWO Act), IPA would continue to apply.


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There are sound legal grounds based on the advice of Mr Hinson SC that the use of s.109 Regulations directing the Coordinator-General to undertake the GCUH project mean that approvals that would otherwise be required under IPA for the project, are not required.

10.1.2 Environmental Issues

Existing Site Hydrology and Flooding

Gold Coast City Council’s flood mapping indicates that the site is not vulnerable to flooding, however the site is listed as being susceptible to stormwater issues. This issue is likely to be exacerbated by the clearing of remnant vegetation. The site is located within the catchments of Loders and Biggera Creeks, which contain a significant diversity of protected flora and fauna species.

The impact of stormwater quantity and quality on surrounding ecosystems must be closely managed and considered in project designs. Site development should consider the location of this waterway and ensure sediment loss from the site is appropriately managed. Liaison with the local authority is required to establish the nature of existing stormwater drainage issues to ensure these are appropriately considered in project designs. It is recommended that a stormwater management plan is prepared for the development. Due care will be required during design of any new buildings to ensure the development area has adequate freeboard from the flow path and surface flows are adequately drained away from the building platform. Standard best practice controls are to be implemented during construction to minimise potential impacts on stormwater quality.

Topography and Geotechnical Characteristics

The site generally slopes towards the north-east, where a large detention basin designed to capture overland flow resides within the harness racing track. The site’s topography is not expected to cause any significant issues with the proposed hospital’s design and ultimate construction.

The site geology consists of clay soils overlying extensively weathered bedrock. Areas of shallow topsoil overlying bedrock towards the northern boundary of the site have been identified.

The site elevations are generally greater than 10mAHD hence it is considered unlikely that acid sulphate soils are present on the site. Nevertheless, if excavations extend below 5mAHD in depth, consideration of potential presence of acid sulphate soils is required. The geotechnical investigations carried out to date have not indicated any possibility of acid sulphate soils.

It is recommended that consideration of dispersivity of site soils is established during further (stage 3) site geotechnical investigations to ensure appropriate erosion and sediment control measures are implemented during construction and operation of the facility to protect nearby sensitive stormwater receptors.

Existing Vegetation and Habitats

Council’s on-line mapping shows that no specific vegetation protection orders exist for the site. However, Council does provide ‘protected vegetation’ status to all vegetation on freehold land with a girth of 40 centimetres or more at a height of 1.3 metres. On-line mapping also indicates that the western side of Lot 188 is affected by ‘significant remnants’ within the Conservation Strategy overlay and the eastern side of Lot 458 appears to be affected by the ‘bushland


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mosaics’ designation within Council’s Conservation Strategy. Both allotments are mapped as containing existing 1994 remnant vegetation (and other natural systems). Potential difficulties associated with these issues are to be avoided by the use of works regulations under s.109 of the SDPWO Act as explained above.

The Environment Protection and Biodiversity Conservation Act 1999 Protected Matters report identifies 38 threatened species and 44 migratory species whose habitats occur within five kilometres of the site.

The site is not within a restricted fire ant area as defined by Department of Primary Industries and Fisheries mapping.

The site is not located within a Koala habitat, conservation or living area under the Nature Conservation (Koala) Conservation Plan 2006 and Management Program 2006-2016 (Koala Plan).

Site Contamination and Waste Management

The sites are not listed on the Environmental Protection Agency’s Environmental Management Register or Contaminated Land Register. Coffey Environments PL was engaged by Bovis Lend Lease to conduct a hazardous building materials audit of various buildings within the defined GCUH boundary. The aim of the audit was to identify, as far as practicable, the location and condition of hazardous building materials (asbestos containing material and synthetic mineral fibre products and potential for polychlorinated biphenyls (PCB) capacitors, lead based paints and ozone depleting substances (ODS)), and provide recommendations regarding their management during the proposed demolition work.

Coffey Environments conducted its inspections on June 16 and 17, 2008 and a subsequent report with clearly identified procedures will be included in the documentation package for an Early Works tender.

Disposal of demolition and construction wastes to landfill should be minimised through waste prevention, minimisation, reuse and recycling programs. It is recommended that the successful contractor be required to produce a Waste Management Plan as part of the Construction Environmental Management Plan to ensure this issue is given due consideration.

Air and Acoustic Quality

There are no residential properties located immediately adjacent to the site. Some residences are located within 500 metres to the north, west and south of the proposed site. Consideration of potential amenity impacts, including nuisance from increased traffic, noise and lighting, on these nearby residences must be considered and managed during the design, construction and operational phases of the facility. Additional consideration should be given to the access and egress routes taken by emergency vehicles, including helicopter flight paths. Potential noise and air quality impacts on the site users from road traffic and other site activities should also be considered during design of the facility.

10.1.3 Cultural Heritage and Native Title Issues

The properties are not listed on the Queensland Heritage Register or the National Heritage Register databases, however a Memorial Tree is noted on the site survey within Lot 496. There are no listings for the properties on the Department of Natural Resources and Water’s Aboriginal Cultural Heritage database or register.


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Queensland health in conjunction with Crown Law is currently negotiating a Cultural Heritage Management Plan, pursuant to the Aboriginal Cultural Heritage Act 2003. Actions required to address Aboriginal Cultural Heritage will differ across the sites depending on the previous level of disturbance.

The majority of the site could be considered as Category 4 (Areas previously subject to Significant Ground Disturbance) under the Aboriginal Heritage Act 2003 Duty of Care Guidelines. In these circumstances subject to measures set out in paragraph 5.6. In some cases, despite an area having been previously subject to Significant Ground Disturbance, certain features of the area may have residual Cultural Heritage significance.

The remainder of the site (part of Lot 188 WD10612) could be considered as category 5 (Activities causing additional surface disturbance) under the Aboriginal Heritage Act 2003 Duty of Care Guidelines. In these circumstances subject to the measures set out in 5.13 – 5.16 of the guidelines it is necessary that the activity should not proceed without Cultural Heritage assessment.

Both of these categories will be dealt with via means of a survey and other requirements as determined by an approved Cultural Heritage Management Plan. A draft Cultural Heritage Management Plan prepared by Crown Law was released on the 27th June for review.

Native Title

With respect to Lot 458 on WD6223, Lot 496 on WD6012 and Lot 497 on WD6012 native title is considered to be extinguished via either a valid freehold or leasehold Previous Exclusions Possession Act. However, given Lot 188 on WD6012 is a reserve, there is no basis to extinguish native title over this allotment either via Previous Exclusive Possession Act or a valid public work. Queensland Health has confirmed this with the Director, Native Title Policy and Legislation Services within the DNRW. The area of land affected by Native Title will require the Acquisition of Native Title rights by the State. Queensland Health has applied to The Department of Natural Resources and Water on 5 June 2008 to commence this process.

10.2 Employee, employment and skills issues The Value for Money Guidance Material requires an assessment of any likely significant employee, employment and skills issues that might require attention during the project delivery.

This section contains provides further information on:

• the current GCHSD workforce and project workforce

• employment and workforce issues

• employment issues associated with the construction of the facility.

10.2.1 Workforce profile

The GCHSD has 4,104 staff (3,393 FTE) which equates to 17.9% of the Southern Area Health Service (SAHS) workforce population, as at September 2007.


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The table below illustrates the Headcount and FTE comparisons for the September 2006 and 2007 quarters. The percentage increase in staff is significantly greater at 17.7% pa compared with that of SAHS of 12.3%.

Table 10.1 Headcount and FTE comparisons for the September 2006 and 2007 quarters

Sep-06 Sept-07 FTE Increase 06-07

Headcount FTE Headcount FTE FTE % Gold Coast 3,542 2,882.43 4,104 3,392.98 510.55 17.7%

SASH Total 20,729 16,844.74 23,008 18,914.58 2069.84 12.3% Source: Queensland Health, MOHRI Reports - June 2006 & 2007

Age Profile

The average age of workers in the health industry is rising, resulting in a range of issues associated with an ageing workforce and the limited availability of new recruits. Currently, in the GCHSD, approximately 32% of the permanently appointed workforce are aged 50 years and over as illustrated in the following figure

Figure 10.1 Staff Age Profile

Staff Age Profile (GCHSD Vs SAHS)

0.00% 5.00% 10.00% 15.00% 20.00%

19 and less

25 - 29

35 - 39

45 - 49

55 - 59

65 and Over

Gold Coast

Southern Area HealthService

(Source: MOHRI Report September 2007)

Retirement Replacement

Currently staff eligible for retirement is 6.23%. In 2012 staff eligible for retirement will more than double to 14.07% which equates to approximately 577 staff.

Employment Status


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The GCHSD workforce is made up of 75.51% permanent staff. ABS figures (2001) indicate that only 50.8% of female nursing workers worked full-time while the other 49.2% worked part-time19. GCHSD’s nursing data supports this trend towards part-time work (34%). The nursing stream constitutes 46% of the GCHSD workforce and has a significant impact on workforce issues associated with skill mix, continuity of care, and flexible work patterns, which will become more important as this reduction in fulltime participation trend increases.

Workforce Growth

GCSHD has experienced quite significant growth in workforce numbers in the last 2 years. This is related to multiple factors including increased service delivery demand, being able to recruit to positions that have been previously vacant, and significant funding allocation from Queensland Health since 2006.

Medical workforce has had the greatest percentage staffing increase with a 48% growth from 2005-2007 (refer table below). Allied Health has had significant growth of 29% within the same time period and Nursing has 25%, less than the total staff percentage growth. An implication of the increase in medical staff is the workload effect on other streams which have not had the same percentage increase. It will be important to ensure that workforce planning is not only related to one stream when service delivery changes or increases are identified

Table 10.2 FTE’s by Stream September 2005 Vs September 2007

FTE Increase % Increase Stream Sep-05 Sep-07 Sep-07 Managerial and Clerical 358 528 47.49% Medical (Inc VMOs) 351 522 48.72% Nursing 1,488 1,868 25.54% Operational 548 673 22.81% Trades & Artisans 13 14 7.69% Allied Health / Professional / Scientists 350 452 29.14% Technical 47 54 14.89% All Pay points 3,155 4,111 30.30% Source: Queensland Health, Plan Reports compiled by HR Informatics - Sept 2006 and Sept 2007

The following table provides an estimate of the likely increase in FTE by district per based on the anticipated increase in bed numbers as contained in the draft Bed Transition Strategy prepared in October 2007.

Table 10.3 Estimated Increase in FTE by District (per Increase in Bed Numbers)

District Year Bed Increase

Medical Nursing A/Health Professional

Support Staff

Total

Gold Coast 2006-07 20 25 88 21 25 158 2007-08 41 51 180 42 51 324 2008-12 73 30 157 29 98 314 2012-13 121 150 531 125 150 956

19 Australian Bureau of Statistics, 2005. 4102.0 - Australian Social Trends, retrieved on 01/10/07 from http://www.abs.gov.au/ausstats/[email protected]/2f762f95845417aeca25706c00834efa/8a87ef112b5bcf8bca25703b0080ccd9!OpenDocument


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District Year Bed Increase

Medical Nursing A/Health Professional

Support Staff

Total

2013-14 59 73 259 61 73 466 2014-15 33 41 145 34 41 261 2015-16 35 43 154 36 43 276 Source: Queensland Health, Projected increase in bed numbers from the draft Bed Transition Strategy October 2007 Note: To calculate the staffing ratios the full time equivalent (FTE) for each professional group was divided by the number of beds to derive FTE per bed for October 2007. This ratio was then multiplied by the increase in bed numbers per year. 2008-12 includes the Carrara Facility and Surgicentre Initiatives.

Please note that varying staffing levels due to various models of care has not been taken into consideration. The above numbers are a broad estimate of staffing FTEs required for the increase in bed numbers. The total increase in staff during the period from 2006 to 2016 is 2,520 FTE which can be broken down into:

• 395 Medical Staff

• 1,406 Nursing Staff

• 329 Health Professionals

• 395 Support Staff.

10.2.2 Key Workforce and Employment Issues

The key work force issues for the proposed GCUH Project that need to be addressed as part of the development of the project include:

• Recruitment, retention and retraining: Ability to make key future appointments to clinical services at the GCUH facility. The proposed strategies to recruit, retrain clinicians, nurses and support staff include:

- the establishment of links with the existing and emerging university health programs to maximise consequent recruitment

- plan for student clinical education within overall staffing numbers so that local recruitment is enhanced

- the establish of links with local high schools and VET sector for recruitment of support clinical staff and support non-clinical staff..

These strategies will also need to recognise and focus on the additional workforce requirement due to the increased number of staff members entering the retirement age or close to retirement age.

• Potential inclusion of the facility management and maintenance into Managing Contractor Contract: Queensland Health is currently investigating the potential benefits of including the facility management and maintenance into the contract for the Managing Contractor. The benefits may include a more whole of life design.


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The affected staff under this proposal primarily include the Building, Engineering and Maintenance (BEMS) Staff and Grounds / Gardens Staff.

Of significance is the pending expiry of current enterprise agreements in August 2008 and the negotiations surrounding EB7 which will commence shortly. Given that enterprise agreements usually last for three years, there is potential for the EB8 bargaining period to also be problematic.

Transmission of business provisions exist within industrial legislation to protect the entitlements and conditions of staff employed through privatisation of a service. However, only Queensland Government employees are entitled to access QSuper.

Strategies for managing major organisational change and contracting out are clearly articulated in the Qld Public Health Sector Certified Agreement [No 6] 2005 [sections 4.1 and 6.2] and the Queensland Health Building Engineering and Maintenance Services Certified Agreement (No 3) 2006 [section 7.3]. Both agreements require early consultation with unions and detailed discussion prior to going to tender or entering into any binding legal agreement.

• Work Practice Changes: The scope of services for the new hospital and the ability to transition staff from acute to community contexts as population health initiatives and changes in models of care take effect will necessitate significant changes to current workforce practices. To effectively undertake the work practice changes, the Gold Coast Workforce Planning Committee will require buy in and input from clinician and support services planning groups. However, clinical groups have been affected by recent changes at the systemic level in Queensland Health and maybe reluctant to engage in further change.

Strategies to address these employment issues are being developed through a Strategic Workforce Planning Committee including representatives of GCHSD. In addition strategies are being developed at a corporate level to address consistent practices and processes affecting the major Hospital developments. These strategies will include direct negotiation with Unions at a whole of Queensland Health level to establish processes for local negotiation and development of change management strategies.

10.2.3 Employment Issues Associated With Construction of the Facility

A project of this magnitude will offer considerable opportunities for employment, either as direct employment during the construction phase of the project, or indirectly via the employment of those providing goods and services as inputs to the project. It has been estimated by the building consultant that during the construction phase of the Hospital, 2200 – 3000 full time equivalents will be required over three years.

Skills development

Since 1993, a minimum of 10 per cent of the total labour hours on any Queensland Government building or civil construction project (valued over $250,000 for building or $500,000 for civil construction) must be undertaken by apprentices, trainees or cadets, or used for the up-skilling of existing employees (to a maximum of 25 per cent of the deemed hours).

The Queensland Government's Building and Construction Contracts - Structured Training Policy, known as the '10 per cent Training Policy', ensures structured training occurs within Queensland Government building and construction contracts. This policy requires that


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apprentices, trainees and cadets must be engaged in approved training that leads to a nationally recognised building and construction competency or qualification.

Contractors are required to provide evidence of compliance with this policy and this information will ultimately be considered in any review of their eligibility to tender for future government work.

Sourcing goods and services

The Queensland Government is committed to supporting competitive local industry and to ensuring that local industry is provided with full, fair and reasonable opportunity to tender for work on infrastructure and resource-based projects and major procurements in Queensland.

Accordingly the Government expects that project proponents, developers and operators will:

• recognise that involving local industry in projects and capital asset acquisitions provides economic benefits to all parties and is crucial to the long-term development of a strategic manufacturing and service capability that underpins a strong and diversified Queensland economy

• ensure that Queensland and Australian suppliers, contractors and manufacturers are given full, fair and reasonable opportunity to tender and participate in all stages of projects and acquisitions subject to this Policy

• use Australian Standards and Codes in the formulation of specifications, tenders and the letting of contracts (except where it is unreasonable to do so)

• seek to maximise levels of goods and services, including design services, from local companies where they are competitive with respect to cost, quality and timeliness

• seek to incorporate this Policy into contracts entered into with third parties for the supply of goods and services

• encourage private sector project proponents, who are not formally subject to the provisions of the Policy, to apply the principles espoused in the Policy to their projects on a voluntary basis as ‘good corporate citizens’.

This approach is designed to ensure that investment decisions in key projects provide opportunities for local industry without adverse effects on cost, quality or timeliness.

The Government requires that the proponents of any infrastructure or projects funded by the public sector with a value greater than $5 million will be required to develop Local Industry Participation Plans. Local Industry Participation Plans are designed to support the involvement of local industry in purchases subject to the provisions of the Local Industry Policy. Each Plan lists competitive local suppliers that will be invited to tender and will detail the level of local industry participation expected in projects and the benefits that will flow to Queensland in industry development, technology transfer, job creation and skills development.

Equal Employment Opportunity and the Anti-Discrimination Act

Queensland Health is committed to ensuring that workplace recruitment is based on Equal Employment Opportunity and the Anti-Discrimination Act and encourage applications from all members of the community. In addition to these principles, there are specific opportunities for indigenous groups to be involved in the project relating to cultural heritage.


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10.3 Stakeholder Issue Management Several stakeholder groups will be impacted by the proposed GCUH project and the broader precinct development. These groups and the respective project issues affecting them are discussed in this section under the following headings:

• health related stakeholder considerations and issues management

• broader community stakeholder considerations and issues management.

10.3.1 Health related stakeholder consideration

The health related stakeholder considerations and issues have been categorised into the following groups:

• patients, relatives and users of the health facility

• clinicians including medical, nursing and allied health staff

• local community.

Consultation in relation in relation to the health related issues has been undertaken by a number of means including Stakeholder Advisory Committee, ‘Lean Thinking’ initiatives, Service Planning Groups and Executive Service Planning Groups. The main stakeholders and their issues are described in the following section.

Patients, relatives, users of the health facility

Overall project objectives include the development of services and a facility that are patient focussed as well as relative and family friendly. The District has been proactive in establishing programs to delivery on those objectives. The following provides detailed information on past, current and planned stakeholder engagement activities.

Consultation to date

‘Lean thinking’ initiatives have been underway in GCHSD since February 2006. The process of ‘lean thinking’ focuses on what is of value to the customer across the patient journey. Reviews of patient flow, have resulted in the identification of recommendations for improvements. The review of patient flow has occurred across the following Departments and patient groups:

• Medicine – elderly breathless patient

• Orthopaedics – elective hip arthroplasty

• Emergency Department – presentation of paediatric patient

• Intensive Care – discharged patient

• Mental Health – community care of dual diagnosis patient ready for discharge.

In addition to information collected through the above flow projects a process is underway to obtain consumer/user input of people accessing the service over the next few months into the design of the GCUH. This process will include:


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• some patient groups will be tracked and mapped through their journey in the current facility with particular objective of obtaining feedback from the patient themselves, their relatives and friends and staff regarding their perceptions and expectations of what the new facility should have and how it will best meet then needs of the community. Some initial tracking has already occurred and the results reviewed

• some patients and their relatives (or significant other) will be requested to keep a ‘diary’ of their journey, with particular reference of their experience of the physical environment. A preliminary assessment of the tool to be used has already occurred, results reviewed and implemented in January 2008

• some client groups have been identified for focus groups and ‘experiential’ mapping of a journey through current processes – for example, linguistically and culturally diverse clients will be asked to participate in an exercise where they are asked to ‘find’ Medical Imaging while being tracked

• some clients will be asked to participate in a process where other facilities are visited to identify ‘good’ design and things that that do not work.

Issues raised

A number of issues have been identified and prioritised for action. Primary issue relates to communication across the continuum of care.

Potential issues and mitigation strategies

Issues identified through this process were included in project development through the Schematic Design phase.

Clinicians including medical, nursing and allied health staff

The development of the Health Service Plan, Project Definition Plan and Schematic Design has involved over 120 clinical staff through both Service Planning of which there were 39 and 14 Executive Service Planning Groups. These groups have developed models of care and functional briefs for inclusion in the endorsed Project Definition Plan.

General practitioners

This important group of primary health care providers and stakeholders is represented on the project Stakeholder Advisory Committee.

Non-clinical support

These staff have been included in the planning processes through membership of the Service Planning Groups and Executive Service Planning Groups established for the project.

Staff Consultation/Information Sharing

The existence and creation of new robust information dissemination systems have been created to highlight project progress enhanced practices making change appealing to staff20.

20 (Plsek & Wilson 2001, p.748)


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In an effort to disseminate rich, timely information regarding upcoming opportunities and service evolution, a number of inclusive strategies have been defined. Processes undertaken or planned include:

• staff forums

• surveys

• presentations at staff functions

• district broadcasts.

With this in mind, strategies have been developed which will facilitate the “sharing of meaningful information that touches natural attractors or creates new ones”21. Staff forums are just one of the strategies in which to share information. Staff forums in addition to providing an opportunity to generate staff buy in, this strategy has allowed the “foundation of our services”22 to have their say.

The facilitation of sharing information staff will be accomplished through a number of mechanisms including: media releases, public notice boards and websites, articles in Queensland Health publications including Healthwaves and Healthmatters and other appropriate media opportunities as they arise. It is envisaged that there will be synergy with GCHSD Service Development initiatives which will include:

• Service Development Newsletter. It is envisaged that that 1 page Service Development publication will be produced fortnightly or monthly as appropriate and that it will be disseminated via email through GGHSD Broadcasts. Key milestones and additional information from this publication will then be used to populate a regular service development feature in Healthwaves.

• Healthwaves (local District newsletter) articles. A regular service development column in this bi -monthly publication will ensure accurate and timely information to staff and consumers alike.

To date the following activities have been undertaken:

• staff surveys completed October 2007 and was planned for December 2007

• presentation by District Manager at Achievement Awards December 2007

• article in Healthwaves November 2007

• staff gallery review of the Schematic Design progress in July 2008

• district broadcasts.

Unions

Union consultation principally occurs through the District Consultative Forums (DCF). The DCF includes Queensland Health, Mater Health Services Ltd, the health unions represented on the 21 (Plsek & Wilson 2001, p.748) 22 Strategic Plan 2007-2012


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State Bargaining Unit, the Queensland Nurses Union and the Medical Interested Based Bargaining. Through the DCF both Union and Management representative meet on a monthly basis. Issues affecting the project are raised and resolved through that forum as well as reference to the project planning groups.

A separate working committee is also being established to specifically look at the employment issues associated with the current development of the three major health facilities in South East Queensland (i.e. the proposed GCUH, Sunshine Coast Hospital and the Children’s Hospital).

Potential labour related issues for the GCUH Project include:

• car parking policy – how staff parking tariffs for the proposed GCUH car parks will be set as discussed in the Car Park Business Case provided in Appendix D

• work practice changes as outlined in Section 10.2.2

• potential inclusion of the facility management and maintenance into Managing Contractor Contract as outlined in Section 10.2.2.

Local community

The development of the GCHSD Master Plan included community consultation forums to facilitate community input into service planning.

As part of the development of the October 2005 Gold Coast Health Service District Master Plan community consultation on the planning in the District was undertaken to inform the development of the document in 2005.

A series of nine public consultation meetings were held at various venues throughout the Gold Coast, at various times and on various days of the week to optimise access to the community.

The meetings consisted of a presentation of data, demographics, and service planning information. Clinicians and health services planners from within the District attended the meetings and answered questions from the floor at every event.

The meetings were publicised through advertising in the local paper, community service announcements, letter box drops and a series of media articles in local papers and on radio.

A number of publications were also produced outlining the vision for the new GCUH.

More recently, the Gold Coast Health Service District has developed the Helping Consumers Connect Project Plan. The Helping Consumers Connect Project aims to identify, implement and evaluate a systematic approach addressing the following core Gold Coast Health Community Council responsibilities:

• community engagement

• community education about public health services on the Gold Coast

• quality and safety.


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This project will identify and deliver multiple strategies which will be actioned as part of the wider strategic agenda provided for Health Community Councils by the Minister for Health under the provisions of Section 28M of the Health Services Act 1991. Strategy selection has been informed by existing best practice community engagement evidence and has capitalised on current and/or planned consultative activities.

This plan will include opportunities for the community to participate and engage directly with the planning processes of the new GCUH.

In addition to the above mentioned local initiatives, a comprehensive Communication Strategy has been developed by Capital Works and Asset Management Branch. This strategy ‘provides the overarching strategic direction for communication relating to the development and construction stages of the GCUH’.

A Stakeholder Advisory Committee has been established for the GCUH which includes community representatives as well as key stakeholders mentioned above. The purpose of this Committee is to provide advice to the District and the Project Team in relation to services proposed for the new GCUH as well as design including accessibility, way finding and other initiatives to ensure a patient and relative friendly care environment.

The Gold Coast Health Community Council as previously mentioned is also a key stakeholder in the development and consultation processes including community input into the design of the new GCUH and service provided.

Griffith and Bond Universities

A “Relationship Agreement” has been negotiated between these organisations and the GCHSD agreeing to a process for the development of shared services between the parties on the GCUH site and across the District. This agreement recognises the necessary partnerships involved to make the concept of a University Teaching Hospital a success.

Agreement has also been reached on the advertising and funding arrangements for joint appointments between Qld Health and Griffith University which will impact on the GCUH and developing relationships between the District and the University.

Detailed discussions have been held with Griffith University relating to the Master Planning of the GCUH to ensure synergy and connectivity is established between the two facilities in the delivery of teaching and research programs.

10.3.2 Broader Community Stakeholders

Consultation in relation precinct has been facilitated through the Precinct Master Planning. The main stakeholder affected and their issues are described in the following section.

Local Council

The Gold Coast City Council (GCCC) was involved in the Precinct Master Planning coordinated through the Department of Infrastructure and Planning. The Plan is currently being revised. In addition, the GCCC is represented on the previously mentioned Stakeholder Advisory Group for the project.


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Gold Coast City Council is trustee for the current cemetery expansion land and agreed to release the land for the development of the new hospital, based on the assurance of the State to provide alternate cemetery land elsewhere within the city. Gold Coast City Council has also indicated its interest in economic development opportunities, particularly knowledge industries.

Gold Coast City Council is responsible for the road network surrounding the new hospital and the Knowledge Precinct (except Olsen Avenue and Smith Street which are managed by the Department of Main Roads).

Church of Christ

The Church of Christ is a freehold land owner located to the south of the lawn cemetery, central to the proposed location of the hospital. In addition to church services, they undertake a range of activities on their premises such as child care related functions, provision of off-street parking for Griffith University students, crisis and relationship counselling, student support services largely for international students, theological education and youth programmes for surrounding State Schools.

Church of Christ has agreed in principle to relocate to a portion of a site currently owned by Griffith University on the southern side of Smith Street, Parkwood subject to a number of conditions including the acquisition of freehold title to the area in question. In conjunction with the preliminary works commenced following the making of State Development and Public Works Organisation Amendment Regulation (No. 1) 2008, the Coordinator-General has been directed to undertake a program of works comprising all further works required to design, construct and commission the Gold Coast University Hospital facilities. This regulation also directs the Coordinator-General to undertake all other works and activities reasonably incidental to the main hospital works, including measures relating to environmental management, traffic management measures, stormwater management and, if agreement is reached between the Coordinator-General and the Churches of Christ, reinstatement of the Churches of Christ complex.

The Church of Christ has vacated its site to interim leased premises in the vicinity on the expectation that an agreement with the State for suitable compensation associated with the acquisition of the site will be achieved.

Discussions conducted with Church representatives has also indicated a preparedness for an interim move in the short term as long as there was a reasonable exit strategy that would enable the Church to continue to serve the community within a similar area.

An interim child care facility has been established on the Parklands Showgrounds site to ensure continuity of this important community service. Childcare commenced at the new facility on 1 September 2008. A permanent facility will be constructed as part of the relocated Church of Christ facility on a 2 hectare site south of Smith Street and opposite Crestwood Drive Southport, if an agreement with the Church of Christ is finalised.

Section 135(1) of the SDPWO Act provides that the Government may enter into an Agreement with any person that private works agreed on by them shall be undertaken by the Coordinator-General on such terms and conditions as are provided in the Agreement.

Section 135(2) of the SDPWO Act provides that a regulation may authorise the Coordinator-General to undertake works agreed by the Government (whether under section 135(1) or otherwise) to be undertaken by the Coordinator-General and the Coordinator-General is thereby


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empowered to undertake those works as authorised works subject to and in accordance with the regulation and the material Agreement.

On 10 June 2008, the State entered into an agreement with the Churches of Christ for provision of a temporary child care centre for the use of the Church, pending reinstatement of the Church buildings. Pursuant to the State Development and Public Works Organisation Amendment Regulation (No. 3) 2008, and s.135 of the SDPWO Act, the Coordinator-General has been directed to undertake the works necessary to deliver the temporary child care centre for the Churches of Christ.

Salvation Army

The Salvation Army currently occupies land in trust from the State Government on the proposed hospital site. A warehouse/distribution service for their District is operated from this site, as well as the Fairhaven Rehabilitation Centre, offering detoxification services relating to drug and alcohol addictions. A new warehouse facility at Molendinar has been purchased by Queensland Health and leased to the Salvation Army for their distribution service. Negotiations are continuing for a suitable replacement facility for the drug and rehabilitation service and it is planned for this to occur within a timeframe that will permit the Salvation Army to continue to provide this service with little or no disruption.

Queensland Health has no intention of incorporating the drug rehabilitation service within the Gold Coast University Hospital. Queensland Health would continue to fund the Salvation Army to operate this service.

The Parklands Gold Coast Trust, the Greyhound Racing Authority and the Harness Racing Association

The Parklands Gold Coast Trust currently manages land in trust from the State Government upon which leases have been granted to Greyhound Racing Authority and the Harness Racing Association. The balance of this site contains the Showgrounds facilities.

The land currently utilised as a greyhound track and associated car park are within the footprint of the Gold Coast University Hospital. An alternative venue for greyhound racing has been identified at Slacks Creek and a proposal from the Greyhound Racing Authority to progress this is currently under consideration.

The hospital development itself will have some impact on the harness racing facilities, requiring relocation of stables. In the longer term, the development of the Gold Coast Hospital and Knowledge Precinct would require relocation of the harness racing track. Options for a combined site for thoroughbred and harness racing on the Gold Coast are being investigated.

Griffith University

The construction of the new Gold Coast University Hospital will require the relocation of the University’s Medical and Oral Health School currently adjacent to the existing Gold Coast Hospital at Southport to Parkwood to ensure continued close integration of teaching activities. Resolution has been reached between QH and Griffith University on the location of the Medical and Oral Health School on university land that will most effectively achieve connectivity with the Gold Coast University Hospital.

The State will provide funding for the construction of the replacement Medical and Dental School on a “like for like basis” in accordance with an agreed timetable. The basis of transfer of


September 2008


ownership of the existing Medical and Dental School from the University to the State is currently being progressed.

Subject to the outcome of the ongoing preliminary works, it is anticipated that the project works required to deliver the Griffith University Medical and Dental school, and other incidental developments, will be undertaken by the Coordinator-General pursuant to a further works regulation made under section 109 of the SDPWO Act.


Department of Main Roads are the road network owner and manager of the two major thoroughfares (Smith Street Motorway and Olsen Avenue) linking to the Gold Coast University Hospital.

Department of Main Roads conducted a preliminary analysis and costing which significantly impacted on the decision to move the Gold Coast University Hospital site from its initially announced location south of Smith Street on Olsen Avenue to north of Smith Street on Olsen Avenue/Parklands Drive.

Department of Main Roads identified significant road infrastructure cost savings of between $260 - $360 million by building the hospital on the Northern Site at Parklands. The major savings are through major interchanges that would have been required for the southern site at Olsen Ave/Crestwood Dve and Olsen Ave/Southport-Nerang Rd either not being required or being deferred for decades.

Funding for upgrades of road infrastructure on the northern site has been estimated to be $250 million. Road upgrades consist of:

• upgrading of the existing Smith Street Connection Road/Labrador-Carrara Road (Olsen Avenue)grade separated interchange

• construction of new Smith Street Connection Road/Parklands Drive (eastern end) grade separated interchange

• construction of a signalised at grade intersection at Tonga Place at an estimated cost of $7m

• preferably (but not essential) an improved more directional left-turn off Labrador - Carrara Road (Olsen Ave) into the western end of Parklands Drive at an estimated cost of $1m

• preferably (but not essential) an improved more directional left-turn lane off Labrador - Carrara Road (Olsen Ave) into Southport - Nerang Road at an estimated cost of $1m

• non-signalised at grade intersection from the hospital to connect to Musgrave Avenue to provide an additional low-usage ambulance and emergency vehicle access point to the surrounding local road network at an estimated cost of $1m.

Department of Main Roads are currently updating and refining the road upgraded costs required for the Gold Coast Hospital in line with developments on the master planning for the precinct and hospital site.

Queensland Transport / Gold Coast Rapid Transit

Queensland Transport is planning the development of the Gold Coast Rapid Transit project. Queensland Transport has indicated a rapid transit station servicing Griffith University & Gold


September 2008


Coast University Hospital is a priority for the project and will be accommodated in the final solution. Construction of this station is included in the first stage of the Gold Coast Rapid Transit project which is scheduled to be completed in 2012, in line with the completion of the Gold Coast University Hospital. The Rapid Transit is integral to a whole-of-transport access solution for the Gold Coast University Hospital.

Department of Infrastructure and Planning is coordinating all stakeholders including Queensland Transport, Department of Main Roads, Queensland Health, Gold Coast City Council and Griffith University to inform the design of the rapid transit station and corridor infrastructure that will interface with the Gold Coast University Hospital.

Department of Natural Resources and Water

Department of Natural Resources and Water’s role is to determine the vegetation management issues with the Gold Coast University Hospital site. The use of works regulations under s.109 of the SDPWO Act overcomes the Integrated Planning Act and therefore the Vegetation Management Act implications for the project development.

Department of Infrastructure and Planning

The Department of Infrastructure and Planning are working with Queensland Health to ensure that access to the northern site for construction of the hospital is not impeded by access issues, in relation to holders of interests in land or transport networks around the site, or on which the hospital is to be constructed. The Department of Infrastructure and Planning will inform the timely and integrated delivery of major infrastructure projects in the area, namely the Gold Coast Rapid Transit and the road network upgrades.

The acquisition of land required for the Gold Coast University Hospital but currently occupied by the Council, the Salvation Army, the Church of Christ and the Parklands Gold Coast Trust is required to be resolved by August 2008 in order to facilitate the implementation of a Works Regulation under the State Development and Public Works Organisation Act.

Office of Urban Management

The former Office of Urban Management facilitated a master planning exercise for the Hospital and Knowledge precinct. The Office of Urban Management’s objectives were to:

• deliver a precinct framework that will provide leadership through a unifying vision for the future development of the precinct

• show how new development can be integrated with the wider area

• deliver collective and integrated outcomes

• ensure the efficient use of land.

The Department of Infrastructure and Planning is managing the revision of the master plan since a number of infrastructure studies to support the hospital development have been completed.

Department of Local Government, Sport & Recreation

The Department of Local Government, Sport & Recreation are assisting the Department of Infrastructure and Planning in consultation with the affected lessees at Parklands; the


September 2008


Greyhound Racing Authority and Harness Racing Association as well as the Parklands Gold Coast Trust. In addition to this they:

• ensure usable alternative sport and recreation opportunities remain, if existing facilities are lost;

• ensure green space provisions in the area are enough to support growing demand

• are considering the option of building an indoor sports stadium in the Precinct that could have synergy with Griffith University and the hospital - rehabilitation/sports science/sports medicine

Department of Tourism, Regional Development and Industry (formerly Department of State Development)

The Department of Tourism, Regional Development and Industry’s primary concern is to ensure adequate allowance for knowledge-based industries are planned within the Precinct. They are responsible for the development of the Smart Water Research Facility and the Queensland Academy of Health and Medical Science at the Precinct. The links between these knowledge-based industries and the Gold Coast University Hospital tertiary facilities are being explored.

Other Parties

Matters likely to be of interest to nearby land owners and other parties include (but are not limited to):

• built form, height and bulk

• design, including architectural and landscape treatments

• intended site population

• vehicular and pedestrian access and circulation

• hours of operation

• management of stormwater discharge

• potential future implications for the ongoing and viable development of adjacent lands

• impacts during construction.

10.4 Communication Strategy The communication strategy provides the overarching strategic direction for communication relating to the development and construction stages of the Gold Coast University Hospital. It will provide guidance towards branding, public relations, community engagement, and stakeholder relations activities. It is intended that the strategy provides communication support throughout the lifetime of the project stages, including master planning, schematic design, design development, tender, construction, practical completion and opening.

The Gold Coast Service Development team will manage communications relating to internal staff communication, service planning and philosophy of care for the hospital, hospital governance, human resources and change management.

The Major Hospitals Project Office will manage all project specific communications issues.


September 2008


10.4.1 Purpose of the Communication Strategy

The purpose of the strategy is to:

• raise awareness and understanding of how the project intends to manage and communicate key messages to identified stakeholders and target audiences

• provide the steering committee and senior management with a documented framework detailing which communication mechanisms/tools would be most appropriate for the identified stakeholders and target audiences

• ensure the communication of issues, implementation of issues and project updates to key stakeholders

• provide a mechanism for seeking and acting on feedback to encourage the involvement of, and assist in 'selling' the project to, the key stakeholders

• identify and manage communication and reputation risk associated with the project

• identify the actions required for implementation of the strategy and associated costs.

10.4.2 Communication objectives

Awareness • to increase awareness of the Gold Coast University Hospital project, its benefits and what it

will mean to users and their families, staff, and local community

• to inform and educate audiences about the planning and development stages and associated impacts

• to promote and manage the reputation of Queensland Health.

Attitude • to generate or strengthen users’, staff and the community’s personal relevance to the

messages of the campaign

• to foster a sense of community pride and ownership of the new hospital.

Behaviour • to achieve active participation in engagement activities from staff, users, special interest

groups and local members of the community throughout the lifetime of the project

• to attract and retain quality staff to the Gold Coast University Hospital across all professional areas during the lead up to opening in 2012

• to encourage message champions within Queensland Health and in the community (including residents, businesses, and the private health sector) throughout the lifetime of the project.

10.4.2.1 Key messages

The overarching campaign slogan is “we’re building a healthier community”. This message will be supported by three key messages for the Gold Coast University Hospital:


September 2008


We’re building a new hospital • we are delivering a hospital not just for today, but one that meets the health care needs of

the community well into the future

• we are allowing for future flexibility and expansion as the need for health services and the population change and grow

• it is vital that the new hospital integrates with the community and the surrounding environment

• we will use ecologically sustainable design principles

• this is an exciting opportunity to create a new and innovative facility.

We’re building sustainable health services • the new hospital is one element of an integrated network of health services being developed

• Queensland Health is expanding health services to meet the demands of an increasing population

• we are building more health services in your local community, close to where you live

• we will deliver a higher level of more complex health care services then ever before

• We are changing models of care to be more patient focussed.

We’re building a place to work and learn • the new Gold Coast University Hospital will be a teaching hospital to train the health

professionals for the future at the same time providing career and skills development opportunities for staff

• we are creating a place where staff want to work because the culture and clinical environment values teams and all their members

• new staff will be attracted to the Gold Coast University Hospital because it will be one of the most advanced in the country.

10.4.3 Community Strategy Action Plan

The Communication Strategy contains a detailed Action Plan for the implementation of the strategy over 2007 and 2008. This Action Plan primarily focuses on the development of communication documents and channels and consultation activities.

10.5 Accountability and transparency The GCUH Project governance structure is illustrated in the following diagram. It should be noted this structure was endorsed in November 2007. The introduction of the Major Hospitals Project Office on 23 June 2008 has necessitated that some “streamlining” changes be made and reflected in the Governance structure. At the time this update of the Business Case was compiled, a revised endorsed Governance structure was not available.


September 2008


The key components of the governance structure are outlined below:

• Cabinet Budget Review Committee. It is proposed that the Cabinet Budget Review Committee will be formally updated and required to approve progress on the GCUH Project at the following milestones:


September 2008


- the end of the Schematic Design (via this Business Case). Anticipated date – mid October 2008

- when an acceptable ‘GCS Offer’ is obtained (to approved funding and for the project to proceed to construction). Anticipated date – May 2009.

• CEO’s Committee. The CEO’s Committee will be regularly updated on the progress of the development of the Project and Interrelated Projects (e.g. Rapid Transit Project, Site Acquisition, Upgrade to Surrounding Roads, etc). This committee will also if required make decisions on the Project and the Interrelated Projects.

• EMT/ Capital Works and Asset Management Committee. This committee will be regularly updated on the development of the Project and will make necessary policy decisions for the Project to continue development.

• GCUH Government Steering Committee. This committee will closely monitor the progress and will make decisions on the policy and project related issues to facilitate the ongoing development of the Project.

• GCUH Project Control Group. This Group undertakes more of the day to day management of the Project Team and the development of the Project.

10.5.1 Communication principles

The approved Communication Strategy for the Project states that throughout all stages of the Project development, the project communication will adhere to the following principles:

• honest, open and two-way

• timely, accurate and reflect the corporate position of the Queensland Health

• targeted to the information needs of specific audiences

• proactive - don’t wait until there is a problem

• no surprises - staff should be told about stages of the project first or simultaneously with outside audiences. They should not be surprised by what they hear about the project from other sources, i.e. the media

• consistent themes, messages, tone and style that ensure a constant look and feel to all communications from Queensland Health to all audiences

• clear and plain English used at all times

• All materials used for communication internally and externally must reflect the campaign brand identity and be instantly recognisable as being from Queensland Health.

10.5.2 Public access and equity

The public access and equity principles for the Project that have been addressed through the issues management process include:

• Planning, Environmental, Cultural Heritage and Native Title issues which have been addressed in Section 10.1

• Employment issues which have been addressed in Section 10.2

• Health related stakeholder consideration and issues which have been addressed in Section 10.3


September 2008


• Communication Strategy which has been addressed in 10.4

• Project governance structure which has been addressed in 10.5.


September 2008


A Glossary ABS – Australian Bureau of Statistics

AHFG – Australasian Health Facility Guidelines

ATODS – Alcohol, Tobacco and Other Drugs Services

BEMs – Building, Engineering and Maintenance

BOOT – Build Own Operate Transfer

CBA – Cost Benefit Analysis

CBRC - Cabinet Budget Review Committee

CEA – Cost Effectiveness Analysis

CPA – Chest Pain Assessment unit

CPI – Consumer Price Index

CW&AMB – Capital Works and Asset Management Branch

DDA – Disability Discrimination Act

DLA – Davis Langdon Associates

DMR – Department of Main Roads

DNRW – Department of Natural Resources and Water

DPW – Department of Public Works

DRGs – Diagnostic Related Groups

ED – Emergency Department

ESD – Environmentally Sustainable Design

FF&E – Furniture, Fittings, fixtures, and Equipment

FTE – Full Time Equivalents

FWC – Family, Women and Children

GCCC – Gold Coast City Council

GCH – Gold Coast Hospital

GCHSD – Gold Coast Health Service District

GCRT – Gold Coast Rapid Transit

GCS – Guaranteed Construction Sum

GCUH – Gold Coast University Hospital

ICU – Intensive Care Unit


September 2008


ICT – Information and Communication Technology

IDAS – Integrated Development Assessment System

IDMS – Interim Demand Management Strategy 2008-2012

IPA – Integrated Planning Act

IPOLA Act – Integrated Planning and Other Legislation Amendment Act, 2003

IPUs – Inpatient Unit

IT – Information Technology

LCC – Life Cycle Costs

MID – Medical Imaging Department

MC – Managing Contractor

OH&S – Occupational Health and Safety

PDP – Project Definition Plan

PACS – Picture Acquisition and Communication System

QH – Queensland Health

Robina – Gold Coast Hospital Robina Hospital

SAHS – Southern Area Health Service

SEQIPP – South East Queensland Infrastructure Plan and Program

SCN – Special Care Nursery

The Southport Facility – Gold Coast Hospital Southport Campus

VET – Vocational Education and Training

VHFG – Victorian Health Facility Guidelines

VOC – Volatile Organic Compounds


September 2008


B Raw costs inputs 7 pages

GOLD COAST UNIVERSITY HOSPITAL

SD COST PLAN REPORTDate: 16‐Sep‐08

SUMMARY Revision: 5

COST PLAN SUMMARY BY FUNCTIONAL AREADescription % of Value Quantity Units Rate $ Amount $

1 Generic Inpatient Unit 14% 19,057 m² 4,392 83,704,442

2 Education & Research 2% 3,871 m² 3,567 13,808,980

3 Division of Medicine 16% 24,437 m² 3,876 94,718,789

4 Division of Surgery & Critical Care 11% 16,032 m² 4,280 68,618,884

5 Division of Family, Women & Children 9% 14,018 m² 3,963 55,553,755

6 Division of Mental Health 3% 5,817 m² 3,337 19,409,700

7 Division of CARAS 4% 7,359 m² 3,409 25,087,199

8 Division of Medical Services 4% 5,923 m² 4,161 24,645,899

9 Division of Pathology 4% 5,039 m² 4,770 24,035,879

10 Corporate Services, Amenities & Retail 10% 16,556 m² 3,811 63,090,611

Sub‐Total ‐ Functional Area 78% 118,109 m² 4,002 472,674,138

11 Travel and Engineering 22% 46,253 m² 2,802 129,585,101

Sub‐total ‐ Gross Floor Area (GFA) 100% 164,362 m² 3,664 602,259,239

COST PLAN SUMMARY BY BUILDINGDescription Quantity Units Rate $ Amount $

Main Building ‐ Acute 99,437 m² 3,561 354,128,126

West IPU 17,888 m² 3,903 69,815,590

South IPU 22,805 m² 3,680 83,922,307

Pathology and Education 12,315 m² 3,664 45,116,226gy , , , ,

Mental Health 7,176 m² 4,289 30,774,557

Engineering Offices and Workshops 979 m² 3,402 3,330,694

Central Energy Building 3,762 m² 4,033 15,171,739

Sub‐total ‐ Gross Floor Area (GFA) 164,362 m² 3,664 602,259,239

Trade Preliminaries 75,948,045

Central Plant / Engineering Project Specifics etc 127,058,334

External Works / Siteworks 43,952,164

Prior Works (Bulk Earthworks, Fencing etc) 13,428,000

Project Specific Allowances ‐ Mock‐ups / Prototypes 1,000,000

ESD Initiatives ‐ Green Star Rating 47,000,000

Actual Cost of Construction [ACS] ‐ July 2008 910,645,782

MC Fees and overheads 20% 182,129,156

Design Fees ‐ Novated @ end of SD 85,233,186

Sub‐total ‐ Construction Cost Including Fees 1,178,008,124

Professional Fees ‐ up to SD plus audit fees 55,022,532

Statutory and Authority Fees, (eg PLSL @ 0.425%) 6,000,000

FF&E / ICT 168,500,000

Queensland Health Costs, Commissioning etc 31,000,000

Public Art Allowance 2,000,000

Sub‐total ‐ Current Day Project Cost ‐ July 2008 1,440,530,656

Contingency (10%) to be agreed with Commercial Adviser 10% 144,053,066

Sub‐total 1,584,583,722

Site Aquisition 52,200,000

Surrounding Infrastructure 62,600,000

Medical School 62,600,000 177,400,000

Total Estimated Project Cost ‐ July 2008 1,761,983,722

Escalation to Project Completion now based on review of Major Hospitals 19.37% 341,290,329

To be agreed with Commercial Adviser

Total Project Cost ‐ December 2012 2,103,274,050

FF&E / ICT

GENERIC INPATIENT UNIT

1 IPU 1 - Cardiology 1 757,119.00 757,119.00

2 IPU 10- Gastro Surgery( including colorectal) 1 468,506.00 468,506.00

3 IPU 11 - Short Stay Surgical 1 468,506.00 468,506.00

4 IPU 12 - Neurosurgery 1 468,506.00 468,506.00

5 IPU 13- ENT, EYE,MF Surgical Unit 1 468,506.00 468,506.00

6 IPU 15 - Vascular Surgery 1 468,506.00 468,506.00

7 IPU 16- Cardiovascular Surgery 1 440,949.00 440,949.00

8 IPU 2 - General Medicine 1 423,784.00 423,784.00

9 IPU 3 - Infectious Diseases 1 413,607.00 413,607.00

10 IPU 4- Medical Assesment Unit 1 965,681.00 965,681.00

11 IPU 5 - Neurology 1 518,533.00 518,533.00

12 IPU 6 - Renal Medicine 1 552,256.00 552,256.00

13 IPU 7 - Respiratory Medicine 1 420,359.00 420,359.00

14 IPU 8 - Orthopaedic Surgery( Elective) 1 469,331.00 469,331.00

15 IPU 9 - Orthopaedic Trauma Surgery 1 468,506.00 468,506.00

16 Neurology - Ortho Rehab Inpatient Unit 1 503,535.00 503,535.00

17 Obstets IPU1 &2 1 474,435.00 474,435.00

18 Shared Areas Level 2 1 59,599.00 59,599.00


20 Shared Areas Level 4 South 1 79,001.00 79,001.00

21 Shared Areas Level 4 West 1 73,334.00 73,334.00



24 Shared Areas Lower Ground 1 35,751.00 35,751.00

Sub Total 9,258,614.00

EDUCATION AND RESEARCH

25 Education Unit 1 919,006.00 919,006.00

Sub Total 919,006.00

DIVISION OF MEDICINE

26 Acute Dialysis Unit 1 560,974.00 560,974.00

27 Ambulatory Day Care 1 3,452,705.00 3,452,705.00

28 Cancer Services - Offices 1 176,650.00 176,650.00

29 Cardiolgy - CCL and Clinical Measurement 1 6,212,607.00 6,212,607.00

30 Day Medical Unit 1 525,010.00 525,010.00

31 Day Oncology & Haematology OPD 1 1,224,925.00 1,224,925.00

32 ED - Short Stay Observation Unit 1 604,444.00 604,444.00

40921 Gold Coast University Hospital

Schematic Design Cost Plan

Version : C-SD DRAFT Revision: 03FF&E / ICTNo. Description Quantity Units Rate $ Amount $

GCUH Page No: 20 Issue Date: 28-Aug-2008

1 Emergency Department 1 4,154,462.00 4,154,462.00

2 Haematology Oncology Inpatient Unit 1 470,744.00 470,744.00

3 ICU - Clinical Adminsitration & Support Areas 1 335,927.00 335,927.00

4 Obstetric Ambulatory Care 1 726,240.00 726,240.00

5 Oncology IPU 1 467,399.00 467,399.00

6 Radiotherapy Unit 1 12,326,470.00 12,326,470.00

7 Renal Medicine Admin 1 69,160.00 69,160.00

8 Shared Areas Cancer IPUs 1 123,737.00 123,737.00

9 Sleep Study Unit 1 307,696.00 307,696.00

Sub Total 31,739,150.00

DIVISION OF SURGERY & CRITICAL CARE

10 Anaesthetics Dept & Pain Management Dept 1 251,764.00 251,764.00

11 Infusion Therapy Services 1 184,047.00 184,047.00

12 Intensive Care Unit 1 5,579,454.00 5,579,454.00

13 Interventional Suite- Operating Unit 1 6,083,740.00 6,083,740.00

14 Interventional Suite - Admin & Support 1 164,630.00 164,630.00

15 Interventional Suite - Endoscopy 1 1,216,661.00 1,216,661.00

16 Interventional Suite - PACA and SDSU 1 928,416.00 928,416.00

17 Interventional Suite -DOSA, DSU Admissions 1 1,133,325.00 1,133,325.00

18 Inteventional Suite - MRI & Angio 1 3,854,315.00 3,854,315.00

19 Pain Manag'ement Unit 1 145,628.00 145,628.00

Sub Total 19,541,980.00

DIVISION OF FAMILY, WOMEN & CHILDREN

20 Birthing Rooms 1 2,037,999.00 2,037,999.00

21 FWC Office Accomodation 1 153,166.00 153,166.00

22 NICU 1 514,795.00 514,795.00

23 Paediatric Ambulatory Care & Clinical Administration 1 531,048.00 531,048.00

24 Paediatric IPU & 10 Day Stay 1 926,865.00 926,865.00

25 Shared Areas Paeds 1 83,751.00 83,751.00

Sub Total 4,247,624.00

DIVISION OF MENTAL HEALTH & ATODS

26 Mental Health IPU1, 2&3 1 1,587,097.00 1,587,097.00

Sub Total 1,587,097.00

DIVISION OF COMMUNITY, ALLIED HEALTH, AGED & REHABILITATION SERVICES

27 Allied Health Ambulatory Care 1 651,222.00 651,222.00

28 Day of Discharge, Transit Lounge 1 231,022.00 231,022.00

29 Homelink Services 1 73,325.00 73,325.00

30 Loan Aides & Equip Pool 1 29,420.00 29,420.00





1 Rehab Therapy Areas 1 450,849.00 450,849.00

Sub Total 1,435,838.00

DIVISION OF MEDICAL SERVICES

2 Medical Imaging - Vascular Labs 1 115,391.00 115,391.00

3 Medical Imaging Dept 1 30,351,700.00 30,351,700.00

4 Pharmacy Main & Production 1 690,494.00 690,494.00

Sub Total 31,157,585.00

DIVISION OF PATHOLOGY

5 Mortuary 1 379,615.00 379,615.00

6 Pathology Department 1 4,375,809.00 4,375,809.00

Sub Total 4,755,424.00

CORPORATE SERVICES, AMENITIES & RETAIL

7 Administration 1 139,345.00 139,345.00

8 Biomedical Engineering 1 106,687.00 106,687.00

9 Central Sterilising Department 1 2,388,947.00 2,388,947.00

10 Clinical Coding and Decision Support 1 48,833.00 48,833.00

11 Clinical Information & Medical Records 1 213,354.00 213,354.00

12 CRU & Bed Store 1 39,654.00 39,654.00

13 Divisional Office Accomodation 1 1,594,620.00 1,594,620.00

14 ED Clinical Admin & Staff Area 1 183,044.00 183,044.00

15 Facilities Management & Engineering 1 161,136.00 161,136.00

16 Hospital Foundation & Volunteers 1 97,335.00 97,335.00

17 Information Technology 1 82,422.00 82,422.00

18 Kitchen Offices& Sup 1 818,322.00 818,322.00

19 Main Entry 1 157,905.00 157,905.00

20 Materials Management Supply Department 1 236,850.00 236,850.00

21 Operational Services Management 1 288,349.00 288,349.00

22 Pastoral Care 1 43,455.00 43,455.00

23 Public & Staff Dinning 1 223,668.00 223,668.00

24 Staff Amenities 1 318,756.00 318,756.00

Sub Total 7,142,682.00

Engineering and Travel

25 Level 6 Hospital Travel 1 Item 230,000.00 230,000.00

26 Hospital Street (Main Atrium and Integration Zone) 1 Item 100,000.00 100,000.00

27 Level 6 Hospital Engineering 1 Item 135,000.00 135,000.00

Sub Total 465,000.00

SUNDRIES

28 Contingency for Unknown Group 2 and 3 Items 20.00 22,450,000.00





1 ICT, major equipment - eg PACS, PABX, CT Scanners, MRI, and other specialized IT system

1 Item 40,000,000.00 40,000,000.00

2 Saving on transferred equipment from existing hospital -1 Item 6,200,000.00 -6,200,000.00

Sub Total 168,500,000.00

Total 168,500,000.00





GOLD COAST UNIVERSITY HOSPITAL

SD COST PLAN REPORTDate: 16‐Sep‐08

CASHFLOW Revision 5

Fin Year

Date Notes Building Costs [ACS]MC Fees and

Overheads [20%]Professional Fees ‐

NovatedProfessional Fees ‐

QH CostQH Costs Statutory Fees FF&E Public Artwork Contingency

Site Acquisition ‐ No Escalation

Off‐Site Infrastructure

Medical School TotalFin Year Total Cash Flow

ESCALATION Total EscalationFin Year Total Cash

Flow

June 2006 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0% 0.0% 0 0 0% 0 0 0

July 2006 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0% 0.0% 0 0 0% 0.0% 0 0

August 2006 Project Start 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0 0 0.0% 0 0

September 2006 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0 0 0.0% 0 0

October 2006 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0 0 0.0% 0 0

November 2006 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0 0 0.0% 0 0

December 2006 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0 0 0.0% 0 0

January 2007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0 0 0.0% 0 0

February 2007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0 0 0.0% 0 0

March 2007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0 0 0.0% 0 0

April 2007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0 0 0.0% 0 0

May 2007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0% 0 0 0.0% 0 0

June 2007 0 0 0 327,494 245,438 0 0 0 0 0 0 0 572,932 572,932 327,494 0.0% 327,494 245,438 0.0% 245,438 0 572,932

July 2007 0 0 0 1,473,881 45,000 0 0 0 0 0 0 0 1,518,881 1,473,881 0% 0.0% 1,473,881 45,000 0% 0.0% 45,000 0

Escalate at 8,7,6,6,5% Excl QH Costs, FF&E, Public Artwork, Site Aquisition

Escalate at 4% ‐ QH Costs, FF&E, Public Artwork

2006

‐2007

2006

‐2007

y , , , , , , , , , , ,

August 2007 0 0 0 1,821,376 45,000 0 0 0 0 0 0 0 1,866,376 1,821,376 0.0% 1,821,376 45,000 0.0% 45,000 0

September 2007 0 0 0 1,821,376 99,562 0 0 0 0 0 0 0 1,920,938 1,821,376 0.0% 1,821,376 99,562 0.0% 99,562 0

October 2007 0 0 0 1,821,376 145,000 0 0 0 0 0 0 0 1,966,376 1,821,376 0.0% 1,821,376 145,000 0.0% 145,000 0

November 2007 0 0 0 1,821,376 145,000 0 0 0 0 0 0 0 1,966,376 1,821,376 0.0% 1,821,376 145,000 0.0% 145,000 0

December 2007 0 0 0 1,821,376 145,000 0 0 0 0 0 0 0 1,966,376 1,821,376 0.0% 1,821,376 145,000 0.0% 145,000 0

January 2008 Finalise PDP ‐ 18 Jan 08 0 0 0 1,821,376 145,000 0 0 0 0 0 0 0 1,966,376 1,821,376 0.0% 1,821,376 145,000 0.0% 145,000 0

February 2008 0 0 0 1,821,376 145,000 0 0 0 0 0 0 0 1,966,376 1,821,376 0.0% 1,821,376 145,000 0.0% 145,000 0

March 2008 0 0 0 1,821,376 145,000 0 0 0 0 0 0 0 1,966,376 1,821,376 0.0% 1,821,376 145,000 0.0% 145,000 0

April 2008 0 0 0 1,821,376 145,000 0 0 0 0 0 0 0 1,966,376 1,821,376 0.0% 1,821,376 145,000 0.0% 145,000 0

May 2008 0 0 0 1,821,376 445,000 0 0 0 0 0 0 0 2,266,376 1,821,376 0.0% 1,821,376 445,000 0.0% 445,000 0

June 2008 0 0 0 1,821,376 3,220,438 0 0 0 0 3,929,008 0 0 8,970,822 30,308,022 1,821,376 0.0% 1,821,376 3,220,438 0.0% 3,220,438 0 30,308,022

July 2008 0 0 0 1,821,376 830,600 0 0 0 0 48,270,992 0 0 50,922,968 1,821,376 8% 0.7% 1,833,518 830,600 4% 0.3% 833,369 14,911

August 2008 0 0 0 1,821,376 330,600 0 0 0 0 0 0 0 2,151,976 1,821,376 1.3% 1,845,661 330,600 0.7% 332,804 26,489

September 2008 Finalise SD ‐ 12 Sep 08 0 0 0 1,821,376 330,600 0 0 0 0 0 0 0 2,151,976 1,821,376 2.0% 1,857,803 330,600 1.0% 333,906 39,734

October 2008 0 0 2,963,476 2,732,730 330,600 0 0 0 0 0 0 0 6,026,805 5,696,205 2.7% 5,848,104 330,600 1.3% 335,008 156,307

November 2008 Start Prior Works (Delayed from end of SD) 500,000 100,000 2,963,476 901,637 330,600 0 0 0 0 0 0 0 4,795,713 4,465,113 3.3% 4,613,950 330,600 1.7% 336,110 154,347

December 2008 1,500,000 300,000 2,963,476 901,637 330,600 0 0 0 0 0 0 0 5,995,713 5,665,113 4.0% 5,891,717 330,600 2.0% 337,212 233,217

January 2009 1,500,000 300,000 2,963,476 901,637 330,600 0 0 0 0 0 0 0 5,995,713 5,665,113 4.7% 5,929,485 330,600 2.3% 338,314 272,086

February 2009 2,000,000 400,000 2,963,476 901,637 330,600 0 0 0 0 0 0 0 6,595,713 6,265,113 5.3% 6,599,252 330,600 2.7% 339,416 342,955

March 2009 Finalise DD 2,000,000 400,000 2,963,476 901,637 330,600 0 0 0 0 0 0 0 6,595,713 6,265,113 6.0% 6,641,019 330,600 3.0% 340,518 385,825

April 2009 Agree GCS 2,500,000 500,000 3,143,163 329,667 330,600 0 0 0 0 0 0 0 6,803,430 6,472,830 6.7% 6,904,352 330,600 3.3% 341,620 442,542

May 2009 Start Main Works 2,250,000 450,000 3,815,042 699,188 330,600 5,000,000 0 0 0 0 0 0 12,544,830 12,214,230 7.3% 13,109,940 330,600 3.7% 342,722 907,832

2007

‐2008

2008

‐2009

2007

‐2008

2008

‐2009

y , , , , , , , , , , , , , , , , , ,

June 2009 6,165,620 1,233,124 3,815,042 699,188 330,600 0 0 0 0 0 0 0 12,243,574 122,824,122 11,912,974 8.0% 12,866,012 330,600 4.0% 343,824 966,262 126,766,628

July 2009 9,074,578 1,814,916 3,815,042 699,188 368,000 0 0 0 1,972,127 0 0 0 17,743,850 17,375,850 7% 0.6% 18,875,386 368,000 4% 0.3% 383,996 1,515,532

August 2009 11,249,939 2,249,988 3,815,042 699,188 368,000 1,000,000 0 0 2,385,623 0 0 0 21,767,780 21,399,780 1.2% 21,649,444 368,000 0.7% 370,453 252,117

September 2009 13,224,588 2,644,918 3,815,042 699,188 368,000 0 0 0 2,287,755 0 0 0 23,039,490 22,671,490 1.8% 24,913,701 368,000 1.0% 386,547 2,260,758

October 2009 14,182,987 2,836,597 3,815,042 699,188 368,000 0 0 0 2,451,069 0 0 0 24,352,884 23,984,884 2.3% 26,508,093 368,000 1.3% 387,823 2,543,033

November 2009 14,409,607 2,881,921 3,815,042 699,188 368,000 0 0 0 2,569,049 0 0 0 24,742,807 24,374,807 2.9% 27,092,598 368,000 1.7% 389,099 2,738,890

December 2009 15,344,034 3,068,807 3,815,042 699,188 368,000 0 0 0 2,700,586 0 10,000,000 0 35,995,657 35,627,657 3.5% 39,824,595 368,000 2.0% 390,374 4,219,312

January 2010 16,370,636 3,274,127 3,815,042 699,188 368,000 0 0 0 2,820,492 0 0 0 27,347,484 26,979,484 4.1% 30,327,638 368,000 2.3% 391,650 3,371,804

February 2010 17,306,464 3,461,293 3,815,042 699,188 368,000 0 0 0 2,930,496 0 0 0 28,580,483 28,212,483 4.7% 31,891,391 368,000 2.7% 392,926 3,703,834

March 2010 18,165,018 3,633,004 3,815,042 699,188 368,000 0 0 0 3,031,874 0 0 0 29,712,125 29,344,125 5.3% 33,355,467 368,000 3.0% 394,202 4,037,544

April 2010 18,956,239 3,791,248 671,880 369,520 368,000 0 0 0 2,728,411 0 0 0 26,885,298 26,517,298 5.8% 30,309,272 368,000 3.3% 395,477 3,819,451

May 2010 19,687,667 3,937,533 671,880 369,520 368,000 0 0 0 2,815,214 0 0 0 27,849,814 27,481,814 6.4% 31,584,848 368,000 3.7% 396,753 4,131,788

June 2010 20,365,138 4,073,028 671,880 369,520 368,000 0 0 0 2,895,692 0 0 0 28,743,257 316,760,930 28,375,257 7.0% 32,790,447 368,000 4.0% 398,029 4,445,219 353,800,210

July 2010 20,993,246 4,198,649 671,880 369,520 390,000 0 0 0 2,972,745 0 0 0 29,596,040 29,206,040 6% 0.5% 33,919,253 390,000 4% 0.3% 423,230 4,746,442

August 2010 21,575,644 4,315,129 671,880 369,520 390,000 0 0 0 3,041,883 0 0 0 30,364,056 29,974,056 1.0% 34,984,399 390,000 0.7% 424,636 5,044,979

September 2010 22,115,249 4,423,050 671,880 369,520 390,000 0 0 0 3,409,749 0 0 0 31,379,448 30,989,448 1.5% 36,348,577 390,000 1.0% 426,042 5,395,171

October 2010 22,614,392 4,522,878 671,880 369,520 390,000 0 0 0 3,137,216 0 0 0 31,705,886 31,315,886 2.0% 36,912,411 390,000 1.3% 427,448 5,633,973

November 2010 23,074,922 4,614,984 671,880 369,520 390,000 0 0 0 3,191,460 0 0 0 32,312,767 31,922,767 2.5% 37,812,199 390,000 1.7% 428,854 5,928,286

December 2010 23,498,282 4,699,656 671,880 369,520 390,000 0 0 0 3,241,082 0 25,000,000 15,000,000 72,870,420 72,480,420 3.0% 86,271,125 390,000 2.0% 430,260 13,830,965

January 2011 23,885,559 4,777,112 671,880 369,520 390,000 0 0 0 3,286,178 0 0 0 33,380,249 32,990,249 3.5% 39,457,855 390,000 2.3% 431,667 6,509,273

February 2011 24,237,524 4,847,505 671,880 369,520 390,000 0 0 0 3,326,812 0 0 0 33,843,241 33,453,241 4.0% 40,204,908 390,000 2.7% 433,073 6,794,740

March 2011 24,554,658 4,910,932 671,880 369,520 390,000 0 7,326,087 0 4,172,639 0 0 0 42,395,715 34,679,628 4.5% 41,879,188 7,716,087 3.0% 8,596,091 8,079,564

2010

‐2011

2009

‐2010

2009

‐2010

2010

‐2011

, , , , , , , , , , , , , , , , , , , , , , ,

April 2011 24,837,159 4,967,432 671,880 369,520 390,000 0 7,326,087 0 4,204,388 0 0 0 42,766,465 35,050,378 5.0% 42,529,428 7,716,087 3.3% 8,623,910 8,386,873

May 2011 25,084,950 5,016,990 671,880 369,520 390,000 0 7,326,087 0 4,231,643 0 0 0 43,091,070 35,374,983 5.5% 43,127,694 7,716,087 3.7% 8,651,729 8,688,353

June 2011 25,297,671 5,059,534 671,880 369,520 390,000 0 7,326,087 0 4,254,320 0 0 0 43,369,012 467,074,371 35,652,925 6.0% 43,672,552 7,716,087 4.0% 8,679,548 8,983,088 555,096,080

July 2011 25,474,659 5,094,932 671,880 369,520 412,000 0 7,326,087 0 4,274,723 0 0 0 43,623,801 35,885,714 6% 0.5% 44,177,491 7,738,087 4% 0.3% 8,733,310 9,287,000

August 2011 25,614,921 5,122,984 671,880 369,520 412,000 0 7,326,087 0 4,260,185 0 0 0 43,777,577 36,039,490 1.0% 44,587,530 7,738,087 0.7% 8,762,324 9,572,277

September 2011 25,717,087 5,143,417 671,880 369,520 412,000 0 7,326,087 0 4,599,702 0 0 0 44,239,693 36,501,607 1.5% 45,382,814 7,738,087 1.0% 8,791,338 9,934,459

October 2011 25,779,346 5,155,869 671,880 369,520 412,000 0 7,326,087 0 4,270,726 0 0 0 43,985,429 36,247,342 2.0% 45,288,688 7,738,087 1.3% 8,820,353 10,123,611

November 2011 25,799,358 5,159,872 671,880 369,520 412,000 0 7,326,087 0 4,267,493 0 0 0 44,006,210 36,268,123 2.5% 45,536,783 7,738,087 1.7% 8,849,367 10,379,940

December 2011 25,774,123 5,154,825 671,880 369,520 412,000 0 7,326,087 0 4,257,970 0 20,000,000 35,000,000 98,966,405 91,228,318 3.0% 115,101,317 7,738,087 2.0% 8,878,381 25,013,293

January 2012 25,699,802 5,139,960 671,880 369,520 412,000 0 7,326,087 0 4,241,525 0 0 0 43,860,775 36,122,688 3.5% 45,796,660 7,738,087 2.3% 8,907,396 10,843,281

February 2012 25,571,455 5,114,291 671,880 369,520 412,000 0 7,326,087 0 4,217,334 0 0 0 43,682,567 35,944,480 4.0% 45,790,875 7,738,087 2.7% 8,936,410 11,044,718

March 2012 25,382,651 5,076,530 671,880 369,520 412,000 0 7,326,087 0 4,184,306 0 0 0 43,422,974 35,684,887 4.5% 45,678,730 7,738,087 3.0% 8,965,424 11,221,180

April 2012 25,124,874 5,024,975 671,880 369,520 412,000 0 7,326,087 0 4,140,959 0 0 0 43,070,295 35,332,208 5.0% 45,443,679 7,738,087 3.3% 8,994,439 11,367,822

May 2012 24,786,568 4,957,314 671,880 369,520 412,000 0 7,326,087 0 4,085,220 0 0 0 42,608,589 34,870,502 5.5% 45,063,410 7,738,087 3.7% 9,023,453 11,478,274

June 2012 24,351,536 4,870,307 671,880 369,520 412,000 0 7,326,087 0 4,014,047 0 0 0 42,015,377 577,259,693 34,277,290 6.0% 44,506,736 7,738,087 4.0% 9,052,467 11,543,826 719,069,374

July 2012 23,796,056 4,759,211 671,880 369,520 960,467 0 7,326,087 0 3,971,171 0 0 0 41,854,392 33,567,838 5% 0.4% 43,767,167 8,286,554 4% 0.3% 9,726,409 11,639,185

August 2012 23,083,233 4,616,647 671,880 369,520 960,467 0 7,326,087 2,000,000 4,072,686 0 0 0 43,100,519 32,813,965 0.8% 42,961,763 10,286,554 0.7% 12,114,038 11,975,283

September 2012 22,150,481 4,430,096 360,007 227,176 960,467 0 7,326,087 0 3,640,391 0 0 0 39,094,705 30,808,152 1.3% 40,502,323 8,286,554 1.0% 9,791,037 11,198,655

October 2012 19,876,330 3,975,266 360,007 227,176 850,467 0 7,326,087 0 3,394,834 0 0 0 36,010,167 27,833,614 1.7% 36,742,393 8,176,554 1.3% 9,692,950 10,425,176

November 2012 17,959,834 3,591,967 360,007 227,176 850,467 0 7,326,087 0 2,855,227 0 0 0 33,170,765 24,994,212 2.1% 33,129,398 8,176,554 1.7% 9,724,835 9,683,468

December 2012 Practical Completion 07 Dec 12 8,748,370 1,749,674 360,007 227,176 550,467 0 7,326,087 0 932,393 0 7,600,000 12,600,000 40,094,173 32,217,619 2.5% 42,878,203 7,876,554 2.0% 9,398,743 12,182,773

January 2013 570,101 114,020 360,007 227,176 550,467 0 7,326,087 0 313,670 0 0 0 9,461,528 1,584,974 2.9% 2,118,006 7,876,554 2.3% 9,429,458 2,085,936

2011

‐2012

012‐2013

012‐2013

2011

‐2012

y , , , , , , , , , , , , , , , , , , , ,

February 2013 570,101 114,020 360,007 227,176 478,095 0 0 0 0 0 0 0 1,749,399 1,271,304 3.3% 1,705,726 478,095 2.7% 574,218 530,545

March 2013 293,128 58,626 360,007 227,176 302,000 0 0 0 0 0 0 0 1,240,937 938,937 3.8% 1,264,863 302,000 3.0% 363,896 387,823

April 2013 0 0 339,137 153,929 302,000 0 0 0 0 0 0 0 795,066 493,066 4.2% 666,888 302,000 3.3% 365,074 236,896

May 2013 0 0 0 0 302,000 0 0 0 0 0 0 0 302,000 0 4.6% 0 302,000 3.7% 366,252 64,252

June 2013 Final Account 0 0 0 0 310,000 0 0 0 0 0 0 0 310,000 247,183,651 0 5.0% 0 310,000 4.0% 377,162 67,162 317,660,804

TOTAL CASH FLOW 910,645,782 182,129,156 85,233,186 55,022,532 31,000,000 6,000,000 168,500,000 2,000,000 144,053,065 52,200,000 62,600,000 62,600,000 1,761,983,721 1,761,983,721 1,508,283,721 1,820,111,236 201,500,000 230,962,814 341,290,329 2,103,274,050

2020


September 2008


C Risk analysis methodology

C.1 Introduction This appendix provides details of:

• the purpose of the risk analysis undertaken for the Project

• the methodology that has been followed to identify, quantify and allocate Project risks

• the risk matrix that has been developed for the Project

The risk analysis considers risks during the procurement, construction and operations phases. The risk matrix includes the expected value of each risk, dissected into the following categories:

• retained risks where the State bears the consequences of the risk occurring

• transferred risks where the Managing contractor bears the consequences of the risk occurring.

Some risks are shared in that the impacts affect both the State and the Managing Contractor.

C.2 Objectives A risk analysis and quantification has been carried out for the Proposed Delivery Model to achieve a number of related objectives, as follows:

• to calculate a risk-adjusted cost for the Government Benchmark Model which represents the expected value of total project expenditures, including retained and transferred risks

• to inform the negotiation of the Guaranteed Construction Sum and Managing Contractor fees based on an estimate of transferred risks

• to assist in development of Project contract documents through identification of Project risks and allocation as retained or transferred based on an understanding of the risk characteristics and, accordingly, an assessment of the party that is best placed to manage the risks

• to facilitate informed decision making by Queensland Health and the Queensland Government by ensuring that project risks are appropriately identified and valued

• to contribute to risk management by identifying risks, potential consequences and mitigation strategies.

C.3 Risk valuation methodology Three risk workshops and related working sessions were held with participation from Queensland Health, Queensland Treasury, the Department of Infrastructure and project technical advisers. The workshops were facilitated by KPMG and followed a three-stage process for identifying, quantifying and allocating risks as summarised below:

The approach to determining the risk adjustment was a three stage process:


September 2008


1 Identification of risks – participants in the risk workshop identified the relevant material risks applying to the Project by expanding and amending a preliminary list of risks prepared by KPMG on the basis of experience from previous projects.

In identifying each risk, participants considered the appropriate risk description, expected consequences (principally in terms of delay or cost impacts) and mitigation strategies. The risk analysis was confined to risks affecting the GCUH project (and not inter-related projects) and focussed on material risks during the procurement, construction and operating periods.

The construction phase risks cover project risks that would otherwise be included in contingencies within a conventional cost plan. Consequently, the cost plan for this project includes the quantified risk adjustment and does not include a contingencies provision. The operations phase risks are confined to services which are candidates for private sector delivery under a long-term operating contract, specifically, building and plant maintenance (including group 1 FF&FE items), grounds maintenance, utilities management (including utilities volume risk but not price risk) and external cleaning. The scope of the risk analysis excludes other support services and all clinical services.

2 Quantification of risks – Workshop participants quantified each risk by assessing potential impacts and probabilities in accordance with the following procedure. For each risk, participants:

- assessed the probability of the risk occurring for the project.

- identified the financial drivers for each risk, if applicable. The financial driver is a project cost component which is used to determine the value of the risk based on an assessed percentage of the cost component. Where the risk impact is not expected to vary with changes in a project cost component, the impact was assessed as an absolute (i.e. fixed) dollar value.

- determined the range of impact, in percentage or absolute terms, if the event does occur. The range was spread between “low”, “medium” and “high” outcomes.

- determined the probability of each “low”, “medium” and “high” risk impact occurring (noting that in total these had to add to 100%).

KPMG took the inputs from the risk workshop and calculated the value of retained and transferred risks using both the “expected value” and Monte Carlo approaches.

- The expected value approach calculates a single value for the risk adjustment by probability weighting the potential outcomes associated with each risk – it is an intuitive and simple way to calculate a risk adjustment.

- Monte Carlo analysis yields a probability distribution of the risk valuation, giving an added dimension to the risk assessment. One of the advantages of Monte Carlo analysis is that it can be used to select a level of confidence around the expected risk value, whereas expected value analysis is, by definition, the mean outcome of the risk metrics specified.

3 Allocation of risks – The third risk workshop allocated the risks into retained and transferred categories, reflecting the likely allocation to the State and the Managing


September 2008


Contractor, respectively, under the planned Managing Contractor form of contract. The workshop reviewed an indicative risk allocation provided by the Department of Public Works based on the proposed contract and considered the appropriateness of this allocation based on the understanding of the risks developed during the workshops.

C.4 Monte Carlo analysis The value of risk adjustment included in the total project cost was calculated using the “@Risk” software. @Risk software allows probability inputs to be converted into expected outcomes using iterative random sampling techniques. The value of risks included in the total project cost is the mean quantified value. The cash flow profile of the nominal project cost has been adjusted to include the mean value of these risks.

The following risk distribution curve has been generated from the @Risk software program using input determined as part of the risk quantification exercise. The curve has been calculated on the basis of 5,000 iterations and shows the nominal value of the total capital project cost (i.e. the total value of capital risks plus the total raw capital project costs) for the Proposed Delivery Model.

This curve identifies:

• The mean value of nominal capital project costs ($2.108b).

• The range in the nominal value of the total capital project costs, respectively due to potential variations in the value of risk.

• The graph identifies the range in nominal costs within the 5% and 95% confidence intervals. There is a 90% certainty that when risk crystallises, the project cost will fall within this range ($1.988b to $2.250b).

Distribution for Total risk adjusted capital costs

M ean = 2.108b

X <=1.988b5%

X <=2.25095%

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

5

1.9 2.025 2.15 2.275 2.4

$ billion

Val

ues

in 1

0^ -9


September 2008


C.5 Risk matrix The following risk matrix table contains further information on each of the risks analysed, including details of:

• a description of the risk

• consequences if the risk eventuates

• mitigation strategies for the risk

• the expected value of each risk and the element either transferred or retained.

6 pages

DRAFT COMMERCIAL IN CONFIDENCE

Queensland HealthGold Coast HospitalRisks

Risk category Description Consequence Mitigation Justification

1 Site SITE ACCESS - Risk that some or all of the site is not accessible as expected by the MC.

Delay to works commencement

Enabling works to be carefully managed.

STATE

Delay to commencement of works. Escaln per mth is $1.4b real x 8% / 12= 9.3m /mth. 1wk (L), 1mth (M), 3mths (H). 12,203,653 0,000 12,203,653

2 Site SITE SIZE - Risk that the size of the site is inadequate for the facility initially required and/ or is unable to cope with future facility expansion (health plan: 20 ha site required to allow for private hospital and open space).

Impact on amenity, not quantified.

Preparation of site master plan and acceptance by Government. Precinct Master Plan to correlate with hospital site Master Plan

STATE

Not quantifiable. May restrict research investment, health facilities offered etc

0,000 0,000 0,000

3 Site SITE ACCESS - risk of inadequate road-way access to the hospital for delivery trucks, private vehicles, emergency vehicles, public transport

Inefficient and unsafe operation of hospital. Impact on constructability (costs).

Preparation of satisfactory Precinct Plan for incorporation in Local Area Plan. Office of Urban Management facilitates this process.

STATE

Not quantified. Potential impact on functionality/amenity and constructibility. Latter is not likely to be material. 0,000 0,000 0,000

4 Site LAND ACQUISITION - Delays to land acquisition and resolution of access arrangements.

Delays to works commencement

Department of Infrastructure to negotiate access to land in time to meet project schedule.

STATE

Quantified in risk 1.

0,000 0,000 0,000

5 Scope (capital phase)

INADEQUATE BUDGET - Risk that the original capital budget was not established on a realistic basis. (DELAY)

Delays to works commencement

Prepare realistic budget and obtain QH and Treasury support.

STATE

QH will develop budget that is consistent with funding - zero probability.

0,000 0,000 0,000


INADEQUATE BUDGET - Risk that the original capital budget was not established on a realistic basis. (COST)

Costs Prepare realistic budget and obtain QH and Treasury support.

STATE

QH will develop budget that is consistent with funding - zero probability. 0,000 0,000 0,000


BUDGET REALLOCATION - Risk that cost of medical school ($50m), site acquisition ($50m) reallocated to Project budget.

Delays and costs CEO level discussions (Health, Tsy, Infrastructure, Main Roads, Transport, Public Works. Confirm prior in principle agreement to fund site from project budget but then readjust budget; Govt fund medical school. STATE

Quantified in risk 5&6. (Even $50m rework would substantially affect scope.)

0,000 0,000 0,000


BUDGET REALLOCATION - Risk that car park not fully viable on projected rates and volumes and requires either a capital or operating subsidy from the project or QH.

Delays and costs Assess viability through traffic study and business case; adjust mix of basement and above ground car parks to ensure capex can be recovered from revenues. STATE

Impact is potential subsidy (upfront or ongoing tariff support) if full capital recovery model not accepted. Current carpark Business Case: subsidy $14.6m.

0,000 0,000 0,000


SCOPE (CAPITAL) - Rick of State imposed changes to the service outputs / technology / model of care required for the hospital

Cost Increases The State can mitigate this risk to an extent by minimising the chance of its specifications changing and, to the extent they must change, ensuring the design is likely to accommodate it at minimal expense; this will involve considerable time and effort in specifying the outputs up front and planning likely output requirements over the term.

STATE

Quantification confined to risks that would be funded out of project budget (client contingency). Major changes to service outputs are regarded as a separate project. Refer risk 77.

0,000 0,000 0,000


SCOPE (CAPITAL) - Risk of revised forecasts of population, utilisation, private hospital development and Commonwealth aged care bed licences resulting in revised bed numbers. (Capital)

Cost Increases Queensland Health will examine 2006 census results and monitor aged care licences and revisit bed requirements. STATE

Not quantified. Not a risk to this project. (Potential risk to future projects (private hospital, future expansion, etc.)

0,000 0,000 0,000


FUTURE PROOFING - risk that facility design does not keep pace with future medical needs and/or population growth

Additional costs (future) Careful planning and design. QH is developing a strategic approach to future proofing all its new facilities. STATE

Additional future proofing expenditure could be up to $10m, eg for communications upgrade. 2,805,904 0,000 2,805,904

12 Approvals STATE APPROVAL - Risk of delay to CBRC approval of the Business Case (e.g. Concern over accuracy of total capital or recurrent costs). (DELAY)

Delay in works commencement

The State can ensure that approval time is conservative in planning Project timelines.

STATE

CBRC keeps QH whole for escaln to BC approval.

0,000 0,000 0,000

13 Approvals STATE APPROVAL - Risk that the planning approval (for e.g. Community Infrastructure Designation, Environmental, Aboriginal, Flora & Fauna and Artefacts) process is longer than anticipated arising from delays in obtaining approvals (government, planning or service issues) or requires further approvals associated with the detailed design phase. (DELAY)


The State can ensure that approval time is conservative in planning Project timelines. QH normally designates a site for Ministerial approval. QH will undertake comprehensive assessments of planning risks including aboriginal heritage etc.

STATE

Delay unlikely because of Works Regulation. Any cultural heritage impacts costed in Risk #1

0,000 0,000 0,000

14 Approvals STATE APPROVAL - Risk that the planning approval (CID, Environmental, Aboriginal & artefacts) process requires additional cost to comply (DELAY)


The State can ensure that approval time is conservative in planning Project timelines. QH normally designates a site for Ministerial approval. QH will undertake comprehensive assessments of planning risks including aboriginal heritage etc.

STATE

See above

0,000 0,000 0,000

15 Approvals STATE APPROVAL - Risk that the planning approval (CID, Environmental, Aboriginal & artefacts) process requires additional cost to comply (COST)

Cost increases. The State can ensure that approval time is conservative in planning Project timelines. QH normally designates a site for Ministerial approval. QH will undertake comprehensive assessments of planning risks including aboriginal heritage etc. STATE

Costing of additional conditions $1m (L), $1m (M), $2m (H).

130,000 0,000 130,000

16 Approvals MC APPROVALS - Risk that the MC is delayed in obtaining required building approvals or certifications (Sch 8) (DELAY)

Delay Building Consultant to develop program as part of Proposal.

MC

See risk #13

0,000 0,000 0,000

17 Approvals MC APPROVALS - Risk that the MC incurs cost in obtaining required building approvals or certifications (Sch 8) (COST)

Cost Building Consultant to develop program as part of Proposal. MC

Quantified in risk 18.0,000 0,000 0,000

18 Approvals BUILDING CERTIFICATION - risk that Building Certification and fire assessment approvals are delayed due to lack of resources within Project Services and Qld Fire & Rescue Service (QFRS), respectively.

Delay of project works and completion

Liaison with Project Services and QFRS to ensure adequate resources are available in time.

MC

Delay of 1L, 2M, 3H mths to completion. Costed at MC fees / mth plus escaln (1.4b / 46 x 8/12) = $4.5m/mth. Plus QH lease costs and damages $500k/mth (part of retained cost).

3,977,860 2,386,716 1,591,144

Transferred $ Retained $Nominal $Preferred allocation

3411740_1.xls 1


Risk category Description Consequence Mitigation JustificationTransferred $ Retained $Nominal $

Preferred allocation

19 Approvals NEGOTIATIONS - Risk that the GCS negotiations with the MC are protracted

Delay Building Consultant involvement in design development allows long lead time and greater confidence about build up of GCS. STATE

Delay of 1L, 2M, 6H mths to contract. 6mths is 3mths retender plus 3mths negotiate. Costed at escaln pre contract of $8.3m/mth.

10,446,390 0,000 10,446,390

20 Approvals NEGOTIATIONS - Risk that the GCS negotiations with the MC fail and retender results in higher price and redesign costs

Delay Building Consultant involvement in design development allows long lead time and greater confidence about build up of GCS.

STATE

If risk 19 occurs (prob 80%), there is a 50% chance that the resulting retender (ie 40% prob overall) will result in higher costs. Even if market response is rejected in favour of MC offer, MC offer at this point is likely to be higher than budget. In addition, possible redesign cost. 0% +$1m (L), 2% +$3m (M), 5%+$5m (H).

13,385,736 0,000 13,385,736

21 Approvals TENDER PROCESS - (Maintenance) Risk that the tender process is delayed due to IR issues over inclusion of maintenance services in MC contract.

Delay Early discussions with unions.

STATE

Maintenance option will not be allowed to hold up project; operations phase would be removed from contract. No cost impact (other than lost opportunity to improve maintenance performance).

0,000 0,000 0,000

22 Approvals CONTRACT DRAFTING - Risk that MC form of contract is not agreed to by QH (i.e. not related to MC)

Delay Early and ongoing discussions with Project Services over contract form. Continue works via series of small early works packages (within overarching contract) until contract issues resolved.

STATE

Small risk because of mitigation strategies. 1mth (L), 2 mth (M), 3mth (H). 1,232,606 0,000 1,232,606

23 Approvals APPROVALS -Risk that adjacent land use will impede future development of hospital

Impact on amenity and future projects

Ensure that precinct plan as enshrined in Local Area Plan prevents inappropriate development on adjoining sites that may jeopardise future expansion.

STATE

Not quantified.

0,000 0,000 0,000

24 Design & Construction

CONSTRUCTION ACCESS - risk that construction works access (e.g. large vehicles, cranes etc) is restricted

Delay in works Early discussion between Project Team/BC/MC and Dept of Main Roads to ensure that significant road works in vicinity do not impede the hospital works.

MC

Not quantified. Impact on constructibility not material (see risk 3). 0,000 0,000 0,000


CAR PARK AVAILABILITTY - Risk of inadequate Car Parking spaces during development (to cater for construction and other on-site workers)

Disruption to existing University students using current space, IR issues, reputation issues (will not look attractive if not managed appropriately)

Explore potential for early construction of car parking, subject to demonstration of viability through business case process and discussions with BC. MC

Not quantifed. Not considered risk to project.

0,000 0,000 0,000


INTERFACE with CARPARK - risk of car park development disrupting construction process (separate BOOT contractor)

Costs QH/Project Services will ensure works programs are coordinated. MC

Not quantified because not considered material. 0,000 0,000 0,000


INTERFACE with CAR PARK - risk that Car Park Business Case is not approved in time (relevant for basement car park)


Project Team to manage Business Case development and resolve impediments through CEO's Committee. STATE

Not quantified because not considered material. Manage carpark business case delay within program, ie, plan on basis of reasonable assumptions until approval obtained.

0,000 0,000 0,000


INTERFACE with CAR PARK - risk that Car Park BOOT contractor is not procured in time

Delay in works Project Team to manage procurement and resolve impediments through CEO's Committee. STATE

Delay to commissioning costed at Southport continuation cost of $0.5m/mth. Zero (L), 1mth (M), 2mths (H).

0,000 0,000 0,000


ESCALATION - Risk that the construction cost estimates materially change between building consultant to MC phase date due to underlying costs (labour or materials).

Increase in costs. Early procurement of the project will mitigate escalation risks

STATE

-1%pa(L), 0%(M), +2%(H) change. Costed at 1%pa x 4yrs / (8%+8%+6%+6%) = 1/7. Escaln of $350m x 1/7 = $50m for each 1%pa change. Incorporates risk 30.

15,000,000 12,750,000 2,250,000


ESCALATION - Risk that the construction cost estimates materially change between MC contract and completion due to changes in underlying costs (labour or materials).

Increase in costs. Early procurement of the project will mitigate escalation risks

MC

Incorporated in 85:15 risk retained:transferred risk allocation, ie, 7mths pre contract, 35mths post contract

0,000 0,000 0,000


ESCALATION - Risk that escalation is not adequately funded by the Government

Delay and costs Ensure that escalation rate is set on an appropriate basis in conjunction with Treasury. STATE Budget reallocation quantified under

risk 5 & 6. 0,000 0,000 0,000


ESCALATION - Risk that the State is unable to reach agreement with MC regarding escalation allowances

Increase / decrease in costs. OR Scope change to meet budget

Negotiate with MC to obtain the best outcome.STATE

Quantified under risk 19.0,000 0,000 0,000


CONTAMINATION - Risk that after contract close offsite contamination is caused to adjacent land (damage to park land site)

Clean-up liability. MC can manage site activity and reduce possibility of offsite contamination. MC

Not quantifed because not material.0,000 0,000 0,000


CONTAMINATION - Risk that land is listed on contaminated land register

Delay State to check if land is on contaminated land register. Unlikely to be an issue. STATE See risk 36 0,000 0,000 0,000


CONTAMINATION - Risk that site is contaminated from past uses and is not on register, includes imported fill - before MC appointed

Clean-up liability. Investigate during early civil site works to minimise risk impact to program. STATE

See risk 360,000 0,000 0,000


CONTAMINATION - Risk that site is contaminated from existing building/structure, e.g. asbestos after MC appointed

Clean-up liability. State to commission reports on existing buildings to identify asbestos and hazardous materials to be removed during demolition works

STATE (for latent condition, otherwise MC)

Hazardous materials report obtained. No material risk. 0,000 0,000 0,000


CONTAMINATION - Risk that site is contaminated from adjacent works (roads, Rapid Transport System, Energex)

Clean-up liability. Liase with authorities responsible for adjacent works to ensure that their projects include appropriate measures to prevent contamination of GCUH site

STATE

Not project risk.

0,000 0,000 0,000


HERITAGE - Risk that site includes graves (adjacent cemetery)

Clean-up liability. State to liase with cemetery management regarding extent of burial sites. MC to undertake additional ground disturbance surveys prior to early site works to minimise risk to delay STATE

Not quantified - negligible risk.

0,000 0,000 0,000


GEOTECHNICAL - Risk of unanticipated adverse site conditions in relation to existing site conditions. (e.g. geotechnical ground conditions (rock), latent conditions) due to limited geotechnical work.

Additional construction cost.

Undertake a geotechnical site investigation assessment, but the State will not provide any warranties or indemnities in relation to the information provided. STATE

First geotechnical report available. Foundation sub-structure conservatively designed.

4,800,000 0,000 4,800,000


GEOTECHNICAL - risk of delay of suitable access for geotech investigation or availability of results of geo tech investigation

Delay State to commission geotech in staged process. Access to site to be requested for investigations prior to transfer of title.

STATENeglible - studies already underway.

0,000 0,000 0,000


GEOTECHNICAL - risk of inappropriate or inadequate brief

Cost Staged geotech investigations proposed STATE Quantified in risk 39 0,000 0,000 0,000


GEOTECHNICAL - risk that ground water conditions are not as anticipated in the investigations

Cost Include in analysis of relevant reports into use of groundwater STATE Quantified in risk 39 0,000 0,000 0,000


GEOTECHNICAL - risk of discovery of acid sulphate soils Additional construction cost.

Allow for treatment, identify extent via geotechnical survey STATE First geotechnical report available.

Acid sulphate soils not expected. 0,000 0,000 0,000


GEOTECHNICAL - risk that the MC finds the geotechnical investigation to be insufficient

Delay Building Consultant to provide necessary advice during early investigations. STATE Quantified in risk 39 0,000 0,000 0,000


GEOTECHNICAL - risk of being unable to remove material from the site

Cost Include cut/fill analysis in schematic design process STATE Quantified in risk 39 0,000 0,000 0,000


CONSTRUCTION MATERIALS - risk of inappropriate geo tech testing in respect of fill material (brought on site by MC) & compacting

Delay Tight specification of geo tech testing. MC to manage compliance. MC

Quantified in risk 390,000 0,000 0,000


ENVIRONMENTAL - Risk of unanticipated adverse environmental conditions


Environmental survey is being undertaken STATE Quantified in risk 14&15 0,000 0,000 0,000


ENVIRONMENTAL - risk of adverse outcomes of site designation process including EIS after design commenced


State to monitor site designation process and advise design team of any outcomes to undertake compliance actions

STATEQuantified in risk 14&15

0,000 0,000 0,000


ENVIRONMENTAL - Risk that a suitable offset parcel needs to be procured to make up for lost vegetation


Environmental survey is being undertaken

STATE

Risk removed under Works Regulation. Issue will be addressed on whole of govt basis (not project risk).

0,000 0,000 0,000


ENVIRONMENTAL - risk of failure to comply with the Environmental Management Plan

Cost and time delay. MC to manage through audit and compliance program within EMP MC

Not quantified because considered negligible as part of normal contract management.

0,000 0,000 0,000

3411740_1.xls 2





ENVIRONMENTAL - Risk of discovery of endangered flora or fauna

Cost and time delay. Environmental survey is being undertaken STATE Quantified in risk 14&15 0,000 0,000 0,000


ENVIRONMENTAL - Risk of overland flows causing impact on adjacent sites


Environmental survey is being undertakenSHARED

Not quantified because considered negligible - plan to contain flows on site.

0,000 0,000 0,000


SUBSURFACE INFRASTRUCTURE - The risk that new and existing subsurface infrastructure will be damaged during construction

increased cost Survey of existing underground services prior to early works. Early consultation with authorities MC

Not quantified - should be covered by construction insurance. 0,000 0,000 0,000


SUBSURFACE INFRASTRUCTURE - The risk that existing subsurface infrastructure will need to be repaired or replaced.

increased cost Identify services diversion works during SD phase.SHARED

Not quantified - not much infrastructure to be replaced. 0,000 0,000 0,000


SUBSURFACE INFRASTRUCTURE - The risk that existing subsurface infrastructure will need to be maintained

increased cost Identify services that require to be maintained during works during SD phase. STATE

Not quantified - not much infrastructure to be maintained. 0,000 0,000 0,000


EARLY WORKS - The risk that early works has to be modified because they do not integrate with final design solution

increased cost Co-ordinate SD phase and agree structured approach to site services to minimise risk of rework. Careful planning and design. Car parking will not be commenced without full knowledge of integration with project requirements and works program. STATE

Budget reallocation quantified under risk 5&6.

110,000 0,000 110,000


FIT FOR PURPOSE - Risk that the design is not fit for purpose in terms of functionality at schematic design stage. (DELAY)

Delay (in signing contract with MC)

Comprehensive value management study, design review and extensive consultations with end-users. STATE

Not quantified - negligible risk because BC involved during schematic design. Any design corrections easily rectified.

0,000 0,000 0,000


FIT FOR PURPOSE - Risk that the detailed design is not fit for purpose in terms of functionality. (DELAY)

Delay to works Careful review of MC designs. MC Not quantified. At detailed design can change designs fairly easily. 0,000 0,000 0,000


FIT FOR PURPOSE - Risk that the design is not fit for purpose in terms of functionality at practical completion. (DELAY)

Delay completion of works Thorough inspections during works phase.MC

Quantified in risk 62 & 630,000 0,000 0,000


FIT FOR PURPOSE - Risk that the design is not fit for purpose in terms of functionality at practical completion. (COST)

Increase in cost to rectify. Thorough inspections during works phase.MC



COMPLIANCE WITH PDP - Risk that Schematic Design is not compliant with the PDP due to design error (DELAY)

Delay (in signing contract) Comprehensive value management study, design review and extensive consultations with end-users. Collaboration between State parties and Building Consultant to develop schematic design.

STATE

Not quantified - negligible risk because BC involved during schematic design. Any design corrections easily rectified.

0,000 0,000 0,000


COMPLIANCE WITH PDP/Schematic Design - Risk that building is DEFECTIVE - not compliant with the PDP/Schematic Designs due to design error or poor workmanship (DELAY)

Delay to completion Under D&C risk is largely transferred to contractor. PI Insurance held by consultants.

MC

Worst case 3mths delay to replace significant system eg IT. Say $10m rectification. Delay cost for MC of $4.5m/mth and QH of $0.5m/mth. Concurrent with #71

0,000 0,000 0,000


COMPLIANCE WITH PDP/Schematic Design - Risk that building is DEFECTIVE - not compliant with the PDP/Schematic Designs due to design error or poor workmanship (COST)

Additional costs to rectify Under D&C risk is largely transferred to contractor. PI Insurance held by consultants.

MC

Worst case replace significant system eg IT, say, $10m rectification.

3,401,096 2,720,877 680,219


COMPLIANCE WITH PDP/Schematic Design - Risk that equipment is not compliant with PDP/Schematic Designs (DELAY)

Delay to completion Thorough design review and inspections during works phase. STATE



COMPLIANCE WITH PDP/Schematic Design - Risk that equipment is not compliant with PDP/Schematic Designs (COSTS)

Additional costs to rectify Thorough design review and inspections during works phase. STATE



PDP/SCHEMATIC DESIGN ERROR - Risk that PDP/Schematic Design is not sufficiently well defined (DELAY)

Delay (in signing contract) Comprehensive value management study, design review and extensive consultations with end-users.

STATE

Risk is low with BC involved in process. But BC will want to maximise design definition before becomes MC. This is risk of protracted negotiations - costed in risk 17. See also risk 74 to extent that SD deficiencies lead to variations.

0,000 0,000 0,000


DETAILED DESIGN ERROR - Risk that Detailed Design is not sufficiently well defined (DELAY)

Delay to completion Design review.

MC

Generally minor issues with small impact on delay: 0 mths (L), 1mth (M), 2mths (H). Assume delay is start of d&c therefore $8.3m/mth plus 25% of MC cost. Incorporated in risk 68.

0,000 0,000 0,000


DETAILED DESIGN ERROR - Risk that Detailed Design is not sufficiently well defined (COST)

Additional costs Design review.

MC

Generally minor issues with small impact on cost : $0.1m (L), $0.5m (M), $1m (H). Incorporates risk 67. 741,208 741,208 0,000


PDP & SCHEMATIC DOCUMENTATION DELAYS - Risk that PDP & Schematic Documentation time is longer than anticipated due to resourcing constraints


All consultants have confirmed that resources are adequate to achieve the program.

STATE

Risk of not getting timely decisions. Impact is on cost escalation. 1mth (L), 2mths (M), 3mths (H). Concurrent with risk #12 0,000 0,000 0,000


DETAILED DESIGN AND CONTRACT DOCUMENTATION DELAYS - Risk that detailed design and contract documentation time is longer than anticipated.

Delay in works and cost increases.

Close monitoring of process including effective management of user group consultation and use of consultants.

MC

Escalation $8.3m/mth plus 25% of MC fees of $4m/mth because MC not fully mobilised. 1mth (L), 2mths (M), 3mths (H). Concurrent with #71. 0,000 0,000 0,000


EQUIPMENT SELECTION - risk that selection of medical equipment is not done in a timely fashion and impacts on or delays design decisions (DELAY)

Delay Consultants need to design for alternative equipment models.

STATE

Delays costed in escalation (assume 10mths, ie 1.4b*8%/12/46*10), MC fees. 2 wks (L), 1mth (M), 2mths (H). User group process started, group advising on lead times.

1,080,882 0,000 1,080,882


EQUIPMENT SELECTION - risk that selection of medical equipment is not done in a timely fashion and impacts on or delays design decisions (COST)

Cost Consultants need to design for alternative equipment models.

STATE

Cost of rework. $2m (L), 4m (M), $5m (H)

588,723 0,000 588,723


ESTIMATING - risks that the capital costs are under estimated prior to entering into MC contract. Cost quantified from potential differences in Business Case stage to entering into MC contract

Reduction in scope Detailed estimates will be prepared and subject to peer review, including building consultant.

STATE

Cost driver is total construction less FF&E because can adapt quantities of latter (use existing, etc), also less land acquisition cost ($50m and Medical School ($60m) .

35,173,488 0,000 35,173,488


ESTIMATING - risks that the capital costs are under estimated post entering into MC contract.

Additional costs Detailed estimates will be prepared and subject to peer review.

MC

Cost driver is trade costs. MC is currently getting prices for half scope now via competitive process. 17,962,536 17,962,536 0,000


EXCHANGE RATE: Foreign exchange rate movement - (equipment or materials purchased overseas).

Increased costs. Queensland Health could hedge some large equipment purchases (through QTC)

SHARED

Services plant is approx 45% of trade cost, about 30% of that is imported. About 75% of FF&FE of $150m is imported. Imported content: $1b*45%*30% + $150m*75% = $250m. Assume exchange variation +/-5%.

(0,000) (0,000) (0,000)


INDUSTRIAL ACTION: Risks of strikes, industrial action or civil commotion causing delay and cost to the works.

Delay in works. Compliance with Queensland Health policies; proactive management of issues; MC management systems MC

Delays costed in escalation (assume 20mths, ie 1.25b*8%/12/46*20), MC fees. 1week (L), 1mth (M), 2mths (H) 797,163 797,163 0,000

3411740_1.xls 3





CLIENT CHANGES - Risk that the client changes the specified design of the works (minor variations) e.g. due to user group requirements

Cost increases and delays The State can mitigate this risk to an extent by minimising the chance of its specifications changing and, to the extent they must change, ensuring the design is likely to accommodate it at least expense; this will involve considerable time and effort in specifying the outputs up front and

STATE

Quantified as $15m or 1% of construction costs (L), $30m or 2%, $45m or 3% (H). No lattitude in budget; most changes would be offset within budget.

15,542,090 0,000 15,542,090


CHANGES IN OPERATIONAL POLICIES - Changes in operational practices / policies at the hospital change the anticipated capital costs.

Cost increases and delays QH/District can to some extent selectively manage implementation of changes in policies. STATE

Quantified under client changes. See risk 76. 0,000 0,000 0,000


CHANGES IN LAW - Changes in Federal State and Local Govt laws & regulations change the anticipated capital costs.

Cost increases and delays State can to some extent selectively manage implementation of changes in law

STATE

Worst case based on changes to employee entitlements/allowances or additional energy efficiency requirements, say, 1% of trade costs.

649,960 162,490 487,470


INTERFACE RISK - risk that the design and construction works do not interface effectively with any collocated private hospital and research facilities.

Increase in costs. Ensure that Precinct Plan provides adequate provision for the private hospital and research facilities.

STATENot quantified. Loss of amenity.

0,000 0,000 0,000


EXTERNAL INFRASTRUCTURE - Risk that services (power, gas, sewer. stormwater, traffic management ) require unanticipated service upgrade. (COST)

Cost increases. Forward consultation with utilties and DMR to ensure adequate planning and resourcing of requirements. STATE

Cost is potential contribution to external works (probably not electricity or gas) above current $9m headworks provision, eg northern road or sewer main augmentation.

500,000 0,000 500,000


EXTERNAL INFRASTRUCTURE - Risk that services (power, gas, sewer. stormwater, traffic management ) require unanticipated service upgrade. (DELAY)

Delay to completion Programmer to liaise with all parties to ensure that external works (as identified in Precinct Plan) are coordinated. Conflicts to be resolved by Executives supported by CEO's Committee.

STATE

1mth (L), 2mths (M), 3mths (H) escalation ($8.3m/mth) and 25% of MC onsite costs ($4m/mth). Concurrent with #71.

0,000 0,000 0,000


EXTERNAL INFRASTRUCTURE INTERFACE - risk that external works (Main Roads, Energex, RTS, Griffith, gas, GCCC) are not completed on time

Delay to completion Programmer to liaise with all parties to ensure that external works (as identified in Precinct Plan) are coordinated. Conflicts to be resolved by Executives supported by CEO's Committee.

STATE

Quantified in risk 81

0,000 0,000 0,000


EXTERNAL WORKS - risk that project budget has to contribute to the external works (Main Roads, Energex, RTS, Griffith, gas, GCCC)

Costs Forward consultation with utilties and DMR to ensure adequate planning and resourcing of requirements.

STATEQuantified in risk 80

0,000 0,000 0,000


SITE INFRASTRUCTURE - Risk that infrastructure services require land area at the site, in particular ENERGEX, RTS (bus turning circle)

Cost Ensure that Precinct Plan manages requirements and that issues are resolved through CEO's Committee.

STATENot quantified as not considered significant (some land may be reallocated).

0,000 0,000 0,000


INTERFACE RISK - Risk that QH is obliged to accept medical schools, private hospital, research facilities, on main hospital site.

Amenity Ensure that Precinct Plan allows expansion space for possible Medical School and private hospital on adjoining 4.5ha site (across road from main 15.5ha hospital site). Medical School currently planned for Griffith University site.

STATE

Not quantified. Impact mainly in terms of site amenity.

0,000 0,000 0,000


CONTRACTOR DEFAULT - Risk of default of MC contractor (DELAY)

Delay to completion Experience and Financial Capability of Construction Contractor will be reviewed. Bonds will be used to cover default. Progress payments made to ensure contractor is not overpaid. STATE

Delay (assume half way through contract, hence escalation $3.6m/mth plus Southport costs $0.5m/mth) 2mths (L), 4mths (M), 6mths (H) 1,043,790 0,000 1,043,790


CONTRACTOR DEFAULT - Risk of default of MC contractor (COSTS)

Additional costs Experience and Financial Capability of Construction Contractor will be reviewed. Bonds will be used to cover default. Progress payments made to ensure contractor is not overpaid. STATE

Cost of rectifying defective work, paying unpaid employees, retendering etc $10m (L), $20m (M), $50m (H) 1,909,373 0,000 1,909,373


CONTRACTOR DEFAULT - Risk of default of major sub contractor

delay Project Services to monitor appointment and management of subcontractors, MC management systems MC

Cost of rectifying defective work, paying unpaid employees, retendering etc, acceleration penalty $5m (L), $10m (M), $25m (H)

954,686 954,686 0,000


INCLEMENT WEATHER - delays resulting from inclement weather.

Delay Additional float provided to cover excessive delays resulting from inclement whether MC

Not quantified. Weather is adequately provided in builders float. 0,000 0,000 0,000


CONTRACTOR DELAY - Risk that project may be delayed as a consequence of shortage of labour (MC Impact) (DELAY)

Delay to completion Building Consultant will conduct market soundings. Experienced contractors engaged. Contract provisions to manage default and delay MC

Refer risk 92. Labour penalty is mitigation of risk and should not result in delay. 0,000 0,000 0,000


CONTRACTOR DELAY - Risk that project may be delayed as a consequence of shortage of labour (MC Impact) (COST)

Additional cost Building Consultant will conduct market soundings. Experienced contractors engaged. Contract provisions to manage default and delay MC

Labour content 45% of trade costs x cost penalty 1%(L), 5% (M), 10% (H). Incorporates risk 91. 10,529,355 10,529,355 0,000


CONTRACTOR DELAY - Risk that project may be delayed as a consequence of shortage of labour (QH impact)

Additional cost and delay Building Consultant will conduct market soundings. Experienced contractors engaged. Contract provisions to manage default and delay

STATE

Delay in completion in worst case scenario leads to additional QH lease costs at Southport ($200k / mth) plus other damages ($500k / mth). 800,000 0,000 800,000


CONTRACTOR DELAY - Risk that project may be delayed as a consequence of materials shortage and long order times for major equipment (Group 1)

Additional cost and delay Plan for long lead-times for ordering equipment and pre-purchase materials and equipment where necessary.

MC

Materials shortages will only be apparent during construction after tendering of trade packages - therefore actual likely cost would beadditional preliminaries in delays to the MC - base on average $4.3M per month plus (10*$0.18m)/mth escaln (ie delay around mth 36). 1mth(L), 2mths (M), 3mths (H).

2,588,261 2,070,609 517,652


CONTRACTOR DELAY - Risk that project may be delayed as a consequence of poor construction management

Additional cost and delay Experienced contractors engaged. Contract provisions to manage default and delay MC

Not quantified. MC unlikely to allow for this risk. 0,000 0,000 0,000


CONTRACTOR DELAY - Risk that contractor delayed by Group 2 and 3 items

Additional cost and delay Preparation of program for supply of Group 2 & 3 items; coordination with State Purchasing Board and QH central purchasing. Involve building consultant in planning of program STATE

Quantified in risk 100, below, in terms of delay to commissioning.

0,000 0,000 0,000


OH&S - Risk that a breach of the OH&S Standards occurs during the construction phase.

Additional construction time and cost.

OH&S plan and procedures in place. Site supervision by Principal and head contractor to enforce OH&S MC

Main risk is that a major breach of OH & S leads to strike action closing down the site - cost is in delays @ $4.3M per month plus $3.6m escalation. 1 week (L), 2 wks (M), 1mth (H).

890,378 890,378 0,000


PRINCIPAL/QH DELAYS - Risk that principal delays the project due to untimely decision making

Delay to commencement and completion

Ensure appropriate decision milestones flagged in program. Seek approval in principle to proceed at each milestone (on basis that formal approval forthcoming).

STATE

Highly likely cause of delay before construction commences - escalation @ $8.3m per month plus MC @25% (0.8m/mth). 2wks (L), 1mth (M), 2mths (H).

4,826,470 0,000 4,826,470


THIRD PARTY RISK - Risk of construction works impacting on third parties

Cost and delay Planning of access routes to mitigate impacts on adjacent facilities. Effective stakeholder management.

MCNot quantified. More of a management than cost risk issue 0,000 0,000 0,000


THIRD PARTY RISK - Risk of third parties impacting on construction works

Cost and delay MC involved in coordinating program interface with external works MC Once existing tenants have vacated,

risk is negligible 0,000 0,000 0,000


STAGING - Risk of unanticipated delay or additional costs resulting from failure to adequately manage staging requirements

Cost and delay Early engagement of BC to develop staging plan. Staging to be developed to provide adequate float for completion of activities. Appropriate design which allows for staging.

MC

Greenfield site, staging not an issue - MC will likely stagger works to ensure flow of tradesmen from one building to the next

0,000 0,000 0,000


STAGING - Risk of delay due to cash-flow funding issues from Treasury

Cost and delay Early involvement of Treasury and QH to match funding to cash-flow requirements STATE

More of a management issue keeping Treasury & QH informed of cashflow peaks

0,000 0,000 0,000


SECURITY OF SITE - Risk of theft and vandalism during construction

Cost and delay MC responsible to provide appropriate site security. MC Usual construction risk item -

covered under insurances 0,000 0,000 0,000


INSURANCE - Risk of inability to obtain insurance or material increases in insurance premiums e.g., construction, third party, professional indemnity, collapse of insurance company, WorkCover etc.

Material increases in premiums priced into the bid by the MC or inability to obtain the relevant insurance.

Insurance advisers will be engaged to consider the likelihood of being unable to obtain insurance cover. MC

Given that MC will be a Tier One builder, this is extremely unlikely

0,000 0,000 0,000

3411740_1.xls 4




105 Commissioning CLINICAL COMMISSIONING - Risk that the clinical commissioning tests which are required for the provision of clinical services to commence are delayed, cost more to complete or cannot be successfully completed.

Cost and delay Commissioning team will be developed to manage commissioning process.

STATE

Worst case could delay opening the hospita for, say, 2 mths @ $0.5M per month 2wks (L), 1mth (M), 2mths (H). Concurrent with #71

0,000 0,000 0,000

106 Commissioning FACILITY COMMISSIONING - Risk that the building commissioning tests which are required to commence operation are delayed, cost more to complete or cannot be successfully completed.

Delay in construction or completion.

MC to prepare commissioning plan in conjunction with client. MC to manage through long term subcontracts with suitability qualified and resourced sub-contractors and through formal or informal consultation processes with the State.

MC

Risk is delay in completing - cost would be MC preliminaries - end of project so reduced cost, say $1.0M per month 2wks (L), 1mth (M), 2mths (H)

0,000 0,000 0,000

107 Commissioning CLINICAL EXPERTISE - risk of lack of clinical expertise to manage commissioning of equipment and services

Delay Early advice of equipment so that QH can begin to resource clinical expertise appropriately. STATE


108 Commissioning TRANSITION PLANNING - Risk that there is inadequate decanting planning and that the actual timing of decanting is different than anticipated.

Delay District Health Service will develop a decanting plan and ensure that it is appropriately resourced. STATE


109 Commissioning TRANSITION RESOURCING - Risk that there is inadequate decant resourcing.

Cost District Health Service will develop a decanting plan and ensure that it is appropriately resourced. STATE

Potential overrun on relocation budget of $12m 4,200,000 0,000 4,200,000

110 Decommissioning of Southport

SCOPE of DECOMMISSIONING - risk that scope of decommissioning and role of Southport is not well defined

Delay and impact on project budget, empty buildings on site, decanting risk

PDP should specify the role, if any, of the current Gold Coast hospital (Southport). QH/District will prepare a decommissioning plan and will need to ensure that it is resourced appropriately.

STATE

See 106 below

0,000 0,000 0,000

111 Decommissioning of Southport

SECURITY - risk that Southport empty facility is not adequately secured or is unsafe

Additional costs QH/District will prepare a decommissioning plan and will need to ensure that it is resourced appropriately. STATE

Potential cost to make safe and secure the existing facility - no cost in current budget for any works at Southport $100k (L), $500k (M), $1m (H).

490,000 0,000 490,000

112 Revenue opportunities

REVENUE - Revenue opportunity from sale of Southport site, or part of site

Additional funds for the project

PDP should specify the role, if any, of the current Gold Coast hospital (Southport). QH/District will prepare a decommissioning plan and will need to ensure that it is implemented on schedule.

STATE 0,000 0,000 0,000

The following risks relate to maintenance-related services. Their inclusion is subject to Government approval to include maintenance in a long-term operations contract 0,000 0,000 0,000

113 Scope (operations phase)

SCOPE (MAINTENANCE, FF&FE, ENERGY) - Risk of revised forecasts of population, utilisation and Commonwealth aged care bed licences resulting in revised bed numbers.

Cost Increases Queensland Health will examine 2006 census results and monitor aged care licences and revisit bed requirements. Flexibility required to allow changes in scope through the operating phase at minimal cost. STATE

Not quantified. Retained risk outside project scope.

0,000 0,000 0,000


SCOPE (MAINTENANCE, FF&FE, ENERGY) - Risk of changes to the service outputs required from the MC as specified by Queensland Health. (Operating)

Operating Cost Increases State requires a robust output specification for the operating phase. Flexibility required to allow changes in scope through the operating phase at minimal cost.

STATE

Not quantified. Retained risk outside project scope. 0,000 0,000 0,000


SCOPE (MAINTENANCE) - Risk that additional capex required by QH with associated maintenance impact

Cost Increases State requires a robust output specification for the operating phase. STATE Not quantified. Retained risk outside

project scope. 0,000 0,000 0,000


SCOPE (GROUP 1 FF&FE) - Risk that additional capex required by QH for Group 1 FF&FE with associated maintenance impact

Cost Increases State requires a robust output specification for the operating phase. STATE



SCOPE (ENERGY) - Risk that additional capex or services required by QH with associated utilities impact

Cost Increases State requires a robust output specification for the operating phase. STATE



STATE INITIATED CHANGES - risk of state changes impacting on service provisions

Additional Cost State must have robust change management procedures STATE Not quantified. Retained risk outside

project scope. 0,000 0,000 0,000

119 Operations SERVICE DEMAND - Risk that demand for support services differs from the expected level, eg. maintenance works are higher than expected due to unanticipated increase in clinical activity. (Volume element)

Additional cost (wear and tear)

Capacity of facility is limited. Finishes and equipment selected to minimise impact of increased use.

STATE

Not quantified. Retained risk outside project scope.

0,000 0,000 0,000

120 Operations (building and plant maintenance)

ESTIMATING RISK - Risk that building and plant maintenance costs are underestimated

Cost increases. Robust output specification; sound costings, checked against QH benchmarks.

MC

Significant potential for error given preliminary nature of estimates: 0% of total LCC of $30m x 20yrs (L), 10% (M), 20% (H). ($21.4m capex replacement + 160,000m2 * $55/m2 = $8.8m + profit = $9.6m = $31m (minus insurance $0.6m). Total nominal value over 20 years of routine and lifecycle is $886m.

110,750,000 110,750,000 0,000

121 Operations ( FF&FE maintenance)

ESTIMATING RISK - Risk that Group 1 FF&FE maintenance costs are underestimated

Cost Robust output specification; sound costings, checked against QH benchmarks.

MC

Quantified in risk #121

0,000 0,000 0,000

122 Operations (grounds maintenance)

ESTIMATING RISK - Risk that grounds maintenance costs are underestimated

Cost Robust output specification; sound costings, checked against QH benchmarks. MC

Significant potential for error given prelminary nature of estimates: 0% x 20yrs (L), 10% (M), 20% (H). Cost of $0.250m (4 gardeners)

1,270,330 1,270,330 0,000

123 Operations (utilities management)

ESTIMATING RISK - Risk that utilities management costs are underestimated


Quantified in risk #1260,000 0,000 0,000

124 Operations (external cleaning)

ESTIMATING RISK - Risk that external cleaning costs are underestimated


Significant potential for error given prelminary nature of estimates: 0% (L), 10% (M), 20% (H). 6wks*6 staff p.a. =$0.1m x 20yrs = $2m

3,718,479 3,718,479 0,000

125 Operations ESTIMATING RISK - Risk that costs in relation to insurances are underestimated

Cost increases. Insurance advisor will be engaged to provide estimates on insurance costs

STATE

Significant potential for error given prelminary nature of estimates: 0% (L), 10% (M), 20% (H). Property insurance $4/m2 x 160000 = $0.6m x 20 yrs = $12m

450,000 0,000 450,000

126 Operations ENERGY CONSUMPTION - Risk of energy & water consumption increasing beyond expectations

Cost increases ESD strategies. Sound estimates checked against QH benchmarks.

MC

Significant potential for error given prelminary nature of estimates: 0% (L), 10% (M), 20% (H). $40/m x 160000m2 = $7.9m x 20yrs = $158m

24,016,158 24,016,158 0,000

127 Operations ESCALATION - Risk that relevant support staff cost estimates materially change over forecasts for the operating period

Cost increases Health Award rates are determined by State awards MC

Quantified under relevant service, below. 0,000 0,000 0,000

128 Operations ESCALATION - Risk that Goods and Services and Management Costs materially change to forecasts over the operating period

Cost increases CPI adjustments made to service costsMC

Quantified under relevant service, below. 0,000 0,000 0,000

129 Operations (building and plant maintenance)

ESCALATION - Risk that building and plant maintenance costs materially change to forecasts over the operating period

Cost increases Ensure appropriate provision for escalation under the contract.

MC

Potential that actual escalation is 0.25% above or below the indexed service payment -0.25% (L), 0% (M), +0.25% (H). See wksheet "risk # 127ff escalation workings"

4,200,000 4,200,000 0,000

130 Operations ( FF&FE maintenance)

ESCALATION - Risk that Group 1 FF&FE maintenance costs materially change to forecasts over the operating period

Cost increases Ensure appropriate provision for escalation under the contract. MC

Quantified in risk # 1290,000 0,000 0,000

131 Operations (grounds maintenance)

ESCALATION - Risk that grounds maintenance costs materially change to forecasts over the operating period


MC


37,500 37,500 0,000

132 Operations (utilities management)

ESCALATION - Risk that utilities maintenance costs materially change to forecasts over the operating period

Cost increases Ensure appropriate provision for escalation under the contract. MC

Quantified in risk #1290,000 0,000 0,000

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133 Operations (external cleaning)

ESCALATION - Risk that external cleaning costs materially change to forecasts over the operating period


MC


91,438 91,438 0,000

134 Operations ESCALATION - Risk of energy & water prices increasing beyond expectations

Cost increases Ensure appropriate provision for escalation under the contract. STATE Not quantified. Retained risk outside

project scope. 0,000 0,000 0,000

135 Operations CAR PARK DEMAND -Risk of under or over estimation of number of car park spaces required for staff

Cost increases, traffic disruption

Traffic studies to obtain best estimate of demand. Not quantified. Retained risk outside project scope. 0,000 0,000 0,000

136 Operations CAR PARK DEMAND -Risk of under or over estimation of number of car park spaces required for visitors

Cost increases, traffic disruption

Traffic studies to obtain best estimate of demand. Not quantified. Retained risk outside project scope. 0,000 0,000 0,000

137 Commissioning MOBILISATION (Maintenance and related support services) - Risk that the costs and timetable associated with the mobilisation of staff and management to new hospital exceed the budgeted level.

Delay and cost MC will develop a mobilisation plan and will need to ensure that it is appropriately resourced.

MC

Extended mobilisation period costed at $1m annual labour /12mths = $85k/mth. 1mth (L), 2mths (M), 3 mths (H)

41,667 41,667 0,000

138 Operations LATENT DEFECTS – risk of latent defect occurring which is outside the scope of warranty provisions

Increase in cost to rectify Recourse to contractor through defects liability period MC $2m (L), $10m (M), $50m (H) 3,190,714 3,190,714 0,000

139 Operations INSURANCE - Risk of events (such as vandalism, malicious damage, terrorism) may not be fully covered by insurance

Additional cost Security procedures, robust designSTATE


140 Operations CONTAMINATION - Risk that MC maintenance responsibilities cause contamination on adjacent third-party land.

Clean-up liability. MC can manage site activity. Not quantified. Not material.0,000 0,000 0,000

141 Operations CONTAMINATION - Risk that there is undiscovered onsite contamination

Clean-up liability. MC can manage site activity. MC Not quantified. Not likely due to significant cut and fill site works. 0,000 0,000 0,000

142 Operations CONTAMINATION - Risk that the use of the project site over the contract term results in a significant clean up or rehabilitation obligation to make the site fit for future anticipated use.

Increase in cost which may also result in a corresponding adverse effect on Queensland Health’s ability to deliver the Hospital’s core services.

MC can manage site activity.

MC

Small risk of spills, etc. $0.1m (L), $0.25m (M), $1m (H)

68,000 68,000 0,000

143 Operations END OF MC CONTRACT - Risk that additional costs are incurred to bring facility up to desired standard

Increased cost to comply Standards will be maintained through performance specifications, minimising need for significant work at the end of the Term

MCNot quantified. Included in estimation error risk # 120 0,000 0,000 0,000

144 Operations FACILITIES STANDARD - The risk that new facilities are not fully compatible with the service specification resulting in additional Support Services Costs (eg due to design availability, or substituted materials)

Increase in cost to provide support services

MC will be responsible for designing the facility to maximise performance of support services. Asset management unit standards are incorporated in the MC contract. Extended maintenance period will assist.

MC

Small risk of rectification. $1m (L), $2m (M), $5m (H)

259,984 259,984 0,000

145 Operations FACILITIES STANDARD - The risk that new facilities are not fully compatible with the service specification resulting in additional Clinical Costs

Increase cost to provide Clinical Services

MC will be responsible for designing the facility to maximise performance of support services. Clinical service standards to be incorporated in the MC contract.

STATE


146 Operations FACILITIES STANDARD - The risk that facilities manager defaults on completion because of dispute over facility standard

Increase in cost to provide support services

MC in conjunction facility manager will be responsible for designing the facility to maximise performance of support services STATE

Either State takes over leading to potential loss of LCC benefits (amenity issue) or retender. Risk costed on retender of $500k.

50,000 0,000 50,000

147 Operations FACILITIES STANDARD - Risk that the facility does not meet users expectations.

Increased cost to satisfy users

Specifications will be output based. Extensive user consultation undertaken. Use of standard facility guidelines

STATENot quantified. Retained risk outside project scope. 0,000 0,000 0,000

148 Operations TECHNOLOGICAL OBSOLESENCE - MAINTENANCE - Risk of the building and plant not keeping pace, from a technological perspective, with service requirements.

Increase in costs. FM specification needs to anticipate upgrade requirements MC

Specification will require upgrade of control systems and associated software. $1m (L), $2.5m (M), $5m (H)

2,650,000 2,650,000 0,000

149 Operations TECHNOLOGICAL OBSOLESENCE - FF&FE Risk of the Group 1 FF&FE not keeping pace, from a technological perspective, with service requirements.

Increase in costs. FM specification needs to anticipate upgrade requirements MC

Quantified in risk #148 above0,000 0,000 0,000

150 Operations TECHNOLOGICAL OBSOLESENCE - UTILITIES - Risk of the utilities plant not keeping pace, from a technological perspective, with service requirements.

Increase in costs. FM specification needs to anticipate upgrade requirements STATE


151 Operations PERFORMANCE (Maintenance) - Risk of failure of building and plant maintenance service to achieve specification standards

Increase in cost to rectify and/or performance penalties.

Systems and processes will be put in place by the MC to mitigate risk. Services Specification aligned with current and achievable outcomes. Periodic condition survey and client monitoring.

MC

Quantified in estimation error risk #120 0,000 0,000 0,000

152 Operations PERFORMANCE (Utilities) Risk of failure of utilities service to achieve consumptions estimates


Systems and processes will be put in place by the MC to mitigate risk. Services Specification aligned with current and achievable outcomes

MCQuantified in estimation error risk #125 0,000 0,000 0,000

153 Operations PERFORMANCE (FFF&E) Risk of failure of FF&E maintenance services to achieve specification standards




154 Operations PERFORMANCE (external cleaning ) Risk of failure of external cleaning services to achieve specification standards




155 Operations PERFORMANCE (MANAGEMENT SERVICES) Risk of failure of the management services to achieve specification standard




156 Operations SPECIFICATION - Risk that specification standards (for building maintenance, grounds maintenance, utilities etc) are inadequate

Increase in costs Use proven specifications for long-term contracts (precedents). Apply Asset Management Branch standards. Ability to review contract at certain stages during its life.

STATE


157 Operations CHANGE MANAGEMENT - Risk of additional costs associated with support services change management

Adverse cost consequences in order to achieve ongoing service outcomes and costs

Planning and resourcing of mobilisation activities to minimise change management risks by providing ample time for processes to occur. MC

Not quantified. Not material.

0,000 0,000 0,000

158 Operations CHANGES IN LAW - Changes in Federal / State laws change the anticipated operating costs.

Cost increases QH/District can to some extent selectively manage implementation of changes in law MC Minor transferred risk. $0.5m (L),

$1m (M), $2m (H) 575,000 575,000 0,000

159 Operations CHANGES IN POLICIES - Changes in operational practices / policies at the hospital change the anticipated operating costs.

Cost increases QH/District can to some extent selectively manage implementation of changes in law STATE


160 Operations CHANGE IN OWNERSHIP: The risk that a change in ownership or control of the MC results in a weakening in its financial standing or support or other detriment to the project.

Cost and time delay. Established contract provisions giving State approval rights. STATE


161 Operations EXCHANGE RATE: Foreign exchange rate movement - (equipment or materials purchased overseas).

Increased costs. Attempt to align equipment purchases with favourable exchange rates. MC

Assume 50% of LCC expenditure of $30m x 20 yrs is plant ie $300m. Assume 30% imported = $90m. -5% (L), 0% M, 20% (H)

2,025,000 2,025,000 0,000

162 Operations INDUSTRIAL ACTION: Risks of strikes, industrial action or civil commotion causing delay and cost to the services

Increased costs / diminution of service

Compliance with Queensland Health policies; proactive management of issues; local and HO expertise with IR issues

MCNot quantified. Indeterminate impact on abatements 0,000 0,000 0,000

163 IR INDUSTRIAL ACTION: (as result of procurement process) Risks of strikes, industrial action or civil commotion causing change of scope, exclusion of maintenance services

Potential loss of whole of life optimisation

QH needs to engage with HR/IR to change work practices STATE

See risk #21

0,000 0,000 0,000

164 Community COMMUNITY PROTEST: Risk of adverse reaction and protest from local community to the Project prior to the operational phase.

Delay in works/increase in cost

Extensive community consultation will be carried out during the planning process. MC

Not quantified. Not material (minor extension of mobilisation costs.) 0,000 0,000 0,000

165 Community COMMUNITY PROTEST: Risk of adverse reaction and protest from local community to the Project during the operational phase.

Increased costs. Extensive community consultation will be carried out during the planning process. MC

Not quantified. Not material.0,000 0,000 0,000

166 Commissioning EXTERNAL INFRASTRUCTURE: Risk of delay in commissioning Energex zone substation leading to delay in commissioning hospital.

Additional cost and delay Forward consultation with Energex. Programmer to ensure all external works are coordinated. STATE

Costed as $700K/month for 0 months (L), 1 month (M), 1.5 months (H) 122,500 0,000 122,500


INADEQUATE BUDGET - MEDICAL SCHOOL: Risk that escalation of Medical School capital costs will be included in budget and not reimbursed.

Additional cost. CEO level discussions (Health, Treasury) to confirm source of funding (Govt).

STATE Estimated $15m escalation cost ($75m-$60m), 50% chance. 7,500,000 0,000 7,500,000

168 Site INADEQUATE BUDGET - SITE ACQUISITION: Risk that additional items related to site acquisition will cause total cost to exceed budget. E.g. requests for transfer of certain land to QH at $0 cost not agreed to.

Delay and cost. Early discussions to resolve significant items that may require funding. QH has written to Treasury

STATE Between $0 and $30m overrun. Eg cemetery worth $20m mkt value. 3,000,000 0,000 3,000,000

332,778,378 204,860,287 127,918,091

3411740_1.xls 6


September 2008


C.6 Risk quantification reconciliation with previous Business Case The following table summarises the adjustments made in this business case to the risk valuations in the February 2008 business case.

Risk Rationale for revision of risk valuation

February Business Case $M

Updated Business Case $M

Adjustment $M

1 - Site is not accessible

Risk previously treated as concurrent with a risk that has been removed following review

0.00 12.20 12.20

5 - Inadequate capital funding

Capital expenditure will match available funding

28.74 0.00 (28.74)

9 - State imposed scope changes


5.21 0.00 (5.21)

30 - Escalation provision inadequate

Construction cost escalation risks now treated concurrently. Revised methodology (best case 1%p.a. below most likely index; worst case 2%p.a. above index)

35.79 0.00 (35.79)

39 - Adverse ground conditions

Conservative assumption pending second round geotechnical report

0.00 4.80 4.80

43 - Discovery of acid sulphate soils

First round geotechnical report indicated absence of acid sulphate soils

5.76 0.00 (5.76)

71 - Equipment selection delayed (delay)

Mitigation implemented (user group advising on lead times)

12.20 1.08 (11.12)

72 - Equipment selection delayed (cost)

Mitigation implemented (user group advising on lead times)

3.22 0.59 (2.63)

73 - Estimation error prior to MC contract

Improved understanding of engineering services scope; alignment with Building Consultant prices which are being obtained through a competitive process

58.39 35.17 (23.21)

74 - Estimation error post MC contract

Improved understanding of engineering services scope; alignment with Building Consultant prices which are being obtained through a competitive process

21.62 17.96 (3.66)

77 - Client minor variations

Limited funding will require that most changes are offset by savings

30.17 15.54 (14.63)

91 - Shortage of labour (delay)

Building Consultant will engage sub-contractors early in process

5.94 0.00 (5.94)

92 - Shortage of labour (cost)

Building Consultant will engage sub-contractors early in process

33.79 10.53 (23.26)

6 - Redesign due to inadequate capital budget


5.11 0.00 (5.11)


September 2008


Risk Rationale for revision of risk valuation

February Business Case $M

Updated Business Case $M

Adjustment $M

49 - Procurement of lost vegetation offset parcel

Works Regulation process avoids risk 3.10 0.00 (3.10)

109 - Inadequate funding of transition (decant) program

New risk reflecting uncertainty about transition resource requirement and funding

0.00 4.20 4.20

167 - Unfunded escalation in Medical School costs

New risk associated with inclusion of medical budget

0.00 7.50 7.50

168 - Unfunded site acquisition costs

New risk associated with inclusion of site acquisition budget

0.00 3.00 3.00

Other risk adjustments (3.73) Total (140.19)


September 2008


D Gold Coast Hospital Car Park Report 61 pages

ABCD

© 2007 KPMG, an Australian partnership and a member firm of the KPMG network of independent member firms affiliated with KPMG International, a Swiss cooperative. All rights reserved.

The KPMG logo and name are trademarks of KPMG.

Queensland Health

Gold Coast University Hospital Procurement of Car Parking

KPMG Corporate Finance (Aust) Pty Ltd December 2007

This report contains 61 pages GCUH_ car park business case_FINAL 041207

ABCD Queensland Health

Gold Coast University HospitalKPMG Corporate Finance (Aust) Pty Ltd

December 2007

i

Document review and approval

Revision history Version Author Date Comments 1.0 Sabine Schleicher 29 October 2007 1.1 Sabine Schleicher 9 November 2007 Sent to Queensland Health 1.2 Sabine Schleicher 30 November 2007 Sent to Queensland Health 1.3 Sabine Schleicher 20 December 2007 Incorporates feed-back from business case

working group

This document has been reviewed by Reviewer Date reviewed

1 Paul Foxlee 30 October 2 Paul Foxlee 30 November 3 4 5

This document has been approved by Subject matter experts Name Signature Date reviewed

1 Don Glynn 03 December 2007 2 3 4 5



December 2007

ii

Contents

1 Executive Summary 1 1.1 Introduction 1 1.2 Forecast demand 1 1.3 Car parking configurations and delivery timing 1 1.4 Procurement methodology 2 1.5 Commercial principles 3 1.6 Bridging finance required for provision of underground car park 3 1.7 Financial analysis 4 1.7.1 Staff tariff 4 1.7.2 Patients and visitors tariff 5 1.7.3 Parking bay turnover 6 1.7.4 Results of preliminary analysis 6 1.8 Conclusion 8

2 Introduction 10 2.1 Background 10 2.2 Queensland Health objectives 10 2.3 Purpose of this report 11 2.4 The structure of this report 11

3 Car parking demand and usage levels 12 3.1 Methodology 12 3.2 Usage level and car parking requirement 12 3.3 Two demand scenarios 14 3.4 Risks in respect of long-term demand for car parking 14

4 Car parking options 16 4.1 Configuration A 16 4.2 Configuration B 17 4.3 Configuration C 17 4.4 Delivery timing 17

5 Procurement methodology 19 5.1 Objectives 19 5.2 Procurement options 19 5.3 Preferred procurement methodology 22 5.4 Bridging Finance Required for Provision of Underground Car Park 23 5.5 Commercial principles 24 5.6 Concession term and payment by Queensland Health 25

6 Financial analysis 27



December 2007

iii

6.1 Options analysed 28 6.2 Capital cost estimates 30 6.3 Operating cost estimates 33 6.4 Revenue assumptions 34 6.4.1 Tariff structure 34 6.4.2 Patients and visitors 36 6.4.3 Parking bay turnover 37 6.5 Financing structure 38 6.5.1 Car Park B (basement) 38 6.5.2 Car Park A and C 38 6.5.3 Financing assumptions 38 6.6 Other modelling assumptions 39

7 Results of preliminary analysis 40 7.1 Summary 43 7.2 Procurement process 44 7.3 Procurement timetable 44 7.4 Early delivery option 45 7.5 Information required for tender process 46 7.6 Market sounding process 46 7.6.1 Process 46 7.6.2 Participants 47 7.6.3 Key findings 47

8 Disclaimer 49

A Market sounding process files notes 50 A.1 International Parking Group 50 A.2 Ariadne 51 A.3 Westpac 52 A.4 Macquarie 53

B Fact sheet for market sounding process 54

C Capital and operating cost estimates 57



December 2007

1

1 Executive Summary

1.1 Introduction Queensland Health has commenced the development of the 750 bed Gold Coast University Hospital (GCUH or the Project) to be constructed and operational by December 2012 using a traditional procurement process. Queensland Health intends to run a separate procurement process for the selection of an operator/consortium to design, construct, finance, operate and maintain the car park facilities required for the GCUH.

1.2 Forecast demand As part of the current Master Planning process, GCUH Engineering, a joint venture between Sinclair Knight Merz, Connell Wagner and S2F, has undertaken preliminary analysis of car parking demand. The analysis indicates a total demand of 2,750 bays, made up of 2,300 staff bays and 450 visitor bays. This estimate was confirmed as being consistent with private sector expectations through the preliminary market sounding process. All options based on an earlier demand scenario of 3,000 spaces (incorporating 900 visitor bays), have therefore been disregarded.

The analysis in this Business Case assumes that there is a demand for car parking over the economic life of the facilities. However, there could be circumstances arising where this may not be the case. The potential risk of decline of private car usage may provide reason to conservatively size the car parking facilities, based on a lower percentage of private car usage, e.g. 70% instead of 80% of staff travel to the hospital. This would reduce the demand for staff car parking by 200 bays.

We consider it unlikely that demand for car parking would disappear entirely. Even if demand for car parking arising from the GCUH reduced the risk is somewhat mitigated by the fact that the hospital is part of a larger growing health precinct which could make up for some decline in demand at GCUH.

It is also important to note that the assessment of car parking demand excludes any additional car park space requirements in the precinct which may arise from either collocation with Griffith University or the potential development of a private hospital on the site.

1.3 Car parking configurations and delivery timing As part of the Master Planning process, two alternative car parking configurations, both incorporating free standing car parking (Car Park A and C) and underground car parking (Car Park B), have been investigated. The underground car park is intended to be used for staff and specialist car parking only. While coming at a cost premium, it is considered as the desired way of providing secure car parking which is particularly important for night shift nurses.



December 2007

2

In addition, a car parking configuration excluding underground car parking has been analysed in order to determine the premium associated with the provision of underground car parking.

In terms of the delivery timing of the car parking facilities, Queensland Health is currently investigating three options:

• All car parks delivered and operational by 1 July 2012.

• Early commissioning of one free standing multi-deck car park delivered and operational by 1 July 2010 or earlier, with the remainder of car parking bays being operational by 1 July 2012.

• Late commissioning where one car park is delivered and operational by 1 July 2013, with the remainder of car parking bays being operational by 1 July 2012.

The underground Car Park B is assumed to be completed by December 2009, but not operational until 1 July 2012.

1.4 Procurement methodology To assist in the analysis and selection of the preferred procurement methodology, KPMG prepared a presentation on procurement options available to Queensland Health and facilitated a workshop which analysed the advantages and disadvantages associated with the identified procurement options. The preferred methodology is a combination between traditional and Build Own Operate and Transfer (BOOT) style procurement.

The Managing Contractor (MC) would be responsible for designing and constructing any underground car parking spaces to avoid the interface risk with the main hospital structure above, whereas the stand-alone multi-deck car parks would be delivered through a BOOT. Queensland Health would run a competitive tender process to select the BOOT partner. The BOOT partner would also be responsible for the operation and maintenance of all car parking spaces allowing for optimisation of operating costs across all car parks.

Typically, for a project such as this, we recommend to run a two stage procurement process comprising a:

• Expression of Interest Process and followed by

• Selective Request for Proposals.

Dependent on the number of interested parties and level of competition, we suggest selecting three parties which would then be invited to participate in the Request for Proposal Process. The Managing Contractor may wish to participate in the process which may offer synergies with delivery of the hospital structure, especially in the early delivery options. The procurement process would need to be commenced by December 2009, in the absence of an early commissioning scenario.



December 2007

3

1.5 Commercial principles Queensland Health’s indicative commercial arrangements for the car park facilities are as follows:

• Concession Term: 25 years from commercial operation date.

• Payment from Queensland Health to the private operator/consortium at the end of the concession period (Residual Value Payment).

• Staff car parking rates to be agreed between Queensland Health and the private operator/consortium and linked to CPI indexation post commercial operation date.

• A minimum of 2,100 car parks allocated for staff usage.

The economic life of car parking facilities is generally accepted to be 40 years. With a concession term of 25 years, there is still significant value available post the initial concession term from the ongoing operation of the car park. KPMG proposes to combine the 25 year concession period with a payment for the residual value of the car parks to the private car park operator/consortium at the end of the concession term.

The residual value payment will allow the car park operator/consortium to structure its financing arrangements with a balloon payment upon termination which results in an overall reduction of financing costs of the project.

It is envisaged that Queensland Health would retender the car parking facilities at the of the concession period, with the proceeds of the upfront concession payment for the second concession term likely to exceed the residual value payment to the existing car park operator/consortium. This arrangement is considered to represent better “Value for Money” for Queensland Health than offering an extended initial concession period.

We note, however, there remains a residual risk to Queensland Health that if there was a significant decrease in demand for car parking, the concession fee for the second concession term could be less than the residual value payment Queensland Health has to make.

1.6 Bridging finance required for provision of underground car park Should Queensland Health decide to include an underground car park, the Managing Contractor would construct the underground car park. Queensland Health would need to provide temporary funding, until the upfront concession payment would be received from private operator/consortium.

The capital outlay for the underground car park is estimated to be $26 million for a 600 bay underground car park. The costs would be incurred over the financial years 2009 and 2010.



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Staff car parking tariffs would be negotiated at a level, such that the private operator/organisation can afford to make an upfront concession payment to off-set the construction cost incurred by Queensland Health for the underground car park. However, there is a risk that Queensland Health will not be able to fully recoup the capital expenditure associated with the underground car park.

1.7 Financial analysis KPMG has developed a financial model from the perspective of a private sector BOOT operator/consortium. The financial model includes consideration of financing and tax, and is based upon achieving a target return on equity.

Capital and operating costs for car parks vary significantly based on whether car parking can be provided in a free standing above ground structure, or whether car parking is provided underground. This cost differential is primarily driven by costs associated with excavation and ventilation requirements.

Davis Langdon Australia (DLA) has provided indicative capital cost estimates for each of the options, including an allowance for professional fees, contingency and car parking equipment. The total cost (including non construction costs) was derived in September 2007 dollars and then adjusted to allow for cost escalation between now and completion of construction.

David Langdon has also provided indicative operating cost estimates in 2007 dollars for the financial analysis. Car Parks A and C are assumed to be fully naturally ventilated, where as Car Park B requires full ventilation.

1.7.1 Staff tariff Current car parking rates applicable for staff working at the Royal Brisbane Hospital and Princess Alexandra Hospital are around $60 a fortnight or $6 a day. The tariffs were contractually agreed with the owner/operator of both car parks for the duration of the lease agreement and are linked to CPI.

Construction costs have significantly increased in recent years and are forecast to continue to increase significantly. For example, the certified construction cost for the recently completed car park at the Princess Alexandra Hospital was around $26,500,000 million or $18,888 per car1. This compares to $34,557 per car, (under Option 12) as constructed, or $26,582 in September 2007 Dollars before allowing for escalation, which is greater than a 40% increase excluding anticipated cost escalation. Including the effect of escalation, the construction cost is over 80% higher than the recently completed car park at the Princess Alexandra Hospital.

1 Information provided by Michelle Walter, Queensland Health 2 Car park options are defined in Section 0



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We understand that Queensland Health is in the process of developing a policy in relation to car parking development and tariffs applicable to staff. The draft policy considers linking the tariffs for new car park facilities to the rates applicable at the Royal Brisbane Hospital. Such a policy would mean that future large scale car park facilities are unlikely to be able to be developed at no net cost to Queensland Health.

As part of our financial modelling, we have estimated tariffs levels required for staff and visitors to ensure that the car parking facility can be delivered at no net cost Queensland Health. We have escalated staff and visitor tariffs at the same rate to maintain relativity between the two tariffs.

This will result in higher tariffs for staff working at the GCUH in comparison to the RBH or PA. The level of increase required depends on the configuration, split between staff and visitor bays, timing of delivery, concession term and level of residual value payment by Queensland Health (if any) at the end of the concession term.

1.7.2 Patients and visitors tariff Similarly to the arrangements applicable for the operation of the car parks at the RBH and PA, the private operator is assumed to be free to set tariffs applicable to patient and visitors at market rates.

In line with increases in construction costs over recent years and the anticipated continued construction cost increases, car parking tariffs will also have to increase significantly if a cost neutral position to Queensland is to be achieved.

GCUH Engineering has estimated the average parking duration for patients and visitors is 1 hour 40 minutes with about 10 per cent of patients and visitors requiring parking in excess of 4 hours. Based on this usage profile the average car parking ticket using tariffs applicable at hospitals in Brisbane is estimated to be around $8.65 (in $2007).



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1.7.3 Parking bay turnover In order to calculate annual revenue for staff and visitor car parking, we have derived an average daily car park turnover rates as follows:

Parking bay turnover Staff Patients & visitors Parking bay turnover – peak weekday (Number of times the bay is used during the day

1.1 to 1.23 2.44

7 day average5 0.88-0.96 1.92 Source: GCUH Engineering, Technical Note 6, dated 3 October 2007, KPMG analysis

1.7.4 Results of preliminary analysis The financial analysis has been completed for ten alternative options (i.e. different size, configurations, residual value and delivery date). A more detailed description of the options is provided in Section 6.1. The analysis calculates the tariff required to be paid by staff and visitors to ensure that the car park facilities achieve the private operator/consortium target rate of return. For the preliminary analysis, we have used a post tax return of equity of 13% as a target. The results in 2007 Dollars are as follows:

3 Assuming late night parking is separate from day parking 4 GCUH engineering does not have data on parking profile changes by day of week 5 Peak turn-over multiplied by average demand. Late night parking assumed to have same turnover as day parking.



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Financial analysis of car park options Option 1 2 3 4 5 6 7 8 9 10 Configuration

A A B B A A A A C A

Total Bays 3,000 3,000 3,000 3,000 2,750 2,750 2,750 2,750 2,750 2,750Staff bays 2,100 2,100 2,100 2,100 2,300 2,300 2,300 2,300 2,300 2,300Underground 600 600 600 600 300 300 300 600 0 600Early delivery - - - - - LateTerm 25 25 25 25 25 25 25 25 25 25Residual value

- - - - - - 35% 35% 35% 35%

Results Total capital cost $m 103.7 98.2 112.3 105.7 94.5 88.9 94.5 95.5 88.7 96.0

Cost of basement car park

26.0 26.0 26.0 26.0 15.5 15.2 15.2 26.0 0 26.0

Required staff tariff ($2007)

$7.37 $7.37 $7.91 $7.91 $8.80 $8.80 $7.72 $7.76 $7.26 $7.72

Increase to RBH/PA (%) 22.8% 22.8

% 31.8% 31.8% 46.7% 46.7% 28.7% 29.4% 21.0% 28.7%

Gap if staff tariff $6 ($m) 17.4 18.6 23.8 25.1 28.1 29.1 18.0 18.2 13.3 17.4Source: KPMG analysis

Option 9, consisting of two stand-alone multi-deck car parks with no provision for underground car parking, is the most competitive option, but does offer less amenity than the Options including underground car parking.

Option 7 is the next competitive option. There appears to be a loss of economies of scale when reducing underground car park to 300. Option 8 comes at a slight cost disadvantage of $0.50 per day in required staff tariff, but provides higher amenity through providing significantly higher number of car parking bays under the hospital building.

We consider a 25 year concession term, combined with a residual value payment of 35% of the construction cost, provides a better outcome for Queensland Health than a 25 year concession term with no residual value as this reduces the tariff required to be paid by staff by more than a $1 from $8.80 to $7.72 (in 2007 Dollars).

We have also modelled the potential concession payment available to Queensland Health from a retendering process in year 25 for a further 15 years. This modelling indicates that a private operator/consortium should be able to afford to pay in excess of $95 million



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concession payment (in 2038 Dollars). This far exceeds the residual value payment of $33.1 million6.

We therefore propose to run with a 25 year concession term with a pre-agreed residual value. This approach is consistent with the principle that the car park facilities are to be delivered at no net cost to the State.

Preliminary discussion with the Managing Contractor indicated no significant interest in being able to access car parking facilities during the construction period. The required price of $7.75 to $7.90 per day is at the upper end of the range the Managing Contractor believes construction workers would be prepared to pay. Market feed-back indicated that the private operator/consortium felt that the early delivery of a car park facility would complicate the deal and they would also require a revenue guarantee for the period prior to hospital commissioning, estimated to be around $4 million over 24 months.

In addition, the early commissioning scenarios would require an immediate commencement of the procurement process for the car park to be delivered. There are still significant uncertainties in respect of the overall level of demand for car parking on the site as the size and timing of a potential collocated private hospital on site is still to be determined. We therefore suggest not to pursue the early commissioning scenarios any further.

1.8 Conclusion Based on our input assumptions, the car parks facilities cannot be delivered at zero cost to Queensland Heath without car parking tariffs applicable to staff and visitors being increased by between 20% and 30%. This will result in tariffs for staff to be in the range of $7.20 to $7.80 per day (depending on the option selected) in $2007 escalating at CPI as compared to $6.

Option 9, excluding underground car parking, is the current preferred option by Queensland Health, subject to a consultation process to be undertaken with representatives of the workforce. An IR working group has been established and is expected to consult with the workforce on this and other issues in March 2008.

The premium in daily tariff required to be paid by staff to have access to 600 underground car parks versus none is around an additional $0.50 7 per day.

Should Queensland Health decide to impose the tariffs applicable at the RBH and PA, Queensland Health is unlikely to recover the full construction of underground car park through the upfront concession payment.

The funding gap, should Queensland Health choose to maintain tariffs at parity with the PA and RBH ($6 per day), is estimated to be around $13.3 million if no underground car

6 The preliminary financial analysis is based on a nominal residual value payment of 35% of the total construction cost. This could be increased to up to 50% which would reduce required tariff level. 7 This assumes that visitor rates get adjusted pro-rata.



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parking is provided under Option 9 or increasing to $18.2 million under Option 8, which provides for 600 underground car parks.



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2 Introduction

2.1 Background The Queensland Government committed during the 2006 State election to build a new 750 bed hospital adjacent to the Griffith University Gold Coast campus to service the Gold Coast Region. The Project known as the Gold Coast University Hospital is to be constructed and operational by December 2012. The Project will replace the existing Gold Coast hospital located at Southport.

The preferred site for the Project is on land north of Parklands Drive adjacent to the Griffith University Gold Coast Campus, at Parklands. The existing Griffith University medical school is intended to be relocated from its current location in High Street, Southport to the precinct.

The hospital project is being developed using a traditional procurement process (Managing Contractor) for the health related facilities which is currently underway. The car parking facilities required for the Project are subject to a separate procurement process. The car parking facilities are proposed to be delivered under a Build Own Operate Transfer (BOOT) model, which is similar to the procurement process used for the car parks at the Royal Brisbane (RBH) and Princess Alexandra Hospitals (PA).

GCUH Engineering, a joint venture between Sinclair Knight Merz, Connell Wagner and S2F, has been retained as technical consultants to the Project. As part of the current Master Planning process, GCUH Engineering has undertaken preliminary analysis of car parking demand, indicating a total demand of 2,750 bays for the Project. This assessment of car parking spaces excludes any additional car park space requirements in the precinct which may arise from either collocation with Griffith University or the potential development of a private hospital on the site. This Business Case examines the financial viability of car parking facilities designed for between 3,000 and 2,750 bays.

2.2 Queensland Health objectives In accordance with Queensland Health’s policy in respect of provision of car parking at hospital sites, Queensland Health intends to outsource the development and operation of the car park to a private sector operator/consortium, similar to its current arrangements at the RBH and PA.

To achieve a value for money outcome, Queensland Health intends to run a tender process for the selection of an operator/consortium to design, construct, finance, operate and maintain the car parking facilities required for the Project.

Queensland Health seeks to achieve a cost neutral outcome (i.e. the development and on-going operation of car parking does not require any funding by Queensland Health).



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2.3 Purpose of this report The purpose of this report is to summarise the proposed procurement methodology and process for the car parking facilities and to analyse the financial viability of the proposed car parking options for the Project.

The financial analysis will assist Queensland Health to select a preferred car parking option and assess any budgetary implications, positive as well as negative, which may arise from the car parking procurement process for the overall Project Budget.

This report is prepared using preliminary demand analysis prepared by GCUH Engineering and capital and operating cost estimates prepared by Davis Langdon Australia (DLA) and incorporates the market input received as part of the market testing process.

We have accepted the information provided at face value and have not attempted to test its veracity. Whilst we believe the statements made in this report are accurate, KPMG Corporate Finance, KPMG, its affiliated companies and their respective officers and employees give no warranty of accuracy or reliability.

2.4 The structure of this report The analysis and findings within our report are contained within the following sections:

• Section 3 summarises the assessment of car parking and assumed usage levels;

• Section 4 details the car parking options assessed as part of this report;

• Section 5 details the preferred procurement methodology and high level commercial principles;

• Section 6 summarises the options underlying the financial analysis;

• Section 7 contains the results of the financial analysis; and

• Section 8 details procurement timetable and considerations in respect of the tender process.



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3 Car parking demand and usage levels

3.1 Methodology GCUH Engineering, a joint venture between Sinclair Knight Merz, Connell Wagner and S2F, has undertaken preliminary analysis of car parking demand, primarily using car parking usage information available for the Princess Alexandra Hospital in Brisbane and as a secondary data source two tertiary hospitals in Perth.

According to GCUH Engineering peak car parking demand typically occurs on Tuesdays and Wednesdays, with an average weekly demand of 80% of this peak demand. GCUH Engineering has estimated required car parking bays for peak demand, using anticipated usage pattern on these peak demand days.

GCUH Engineering provided relative volumes of traffic to derive a proxy for average demand. This average demand figure has then been used to derive weekly average turnover figures which are used to calculate the expected annual revenues.

3.2 Usage level and car parking requirement GCUH Engineering has estimated required car parking bays for the peak days, using the following key assumptions:

Criteria Staff Patients & visitors

Car driver mode share 80% 70%

Ratio of maximum use (bays/ bed) 3.0 to 3.1 0.6 Parking bay turnover – peak weekday (Number of times the bay is used during the day) 1.1 to 1.28 2.49

Source: GCUH Engineering, Technical Note 6, dated 3 October 2007

This results in a total car parking requirement of 2,750 bays for staff, patients and visitors on peak days as follows:

8 Assuming late night parking is separate from day parking 9 GCUH engineering does not have data on parking profile changes by day of week



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Bays Staff Patients & visitors

Total bays required for 750 bed hospital (secure/ non secure) 2,300 450

Fully secure bays for evening and night shift staff (separate, secure access, not accessible to public)

300 (included in above total)


Please note that this analysis excludes any additional car park space requirements in the precinct which may arise from either collocation with Griffith University or the potential development of a private hospital on the site.

Queensland Health also provided the following alternative demand scenario for inclusion in the financial analysis:

• A total of 3,000 bays

- 70% or 2,100 allocated to staff; and

- 900 visitor bays.

This scenario would likely require some rationing of the number of car parks made available for staff or a decrease in private car travel to the hospital from 80% to 70%, according to discussion with GCUH Engineering. We note that accessibility to public transport after hours is limited which caps the ability to increase public transport usage by hospital staff. However, this is subject to final hours of operation of the Rapid Transit system.

The car parking analysis is obviously very sensitive in respect of the assumed mode share which is driven by a number of factors including car parking tariffs. From discussion with GCUH Engineering, we understand that GCUH Engineering proposes to undertake travel surveys at the existing Gold Coast Hospital to firm up these assumptions. The date for the travel survey has not been determined as yet. The results will be reflected in the final scope for the car park facilities.

To calculate annual expected revenues, it is necessary to derive average weekly usage figures. GCUH Engineering has provided estimated demand profile for a typical week, based on relative volumes of traffic to and from a major tertiary hospital, as summarised in the following table:



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Day of the week Estimated demand volume (as % of peak demand)

Monday 95%

Tuesday 100%

Wednesday 100%

Thursday 99%

Friday 88%

Saturday 42% Sunday 36% Average 80% Source: GCUH Engineering, Technical Note 6, dated 3 October 2007

GCUH Engineering advised that traffic volume ratios represent a reasonable proxy for parking demand. The average demand of 80% has been used to calculate average turnover figures.

3.3 Two demand scenarios The following table summarises the two demand scenarios analysed as part of the business case:

Scenario Staff Patients & visitors Total

GCUH Engineering 2,300 450

2,750 (of which 300 underground)

Queensland Health 2,100 900

3,000 (of which 600 underground)

Source: GCUH Engineering and Queensland Health

3.4 Risks in respect of long-term demand for car parking The analysis in this business case assumes that there is a demand for car parking over the economic life of the facilities, (i.e. 40 years). However, there could be circumstances arising where there is significantly less demand for car parking. This could be caused by:

• continued increase in petrol prices;

• mandatory public transport usage; and/or

• significant increase in alternative transport means (e.g public transport, motor cycles, and bicycles).

Governments across Australia continue to invest in road infrastructure and there is currently no indication that private car usage is declining. However, the potential risk of



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decline of private car usage may provide a reason to conservatively size the car parking facilities, based on lower percentage of private car usage, (e.g. assume 70% instead of 80%).

This reduces the demand for staff car parking by 200 bays. Alternatively, Queensland Health could consider a whole of life concession agreement, where the patronage risk is transferred to the private sector for the economic life of the asset.

Queensland Health may also wish to investigate design solutions which allow conversion of the facilities for alternative use, (e.g. offices). This flexibility is likely to come at a cost premium which needs to be evaluated against the likelihood of the risk of decreased demand for car parking actually emerging.

We consider it unlikely that over the time period being assessed car parking facilities will cease to be required. Demand for car parking arising from the GCUH could reduce; however, the hospital is part of a larger health precinct. Should private car travel reduce, additional facilities in the precinct can be serviced by the car park facilities at the GCUH and would delay the need for additional car parking facilities.



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4 Car parking options As part of the Master Planning process, two alternative car parking configurations, both incorporating free standing and underground car parking, have been investigated. The underground car park is intended to be used for staff car parking. While coming at a cost premium, it is considered as the desired way of providing secure car parking which is particularly important for night shift nurses.

In addition, a car parking configuration excluding underground car parking has been analysed in order to determine the premium associated with the provision of underground car parking.

4.1 Configuration A Under the configuration A, car parking would be delivered through three separate car parking facilities under the two demand scenarios as follows:

Car Park Queensland Health

GCUH Engineering

Car Park A - an above ground multi-storey car park facility to be built as a free standing car parking structure at the Western boundary of the site.

1,200 1,225

Car Park B - a car park facility to be incorporated into the basement of one of the main hospital building to be built by the Managing Contractor.

600 300

Car Park C - an above ground multi-storey car park facility to be built as a free standing car parking structure at the Eastern boundary of the site.

1,200 1,225

Total car parking bays 3,000 2,750 Car parking allocated to staff 2,100 2,300 Source: GCUH Engineering and Queensland Health

Car Park B, which is proposed to be developed under one of the main hospital buildings, is intended to be operated in conjunction with car parks A and C by the successful organisation / consortium.



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4.2 Configuration B Under the configuration B, car parking would be delivered through two separate car parking facilities as follows:


GCUH Engineering


1,500 N/a

Car Park B - a car park facility to be incorporated into the basement of one of the main hospital building to be built by the Managing Contractor.

1,500 N/a

Total car parking bays 3,000 Car parking allocated to staff 2,100 Source: Queensland Health

Car Park B, which is proposed to be developed under one of the main hospital buildings, is intended to be operated in conjunction with Car Park A by the successful organisation / consortium.

4.3 Configuration C Under the configuration C, car parking would be delivered through two separate above car parking facilities as follows:


GCUH Engineering


N/a 1,375

Car Park C - an above ground multi-storey car park facility to be built as a free standing car parking structure at the Eastern boundary of the site.

Na/ 1,375

Total car parking bays 2,750 Car parking allocated to staff 2,300 Source: Queensland Health

4.4 Delivery timing In terms of the delivery timing of the car parking facilities, Queensland Health is currently investigating three options:

• the three car park structures delivered and operational by 1 July 2012;

• early commissioning of Car Park A delivered and operational by 1 July 2010, with the remainder of car parking bays being operational by 1 July 2012; and



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• late commissioning of Car Park C delivered and operational by 1 July 2013, with the remainder of car parking bays being operational by 1 July 2012.

The underground Car Park B is assumed to commence construction in July 2008 and be completed by December 2009, but not operational until 1 July 2012 to coincide with the completion of the hospital facilities.



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5 Procurement methodology

5.1 Objectives In discussion with Queensland Health it was established that the car parking facilities and procurement method will need to achieve the following objectives:

• car park development and operation to be self-funding (i.e. car park to be delivered at no cost or risk to Queensland Health);

• deliver value for money;

• avoid, if possible, interface risk that may arise having one builder for the hospital structure and another for below ground (basement) car park (i.e. preference for Managing Contractor to build basement car park); and

• timing of procurement to:

- align below car park with hospital construction;

- align above ground spaces with completion of hospital, but early deliver option to be investigated.

5.2 Procurement options To assist in the analysis and selection of preferred procurement methodology, KPMG prepared a presentation on procurement options available to Queensland Health. The presentation identified four procurement options as follows:

• Private sector BOOT10 (all spaces).

• Managing Contractor Construction (all spaces) with private sector operation (all spaces).

• Managing Contractor BOOT (basement car park) with private sector BOOT (above ground car parks).

• Managing Contractor (basement car park only) with private sector design, construct (above ground spaces) and private sector operation, maintenance (all spaces).

The workshop analysed the advantages and disadvantages associated with each of the options and the selection of the preferred methodology. In the following sections, we provide a summary of each of the options as well as its advantages and disadvantages. 10 Build Own Operate Transfer which generally encapsulates design, construction, operation, maintenance and ownership of the facility followed by transfer of ownership at the end of the contract period.



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Option 1 – Private sector BOOT (all spaces) Description Advantages

• Transfer of design, construction and maintenance risks

• Transfer of car park demand risk

• Low-cost builder used for all car parks. Disadvantages

• Private sector consortium designs, constructs, maintains and operates the car parks (above & below ground)

• Consortium finances the construction cost in return for access to car park revenues for concession term

• Competition either over up-front payment/subsidy or entry charges (up to escalated cap).

• Potential for Interface risk – different contractors engaged to build basement car park and above-ground hospital structure

• Time table risk – co-ordinations of two different contractors may impact construction time-tables

• Project potentially extends over GCUH construction program – consequent impact on provision for cost escalation.

Source: Car park procurement methodology workshop 18 October 2007

Option 2 – Managing Contractor Construction(all spaces) and Private Sector Operation (all spaces) Description Advantages

• Avoids interface risk of using different contractors to build basement car park and associated above-ground hospital structure

• Transfer to design, construction and maintenance risks

• Transfer of car park demand risk Disadvantages

• MC designs and constructs the car parks (basement & above ground spaces)

• Either MC or Private Sector consortium maintains the car parks (all spaces)

• Private sector consortium collects and retains parking fees

• Private sector consortium purchases car park concession with private finance for fixed term

• Competition either over up-front payment or entry charges (up to escalated cap).

• Fee components of D&C cost not procured on a competitive basis (MC engaged for all works)

• Managing Contractor cost premium relative to typical car park builder (2nd Tier)

• Project potentially extends over GCUH construction program – consequent impact on provision for cost escalation.




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Option 3 – MC BOOT (basement) and Private Sector BOOT (above ground) Description Advantages

• Avoids interface risk of using different contractors to build basement car park and above-ground hospital structure



• Design and construction of above-ground car parks procured on a wholly competitive basis

• Procurement of aboveground spaces can be deferred until required (manages cost escalation).

Disadvantages

• MC consortium designs, constructs, finances, operates and maintains the basement car park

• Private Sector consortium designs, constructs, finances, operates and maintains the car parks that are physically separate from new buildings (above ground spaces)

• MC consortium operates the basement car park and collects and retains parking fees. MC competitively sources finance and car park operator

• Private sector consortium operates above-ground car parks and collects and retains parking fees


• Two-tender process – costly and lengthy process

• More complex than Option 1 as MC has to enter into separate BOOT contract

• Overhead costs likely to be higher due to two separate operators (each one will build-in buffers into estimates)

• MC cost premium for basement car park relative to typical car park builder.




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Option 4 – MC construction (basement only) and Private Sector construction (above ground) and Private Sector Operation (all spaces) Description Advantages

• Avoids interface risk of using different contractors to build basement car park and above-ground hospital structure



• Design and construction of above-ground car parks procured on a wholly competitive basis

• Procurement of aboveground car park can be deferred until required (manages cost escalation).

Disadvantages

• Managing Contractor designs and constructs the basement car parks

• Private Sector Contractor designs and constructs the car parks that are physically separate from new buildings (above ground spaces)

• Private sector consortium maintains the car parks and collects and retains parking fees (all spaces)

• Private sector consortium finances its design and construction costs and an upfront payment for a concession to operate the car parks built by the Managing Contractor


• MC cost premium for basement car park relative to typical car park builder.

• Maintenance for underground car park will need to be clearly delineated between MC (e.g. for structural maintenance) and private sector (e.g. fit out).


5.3 Preferred procurement methodology As part of the workshop, the four procurement options were evaluated in respect of their suitability to achieve the above objectives, in particular:

• the ability to avoid interface risk;

• the ability to deliver a no cost solution to Queensland Health; and

• the ability to deliver a Value for Money solution for Queensland Health. For the purposes of this analysis, Value for Money indicates whether the option involves a competitive process, attracts lower-cost builders (2nd tier) and avoids higher operating costs associated with more than one operator.

The rating of the group of each option against these criteria is summarised in the following table:



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Description Avoids interface risk

Self funding VFM

1 Private sector BOOT (all spaces) Design, construct, operate and maintain

2 MC Construction (all spaces) Private sector operation (all spaces)

3 MC BOOT (basement) Private sector BOOT (above ground)

4

MC construction (basement only), Private sector design, construct (above ground spaces) Private sector operation, maintenance (all spaces)


Option 1 was considered unsuitable given the interface risk arising from the Managing Contractor having to build the hospital structure on top of the underground car park constructed by a different party. Allocation of liability in the event of defects/structural faults was considered difficult in this option.

Option 2 was considered undesirable, as car parks are generally constructed by 2nd tier firms, who have proven in the past to be more price competitive than large construction companies. This price effect is likely to be exacerbated by the lack of competition and was considered unlikely to result in Value for Money outcome. Option 2 was therefore discarded.

Under Option 3 the car parks would be operated by two different operators which were considered to result in higher ongoing operating costs and a reduced likelihood a Value for Money outcome.

Option 4 avoids the interface risk associated with Option 1 and allows for competition for the delivery of the above ground car parking spaces, which is considered important to achieve a Value for Money outcome. The private sector operator/consortium would be responsible for the operation and maintenance of all car parking spaces allowing for optimisation of operating costs across all car parks. Option 4 was therefore selected as being the preferred procurement methodology.

5.4 Bridging Finance Required for Provision of Underground Car Park To avoid interface risk in the delivery of the underground car park, the preferred procuring methodology for the underground car park is for the Managing Contractor to be responsible for the construction and on-going structural maintenance.

The underground car park is assumed to commence construction in July 2008 and be completed by December 2009, but not operational until 1 July 2012 to coincide with the completion of the hospital facilities.



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Queensland Health would pay the Managing Contractor for the construction of the underground car park in the first instance as part of regular progress payments.

The capital outlay for the underground car park is estimated to be $26 million for a 600 bay underground car park. The costs would be incurred over the financial years 2009 and 2010.

As part of the procurement process for the freestanding multi-deck car parks, the operation of the underground car park will be included. The private sector operator/organisation will be asked to tender an upfront concession fee for the right to operate and retain the revenues for the underground car park, as well as the rights to the development and operation of the freestanding multi-deck car parks.

Staff car parking tariffs would be negotiated at a level such that the private operator/organisation can afford to make an upfront concession payment to off-set the construction cost incurred by Queensland Health for the underground car park. However, there is a risk that Queensland Health will not be able to fully recoup the capital expenditure associated with the underground car park.

Should Queensland Health decide to proceed with a car parking configuration including an underground car park and wishes to minimise interface risk with the main hospital structure, Queensland Health would need to engage the Managing Contractor to construct the underground car park and provide temporary funding, until the upfront concession payment would be received from private operator/consortium.

5.5 Commercial principles Queensland Health’s indicative commercial arrangements for the car park facilities are as follows:

• Queensland Health will undertake a competitive process for the selection of the operator/consortium for the car park facilities.

• For Car Parks A and C the operator/consortium will be responsible to design, construct, finance, operate and maintain the car parks under a BOOT style transaction. Where the car park revenues exceed costs then an upfront payment to Queensland Health for the right to operate the car parks over the concession period is also envisaged. The design of the car park facilities will be in accordance with the Queensland Health Site Master Plan.

• The Private Sector will be responsible for the operation and maintenance of Car Park B and will be required to make an upfront payment to Queensland Health for the right to operate the car park facility over the concession term.

• The Concession Term will be 25, years commencing from the commercial operation date.



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• The Concession period will be shortened, if commercial operation of the car parking facilities is delayed for reasons other than force majeure, or delays caused by Queensland Health or the Managing Contractor).

• Queensland Health will have step-in rights for certain pre-agreed events (e.g. insolvency).

• The Concession period for car park (basement) extended, if the private operator/consortium cannot commence operation at the agreed commercial operation date.

• Queensland Health will make a payment to the private operator/consortium at the end of the concession period. This payment will be agreed as part of lease/concession agreement.

• Queensland Health will seek to negotiate a revenue share model or super profit clause for any revenue above an agreed base line.

• Staff car parking rates are to be agreed between Queensland Health and private sector and linked to CPI indexation post the commercial operation date.

• A minimum of 2,100 car parks will be allocated for staff usage.

• All car parks will have 24 hour operation.

5.6 Concession term and payment by Queensland Health The economic life of car parking facilities is generally accepted to be 40 years. With a concession term of 25 years, there is still significant value available post the initial concession term from the ongoing operation of the car park.

Typically, Queensland Health has offered a 25 year concession period with no residual value payment at the end of the concession period from Queensland Health to the private car park operator/consortium. Queensland Health becomes the owner of the facilities after the concession period and is free to run another tender process for the operation of the facilities. The QH tender process for the second concession term could be structured such that the car park operator/consortium makes an upfront concession payment or ongoing annual rental payment, linked to turnover.

For the private sector proponent the 25 year concession period creates a need to amortise the cost of the car park over the term of the concession period. The private sector proponent will disregard the residual economic value post the concession period.

KPMG proposes to introduce a payment for the residual value of the car parks to the private car park operator/consortium by Queensland Health at the end of the first concession period.



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The residual value payment will allow the car park operator/consortium to structure its financing arrangements with a balloon payment upon termination which results in an overall reduction of financing costs of the project.

It is envisaged that Queensland Health would retender the car parking facilities at the of the concession period, with the proceeds of the upfront concession payment for the second concession term (e.g. 15 years) likely to exceed the termination payment to the existing car park operator/consortium.

This arrangement is consistent with the principle that the car park be delivered at no net cost to the State. This arrangement is considered to represent better “Value for Money” for Queensland Health than offering an extended initial concession period.

We note, however, there remains a residual risk to Queensland Health that if there was a significant decrease in demand for car parking, the concession fee for the second concession term could be less than the residual value payment Queensland Health has to make.



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6 Financial analysis KPMG has developed a financial model from the perspective of a private sector Build Own Operate and Transfer (BOOT) operator/consortium. The financial model includes consideration of financing and tax, and is based upon achieving a target return on equity over the life of the BOOT.

In this section, we summarise the key assumptions made in the financial analysis of the four options, as well as comment on the financial viability of the options.



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Options analysed We have assessed the financial viability of the following options:

Option Description

Option 1

• Queensland Health demand (3,000 bays) • Configuration A

- Car Park A - an above ground multistorey car park facility with 1,200 bays - Car Park B - an underground car park facility with 600 secure bays - Car Park C - an above ground multistorey car park facility with 1,200 bays

• Concession term: 25 year no residual value • All car parks to be delivered by July 2012

Option 2

• Queensland Health demand (3,000 bays) • Configuration A (as under Option 1 above) • Concession term: 25 year no residual value • Car Park A (West) delivered by July 2010

Option 3

• Queensland Health demand (3,000 bays)

• Configuration B - Car Park A - an above ground multistorey car park facility with 1,500 bays - Car Park B - an underground car park facility with 1,500 bay

• Concession term: 25 year no residual value

• All car parks to be delivered by July 2012

Option 4

• Queensland Health demand (3,000 bays)

• Configuration B (as under Option 3 above)


• Car Park A (West) delivered by July 2010

Option 5

• GCUH demand (2,750 bays) • Configuration A




Option 6




• Car Park A (West) delivered by July 2010

Option 7 • GCUH demand (2,750 bays)



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Option Description

• Configuration A - Car Park A - an above ground multistorey car park facility with 1,225 bays - Car Park B – an underground car park facility with 300 secure bays - Car Park C - an above ground multistorey car park facility with 1,225 bays

• Concession term: 25 year, 35% residual value


Option 8


- Car Park A - an above ground multistorey car park facility with 1,075 bays - Car Park B – an underground car park facility with 600 secure bays - Car Park C - an above ground multistorey car park facility with 1,075 bays

• Concession term: 25 year, 35% residual value • All car parks to be delivered by July 2012

Option 9

• GCUH demand (2,750 bays) • Configuration CA

- Car Park A - an above ground multistorey car park facility with 1,375 bays - Car Park C - an above ground multistorey car park facility with 1,375 bays

• Concession term: 25 year, 35% residual value • All car parks to be delivered by July 2012

Option 10


- Car Park A - an above ground multistorey car park facility with 1,075 bays - Car Park B – an underground car park facility with 600 secure bays - Car Park C - an above ground multistorey car park facility with 1,075 bays

• Concession term: 25 year, 35% residual value • Car Park C (East) delivered by July 2013

Source: KPMG analysis, Davis Langdon Australia, GCUH Engineering

The key differences between the options are summarised in the following table:

Option 1 2 3 4 5 6 7 8 9 10 Configuration A A B B A A A A C A Total Bays 3,000 3,000 3,000 3,000 2,750 2,750 2,750 2,750 2,750 2,750Staff bays 2,100 2,100 2,100 2,100 2,300 2,300 2,300 2,300 2,300 2,300Underground 600 600 600 600 300 300 300 600 0 600Early delivery - - - - - LateTerm 25 25 25 25 25 25 25 25 25 25Residual value

- - - - - - 35% 35% 35% 35%

Source: KPMG analysis



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6.1 Capital cost estimates Capital and operating costs for car parks vary significantly based on whether car parking can be provided in a free standing above ground structure, or whether car parking is provided underground. This cost differential is primarily driven by costs associated with excavation and ventilation requirements.

Davis Langdon Australia (DLA) has provided indicative cost estimates for each of the options, including allowance for professional fees, contingency and car parking equipment. The total cost including non-construction costs was derived in September 2007 dollars and then adjusted to allow for cost escalation between now and completion of construction. For the purposes of the indicative cost estimate, the base cost was escalated to the mid point of construction (late 2011 or 4 years). The compound escalation over the next 4 years accounts for 31% (8%, 8%, 6% and 6%). The detailed cost estimates provided by DLA are included as Appendix A.

The capital cost assumptions in nominal dollars are as follows:



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Description Areas (m2)

Unit Total ($) Cost per car ($)

Comments

Option 1 Car Park A – West – 1,200 spaces

34,272 m2 39,966,825 33,306 Car park max. 5m deep

Car Park B – under hospital – 600 spaces


Car Park C – East - 1,200 spaces

34,272 m2 37,479,590 31,233 Minimum earthworks

Totals 87,144 m2 103,672,378 34,557 Option 2 (Car Park A delivered early) Car Park A – West – 1,200 spaces






Totals 87,144 m2 98,230,741 32,744 Option 3 Car Park A – West – 1,500 spaces


Car Park B – under hospital – 1,500 spaces




Car Park B – under hospital – 1,500 spaces


Totals 89,340 m2 105,675,287 35,225 Options 5 & 7 Car Park A – West – 1,225 spaces












Totals 79,272 m2 88,937,647 32,341



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Description Areas (m2)

Unit Total ($) Cost per car ($)

Comments

Option 8 (retain secure 600 spaces) Car Park A – West – 1,075 spaces

n/a 35,737,130 33,244 Based on Option 5 (pro rata adjusted)


n/a 26,225,963 43,710 As per Option 1



Totals 95,517,548 34,734 Option 9 (no underground car spaces) Car Park A – West – 1,375 spaces




Totals 88,741,125 32,269 Option 10 (Car Park C delivered late) Car Park A – West – 1,075 spaces



n/a 26,225,963 43,710 As per Option 1


n/a 34,896,134 32,461 Based on Option 5 (pro rata adjusted) and allowed for additional escalation of 4%

Totals 96,859,227 35,221 Source: DLA, GCUH Car park indicative cost options 11 October and



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6.2 Operating cost estimates David Langdon has also provided indicative operating cost estimates in 2007 dollars for the financial analysis as follows:

Description Annual maintenance cost incl. insurance & cash collection ($)

Average annual replacement cost ($)

Annual energy cost ($)

Staffing costs ($)

Totals per annum($)

Options 1 & 2 & 8 & 10 Car Park A – West 150,000 72,000 48,000 270,000 Car Park B – under hospital 100,000 72,000 48,000 220,000 Car Park C – East 150,000 72,000 48,000 270,000 Staffing – whole site (2 staff FT plus admin)

200,000 200,000

Totals – Options 1 & 2 & 8 & 10

960,000

Options 3 & 4 Car Park A – West 160,000 96,000 60,000 316,000 Car Park B – under hospital 200,000 96,000 120,000 416,000 Staffing – whole site (2 staff FT plus admin)

200,000 200,000

Totals – Options 3 & 4 932,000 Options 5 & 6 & 7 – 2750 spaces

Car Park A – West 153,000 72,000 49,000 274,000 Car Park B – under hospital 75,000 60,000 24,000 159,000 Car Park C – East 153,000 72,000 49,000 274,000 Staffing – whole site (2 staff FT plus admin)

200,000 200,000

Totals – Options 5 & 6 & 7 907,000 Option 9– 2750 spaces (no underground)

Car Park A – West 160,000 96,000 60,000 316,000 Car Park C – East 160,000 96,000 60,000 316,000 Staffing – whole site (2 staff FT plus admin)

200,000 200,000

Totals – Option 9 832,000 Source: DLA, GCUH car park - Indicative Running Cost Options, Rev A and Rev B, 2007 Dollars, Option 7, 8, 9, 10 KPMG

Car Parks A and C are assumed to be fully naturally ventilated, where as Car Park B requires full ventilation.



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6.3 Revenue assumptions In respect of the revenue, we have made the following modelling assumptions:

• The hospital has 750 beds and is operational by December 2012, with commissioning taken place from July 2012.

• The staff to visitor and patient ratio is fixed over the term.

• There is full utilisation from the second year of commercial operation.

• There is average utilisation of 60% during first 12 months of commercial operation.

• For the early commissioning options, Car Park A is delivered and operational by July 2010 with the remaining car parking bays operational from July 2012. For late commissioning options, all car parks are operational from July 2012.

• In the early commissioning options, Car Park A is assumed to earn revenue which will be primarily derived from construction workers through an arrangement with the Managing Contractor. The rate has been set that the early commissioning scenarios come at no net cost to Queensland Health.

6.3.1 Tariff structure

6.3.1.1 Staff Current car parking rates applicable for staff working at the Royal Brisbane Hospital and Princess Alexandra Hospital are around $60 a fortnight or $6 a day. The tariffs were contractually agreed with the owner/operator of both car parks for the duration of the lease agreement and are linked to CPI.

Construction costs have significantly increased in recent years and are forecast to continue to increase significantly above inflation, with forecast capital costs increases of 6% to 8% over the next four years.

To ensure that the proposed car parking facilities to be provided in conjunction with the Project are financially viable on a stand-alone basis, it is necessary to set the initial car parking tariffs applicable for staff at levels commensurate with the significantly increased construction cost.

For example, the certified construction cost for the recently completed car park at the Princess Alexandra Hospital was around $26,500,000 million or $18,888 per car11. This compares to $34,557 per car, under Option 1, or $26,582 before allowing for escalation, which is greater than a 40% increase before allowing for escalation. Including the effect

11 Information provided by Michelle Walter, Queensland Health



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of escalation the construction cost of the new car parks is expected to be over 80% higher than the cost of the recently completed car park at the Princess Alexandra Hospital.

In line with increases in construction costs over recent years and the anticipated continued construction cost increases, car parking tariffs will also have to increase significantly if a cost neutral position to Queensland Health is to be achieved.

We understand that Queensland Health is in the process of developing a policy in relation to car parking development and tariffs applicable to staff. The draft policy considers linking the tariffs to the rates applicable at the Royal Brisbane Hospital. Such a policy would mean that the car park facilities are unlikely be developed at no net cost to Queensland Health.

As part of our financial modelling, we have estimated tariffs levels required for staff and visitors to ensure that the car parking facility can be delivered at no net cost Queensland Health. We have escalated staff and visitor tariffs at the same rate to maintain relativity between the two tariffs.

This will result in higher tariffs for staff working at the GCUH in comparison to the RBH or PA. The level of increase required depends on the configuration, split between staff and visitor bays, timing of delivery, concession term and level of residual value payment by Queensland Health (if any) at the end of the concession term.

Should this not be acceptable to Queensland Health, we have identified the following options to address this issue:

• introduction of a car parking equalisation fund with Queensland Health setting uniform tariffs for all staff car parking at major hospitals in South East Queensland and taking on the role of redistributing the revenue to the respective car park operators;

• Gold Coast district to provide a rebate on staff car parking cost incurred; or

• Queensland Health only partly recovering the cost for the development of the underground car park from the private operator/consortium.

6.3.1.2 Way of charging for car parking We have had discussions with GCUH Engineering in respect of tariff structure and the way staff actually pay for car park usage. GCUH Engineering is a strong advocate of levying commercial car parking rates to achieve economic-efficient choices.

GCUH Engineering is not a supporter of paying for car parking through pay-roll deductions as it does not encourage car pooling and alternative means of transport, e.g. cycling even on a sporadic basis. GCUH Engineering favours a “pay as go” regime to encourage greater use of alternative means of transport.



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6.3.2 Patients and visitors Consistent with the arrangements applicable for the operation of the car parks at the RBH and PA, the private operator is assumed to be free to set tariffs applicable to patient and visitors at market rates.

The benchmark rates, are based on current the car parking tariffs applicable for patients and visitors at Brisbane hospital sites.

Hospital Operator First Half Hour Following Half Hours Maximum

Wesley Hospital Security (Internal) $4.00 $2.00 $14.00

Prince Charles Metro $2.30 $2.30 $11.00

Holy Spirit Metro $2.30 $2.30 $11.00St Andrews Secure Parking $5.00 Approx. $2.00 $15.50

Royal Brisbane IPG $3.10 $3.10 $15.00Proposed GCUH $3.50 $2.50 $15.00Note: 2007 dollars. Rates do not include an allowance for escalation.

Source: Queensland Health, KPMG research

Given the staged tariff structure, it is important to know the distribution of length of stay in order to determine the average price paid by each visitor.

GCUH Engineering has estimated the average parking duration for patients and visitors as 1 hour 40 minutes with about 10 per cent of patients and visitors requiring parking in excess of 4 hours as illustrated in the following graph.

Applying this usage profile the average car parking ticket is $8.65 (in $2007). Reducing the rate applicable to the first half hour and the following half hour by $0.50 each reduces the average ticket price to $7.34 (in $2007). The financial model uses the average ticket price of $8.65 (which is 44% higher than the daily staff rate of $6.00), before adjusting visitor and staff tariffs on a pro-rata basis to achieve the operator’s target rate of return.



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GCUH - estimated percentage parking duration for patients and visitors

15%

19%

34%

15%

7%

3%1% 1% 1% 1% 1% 1% 1%

0%

5%

10%

15%

20%

25%

30%

35%

40%

<30 mins 30 mins -1 hrs

1-2 hrs 2-3 hrs 3-4 hrs 4-5 hrs 5-6 hrs 6-7 hrs 7-8 hrs 8-9 hrs 9-10 hrs 10-11 hrs >11 hrs

Percentage total parked vehicles


6.3.3 Parking bay turnover In order to calculate annual revenue for staff and visitor car parking, we need to derive an average daily turnover.

GCUH Engineering have provided the peak weekday turnover rates only (observed on Tuesday and Wednesday). We have assumed the same turnover rates for late night parking. No information in respect of the parking profile by day of week is available. These rates have then been converted into average 7 day turnover rates using the average weekly parking demand. This approach has been confirmed with GCUH Engineering. The average daily turnover rates are shown in the following table:



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Parking bay turnover Staff Patients & visitors Parking bay turnover – peak weekday (Number of times the bay is used during the day

1.1 to 1.212 2.413

7 day average14 0.88-0.96 1.92 Source: GCUH Engineering, Technical Note 6, dated 3 October 2007, KPMG analysis

6.4 Financing structure To model the profitability of the various car parking options, KPMG has made a number of assumptions in respect of the financing structure that a private operator/consortium may adopt for the development and operation of the car parking facilities.

6.4.1 Car Park B (basement) Car Park B (basement) is assumed to be designed and constructed by the Managing Contractor, with Queensland Health initially paying for the construction of the car park through progress payments. On the commercial operation date for the Car Park B, the car park operator is assumed to make an upfront concession payment for the right to operate and collect the revenues for the concession term.

For modelling purposes, this upfront concession payment is assumed to be equal to the construction cost for Car Park B. No allowance for interest during construction has been made in respect of Car Park B.

In practice, the concession payment will be the result of the tender process.

6.4.2 Car Park A and C The private car park operator/consortium is responsible for the design and construction of Car Parks A and C. It is assumed that the construction is to 100% financed with a construction facility. Interest during construction is capitalised during the construction period. The construction facility, including capitalised interest during construction and the concession payment for Car Park B will be refinanced with term debt and equity upon commercial operation.

6.4.3 Financing assumptions We have made the following assumptions in respect of the financing structure from commercial operation onwards:

• gearing ratio (debt / debt+equity) of 65%; 12 Assuming late night parking is separate from day parking 13 GCUH engineering does not have data on parking profile changes by day of week 14 Peak turnover multiplied by average demand



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• for no residual value scenarios:

- Amortising tranche only (amortising over concession term);

• for residual value scenarios:

- Amortising tranche (amortising over concession term);

- Bullet tranche: sized to match residual value (interest only);

- Terminal value payable by Queensland Health at the end of the term equal to 35% of total project cost. Terminal value will be used to repay bullet tranche.

• risk free rate of 6.25% per annum;

• construction debt margin of 1.5%;

• term debt margin of 1.25%;

• target IRR on equity investment post tax for private sector participant of 13%;

• economic life of the car parking facilities 40 years; and

• retender in year 25 for further 15 years.

The residual value payment has been set with reference to the total project cost. The residual value has been set not to exceed the depreciated book value of the asset. The market value is anticipated to exceed this residual value payment.

6.5 Other modelling assumptions In addition, we have made the following modelling assumptions:

• CPI rate of 2.5% per annum.

• Operating cost to escalate at 4% per annum post commissioning.

• Corporate tax rate of 30%.

• Underground Car Park B treated as an acquisition.

• BOOT operator will be able to claim depreciation on the underground car park.

• Revenues do not trigger revenue share level with Queensland Health.



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7 Results of preliminary analysis We have estimated the tariff required to be paid by staff and visitors to ensure that the car park facilities achieve the private operator/consortium target rate of return. For the preliminary analysis, we have used a post tax return of equity of 13% as a target. The results in 2007 dollars are as follows:

Option 1 2 3 4 5 6 7 8 9 10 Configuration A A B B A A A A C A Total Bays 3,000 3,000 3,000 3,000 2,750 2,750 2,750 2,750 2,750 2,750Staff bays 2,100 2,100 2,100 2,100 2,300 2,300 2,300 2,300 2,300 2,300Underground 600 600 600 600 300 300 300 600 0 600Early delivery - - - - - LateTerm 25 25 25 25 25 25 25 25 25 25Residual value

- - - - - - 35% 35% 35% 35%

Results Total capital cost $m 103.7 98.2 112.3 105.7 94.5 88.9 94.5 95.5 88.7 96.0

Cost of basement car park

26.0 26.0 26.0 26.0 15.5 15.2 15.2 26.0 0 26.0

Required staff tariff ($2007)

$7.37 $7.37 $7.91 $7.91 $8.80 $8.80 $7.72 $7.76 $7.26 $7.72

Increase to RBH/PA (%) 22.8% 22.8% 31.8% 31.8% 46.7% 46.7% 28.7% 29.4% 21.0% 28.7%

Gap if staff tariff $6 ($m) 17.4 18.6 23.8 25.1 28.1 29.1 18.0 18.2 13.3 17.4Source: KPMG analysis

Option 1-4: Car parking size

Feedback received from the market testing process as well as confirmation by GCUH indicates that the patronage risk associated with 900 visitor car parks is unlikely to be underwritten by private sector tenderers. This means Options 1 to 4 are potentially not viable. Options 5 -10 are based on 450 visitor car parking bays, consistent with the advice received from GCUH Engineering and market feedback.

Option 2, 4 and 6 - Early commissioning scenarios

For the early commissioning scenarios, we have assumed 6 day operation with an average 80% occupancy level and one entry per bay per day. Based on these assumptions, we have determined the tariff which would need to be charged during the early commissioning period to make the advancement of the car park cost neutral to Queensland Health.



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The required tariff varies between $7.75 to $7.90 in 2007 dollars escalating at CPI. This translates into revenue in the order of $4 million under Options 4 and 6.

Market feedback by potential car park operator/consortiums indicated that this revenue risk would need to be underwritten by either Queensland Health or the Managing Contractor. Preliminary discussions with the Managing Contractor indicated no significant interest in being able to access car parking facilities during the construction period. The required price is at the upper end of the range that the Managing Contractor believes construction workers are prepared to pay.

In addition, the early commissioning scenarios would require an immediate commencement of the procurement process. There are still significant uncertainties in respect of the overall level of demand for car parking such as the size and timing of a collocated private hospital on site. We therefore suggest not pursuing the early commissioning scenarios any further.

Option 5 and 7 - Concession term versus residual value payment

Option 5 is based on 25 year concession term with no residual value, whereas Option 7 is based on 25 year concession term with a residual value of 35% of the total project cost.

This reduces the tariff required to be paid by staff by more than a $1 from $8.80 to $7.72.

We have also modelled the potential concession payment available to Queensland Health from a retendering process in year 25 for a further 15 years. This modelling indicates that a private operator/consortium should be able to afford to pay a concession payment in excess of $95 million (in 2038 dollars). This far exceeds the residual value payment of $33.1 million.

We therefore propose to run with a 25 year concession term with a pre-agreed residual value. This approach is consistent with the principle of that the car park be delivered at no net cost to the State. This arrangement is considered to represent better “Value for Money” for Queensland Health than offering an extended initial concession period.

Option 8 - 600 versus 300 underground car parking bays

Option 8 was modelled to understand the additional cost of maintaining secure underground car parking bays at 600 in comparison to Option 7, which only allows for 300 underground car parking bays.

Having 600 instead of only 300 underground car parking only adds $0.04 to the required daily car park tariff. Given this small increase in tariff, Option 8 is preferred over Option 7.



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Option 9 – No underground car parking

Option 9 was modelled to understand the additional cost of providing underground car parking in comparison to simply providing two free standing multi-deck car parks. Option 9 needs to be compared to Option 8.

Eliminating underground car parking reduces the required tariff by $0.50 from $7.76 to $7.26.

However, we note Option 9 comes with decreased amenity for staff. We also understand from discussion with Queensland Health that it is more difficult to provide secure car parking in multi-deck car parks.

Option 10 – Delay commissioning of second multi deck car park by 12 months

Option 10 needs to be compared with Option 8. Under Option 10, it is assumed that Car Park C is commissioned 12 months later, (i.e. by July 2013 instead of 2012). This may fit with the ramp up of services at the GCUH. However, this reduces the tariff only marginally. It is recommended to discuss staging further with the interested parties during the procurement process, once the ramp up profile of hospital services and demand for car parking is better defined.

Tariff implications

Based on our input assumptions, the private operator would not find investment in the car parks viable without lifting car parking tariffs applicable to both staff and visitors between 20% and 30% in the residual payment scenarios (Option 8 and 9).

Should Queensland Health decide to impose the tariffs applicable at the RBH and PA, Queensland Health is unlikely to recover the full construction of underground car park through the upfront concession payment.

In order to reduce the tariff required to be paid by staff and visitors to achieve the private operator’s expected return on investment, we have investigated several changes to the modelling assumptions. We have analysed the impact of the proposed changes based on Option 8. The identified options are as follows:



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Proposed options Impact of Option A

Increase residual value payment from 35% to 50% Staff tariff reduces from $7.76 to $7.33 and Visitor and Patient tariff from $11.19 to $10.56.

B Reduce staff car parks to 2,100 (and total car parks to 2,550)

Staff tariff reduces from $7.76 to $7.63 and Visitor and Patient tariff from $11.19 to $11.00.

C Reduce staff car parks to 2,100 (and total car parks to 2,550) combined with 50% residual value

Staff tariff reduces from $7.76 to $7.21 and Visitor and Patient tariff from $11.19 to $10.39.

Source: KPMG analysis

7.1 Summary Option 9, which consist of two stand-alone multi-deck car parks with no provision for underground car parking, is the most competitive option, but does offer fewer amenities than the Options including underground car parking.

Disregarding Options 1 – 4 given there appears no appetite for 900 visitor bays; Option 7 is the next most competitive option.

There appears to be a loss of economies of scale when reducing underground car park to 300. Options 8 and 10 only come at a slight cost disadvantage in comparison to Option 7, but provide higher amenity through providing significantly higher number of car parking bays under the hospital building.

It is worth considering the effect of increasing public transport usage and increasing petrol prices on the percentage of staff travelling by private car. A reduction of private car usage from 80% to 70% decreases the demand for staff car parks from 2,300 to 2,100.

It also worth investigating how to best match the ramp up profile of the hospital with the provision of car parking. Potentially the development of the second stand-alone car park could be completed 12 months after commissioning of the hospital, (i.e. July 2013).

We consider a 25 year concession term, combined with a residual value payment of 35% of the construction cost, provides a better Value for Money outcome for Queensland Health than a 25 year concession term with no residual value.

Preliminary discussion with the Managing Contractor indicated no significant interest in being able to access car parking facilities during the construction period. Early commissioning scenarios would require an immediate commencement of the procurement process. However there are still significant uncertainties in respect of the overall level of demand for car parking such as the size and timing of a collocated private hospital on site. We therefore suggest that the early commissioning scenarios not be progressed any further.



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7.2 Procurement process Typically, for a project such as this, we would recommend to a two stage procurement process comprising:

• an Expression of Interest Process, followed by

• Selective Request for Proposals.

Dependent on the number of interested parties and level of competition, we suggest selecting three parties which would be invited to the Request for Proposal Process. The Managing Contractor may wish to participate in the process which may offer synergies with delivery of the hospital structure, especially in the early delivery options.

7.3 Procurement timetable We have prepared an indicative procurement timetable based on a two stage tender process to ensure all car parks are delivered and operational by 1 December 2012. The timetable and suggested procurement phases as well as key tasks are summarised in the following table:

Phase Tasks Duration Start date 1. Preparation • Finalise Queensland Health requirements (car parking

bays, expansion potential, delivery timing)

• Develop/refine commercial framework

• Collect/review supporting technical reports (e.g. traffic study, hospital and precinct master plan, concept design)

• Prepare Request for Proposal documentation including draft agreement for lease

• Draft RFP with the view to get broad market response and comprehensive range of options

8 weeks December 2009

2. Expression of Interest

• EOI publicly announced

• Registration of interested parties, briefing

• Meeting with interested parties

• Interested parties lodge EOI

3 weeks February 2010

3. Evaluation of Expression of Interests

• Evaluation of EOI responses

• Prepare report recommending shortlist

• Approval process (shortlist and issue of RFP)

• Continue preparation of RFP documents

4 weeks Late February 2010

4.0 RFP • Allow interested parties 8 weeks to respond

• Prepare evaluation tool

• Prepare and conduct bidder workshops (technical and

10 weeks Late March 2010



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Phase Tasks Duration Start date commercial)

• Provide commercial advice as required

• Tenderers lodge Proposals

5. RFT evaluation and short listing

• Analyse Proposals for value for money and risk allocation

• Clarify offers

• Negotiate with short-listed tenderers

• Prepare evaluation report for RFP

• Approval of Preferred Bidder

6 weeks Mid June 2010

6. Finalisation and awarding of contract

• Approval to negotiate with preferred tenderer(s)

• Finalise negotiations

• Finance due diligence

• Award contract

• Settlement

6 weeks Early August 2010

Total lead time prior to construction period 36 weeks

7. Construction period • Allow 3 month for construction lead time and 18 months construction time15

• Construction completed ~mid 2012

21 months September 2010

Commercial operation date December 2012

Source: KPMG

7.4 Early delivery option We understand that Queensland Health will continue to investigate the merits of early delivery of Car Park A.

This issue has been tested as part of the market sounding process. The participants felt that the patronage/revenue risk for the interim period (prior to commissioning of the Gold Coast University Hospital) would need to be underwritten by Queensland Health or the Managing Contractor. Under Option 6, these revenues are around $5.5 million. The early delivery option is also more complex from a financing perspective as it would require two tranches of debt.

However, should the Managing Contractor favour early delivery of Car Park A and Queensland Health is able to reach a suitable commercial arrangement with the Managing Contractor for usage of the car park during the construction phase, early delivery may prove a viable strategy.

15 As advised by DLA



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We would envisage that the tender process would encapsulate the provision of all above ground car parking facilities, with staggered commissioning dates.

In this event, the procurement process would need to be advanced by around 24 months, bringing the commencement date to December 2007. This may be difficult to achieve as CBRC approval for the hospital development is considered a perquisite to commence the procurement process for the car parking facilities. CBRC approval is currently scheduled for March 2008.

However, commencing the procurement process early next year means that negotiations in respect of collocation of a private hospital are unlikely to be completed. It is desirable to have one operator for the whole site and the collocation of a private hospital will influence optimal size and design of car parking facilities.

7.5 Information required for tender process Interested parties are likely to require a significant level of information on issues potentially impacting on patronage figures of the car parks, including the following:

• site plan, integration with Rapid Transit System;

• detailed traffic study;

• site and precinct Master Plan;

• conceptual design for car parking facilities; and

• details of proposed contractual documentation and Queensland Health’s commercial objectives

7.6 Market sounding process

7.6.1 Process To firm up modelling assumptions and gather market feedback on the proposed car parking facilities to be developed in conjunction with the Gold Coast University Hospital, KPMG undertook a selected market sounding process with four participants. The participants in the market sounding process were provided with the fact sheet (provided in Appendix C) prior to the discussion. The participants were selected as being either investors and/or car parking operators in car parking operations.



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7.6.2 Participants The list of participants for the Gold Coast University Hospital car park Market Sounding is as follows:

1. Westpac Institutional Bank

Robert Opiat Director, Principal Group Westpac Institutional Bank Phone: 02 8253 3954 Email: [email protected]

2. International Parking Group

John Beare Phone: 02 9080 8393 Email: [email protected]

3. Ariadne Australia Limited

Jo-Anne Chin Heather Browne Manager – General Property Development Manager Phone: 07 3220 1111 07 3220 1111 Email: [email protected] [email protected]

4. Macquarie Bank

Mick Lilly Blair Townsend Executive Director Associate Director Phone: 02 9237-3333 02 9237 3333 Email: [email protected] [email protected]

7.6.3 Key findings The market sounding discussion was structured around a series of questions to gain insight on how private operator/consortium would approach the project, in particular:

• Alternative delivery mechanisms.

• Funding strategy.

• Risk allocation.



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• Car parking demand/patronage risk.

• Early delivery.

Key findings are summarised in the following table:

Question Comments

Car parking demand • Visitor bay numbers of 900 generally considered too high

• Perceive Greenfield site risk (i.e. hospital not commissioned on time)

Funding strategy • Gearing levels of 60-65%

• Equity rates of return 13%-15%

Concession term / residual value

• Generally no concern about concession term of 20 years in conjunction with residual value payment, but generally prefer longer term

Future hospital/car park expansion

• Expansion risk, need protection against new operator coming in on the site

• Pre-agree formula for extension pricing

Early delivery • Early delivery only viable if patronage/revenue risk borne by Queensland Health

Other • Confirmed assumption that car parks are generally delivered by 2nd tier construction companies which typically offer a cost advantage.

Source: KPMG



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8 Disclaimer

Reliance

The statements and opinions in this report are given in good faith but, in the preparation of this report, KPMG Corporate Finance has relied upon information provided from a number of sources including representatives from GCUH Engineering, DLA and Queensland Health.

Any findings, outcomes or recommendations are based upon our reasonable professional judgement and opinions based on the information on the proposed project that is available at this preliminary scoping stage of the project’s assessment and other publicly available information of which we are aware. Should the project elements, external factors and assumptions on which the findings change then the recommendations, findings contained in this report may not be achievable. Accordingly, we do not confirm, underwrite or guarantee that the outcomes referred in this report will be achieved.

This report has been prepared for Queensland Health and accordingly no warranty is given to third parties which may seek to utilise the information contained in this report.



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A Market sounding process files notes

A.1 International Parking Group

# Question Comments

1 Interest in project

• Interested to participate in proposed structure

• Comfortable with MC being responsible for development of underground car park and ongoing associated building maintenance, would like input into design

• Will require careful delineation of responsibilities in respect of maintenance during concession term

• Fire services to be maintained by hospital

2 Delivery mechanisms

• 20 years considered as the minimum length for concession period as funded by superfunds who require long-term yield

• In respect of Car Park B, would prefer annual rental payment over capital contribution

• No objection to residual value concept/defined repurchase

• Have no strategic relationship with a builder

• Believe that second tier builders are more competitive

• Would assemble specific consortium for the opportunity

3 Funding strategy

• Would be part of asset portfolio not a special purpose vehicle, but treated as stand-alone asset for purposes of tender

• IPG is traditionally financed

• 65% debt

4 Risk allocation • Expansion risk, need protection against new operator coming in on the site,

cited PA structure as an example

• Protection against late delivery, change in bed mix, but accept wind down risk

5 Staff/visitor tariff policy

• Believes that current staff rate at PA is probably the maximum staff is prepared to pay before change of transport mode considered

• Rates significantly lower in Sydney (e. $3 a day)

• Expect around 40% of revenue generated from staff

6a Car parking demand

• Visitor bay numbers are considered too high

• Visitor turn over 2.5-3 times a day

• Ramp period of 12 months

6b Early delivery

• Would require evidence that hospital will be delivered

• Likely to require lease back to Government/MC for the period between early commissioning and commercial operation of hospital

• Would use 2 debt tranches to cater for staged development



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# Question Comments

7 Timely delivery • Comfortable with concession period to commence when hospital

commissioned, i.e. would lead to shortening of concession period in the event of late delivery

8 Other issues • None

A.2 Ariadne

# Question Comments

1 Interest in project • Interested to participate in proposed structure

• Questioned timetable, likelihood of proceeding


• Favour a 20+20 model

• Believe that a shorter concession term will make it difficult to be cost neutral to Queensland Health


• Believes it is very important to clearly define project requirements, e.g. expansion potential, security requirements etc.

3 Funding strategy

• 60% debt

• Perceive greater risk as Greenfield site

• Return requirement of 12.5% - 15%

• Generally invest own equity

4 Risk allocation

Would seek Queensland Health to carry the following risks:

• Cultural heritage • Managing Contractor inability to deliver hospital • Environmental • Community objections • Early closure of hospital

5 Staff/visitor tariff policy • No specific comments

6a Car parking demand • Number car parking bays considered too high.

• Suggested staging of Car Park A and Car Park C to minimise demand risk, with second car park built post ramp phase

6b Early delivery • Depends on revenue potential in the interim period


commissioned, i.e. would lead to shortening of concession period in the event of late delivery

8 Other issues Expansion at future stage

• Suggest trigger points for both sides and pre-agreed formula for pricing of



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# Question Comments expansion

Information requirements for tender process:

• Staff to bed ratios

• Security requirements for staff parking

• Information of Queensland Health tariff policy for staff

• Would require confirmation that Queensland Health would not provide free or subsidised public transport to staff within the first 15 years

A.3 Westpac

# Question Comments


• Considered the project potentially too small for Westpac to be interested

• Asked if there was a requirement for a “Big Name” car park operator to be included in the consortium or could Westpac develop its own car park management business (given the skills required to manage a car park are relatively simple). If they could provide there own operations management then they would be more interested.

2 Delivery mechanisms • No objection to residual value concept/defined repurchase


3 Funding strategy • Funding structure to be similar to a social infrastructure PPP with a high level of debt funding.

4 Risk allocation


• Continued operation of the hospital – some restriction on competitor on the site

• Environmental • Community objections

5 Staff/visitor tariff policy • Clear rules are required to be set in the tender documents.

6a Car parking demand • Number car parking bays considered too high.

• Suggested staging of Car Park A and Car Park C to minimise demand risk, with second car park built post ramp phase

6b Early delivery • Depends on revenue potential in the interim period – would require revenue to be underwritten


commissioned, (i.e. would lead to shortening of concession period in the event of late delivery)



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A.4 Macquarie

# Question Comments


• Very interested in proposed structure and any other car parks that Queensland Health might be interested in developing.

• Comfortable with MC being responsible for development of underground car park and ongoing associated building maintenance, would like input into design.

• Will require careful delineation of responsibilities in respect of maintenance during concession term.

• All building services to be maintained by hospital.



• Has some concern over an upfront payment (given Cross City Motorway). However, understood Queensland Health’s requirement for zero cost. They suggested that some qualitative or quantitative factors be included in the evaluation to protect consumers.


3 Funding strategy • Not answered

4 Risk allocation


• That the hospital is delivered on time

• Continued operation of the hospital – some restriction on competitor on the site (private hospital only being allowed to have the same ratio of beds to spaces as the QH operator)

• Environmental • Community objections All so wants the State to transfer

5 Staff/visitor tariff policy • Require certainty in relation to policy for both staff and visitors.

• Suggested that a maximum tariff for visitors be applied to protect consumers.

6a Car parking demand • Did not have a feel in the meeting about the number of spaces – would require further work for Macquarie to be able

6b Early delivery • Could be provided but would require revenue to be underwritten in the early years.

7 Timely delivery • Believed Liquidated Damages as the best method of managing late delivery

8 Other issues

• Public transport – need to know more information about rapid transit project when preparing bid

• Precinct – need to know more information about rapid transit project when preparing bid



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B Fact sheet for market sounding process Introduction

Queensland Health has commenced the development of a new 750-bed hospital to service the Gold Coast Region. The Project known as the Gold Coast University Hospital is to be constructed and operational by December 2012. The proposed site for the Gold Coast University Hospital is on land north of Parklands Drive adjacent to the Griffith University Gold Coast Campus, at Parklands.

The Project is being developed using a traditional procurement process which is currently underway. At the completion of schematic design Queensland Health will consider whether to enter into a 2-stage Managing Contractor contract. However, Queensland Health intends to run a separate procurement process for the selection of an operator/consortium to design, construct, finance, operate and maintain three car park facilities required for the Project.

KPMG is the commercial adviser for the Project and has been requested to undertake a market sounding process for the car park procurement process. The purpose of this document is to assist the market sounding process by providing background information for the Project.

Car parking space requirements

Queensland Health has undertaken a preliminary car parking demand study for the Gold Coast University Hospital and the current assessment of car parking requirement for the Project is as follows:

• Staff bays - 2,100.

• Visitor bays - 900.

This assessment of car parking spaces for the Gold Coast University Hospital excludes any additional car park space requirements in the precinct which may arise from either collocation with Griffith University or the potential development of a private hospital as part of the precinct.

Master Planning

Queensland Health is currently undertaking Master Planning for the site; the Preliminary Master Plan indicates that the car parking will be delivered through three separate car parking facilities as follows:

• Car Park A - an above ground multistorey car park facility with 1,200 bays to be built as a free standing car parking structure at the Western boundary of the site.



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• Car Park B - a car park facility with 600 secure bays to be incorporated into the basement of the main hospital building(s) which may be built by the Managing Contractor.

• Car Park C - an above ground multistorey car park facility with 1,200 bays to be built as a free standing car parking structure at the Eastern boundary of the site.

Car Park B, which is proposed to be developed under the main hospital building(s), is intended to be operated in conjunction with Car Parks A and C by the successful organisation / consortium.

In terms of the delivery timing of the car parking facilities, Queensland Health is currently investigating two options:

• The three car parks structures with 3,000 parking bays delivered and operational by 1 December 2012.

• Early commissioning of either Car Park A or C with 1,200 spaces delivered and operational by 1 December 2010, with the remainder of car parking bays being operational by 1 December 2012.

Indicative commercial arrangements

Queensland Health’s primary objective in relation to the car park facilities is for it to be built and operated at zero cost to Queensland Health. The indicative commercial arrangements for the car park facilities have been developed around this principle and are as follows:

• Queensland Health will undertake a competitive process for the selection of the organisation / consortium for the car park facilities.

• For Car Parks A and C the operator/consortium will be responsible for the design, construct, finance, operate and maintain under a BOOT style transaction. Where the car park revenues exceed costs then an upfront payment to Queensland Health for the right to operate the car parks over the concession period is also envisaged. The design of the car park facilities will be in accordance with the Queensland Health Site Master Plan.

• The Private Sector will be responsible for the operation and maintenance of Car Park B and will be required to make an upfront payment to Queensland Health for the right to operate the car park facility over the concession term.

• Concession Term: 25 years from commercial operation date.

• Staff car parking rates to be agreed between Queensland Health and private sector and linked to CPI indexation post commercial operation date.



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• 2,100 car parks allocated for staff usage.

• 24 hour operation.

Disclaimer

The Queensland Government and its advisers have developed this market sounding fact sheet for use in the Gold Coast University Hospital car park facilities market sounding process. The market sounding process is subject to the following conditions:

1. Nothing in this document is, or should be relied upon as, a promise or representation by the Queensland Government, that this Project will subsequently proceed. This Market Sounding exercise is not part of any procurement process for the Project. Participants in the Market Sounding exercise should not consider that their responses or participation will be in any way used for evaluation purposes.

2. While the information in this document has been prepared in good faith, it does not purport to be comprehensive or to have been independently verified. Neither the Queensland Government, nor any of its Advisers accepts any liability or responsibility for its adequacy, accuracy or completeness, nor do they make any representation or warranty, express or implied, with respect to the information contained in the Document or on which the Document is based or any information which may be provided in association with it. Any liability therefore is hereby expressly disclaimed.

3. This Document should not be considered as an investment recommendation made by the Queensland Government, or any of its Advisers to any private sector provider. Each person to whom this document is made available must make their own independent assessment of the Project after making such investigation and taking such professional advice, as they deem necessary.

4. The Queensland Government and its Advisers will treat each respondent’s comments as confidential and can, if requested, record comments on an unattributable basis. However, since the results of this Market Sounding exercise are to be used to both gauge potential interest in the Project and help define the scope of any subsequent procurement, no guarantee is given that respondents’ consideration will not be included in subsequent documentation. Respondents should ensure that any responses made as part of this Market Sounding exercise do not contain any intellectual property or other information of a proprietary nature.

5. No reimbursement of costs will be paid to persons or organisations responding to the market sounding process.



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C Capital and operating cost estimates


September 2008


E Space allocation benchmarking 5 pages

Area Analysis GCUH ARCHITECTURE

SD Places

Bed Alternatives MD Beds

Procedure/ Treatment

Places

Consult Rooms AHFG Difference Comments TGFA

m2 Difference

1 Generic Inpatient Unit 20170 19057 11.59% 0 0 400 1 13 16966 2091 18648 409

The majority of the difference, that is 923m2 of the difference can be attributed to shared education & training areas, integrated inpatient multipurpose allied health areas, distressed relative areas and centralised waiting and reception areas.

2 Education & Research 4011 3871 2.36% 0 0 0 0 0 1217 2654 4125 -254

The opportunity and ability to have an integrated education, library, simulation training and research facilities with Griffith university enables improved area efficiency

3 Division of Medicine 24414 24437 14.87% 14 97 76 115 115 19515 4922 22887 1550

This total area has changed as it contains functions and ares that were originally in other planning units, such as Generic Inpatient Units and Corporate Services.

4 Division of Surgery & Critical Care 15976 16032 9.75% 40 0 50 39 11 13159 2873 14376 1656

The differential is largely due to the Anesthetics department being located within this area cluster but in other benchmark facilities it forms part of clinical administration.

5 Division of Family, Women & Children 12777 14018 8.53% 20 0 124 26 39 9809 4209 11499 2519

g y g y& Children's ambulatory care being part of this cluster and inclusion of clinical education & training and allied health areas specific to FWC and includes area previously located within other

6 Division of Mental Health & ATODS 7336 5817 3.54% 8 0 72 0 0 5807 10 5895 -78The differential is largely focused around revised IPU bed configuration, 3 units of 24 beds in lieu of 4 18 bed units.

7 Division of Community, Allied Health Aged & Rehabilitation Services 7342 7359 4.48% 0 0 28 99 10 5791 1568 6502 857

The differential is spread across the cluster with additional services provided which include Orthotics, Transitional care services, and clinical education and training areas.

8 Division of Medical Services 5847 5923 3.60% 0 0 0 28 0 3106 2817 5143 780

The differential is largely due to the inclusion of satellite imaging services with Emergency and Ambulatory care areas, and the inclusion of equipment such as a PET etc,.

9 Division of Pathology 4612 5039 3.07% 0 0 0 8 0 1622 3417 6360 -1321

The differential is largely around the reduction of research facilities for pathology and the fact that other benchmark projects serve larger regions and provide large district and regional services.

10 Corporate Services, Amenities and Retail 18305 16556 10.07% 0 0 0 0 0 3306 13250 16318 238 In alignment with current tertiary projects

0 0 0 0 0 0 0

Total 120790 118109 74 97 750 316 188 80298 37811 111753 6356

Travel Level 6 Hospital = 16% 20390 18580

Plant Level 6 Hospital = 21% 23820 27673

Unenclosed Covered Areas

Gross Area

Total Gross Area 165000 164362

AREA ALLOWANCECyclotron 500

To be considered/advisedArchive StoreChild Care CentreHydrotherapy Pool 398Hyperbaric Unit

Medihotel

Retail Allowance - Not within hospital 5000Carparking Allowance 90000

Total 95000

Comparison with Australia Health Facility Guidelines Benchmarking

Comments

The Australasian Health Facility Guidelines do not cover all departments within a tertiary hospital. A large number of the guidelines relate to a level 4 role delineation only. Thus it is hard to have realistic tertiary level hospital comparisons without benchmarking the proposed facility with other proposed tertiary hospitals within Australia.

Planning Units

Total Gross Functional

Area M2

Scheme Design

Total Gross Functional Area % of total gross

area

Beds/ Treatment PlacesTotal Gross Functional

Area M2

Project Definition

Plan

3435001_1.xls 19/09/2008 1 of 5.

AREA ANALYSIS GCUH ARCHITECTURE

SD Places Bed Alternative

MD Beds (PDP = 24

beds)

MD Beds (SD = 24 & 28 beds)


Places

Consult Rooms AHFG Difference Notes TGFA m2 Difference m2 Comments

1 Generic Inpatient Unit 20170 20208 38 0 0 388 400 1 13 16966 2139 18648 1560

MEDICAL INPATIENT BEDS (EXCLUDING CANCER X 56 BEDS)

IPU 1 Inpatient Unit - Cardiology L4W 1178 1156 -22 24 24 1036 120

75% single bedrooms. Includes Conary Care Beds and Post Angio procedures beds. Bed room size increase is only 17m2 of the functional area, Increase is mainly a reflection of the model of care with three staff

bases and associated clean and dirty utility rooms. Largest area increase isin circulation-Corridors for improved observation and work practices. 1104 52

In a review of Inpatient facilities at the NEW RNSH, Liverpool Hospital,Fiona Stanley Hospital and the NEW RCH the area for an inpatient unit varied from as low as 907 to 1326m2 for a 24 bed IPU. The average General IPU is thus 1036m2 which is 120m2 less than GCUH. This IPU will generally be larger due to the nature of the service, corconary care requiring additional physical requirements to support the unit. It should also be noted that the percentage of single rooms is as low as 30% in some instances and may not reflect the GCUH bed configuration and model of care.

IPU 2 Inpatient Unit - General Medical L5W 1048 1103 55 24 24 920 183

75% single bedrooms.Bed room size increase is about 1.5m2 per bedroomand increase in functional area is only 1m2 of the functional area, Increase

is mainly a reflection of the model of care with three staff bases and associated clean and dirty utility rooms. Largest area increase is in

circulation, 49m2, Corridors for improved observation and work practices. 1052 51

In a review of Inpatient facilities at the NEW RNSH, Liverpool Hospital,Fiona Stanley Hospital and the NEW RCH the area for an inpatient unit varied from as low as 878 to 1301m2 for a 24 bed IPU. The average IPU is thus 1052m2 which is only 51m2 less than GCUH. It should also be noted that the percentage of single rooms is as low as 46% in some instances.

IPU 3 Inpatient Unit - Infectious Disease MCB 5N 1148 1214 66 24 24 972 242

100% single bedrooms.Bed room size increase is about 1.5m2 per bedroom and increase in functional area is only 47m2 of the functional

area, Increase is mainly a reflection of the model of care with three staff bases and associated clean and dirty utility rooms. Largest area increase is

in circulation, 62m2, Corridors for improved observation and work practices. 1134 80

This area has higher level of single bedrooms compared to the NEW RNSH, Liverpool Hospital, NEW RCH.

IPU 4 Inpatient Unit - Medical Assessment Unit LLGW 1295 1138 -157 28 28 1 4 1052 86

100% single bedrooms.Bed room size increase is about 1.5m2 per bedroom and increase in functional area is only 47m2 of the functional




IPU 5 Inpatient Unit - Neurology L5S 1076 1224 148 24 28 1052 172

64% Single Bedrooms. Bed room size increase is about 1.5m2 per bedroom and increase in functional area is only 32m2 of the functional



This area includes Class N room x 1 and Chest Pain Evaluation Rooms x 10. Includes RAPID REVIEW/PROCEDURAL AREA. Co-located with Emergency Department. Mix of single/mulibed rooms only

IPU 6 Inpatient Unit - Renal Medicine L3S 1111 1267 156 24 28 1052 215



circulation, 56m2, Corridors for improved observation and work practices. 1192 75This area is slightly smaller than the benchmarks from the New RNSHLiverpool Hospital and Fiona Stanley Hospital.

IPU 7 Inpatient Unit - Respiratory Medical L5W 1048 1103 55 24 24 920 183

75% single bedrooms. Increase is mainly a reflection of the model of carewith three staff bases and associated clean and dirty utility rooms. Largest area increase is in circulation, 100m2, Corridors for improved observation

and work practices. 1052 51This area is slightly larger than the benchmarks because it includes Class N isolation rooms x 2 & Store for Renal Fluids.

SURGICAL INPATIENT BEDS

IPU 8 Inpatient Unit - Orthopaedic Surgery (Elective) L6S 1058 1211 153 24 28 1052 159




In a review of Inpatient facilities at the NEW RNSH, Liverpool Hospital,Fiona Stanley Hospital and the NEW RCH the area for an inpatient unit varied from as low as 878 to 1301m2 for a 24 bed IPU and 950 to 1290 . The average IPU is thus 1052m2 which is only 159m2 less thanGCUH. It should also be noted that the percentage of single rooms is as low as 46% in some instances.

IPU 9 Inpatient Unit - Orthopaedic/Trauma Surgery L6S 1058 1211 153 24 28 1052 159





IPU 10

Inpatient Unit - Gastrointestinal Surgery (includes Colo-rectal) L2S 1094 1211 117 24 28 1052 159





IPU 11 Inpatient Unit - Short-stay Surgical L2S 1048 1211 163 24 28 1052 159



circulation, 51m2, Corridors for improved observation and work practices. 1120 91The area is slightly larger because it also includes a larger equipment store.

IPU 12 Inpatient Unit - Neurosurgery L4S 1048 1211 163 24 28 1052 159



circulation, 51m2, Corridors for improved observation and work practices. 1120 91The area is slightly larger because it also includes a larger equipment store.

IPU 13 Inpatient Unit - ENT/Eye/MF/Plastics L4S 1048 1211 163 24 28 1052 159

75% single bedrooms.Bed room size increase is about 1.5m2 per bedroomand increase in functional area is only 11m2 of the functional area,

Increase is mainly a reflection of the model of care with three staff bases and associated clean and dirty utility rooms. Largest area increase is in

circulation, 53m2, Corridors for improved observation and work practices. The Stomal Therapy Consult area is included in this IPU, an additional

24m2. 1120 91

IPU 14 Inpatient Unit - Uro/Gynae/Breast 1048 0 -1048 24 0

IPU 15 Inpatient Unit - Vascular Surgery L3S 1048 1211 163 24 28 1052 159





IPU 16 Inpatient Unit - Cardiothoracic Surgery L4W 1048 1103 55

f

24 24 920 -920





SHARED AREAS PER LEVEL

Level Lower Ground LLGW 125 155 30 106 49 Model of Care, with mainly the inclusion of multipurpose allied health room. 320 -165

The shared areas vary from each tertiary hospital based on varyingconfigurations and to reflect the model of care. On some projects the education and training areas are centralized rather then integrated across the facility.

Level 2 MCB 2 492 258 -234f

2 196 62

Model of Care with the inclusion of larger teaching and education areas for the tertiary facility, clinical education & tutorial rooms and multi-purpose /distressed relatives rooms 320 -62 This area also includes Social Work Offices

Level 3 MCB 3 521 391 -130 2 215 176

Model of Care with the inclusion of larger teaching and education areas for the tertiary facility, clinical education & tutorial rooms and multi-purpose /distressed relatives rooms 320 71

The shared areas vary from each tertiary hospital based on varyingconfigurations and to reflect the model of care. On some projects the education and training areas are centralized rather then integrated across the facility.

Level 4 CSB4 635 638 3 1 384 254

Model of Care with the inclusion of larger teaching and education areas forthe tertiary facility, clinical education & tutorial rooms and multi-

purpose/distressed relatives rooms 320 318

The shared areas vary from each tertiary hospital based on varying configurations and to reflect the model of care. On some projects the education and training areas are centralized rather then integrated across the facility.

Level 5 MCB 5 347 504 157 2 562 -58



The shared areas vary from each tertiary hospital based on varyingconfigurations and to reflect the model of care. On some projects the education and training areas are centralised rather then integrated across the facility.

Level 6 MCB 6 648 477 -171 2 215 262




2 Education & Research 4011 3871 140 0 0 0 0 0 0 1217 2654 4125 -254Education 2075 2109 34 1217 2654Education Administration 1116 414 -702Library 418 418 0Clinical Placement Unit & Student Amenities 283 195 -88Medical Illustration/Photograpy & Reprographics.Clinical Photography 119 119 0

Shared Areas 616Research 0 0 0 Wet Research provided by University & Separate funding.

3 Division of Medicine 24414 23416 -998 14 97 68 76 115 115 19515 1163 22887 -43

Planning Units Location

Total Gross

Functional Area M2

PDP

Total GFA M2

Schematic Design

(Briefed)

Difference

Beds/ Treatment Places Comparison with Australia Health Facility Guidelines Benchmarking

4125 -254

The education area is in alignment with other planned tertiary hospitalssuch as the New RNSH, NEW RCH and Fiona Stanley Hospital, It is slightly below the others due to the ability to sharing areas with Griffith University (3358m2, 4548m2 and 4471m2).

3435001_1.xls 19/09/2008 2 of 5.



MD Beds (PDP = 24

beds)



Places




Total Gross

Functional Area M2

PDP

Total GFA M2

Schematic Design

(Briefed)

Difference


3.1 Internal MedicineSleep Studies MCB 5 263 280 17 4 0 280 385 -105

Renal Medicine (Clinical Admin) MCB 3

Included in Medical Offices 293 293

Acute Dialysis Unit CSB 3 942 729 -213 16 3 800 222 708 314

Day Medical Beds MCB L1 648 610 -38 14 2 601 9

Small increase largely around the provision of larger procedure/treatment rooms to enable greater flexibility of use and in alignment with the service

plan and model of care. 701 -91This area is smaller than a benchmark based on the new RNSH, Liverpool Hospital and Fiona Stanley Hospital

Infection Control (Offices) P& E B L2 252 252 0

3.2 Ambulatory Services & OPD MCB L1 6452 6072 -380 13 80 5043 1029

The differences are mainly around the number of consult/examination rooms that are not clearly specified within the AHFG's. Allowances have been made for bariatric patients and thus facilities. The development of

generic pods of 8 consult/exam rooms within clusters of two pods sharing support areas. The development of clinical measurement areas specific to

a number of the clinical functions and thus not covered by the AHFG's. Theinclusion of a pathology collection area, oral/dental services, satellite

radiology, 5808 264

This area includes 80 C/R, including -ve Pressure room x 1, TreatmentRooms x 10, Plaster Rooms x 2 and Clinical Measurement as listed and Nurse Practitioners. In terms of benchmarking the area is slightly higher but it is differcult to determine the what is included in each facility.

3.3 Comprehensive Cancer Service 0 0

IPU 17 Inpatient Unit - Cancer L1S 1025 1134 109 24 28 1062 72

75% single bedrooms.Bed room size increase is about 1.5m2 per bedroomand increase in functional area is only 46m2 of the functional area, larger

for specialised rooms for immuno-comprised/bone marrow transplant patients. Increase is mainly a reflection of the model of care with three stafbases and associated clean and dirty utility rooms. Largest area increase is

in circulation, 61m2, Corridors for improved observation and work practices. 1288 -154

This area is only slightly larger than the benchmark and has higher percentage of single rooms than the New RNSH and Liverpool Hospital projects. It also includes +ve pressure rooms x 4

IPU 18 Inpatient Unit - Cancer L1S 1049 1152 103 24 28 1062 90





Shared areas - Inpatient Units L1S 468 355 -113

Day Oncology/Haematology LGS 832 813 -19 29 754 59





OPD LGS 905 961 56 30 855 106




This area is only slightly larger than the benchmark and has higher percentage of single rooms than the New RNSH and Liverpool Hospital projects. It also includes Lead-lined rooms x 2, -ve pressure rooms x 2 & Palliative Care Beds x 6

Shared areas Day Oncology/OPD + Palliative care Outreach Services LGS 799 716 -83 585 131

The inclusion of Patient Education, internet and Complimentary Therapiesarea and support areas which is not covered by the AHFG's but in

alignment with Comprehensive cancer care services and the model of care. 800 -84 Shared Support areas for day Oncology and Cancer ambulatory care.

Radiotherapy LLLGS 2816 2171 -645 6 1667 -1667 There is no AHFG for Radiation Oncology. 2382 -211The area is only slightly larger than the benchmark and area hasLinacs x 2, Brachytherapy x 1 ( 3 Bunkers)

Clinical Administration LLGS 692 673 -19 585 88

The inclusion of Patient Education, internet and Complimentary Therapiesarea and support areas which is not covered by the AHFG's but in

alignment with Comprehensive cancer care services and the model of care. 0 673 Shared Support areas for day Oncology and Cancer ambulatory care.

3.4 Cardiology Diagnostics, including Clinical Measurement & StressTesting 11 1Cardiac Catheter Labs 18 4

Clinical Administration

3.5 Emergency MedicineEmergency Department 59Sexual Assault UnitChild Protection Unit

Short-stay Observation Unit LLGW 442 498 56 20 20 1Clinical Administration MCB LG 933 892 -41

3.5 OthersDischarge ServicesACIEM

Day of Discharge/Transit LoungeBasement

Level S 479 533 54 30 1 374 159 302 2313.7 Division of Medicine

Clinical Service/Business Unit (C/A) MCB 5N 383 148 -235 0 148 120 28 Office Accom/Store areas

4 Division of Surgery & Critical Care 15976 15997 21 40 0 50 50 39 11 13159 2838 14376 16214.1 Department of Anaesthetics

Anaesthetic & Pain Mgt Offices MCB 3N 1362 1043 -319 1246 -203Additional offices in alignment with staffing profile and not covered in

AHFG.. 0 1043 Generally included with Clinical administration areas

Pain Management OPD MCB G 236 329 93 f 1 194 135 250 79 This area is in alignment with other tertiary level hospitals.

4.2 Infusion Therapy ServicesIV Infusion Therapy Service MCB 4S 85 85 0 84 1 0 85 tertiary level hospitals.

4.3 Intensive Care

ICU/HDU MCB 4 5075 5100 25 50 50 4087 1013

The ICU has more bed bays then the AHFG and room size is based on 25m2 in lieu of 20m2. There is additional support areas in alignment with the

model of care. Some areas are not covered by the AHFG, including pathology bays, pneumatic tube stations, computer server room and

interview rooms. 4954 146 This area is in alignment with other tertiary level hospitals.

4.4 Interventional Suite MCB 2Angiography MCB 2N 2Endoscopy MCB 2S 4Intraoperative MRI MCB 2N 1Perioperative servicesOperating Suite MCB 2 20Post-anaesthetic Care Unit MCB 2Same Day Accommodation MCB 2 40 Number to be confirmed. Includes Paeds Surgical Day StayDOSA & Day Surgery Admissions MCB 2 10Change Room MCB 3Preadmission clinic, Bookings Centre, Referral Centre Included in 3.2

4.5 CSD MCB 3 875 917 42 575 342

The area increase is based on a number of support areas not being within the AHFG for an large tertiary hospital CSD. Additional sorting and prep

areas, trolley areas, stores and sterile stock. 950 -33 This area is in alignment with other tertiary level hospitals.

4.6 Ambulatory Care Included in 3.2Vascular - Vascular Laboratory / Clinical Admin Offices MCB LG

Included in 3.2 180 180 2 120 60 0 180

4.7 Division of Surgery & Critical Care

Clinical Service/Business Unit (C/A) CSB 2 3.7 179 179 120 59 150 29

5 Division of Family, Women & Children 12777 14018 -278 20 0 124 124 26 39 9809 2690 11499 10005.1 Maternity Services

IPU 19 & 20 Inpatient Unit - Maternity Services L3W 2377 2323 -54 48 48 1956 367

75% single bedrooms. With the room size being based on 18m2 based on the model of care and service plan.

Birth Suite L2W 12

The increase is largely a result of the model of care with the inclusion of a birth centre, high acuity birth rooms, and additional support areas which is

not covered by the AHFG's.Birth Centre 6Ante-natal Assessment Clinic L2W 10 2

MCB 4N 1687 1709 22

MCB LG ncluded in 7.

MCB LG3347 3425 78

5

2030 2148 118

8343 8164 -179

1678

This area is in alignment with other tertiary level hospitals. Expansion zone x 2 ORs x 500m2

8072 92

This area is in alignment with other tertiary level hospitals. Includes 5 Transitional Care Unit and Includes 12 D/S (2 being HDU) and 4 Birth Centre4404 67

1622 87

This area is in alignment with other planned tertiary hospitals in Australia. It includes ECHO, Stress ECHOs, TOE, Holter monitoring, Exercise Stress Testing, ECG, Pacemaker.CCL x 3 & TOE Room x 1, RR x 12 places. Plus expansion for CCL/CT Scan x 1 of 200m2

4450 365

This area is in alignment with benchmarking based on the New RNSHFiona Stanley and recently completed Emergency units at Liverpool and RM hospitals.

The area has increases within the operating theatre sizes being 55m2 in lieu of the 42 and 52 m2 within the AHFG. Sterile stock rooms have been

provided to improve work flows and operational efficiency, this is not covered in the AHFG. Increased offices in accordance with current staffing

and projected staffing levels.

470

1323 386The largest difference is circulation, additional 63m2, with largest functiona

area difference being due to the absence of a AHFG for specific areas within tertiary level cardiology services, particularly around procedural

areas such as cardiac catheter suites and TOE procedure rooms and the associated support areas.

3706 1109The area differential between is largely around the functional areas to mee

the projected demand in Emergency and not covered by the AHFG. In alignment with the model of care and the streaming of patients the 77

place unit has increased triage areas, meeting areas, resuscitation bays and treatment areas to meet the health service plan.

6733 1431

3435001_1.xls 19/09/2008 3 of 5.



MD Beds (PDP = 24

beds)



Places




Total Gross

Functional Area M2

PDP

Total GFA M2

Schematic Design

(Briefed)

Difference


Clinical Administration L1W 298

Included in 5.4 Shared

Areas -298

5.2 Neonatal Intensive Care L3 2502 2473 -29 44 44 1961 512

The increased area is largely related to the model of care with additionastaff stations an thus additional support areas to improve operational

efficiency. 2182 291This area is in alignment with other tertiary level hospitals and includes14 NICU, SCN x 30 cots plus expansion to 48 cots

5.3 Paediatric Services

IPU 21 Inpatient - Paediatric & Day Stay LGW2299 2269

-30 10 32 32 2132137

1943326

Paediatric OPD/Allied Health MCB GN

1433 1416 -17 20 769 647

The increased area is largely based on the model of care with larger area for specilaised services that are generally not covered by the AHFG's such

as Generic services, Pathology collection, integrated waiting and staff support areas.

1250 166

In alignment with benchmark based on the number of consulting rooms provided -Victorian area benchmarks.

5.4 FWC - OPD & Ambulatory ServicesAnte-natal Clinic 10 769 152 1000 -79Qld Genetic Counselling 1Fetal -Maternal Assessment Clinic Assessment Unit 4NeonatologyGynaecology/Gyn Oncology 2 6

Early Assessment Pregnancy Clinic 2

Shared AreasL1W

534 616 82 345 271The additional areas is largely focused around the provision of clinical

education and research areas within the ambulatory care areas. 320 296


6 Division of Mental Health & ATODS 7336 5817 -1519 0 0 72 72 0 0 5807 10 5895 -78

Adult Inpt Unit MHU 6402 5817 -585 72 72 5807 10The additional area related to the provision of 4 18 bed units in lieu of 3 24

bed units. 5895 -78

Area is in alignment with other mental health facilities benchmarks.The larger area is a result of the inclusion of a ECT, Clinical Administration, Consultation Liaison & Research

Alcohol Tobacco and Other Drugs service 934 0 -934 0

7 Division of CARAS 7342 7359 -1533 0 0 48 28 99 10 5791 -1759 6502 -6927.1 Allied Health MCB G 1767 1747 -20

Allied Health Management Hub MCB G 173 173 0

Aids & Equipment (Loan)Basement

LS 267 261 -6 Not covered in the AHFG's The area is only slightly less than the benchmark.

7.2 Community HealthHealth Promotion Unit MCB G Included in 10.2 Locate in/near Front Entry

7.4 Rehabilitation, Aged and Palliative Care Services

Inpatient Unit - Acute Rehabilitation - Neuro L5S

1265 1352

87 24 28 1052 300

100% single bedrooms.Bed room size increase is about 1.5m2 perbedroom and increase in functional area is only 47m2 of the functional




IPU 23 Inpatient Unit - Acute Rehabilitation - Ortho 1253 0 -1253 24 o

Therapy Areas MCB 5 1879 1566 -313 28 6 2045 -2045 1961 -183The area is slightly above the benchmark from other tertiary hospitalscurrently planned.

Shared area per 48 Beds, Day/Inpt Therapy Areas MCB 5 230 212 -18Clinical Administration MCB 5 170 151 -19 170 -170 0 170 Generally included in allied health offices.Palliative Care Services Included in Comprehensive Cancer Services - 3.2

7.5 HomeLink Services

Community Hospital Interface Program (CHIP) 113 216The increase is largely a result of the inclusion of education and training

rooms to reflect the model of care and which are not in the AHFG's 320 9 In alignment with BenchmarkTransitional Care 170 159 0 329 Generally included in allied health offices.

8 Division of Medical Services 5847 5964 117 0 0 0 0 28 0 3106 2453 5143 416

8.1 Medical ImagingBone Densitometry 1CT 3Fluoroscopy 1General Rooms 3Mammography 1MRI 2Nuclear Medicine 2OPG 1PET 1Ultrasound 6

MID - ED Zone MCB LG 406 405 -1 5

8.2 Pharmacy Main Pharmacy MCB LG 1085 1131 46 1148 -17 1042 89 The area is in accordance to current benchmarks

Production Unit MCB LG 264 211 -53 0 211Not covered by the AHFG's.But required to for a comprehensive cancer

care service. 281 -70 The area is in accordance to current benchmarks

9 Division of Pathology 4612 5039 -159 0 0 0 0 8 0 1622 4049 6360 -1907

9.1 PathologyPath

Builbing 3966 3854 -112 1201 3652This pathology department is a district wide service and large portions of

the department are not covered by the AHFG's 5994 -2140

The area is smaller than the benchmark as the pathology in the otherfacilities are for a region/area-wide pathology service including their research facilities.

Shared Areas-Due to separate Building requirements 586 0

9.2 MortuaryPath

Builbing - B 646 599 -47 421 397

This facility includes area such as observation gallery, isolation rooms and resource rooms which are required for cronial inquests and education.

These areas are not with the AHFG's 366 233 The area is larger as it contains cronial inquest and educational areas.

10 Corporate Services, Amenities and Retail 18305 16236 -2069 0 0 0 0 0 0 3306 12335 16318 -82

10.1 District & Hospital Administration 2192 639 -1553450

189The differences are mainly a result of the inclusion of the clinical education

and research areas that are not part of the AHFG's 800 -161In alignment with New RNSH and Fiona Stanley Hospitals.This are also incudes some of the anaesthetics and Pain Management offices.

District Manager Off-siteBoardroom MCB 6Diivision of Corporate ServicesPlanning & Development UnitDistrict - Management (Hotdesks) MCB 6

Disaster Services/ManagementP&E + MCB

LGNDivision of Medical AdministrationMedico-legalMedical appointments MCB 6Division of Medical Administration Off-siteDivision of Nursing & Midwifery Services MCB 6Division of Teaching & Research MCB 6Nursing Support Services MCB 6Bed ManagementClinical Resources Coord.Nursing Workforce Planning & Develop MCB 6Administration - GCUHMedical Typists Off-site

Fundraising & Foundation Services MCB 6 0 341 This area is not covered by the AHFG's 222 119 The area is above the benmark but also conatins foundation facilitiesFoundation Retail MCB G

Volunteer Services MCB GInterpreter Services Off-siteService Improvement UnitCULT LiaisionPatient LiaisonPatient SafetyQuality & Risk ManagementPublic RelationsCommunity & Consumer Advisory Service

10.2 Operational ServicesOperational ServicesMail RoomSatellite Operational Services 176 176 0 0 176 This area is not covered by the AHFG's 176Cleaning & Waste Management 606 702 96 90 612 VIC HFG. 457 245 The area is in accordance to current benchmarks

-35

L1W 348 333 -15

L1W 956 921

MCB LG 338 329 9

MCB LG 4092 4217 125

Off-site

Off-site

MCB G

341 341 0

Off-site

Off-site

MCG B

422 434 12

The additional area is largely related to the increased number of consult rooms and thus the increased support areas and circulation compared to

the AHFG.. 400 -67

397

The area is larger because it includes medical imaging that is located with Emergency and the Ambulatory care area.

0 This area is not covered by the AHFG'sThis area is slightly above above the current benchmarks but this is primary due to how this area is recorded in the various tertiary hospitals.In general it is in alignment with other facilities.

434 494 -60

1958 2259 3820

2241 -60 3087

The additional areas is focused around support areas and the provision of clinical education, tutorial rooms, allied health rooms, volunteer room and

larger bedrooms to enable rooming in for family and carers.

This area is slightly above other tertiary level hospitals as it incorporates educational and allied health services for paeds and Includes shared areas. Thus it is generally in alignment with other tertiary hospitals who provide a networked Paediatric service.


The increased area is largely based on the model of care with larger areafor specilaised services that are generally not covered by the AHFG's such

as Generic services, Pathology collection, integrated waiting and staff support areas.


-906

199

134

3435001_1.xls 19/09/2008 4 of 5.



MD Beds (PDP = 24

beds)



Places




Total Gross

Functional Area M2

PDP

Total GFA M2

Schematic Design

(Briefed)

Difference


Linen Services 244 209 -35 267 -58 450 -241 The area is in accordance to current benchmarksLoading Dock 475 475 0

10.3 Hospital Co-ordination & Public AreasMain Foyer MCB G 267 267 0Operation Co-ordination Centre MCB G 452Central Admissions MCB GRevenue Services MCB GRetail/ Coffee Shop MCB G 1118 1118 0

10.4 Pastoral Care ServicesChaplaincySpiritual Meditation Unit

10.5 Staff AmenitiesCentral Staff Amenities MCB B 271 194 -77 187 -60 VIC HFG-level 4 only.Decentralised Staff Amenities MCB B 36 0 -36 0 0Staff Health Promotion This area is not covered by the AHFG'sGymnasium

Function Rooms CSB 6 187 175 -12 0 175 This area is not covered by the AHFG's 0 175 Included in the education area in other facilities.Staff on-call accommodationSenior Medical StaffRMO Facilities

10.6 Facilities ManagementFacility Management & Building Engineering & ManagementEngineering Services 926 926 0 197 729 1110 -184 In alignment with current planned tertiary facilities.

PABX ,Switchboard, MATV MCB LG & G

Security MCB LG & G Included in 4.1 & 10.3 In alignment with current planned tertiary facilities.

10.7 Food ServicesKitchen MCB G 1388 1388 0 369 1019 VIC HFG-level 4 only. 1355 33 In alignment with current planned tertiary facilities.Public/Staff Cafeteria MCB G 1165 1165 0 450 715 950 215

10.8 District Technology Services

Information Technology MCB 6 1078 926 -152 0 926 1237 -311In alignment with other planned tertiary hospitals who provide a staffand public cafeteria areas.

Patient Information Management Services 0 0 207 -207In alignment with other facilities where IT is centralised for areas orregions.

10.90 Materials Management

Supply Depart MCB B 519 519 0 320 199 VIC HFG-level 4 only. 633 -114

Supply is slightly below other tertiary facilities but this does not reflectthe change to distribution centres. Thus the area is in alignment with current thinking.

Clinical Resource Unit - Equipment/Bed Store MCB B 345 345 0 150 195 VIC HFG-level 4 only. 300 4510.1 Clinical Information Unit

Clinical Information Unit (Medical Records)MCB 1N 575 575 0 758 -183 VIC HFG 600 -25

This area is currently under review in most tertiary hospital with the transition to electronic medical records. The area is in alignment with other planned facilities in australia.

Decision Support0 387 421 -34

The area is slightly less than benchmark but bascialy in alignment with benchmarks from other tertiary Hospitals.

Casemix

10.12 District Finance Service

Finance Services (District) Off-site Included in 10.1Payroll Off-siteHuman Resource Management (District) Off-site

Occupational Health & Safety MCB LG 428 398 -30 0 345 429 =The area is slightly less than benchmark but basically in alignment withbenchmarks from New RNSH and Liverpool Hospital.

10.13 Biomecical Technology Services

Biomedical Engineering MCB G 818 818 0 0 818 799 19In alignment with other tertiary hospital that provides these services tothe hospital and the district.

11.0 Medical Offices - Medical & Surgical Divisions

Clinical Service/Business Unit CSB 3045 0 -3045Clinical Service/Business Unit CSB 2 637 637Clinical Service/Business Unit CSB 4 633 633

Clinical Service/Business Unit MCB 4N 134 134Clinical Service/Business Unit CSB 5 925 925Clinical Service/Business Unit CSB 6 300 300

Total 120790 118109 -2681 74 97 750 750 316 188 111753 6356Travel Level 6 Hospital = 16% 19326 18580 -746Plant Level 6 Hospital = 17% / 21% 23820 27673 3853

Plus Atrium (estimated) 1064 -1064Total Gross Area 165000 164362 -638

AREA ALLOWANCE8 Division of Medical Services

Cyclotron 500

EXPANSION ZONES3 Division of Medicine

Cardiac Catheter Labs 200 4 14 Division of Surgery & Critical Care

Operating Suite 500 25 Division of Family, Women & Children

NICU 420 5 510 Corporate Services, Amenities and Retail

Clinical Information Unit (Medical Records) 1000Total (Expansion Zones) 2120Travel Level 6 Hospital = 16% 339Plant Level 6 Hospital = 17% 418Total Gross Area 2877 0 4 5 5 3 0

LocationsMCB Main Clinical Building

CSB Clinical Services Building (Offices)

P & E Pathology & Education Building

W Inpatient Builfding - West wing (FW&C Building)S Inpatient Builfding - Southt wing (Cancer Servces Building)

626 174

MCB 5 500 388 -112

MCB G 180 180

236 72

0

CEP

MCB 1N 387 387 0

MCB 5 164

0 2629

388 540

-71

0

Larger than other facilities but may be due to definition of what is included. Included staff recreational areas.

378In alignment with other tertiary hospitals and containns accessible toilets located throughout the facility

2700

-184Part of the areais included in other sections. Generally area is within benchmark limitations.

-184

322

-1520

0 236 This are is not covered by the AHFG's

50This area is slightly larger as it contains the chapel, which is some facilities already exists.

227

This area is generally not covered by the AHFG's for retail areas, Health promotion etc,.

68 112 This area is not covered by the AHFG's 130

2011 1784The area is in accordance to current benchmarks

3435001_1.xls 19/09/2008 5 of 5.


September 2008


F Financial model inputs and results 21 pages

COMMERCIAL IN CONFIDENCEQueensland HealthGold Coast HospitalGovernment Benchmark ModelInputs - Construction

Dates

Period start date 1-Jun-07 1-Jul-07 1-Aug-07 1-Sep-07 1-Oct-07 1-Nov-07 1-Dec-07 1-Jan-08 1-Feb-08 1-Mar-08Period end date 30-Jun-07 31-Jul-07 31-Aug-07 30-Sep-07 31-Oct-07 30-Nov-07 31-Dec-07 31-Jan-08 29-Feb-08 31-Mar-08Days in period 30 31 31 30 31 30 31 31 29 31Non-contractor construction phase TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUEContractor construction phase FALSE FALSE FALSE FALSE FALSE FALSE FALSE FALSE FALSE FALSE

Dates and timing inputs

Contract Close 1-Jun-07 Input start of monthBase date - capital costs 1-Jul-08Base date - operating and lifecycle costs 1-Jul-07Net Present Cost Date 1-Jul-08

Construction commencement date for Contractor costs 1-Oct-08Construction period 56 monthsConstruction completion 30-Jun-13Operations (FM) commencement date 1-Jan-13Operations (FM) term 20 yearsOperations end 31-Dec-32

Months in year 12Financial year month end month number 6Days in year 365

Base model or Reference data 1

Indexation and discount ratesNote: Please insert annual rate applying during the period.

Indexation rates pre first model periodNot in use Base date

No indexation 0.00% Capital cost base dateCPI 0.00% Capital cost base dateBPI - Construction 2007/2008 0.00% Capital cost base dateBPI - Construction 2008/2009 0.00% Capital cost base dateOperating Cost 0.00% Operating cost base dateEmployee Cost 0.00% Operating cost base dateLifecycle Cost 0.00% Capital cost base dateQH & FF&E 0.00% Capital cost base dateNon-labour operating cost (per QH) 0.00% Capital cost base date

Indexation rates following first model period

No indexation A Capital cost base date 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%CPI B Capital cost base date 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50%BPI - Construction C Capital cost base date 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%Operating Cost D Operating cost base date 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50%Employee Cost E Operating cost base date 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00%Lifecycle Cost F Capital cost base date 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50%QH & FF&E G Capital cost base date 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%Non-labour operating cost (per QH) H Capital cost base date 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20%

Nominal discount rate 6.50%

S curvesColumn counter for s-curve 8 9 10 11 12 13 14 15 16 17

Construction A 1 TRUE 100% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%Novated Professional Fees B 2 TRUE 100% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%QH Professional Fees C 3 TRUE 100% 0.60% 2.68% 3.31% 3.31% 3.31% 3.31% 3.31% 3.31% 3.31% 3.31%QH Costs D 4 TRUE 100% 0.79% 0.15% 0.15% 0.32% 0.47% 0.47% 0.47% 0.47% 0.47% 0.47%Statutory Fees E 5 TRUE 100% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%FF&E F 6 TRUE 100% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%Public Artwork G 7 TRUE 100% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%

080919 Final Business Case Model_App E.xls.xls 1

COMMERCIAL IN CONFIDENCEPeriod start date 1-Jun-07 1-Jul-07 1-Aug-07 1-Sep-07 1-Oct-07 1-Nov-07 1-Dec-07 1-Jan-08 1-Feb-08 1-Mar-08Period end date 30-Jun-07 31-Jul-07 31-Aug-07 30-Sep-07 31-Oct-07 30-Nov-07 31-Dec-07 31-Jan-08 29-Feb-08 31-Mar-08Days in period 30 31 31 30 31 30 31 31 29 31

Site acquisition H 8 TRUE 100% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%Surrounding Infrastructure I 9 TRUE 100% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%Medical School J 10 TRUE 100% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%

Input costsPlease enter costs as a positive and revenue as a negative in $s.

Capital costs - Contractor

Generic Inpatient Unit Indexation Sub-category S-curveTrade costs C - BPI - ConstrucConstruction costs A - Construction 1 80678112.5 83,704,442 0 0 0 0 0 0 0 0 0 0Managing Contractor's Fees C - BPI - ConstrucConstruction costs A - Construction 1 16135622.5 27,807,799 0 0 0 0 0 0 0 0 0 0Professional Fees - Novated to Contractor (5%) C - BPI - ConstrucProfessional fees B - Novated Profe 2 5038379.72 8,697,622 0 0 0 0 0 0 0 0 0 0Statutory Fees, headworks etc C - BPI - ConstrucStatutory Fees E - Statutory Fees 5 806781.125 612,270 0 0 0 0 0 0 0 0 0 0FF & E G - QH & FF&E FF & E F - FF&E 6 13002010 13,898,231 0 0 0 0 0 0 0 0 0 0TOTAL Generic Inpatient Unit 115660906 134,720,365 0 0 0 0 0 0 0 0 0 0

Education & Research Indexation Sub-category S-curveTrade costs C - BPI - ConstrucConstruction costs A - Construction 1 14489897.7 13,808,980 0 0 0 0 0 0 0 0 0 0Managing Contractor's Fees C - BPI - ConstrucConstruction costs A - Construction 1 2897979.54 4,587,538 0 0 0 0 0 0 0 0 0 0Professional Fees - Novated to Contractor (5%) C - BPI - ConstrucProfessional fees B - Novated Profe 2 904899.785 1,434,874 0 0 0 0 0 0 0 0 0 0Statutory Fees, headworks etc C - BPI - ConstrucStatutory Fees E - Statutory Fees 5 144898.977 101,008 0 0 0 0 0 0 0 0 0 0FF & E G - QH & FF&E FF & E F - FF&E 6 3278368 1,379,532 0 0 0 0 0 0 0 0 0 0TOTAL Education & Research 21716044 21,311,932 0 0 0 0 0 0 0 0 0 0

Division of Medicine Indexation Sub-category S-curveTrade costs C - BPI - ConstrucConstruction costs A - Construction 1 108946918 94,718,789 0 0 0 0 0 0 0 0 0 0Managing Contractor's Fees C - BPI - ConstrucConstruction costs A - Construction 1 21789383.7 31,466,921 0 0 0 0 0 0 0 0 0 0Professional Fees - Novated to Contractor (5%) C - BPI - ConstrucProfessional fees B - Novated Profe 2 6803777.72 9,842,109 0 0 0 0 0 0 0 0 0 0Statutory Fees, headworks etc C - BPI - ConstrucStatutory Fees E - Statutory Fees 5 1089469.18 692,836 0 0 0 0 0 0 0 0 0 0FF & E G - QH & FF&E FF & E F - FF&E 6 45497539 47,644,069 0 0 0 0 0 0 0 0 0 0TOTAL Division of Medicine 184127088 184,364,725 0 0 0 0 0 0 0 0 0 0

Division of Surgery & Critical Care Indexation Sub-category S-curveTrade costs C - BPI - ConstrucConstruction costs A - Construction 1 72226278.4 68,618,884 0 0 0 0 0 0 0 0 0 0Managing Contractor's Fees C - BPI - ConstrucConstruction costs A - Construction 1 14445255.7 22,796,163 0 0 0 0 0 0 0 0 0 0Professional Fees - Novated to Contractor (5%) C - BPI - ConstrucProfessional fees B - Novated Profe 2 4510559.37 7,130,101 0 0 0 0 0 0 0 0 0 0Statutory Fees, headworks etc C - BPI - ConstrucStatutory Fees E - Statutory Fees 5 722262.784 501,924 0 0 0 0 0 0 0 0 0 0FF & E G - QH & FF&E FF & E F - FF&E 6 30567632.3 29,334,732 0 0 0 0 0 0 0 0 0 0TOTAL Division of Surgery & Critical Care 122471988 128,381,804 0 0 0 0 0 0 0 0 0 0

Division of Family, Women & Children Indexation Sub-category S-curveTrade costs C - BPI - ConstrucConstruction costs A - Construction 1 48385167.6 55,553,755 0 0 0 0 0 0 0 0 0 0Managing Contractor's Fees C - BPI - ConstrucConstruction costs A - Construction 1 9677033.51 18,455,743 0 0 0 0 0 0 0 0 0 0Professional Fees - Novated to Contractor (5%) C - BPI - ConstrucProfessional fees B - Novated Profe 2 3021672.66 5,772,520 0 0 0 0 0 0 0 0 0 0Statutory Fees, headworks etc C - BPI - ConstrucStatutory Fees E - Statutory Fees 5 483851.676 406,357 0 0 0 0 0 0 0 0 0 0FF & E G - QH & FF&E FF & E F - FF&E 6 14743961 6,376,166 0 0 0 0 0 0 0 0 0 0TOTAL Division of Family, Women & Children 76311686.4 86,564,540 0 0 0 0 0 0 0 0 0 0

Division of Mental Health & ATODS Indexation Sub-category S-curveTrade costs C - BPI - ConstrucConstruction costs A - Construction 1 24204559.4 19,409,700 0 0 0 0 0 0 0 0 0 0Managing Contractor's Fees C - BPI - ConstrucConstruction costs A - Construction 1 4840911.87 6,448,177 0 0 0 0 0 0 0 0 0 0Professional Fees - Novated to Contractor (5%) C - BPI - ConstrucProfessional fees B - Novated Profe 2 1511584.21 2,016,837 0 0 0 0 0 0 0 0 0 0Statutory Fees, headworks etc C - BPI - ConstrucStatutory Fees E - Statutory Fees 5 242045.594 141,975 0 0 0 0 0 0 0 0 0 0FF & E G - QH & FF&E FF & E F - FF&E 6 2850880 2,382,413 0 0 0 0 0 0 0 0 0 0TOTAL Division of Mental Health & ATODS 33649981 30,399,103 0 0 0 0 0 0 0 0 0 0

Division of Community, Allied Health Aged & RIndexation Sub-category S-curveTrade costs C - BPI - ConstrucConstruction costs A - Construction 1 33009163.3 25,087,199 0 0 0 0 0 0 0 0 0 0Managing Contractor's Fees C - BPI - ConstrucConstruction costs A - Construction 1 6601832.66 8,334,322 0 0 0 0 0 0 0 0 0 0Professional Fees - Novated to Contractor (5%) C - BPI - ConstrucProfessional fees B - Novated Profe 2 2061435.18 2,606,779 0 0 0 0 0 0 0 0 0 0Statutory Fees, headworks etc C - BPI - ConstrucStatutory Fees E - Statutory Fees 5 330091.633 183,505 0 0 0 0 0 0 0 0 0 0FF & E G - QH & FF&E FF & E F - FF&E 6 4621405 2,155,356 0 0 0 0 0 0 0 0 0 0TOTAL Division of Community, Allied Health Aged & Rehabilitation Services 46623927.8 38,367,160 0 0 0 0 0 0 0 0 0 0



Division of Medical Services Indexation Sub-category S-curveTrade costs C - BPI - ConstrucConstruction costs A - Construction 1 25512651.8 24,645,899 0 0 0 0 0 0 0 0 0 0Managing Contractor's Fees C - BPI - ConstrucConstruction costs A - Construction 1 5102530.37 8,187,716 0 0 0 0 0 0 0 0 0 0Professional Fees - Novated to Contractor (5%) C - BPI - ConstrucProfessional fees B - Novated Profe 2 1593275.1 2,560,924 0 0 0 0 0 0 0 0 0 0Statutory Fees, headworks etc C - BPI - ConstrucStatutory Fees E - Statutory Fees 5 255126.518 180,277 0 0 0 0 0 0 0 0 0 0FF & E G - QH & FF&E FF & E F - FF&E 6 13171368 46,771,074 0 0 0 0 0 0 0 0 0 0TOTAL Division of Medical Services 45634951.8 82,345,890 0 0 0 0 0 0 0 0 0 0

Division of Pathology Indexation Sub-category S-curveTrade costs C - BPI - ConstrucConstruction costs A - Construction 1 19935537.6 24,035,879 0 0 0 0 0 0 0 0 0 0Managing Contractor's Fees C - BPI - ConstrucConstruction costs A - Construction 1 3987107.53 7,985,059 0 0 0 0 0 0 0 0 0 0Professional Fees - Novated to Contractor (5%) C - BPI - ConstrucProfessional fees B - Novated Profe 2 1244982.13 2,497,538 0 0 0 0 0 0 0 0 0 0Statutory Fees, headworks etc C - BPI - ConstrucStatutory Fees E - Statutory Fees 5 199355.376 175,814 0 0 0 0 0 0 0 0 0 0FF & E G - QH & FF&E FF & E F - FF&E 6 5198609 7,138,432 0 0 0 0 0 0 0 0 0 0TOTAL Division of Pathology 30565591.7 41,832,721 0 0 0 0 0 0 0 0 0 0

Corporate Services, Amenities and Retail Indexation Sub-category S-curveTrade costs C - BPI - ConstrucConstruction costs A - Construction 1 57293942.8 63,090,611 0 0 0 0 0 0 0 0 0 0Managing Contractor's Fees C - BPI - ConstrucConstruction costs A - Construction 1 11458788.6 20,959,593 0 0 0 0 0 0 0 0 0 0Professional Fees - Novated to Contractor (5%) C - BPI - ConstrucProfessional fees B - Novated Profe 2 3578029.17 6,555,665 0 0 0 0 0 0 0 0 0 0Statutory Fees, headworks etc C - BPI - ConstrucStatutory Fees E - Statutory Fees 5 572939.428 461,487 0 0 0 0 0 0 0 0 0 0FF & E G - QH & FF&E FF & E F - FF&E 6 10136850 10,721,977 0 0 0 0 0 0 0 0 0 0TOTAL Corporate Services, Amenities and Retail 83040550 101,789,333 0 0 0 0 0 0 0 0 0 0

Engineering and Travel Indexation Sub-category S-curveTrade costs C - BPI - ConstrucConstruction costs A - Construction 1 116605836 129,585,101 0 0 0 0 0 0 0 0 0 0Managing Contractor's Fees C - BPI - ConstrucConstruction costs A - Construction 1 23321167.2 43,050,002 0 0 0 0 0 0 0 0 0 0Professional Fees - Novated to Contractor (5%) C - BPI - ConstrucProfessional fees B - Novated Profe 2 7282080.12 13,465,023 0 0 0 0 0 0 0 0 0 0Statutory Fees, headworks etc C - BPI - ConstrucStatutory Fees E - Statutory Fees 5 1166058.36 947,872 0 0 0 0 0 0 0 0 0 0FF & E G - QH & FF&E FF & E F - FF&E 6 25431377.7 698,018 0 0 0 0 0 0 0 0 0 0TOTAL Engineering and Travel 173806519 187,746,016 0 0 0 0 0 0 0 0 0 0

Central Plant Etc Indexation Sub-category S-curveTrade costs C - BPI - ConstrucConstruction costs A - Construction 1 131605336 127,058,334 0 0 0 0 0 0 0 0 0 0Managing Contractor's Fees C - BPI - ConstrucConstruction costs A - Construction 1 26321067.2 42,210,575 0 0 0 0 0 0 0 0 0 0Professional Fees - Novated to Contractor (5%) C - BPI - ConstrucProfessional fees B - Novated Profe 2 8218804.76 13,202,470 0 0 0 0 0 0 0 0 0 0Statutory Fees, headworks etc C - BPI - ConstrucStatutory Fees E - Statutory Fees 5 1316053.36 929,389 0 0 0 0 0 0 0 0 0 0FF & E G - QH & FF&E FF & E F - FF&E 6 0 0TOTAL Central Plant Etc 167461261 183,400,768 0 0 0 0 0 0 0 0 0 0

ESD Initiatives Indexation Sub-category S-curveTrade costs C - BPI - ConstrucConstruction costs A - Construction 1 46936973.5 47,000,000 0 0 0 0 0 0 0 0 0 0Managing Contractor's Fees C - BPI - ConstrucConstruction costs A - Construction 1 9387394.69 15,614,064 0 0 0 0 0 0 0 0 0 0Professional Fees - Novated to Contractor (5%) C - BPI - ConstrucProfessional fees B - Novated Profe 2 2931232.38 4,883,710 0 0 0 0 0 0 0 0 0 0Statutory Fees, headworks etc C - BPI - ConstrucStatutory Fees E - Statutory Fees 5 469369.735 343,789 0 0 0 0 0 0 0 0 0 0FF & E G - QH & FF&E FF & E F - FF&E 6 0 0TOTAL ESD Initiatives 59724970.3 67,841,564 0 0 0 0 0 0 0 0 0 0

External Works Indexation Sub-category S-curveTrade costs C - BPI - ConstrucConstruction costs A - Construction 1 50000000 43,952,164 0 0 0 0 0 0 0 0 0 0Managing Contractor's Fees C - BPI - ConstrucConstruction costs A - Construction 1 10000000 14,601,530 0 0 0 0 0 0 0 0 0 0Professional Fees - Novated to Contractor (5%) C - BPI - ConstrucProfessional fees B - Novated Profe 2 3122519.58 4,567,013 0 0 0 0 0 0 0 0 0 0Statutory Fees, headworks etc C - BPI - ConstrucStatutory Fees E - Statutory Fees 5 500000 321,495 0 0 0 0 0 0 0 0 0 0FF & E G - QH & FF&E FF & E F - FF&E 6 0 0TOTAL External Works 63622519.6 63,442,203 0 0 0 0 0 0 0 0 0 0

Spare Indexation Sub-category S-curveSpare C - BPI - ConstrucConstruction costs A - Construction 1 0 0Spare C - BPI - ConstrucProfessional fees A - Construction 1 0 0Spare C - BPI - ConstrucStatutory Fees A - Construction 1 0 0Spare C - BPI - ConstrucFF & E A - Construction 1 0 0Spare C - BPI - ConstrucFF & E A - Construction 1 0 0Spare A - CPI A - Construction 1 0 0Spare A - CPI A - Construction 1 0 0Spare A - CPI A - Construction 1 0 0Spare A - CPI A - Construction 1 0 0Spare A - CPI A - Construction 1 0 0TOTAL Spare 0 0 0 0 0 0 0 0 0 0 0 0



Total Contractor construction costs 1224417985 1,352,508,124 0 0 0 0 0 0 0 0 0 0

Capital costs - Non-contractor

Non-contractor costs 1 Indexation Sub-category S-curveCommissioning / decanting/QH Costs G - QH & FF&E Commissioning / decaD - QH Costs 4 25000000 31,000,000 245,438 45,000 45,000 99,562 145,000 145,000 145,000 145,000 145,000 145,000Professional Fees (8%) C - BPI - ConstrucProfessional fees C - QH Profession 3 77407435.5 55,022,532 327,494 1,473,881 1,821,376 1,821,376 1,821,376 1,821,376 1,821,376 1,821,376 1,821,376 1,821,376Public Art Allowance G - QH & FF&E Commissioning / decaG - Public Artwork 7 2000000 2,000,000 0 0 0 0 0 0 0 0 0 0Site acquisition A - No indexation Commissioning / decaH - Site acquisitio 8 0 52,200,000 0 0 0 0 0 0 0 0 0 0Additional infrastructure C - BPI - ConstrucCommissioning / decaI - Surrounding Inf 9 0 62,600,000 0 0 0 0 0 0 0 0 0 0Medical and dental school C - BPI - ConstrucCommissioning / decaJ - Medical Schoo 10 0 62,600,000 0 0 0 0 0 0 0 0 0 0Category 7 A - CPI A - Construction 1 0 0Category 8 A - CPI A - Construction 1 0 0Category 9 A - CPI A - Construction 1 0 0Category 10 A - CPI A - Construction 1 0 0TOTAL Non-contractor costs 1 104407435 265,422,532 572,932 1,518,881 1,866,376 1,920,938 1,966,376 1,966,376 1,966,376 1,966,376 1,966,376 1,966,376

Non-contractor costs 2 Indexation Sub-category S-curveCategory 1 A - CPI A - Construction 1 0Category 2 A - CPI A - Construction 1 0Category 3 A - CPI A - Construction 1 0Category 4 A - CPI A - Construction 1 0Category 5 A - CPI A - Construction 1 0Category 6 A - CPI A - Construction 1 0Category 7 A - CPI A - Construction 1 0Category 8 A - CPI A - Construction 1 0Category 9 A - CPI A - Construction 1 0Category 10 A - CPI A - Construction 1 0TOTAL Non-contractor costs 2 0 0 0 0 0 0 0 0 0 0 0

Non-contractor costs 3 Indexation Sub-category S-curveCategory 1 A - CPI A - Construction 1 0Category 2 A - CPI A - Construction 1 0Category 3 A - CPI A - Construction 1 0Category 4 A - CPI A - Construction 1 0Category 5 A - CPI A - Construction 1 0Category 6 A - CPI A - Construction 1 0Category 7 A - CPI A - Construction 1 0Category 8 A - CPI A - Construction 1 0Category 9 A - CPI A - Construction 1 0Category 10 A - CPI A - Construction 1 0TOTAL Non-contractor costs 3 0 0 0 0 0 0 0 0 0 0 0

Total Non-contractor construction costs 265,422,532 572,932 1,518,881 1,866,376 1,920,938 1,966,376 1,966,376 1,966,376 1,966,376 1,966,376 1,966,376

Total construction costs (Contractor and Non-contractor) 1,617,930,656 572,932 1,518,881 1,866,376 1,920,938 1,966,376 1,966,376 1,966,376 1,966,376 1,966,376 1,966,376TRUE


COMMERCIAL IN CONFIDENCEensland Health

d Coast Hospitalernment Benchmark Model

uts - Construction

es

Period start datePeriod end dateDays in periodNon-contractor construction phaseContractor construction phase

es and timing inputs

Contract CloseBase date - capital costsBase date - operating and lifecycle costsNet Present Cost Date

Construction commencement date for Contractor cosConstruction periodConstruction completionOperations (FM) commencement dateOperations (FM) termOperations end

Months in yearFinancial year month end month numberDays in year

Base model or Reference data

exation and discount ratesNote: Please insert annual rate applying during th

Indexation rates pre first model period

No indexationCPIBPI - ConstructionBPI - ConstructionOperating CostEmployee CostLifecycle CostQH & FF&ENon-labour operating cost (per QH)


No indexation ACPI BBPI - Construction COperating Cost DEmployee Cost ELifecycle Cost FQH & FF&E GNon-labour operating cost (per QH) H

Nominal discount rate

urvesColumn counter for s-curve

Construction ANovated Professional Fees BQH Professional Fees CQH Costs DStatutory Fees EFF&E FPublic Artwork G

1-Apr-08 1-May-08 1-Jun-08 1-Jul-08 1-Aug-08 1-Sep-08 1-Oct-08 1-Nov-08 1-Dec-08 1-Jan-09 1-Feb-09 1-Mar-09 1-Apr-09 1-May-09 1-Jun-09 1-Jul-09 1-Aug-0930-Apr-08 31-May-08 30-Jun-08 31-Jul-08 31-Aug-08 30-Sep-08 31-Oct-08 30-Nov-08 31-Dec-08 31-Jan-09 28-Feb-09 31-Mar-09 30-Apr-09 31-May-09 30-Jun-09 31-Jul-09 31-Aug-09

30 31 30 31 31 30 31 30 31 31 28 31 30 31 30 31 31TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUEFALSE FALSE FALSE FALSE FALSE FALSE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE

0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50%0.00% 0.00% 0.00% 8.00% 8.00% 8.00% 8.00% 8.00% 8.00% 8.00% 8.00% 8.00% 8.00% 8.00% 8.00% 7.00% 7.00%2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50%4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00%2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50%0.00% 0.00% 0.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00%3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20%

18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34

0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.05% 0.16% 0.16% 0.22% 0.22% 0.27% 0.25% 0.68% 1.00% 1.24%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 3.48% 3.48% 3.48% 3.48% 3.48% 3.48% 3.69% 4.48% 4.48% 4.48% 4.48%3.31% 3.31% 3.31% 3.31% 3.31% 3.31% 4.97% 1.64% 1.64% 1.64% 1.64% 1.64% 0.60% 1.27% 1.27% 1.27% 1.27%0.47% 1.44% 10.39% 2.68% 1.07% 1.07% 1.07% 1.07% 1.07% 1.07% 1.07% 1.07% 1.07% 1.07% 1.07% 1.19% 1.19%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 83.33% 0.00% 0.00% 16.67%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%


COMMERCIAL IN CONFIDENCEPeriod start datePeriod end dateDays in period

Site acquisition HSurrounding Infrastructure IMedical School J

ut costsPlease enter costs as a positive and revenue as a


Generic Inpatient UnitTrade costsManaging Contractor's FeesProfessional Fees - Novated to Contractor (5%)Statutory Fees, headworks etcFF & ETOTAL Generic Inpatient Unit

Education & ResearchTrade costsManaging Contractor's FeesProfessional Fees - Novated to Contractor (5%)Statutory Fees, headworks etcFF & ETOTAL Education & Research

Division of MedicineTrade costsManaging Contractor's FeesProfessional Fees - Novated to Contractor (5%)Statutory Fees, headworks etcFF & ETOTAL Division of Medicine

Division of Surgery & Critical CareTrade costsManaging Contractor's FeesProfessional Fees - Novated to Contractor (5%)Statutory Fees, headworks etcFF & ETOTAL Division of Surgery & Critical Care

Division of Family, Women & ChildrenTrade costsManaging Contractor's FeesProfessional Fees - Novated to Contractor (5%)Statutory Fees, headworks etcFF & ETOTAL Division of Family, Women & Children

Division of Mental Health & ATODSTrade costsManaging Contractor's FeesProfessional Fees - Novated to Contractor (5%)Statutory Fees, headworks etcFF & ETOTAL Division of Mental Health & ATODS

Division of Community, Allied Health Aged & RTrade costsManaging Contractor's FeesProfessional Fees - Novated to Contractor (5%)Statutory Fees, headworks etcFF & ETOTAL Division of Community, Allied Health Aged


30 31 30 31 31 30 31 30 31 31 28 31 30 31 30 31 310.00% 0.00% 7.53% 92.47% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%

0 0 0 0 0 0 0 45,959 137,877 137,877 183,835 183,835 229,794 206,815 566,729 834,114 1,034,0680 0 0 0 0 0 0 15,268 45,805 45,805 61,073 61,073 76,341 68,707 188,276 277,104 343,5320 0 0 0 0 0 302,408 302,408 302,408 302,408 302,408 302,408 320,744 389,306 389,306 389,306 389,3060 0 0 0 0 0 0 0 0 0 0 0 0 510,225 0 0 102,0450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 302,408 363,635 486,089 486,089 547,316 547,316 626,879 1,175,053 1,144,311 1,500,525 1,868,951

0 0 0 0 0 0 0 7,582 22,746 22,746 30,328 30,328 37,910 34,119 93,495 137,606 170,5930 0 0 0 0 0 0 2,519 7,557 7,557 10,075 10,075 12,594 11,335 31,060 45,715 56,6740 0 0 0 0 0 49,889 49,889 49,889 49,889 49,889 49,889 52,914 64,225 64,225 64,225 64,2250 0 0 0 0 0 0 0 0 0 0 0 0 84,173 0 0 16,8350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 49,889 59,990 80,192 80,192 90,292 90,292 103,418 193,852 188,781 247,546 308,327

0 0 0 0 0 0 0 52,006 156,019 156,019 208,026 208,026 260,032 234,029 641,303 943,872 1,170,1370 0 0 0 0 0 0 17,277 51,832 51,832 69,109 69,109 86,386 77,748 213,050 313,568 388,7360 0 0 0 0 0 342,201 342,201 342,201 342,201 342,201 342,201 362,950 440,533 440,533 440,533 440,5330 0 0 0 0 0 0 0 0 0 0 0 0 577,364 0 0 115,4730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 342,201 411,484 550,052 550,052 619,335 619,335 709,368 1,329,673 1,294,887 1,697,973 2,114,880

0 0 0 0 0 0 0 37,676 113,028 113,028 150,704 150,704 188,380 169,542 464,591 683,787 847,7040 0 0 0 0 0 0 12,516 37,549 37,549 50,066 50,066 62,582 56,324 154,344 227,164 281,6190 0 0 0 0 0 247,907 247,907 247,907 247,907 247,907 247,907 262,938 319,144 319,144 319,144 319,1440 0 0 0 0 0 0 0 0 0 0 0 0 418,270 0 0 83,6540 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 247,907 298,099 398,484 398,484 448,676 448,676 513,900 963,280 938,079 1,230,094 1,532,121

0 0 0 0 0 0 0 30,502 91,507 91,507 122,010 122,010 152,512 137,261 376,132 553,593 686,3000 0 0 0 0 0 0 10,133 30,400 30,400 40,533 40,533 50,667 45,600 124,956 183,911 227,9990 0 0 0 0 0 200,705 200,705 200,705 200,705 200,705 200,705 212,874 258,378 258,378 258,378 258,3780 0 0 0 0 0 0 0 0 0 0 0 0 338,631 0 0 67,7260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 200,705 241,341 322,612 322,612 363,248 363,248 416,053 779,870 759,467 995,882 1,240,403

0 0 0 0 0 0 0 10,657 31,971 31,971 42,628 42,628 53,286 47,957 131,415 193,417 239,7840 0 0 0 0 0 0 3,540 10,621 10,621 14,162 14,162 17,702 15,932 43,658 64,256 79,6600 0 0 0 0 0 70,123 70,123 70,123 70,123 70,123 70,123 74,375 90,274 90,274 90,274 90,2740 0 0 0 0 0 0 0 0 0 0 0 0 118,313 0 0 23,6630 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 70,123 84,321 112,716 112,716 126,914 126,914 145,363 272,476 265,347 347,947 433,379

0 0 0 0 0 0 0 13,774 41,323 41,323 55,098 55,098 68,872 61,985 169,855 249,994 309,9220 0 0 0 0 0 0 4,576 13,728 13,728 18,304 18,304 22,880 20,592 56,428 83,051 102,9610 0 0 0 0 0 90,635 90,635 90,635 90,635 90,635 90,635 96,131 116,680 116,680 116,680 116,6800 0 0 0 0 0 0 0 0 0 0 0 0 152,920 0 0 30,5840 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 90,635 108,986 145,687 145,687 164,037 164,037 187,883 352,177 342,963 449,725 560,147



Division of Medical ServicesTrade costsManaging Contractor's FeesProfessional Fees - Novated to Contractor (5%)Statutory Fees, headworks etcFF & ETOTAL Division of Medical Services

Division of PathologyTrade costsManaging Contractor's FeesProfessional Fees - Novated to Contractor (5%)Statutory Fees, headworks etcFF & ETOTAL Division of Pathology

Corporate Services, Amenities and RetailTrade costsManaging Contractor's FeesProfessional Fees - Novated to Contractor (5%)Statutory Fees, headworks etcFF & ETOTAL Corporate Services, Amenities and Retail

Engineering and TravelTrade costsManaging Contractor's FeesProfessional Fees - Novated to Contractor (5%)Statutory Fees, headworks etcFF & ETOTAL Engineering and Travel

Central Plant EtcTrade costsManaging Contractor's FeesProfessional Fees - Novated to Contractor (5%)Statutory Fees, headworks etcFF & ETOTAL Central Plant Etc

ESD InitiativesTrade costsManaging Contractor's FeesProfessional Fees - Novated to Contractor (5%)Statutory Fees, headworks etcFF & ETOTAL ESD Initiatives

External WorksTrade costsManaging Contractor's FeesProfessional Fees - Novated to Contractor (5%)Statutory Fees, headworks etcFF & ETOTAL External Works

SpareSpareSpareSpareSpareSpareSpareSpareSpareSpareSpareTOTAL Spare


30 31 30 31 31 30 31 30 31 31 28 31 30 31 30 31 31

0 0 0 0 0 0 0 13,532 40,596 40,596 54,128 54,128 67,660 60,894 166,868 245,596 304,4710 0 0 0 0 0 0 4,496 13,487 13,487 17,982 17,982 22,478 20,230 55,436 81,591 101,1490 0 0 0 0 0 89,041 89,041 89,041 89,041 89,041 89,041 94,440 114,627 114,627 114,627 114,6270 0 0 0 0 0 0 0 0 0 0 0 0 150,230 0 0 30,0460 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 89,041 107,069 143,124 143,124 161,151 161,151 184,578 345,982 336,930 441,814 550,293

0 0 0 0 0 0 0 13,197 39,591 39,591 52,789 52,789 65,986 59,387 162,737 239,517 296,9350 0 0 0 0 0 0 4,384 13,153 13,153 17,537 17,537 21,921 19,729 54,064 79,571 98,6460 0 0 0 0 0 86,837 86,837 86,837 86,837 86,837 86,837 92,102 111,790 111,790 111,790 111,7900 0 0 0 0 0 0 0 0 0 0 0 0 146,512 0 0 29,3020 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 86,837 104,418 139,581 139,581 157,163 157,163 180,009 337,418 328,591 430,878 536,673

0 0 0 0 0 0 0 34,641 103,922 103,922 138,562 138,562 173,203 155,883 427,161 628,697 779,4090 0 0 0 0 0 0 11,508 34,524 34,524 46,032 46,032 57,540 51,786 141,909 208,862 258,9310 0 0 0 0 0 227,934 227,934 227,934 227,934 227,934 227,934 241,755 293,432 293,432 293,432 293,4320 0 0 0 0 0 0 0 0 0 0 0 0 384,572 0 0 76,9140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 227,934 274,083 366,380 366,380 412,529 412,529 472,498 885,673 862,502 1,130,992 1,408,686

0 0 0 0 0 0 0 71,150 213,450 213,450 284,600 284,600 355,751 320,176 877,369 1,291,314 1,600,8690 0 0 0 0 0 0 23,637 70,911 70,911 94,548 94,548 118,185 106,367 291,474 428,993 531,8310 0 0 0 0 0 468,166 468,166 468,166 468,166 468,166 468,166 496,553 602,695 602,695 602,695 602,6950 0 0 0 0 0 0 0 0 0 0 0 0 789,893 0 0 157,9790 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 468,166 562,953 752,527 752,527 847,315 847,315 970,488 1,819,131 1,771,539 2,323,003 2,893,374

0 0 0 0 0 0 0 69,763 209,288 209,288 279,051 279,051 348,814 313,932 860,261 1,266,135 1,569,6540 0 0 0 0 0 0 23,176 69,529 69,529 92,705 92,705 115,881 104,293 285,791 420,628 521,4610 0 0 0 0 0 459,037 459,037 459,037 459,037 459,037 459,037 486,870 590,943 590,943 590,943 590,9430 0 0 0 0 0 0 0 0 0 0 0 0 774,491 0 0 154,898

0 0 0 0 0 0 459,037 551,976 737,854 737,854 830,793 830,793 951,565 1,783,660 1,736,996 2,277,707 2,836,956

0 0 0 0 0 0 0 25,806 77,418 77,418 103,223 103,223 129,029 116,126 318,218 468,355 580,6290 0 0 0 0 0 0 8,573 25,719 25,719 34,292 34,292 42,865 38,579 105,717 155,594 192,8930 0 0 0 0 0 169,802 169,802 169,802 169,802 169,802 169,802 180,098 218,595 218,595 218,595 218,5950 0 0 0 0 0 0 0 0 0 0 0 0 286,491 0 0 57,298

0 0 0 0 0 0 169,802 204,181 272,939 272,939 307,318 307,318 351,992 659,791 642,530 842,544 1,049,415

0 0 0 0 0 0 0 24,132 72,397 72,397 96,530 96,530 120,662 108,596 297,583 437,983 542,9760 0 0 0 0 0 0 8,017 24,051 24,051 32,069 32,069 40,086 36,077 98,861 145,504 180,3840 0 0 0 0 0 158,791 158,791 158,791 158,791 158,791 158,791 168,419 204,420 204,420 204,420 204,4200 0 0 0 0 0 0 0 0 0 0 0 0 267,913 0 0 53,583

0 0 0 0 0 0 158,791 190,940 255,239 255,239 287,389 287,389 329,166 617,006 600,864 787,907 981,363

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0



Total Contractor construction costs


Non-contractor costs 1Commissioning / decanting/QH CostsProfessional Fees (8%)Public Art AllowanceSite acquisitionAdditional infrastructureMedical and dental schoolCategory 7Category 8Category 9Category 10TOTAL Non-contractor costs 1

Non-contractor costs 2Category 1Category 2Category 3Category 4Category 5Category 6Category 7Category 8Category 9Category 10TOTAL Non-contractor costs 2


Total Non-contractor construction costs

Total construction costs (Contractor and Non-co


30 31 30 31 31 30 31 30 31 31 28 31 30 31 30 31 31

0 0 0 0 0 0 2,963,476 3,563,476 4,763,476 4,763,476 5,363,476 5,363,476 6,143,163 11,515,042 11,213,786 14,704,535 18,314,970

145,000 445,000 3,220,438 830,600 330,600 330,600 330,600 330,600 330,600 330,600 330,600 330,600 330,600 330,600 330,600 368,000 368,0001,821,376 1,821,376 1,821,376 1,821,376 1,821,376 1,821,376 2,732,730 901,637 901,637 901,637 901,637 901,637 329,667 699,188 699,188 699,188 699,188

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 3,929,008 48,270,992 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1,966,376 2,266,376 8,970,822 50,922,968 2,151,976 2,151,976 3,063,330 1,232,237 1,232,237 1,232,237 1,232,237 1,232,237 660,267 1,029,788 1,029,788 1,067,188 1,067,188

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1,966,376 2,266,376 8,970,822 50,922,968 2,151,976 2,151,976 3,063,330 1,232,237 1,232,237 1,232,237 1,232,237 1,232,237 660,267 1,029,788 1,029,788 1,067,188 1,067,188

1,966,376 2,266,376 8,970,822 50,922,968 2,151,976 2,151,976 6,026,805 4,795,713 5,995,713 5,995,713 6,595,713 6,595,713 6,803,430 12,544,830 12,243,574 15,771,723 19,382,157




uts - Construction

es















1-Sep-09 1-Oct-09 1-Nov-09 1-Dec-09 1-Jan-10 1-Feb-10 1-Mar-10 1-Apr-10 1-May-10 1-Jun-10 1-Jul-10 1-Aug-10 1-Sep-10 1-Oct-10 1-Nov-10 1-Dec-1030-Sep-09 31-Oct-09 30-Nov-09 31-Dec-09 31-Jan-10 28-Feb-10 31-Mar-10 30-Apr-10 31-May-10 30-Jun-10 31-Jul-10 31-Aug-10 30-Sep-10 31-Oct-10 30-Nov-10 31-Dec-10

30 31 30 31 31 28 31 30 31 30 31 31 30 31 30 31TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUETRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE

0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50%7.00% 7.00% 7.00% 7.00% 7.00% 7.00% 7.00% 7.00% 7.00% 7.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00%2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50%4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00%2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50%4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00%3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20%

35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50

1.45% 1.56% 1.58% 1.68% 1.80% 1.90% 1.99% 2.08% 2.16% 2.24% 2.31% 2.37% 2.43% 2.48% 2.53% 2.58%4.48% 4.48% 4.48% 4.48% 4.48% 4.48% 4.48% 0.79% 0.79% 0.79% 0.79% 0.79% 0.79% 0.79% 0.79% 0.79%1.27% 1.27% 1.27% 1.27% 1.27% 1.27% 1.27% 0.67% 0.67% 0.67% 0.67% 0.67% 0.67% 0.67% 0.67% 0.67%1.19% 1.19% 1.19% 1.19% 1.19% 1.19% 1.19% 1.19% 1.19% 1.19% 1.26% 1.26% 1.26% 1.26% 1.26% 1.26%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%














30 31 30 31 31 28 31 30 31 30 31 31 30 31 30 310.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%0.00% 0.00% 0.00% 15.97% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 39.94%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 23.96%

1,215,573 1,303,667 1,324,498 1,410,388 1,504,751 1,590,770 1,669,686 1,742,413 1,809,645 1,871,916 1,929,650 1,983,183 2,032,782 2,078,662 2,120,993 2,159,907403,831 433,097 440,017 468,551 499,899 528,476 554,693 578,854 601,189 621,877 641,057 658,841 675,319 690,561 704,624 717,552389,306 389,306 389,306 389,306 389,306 389,306 389,306 68,562 68,562 68,562 68,562 68,562 68,562 68,562 68,562 68,562

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2,008,710 2,126,070 2,153,820 2,268,245 2,393,956 2,508,552 2,613,686 2,389,830 2,479,396 2,562,355 2,639,269 2,710,586 2,776,663 2,837,785 2,894,179 2,946,021

200,537 215,070 218,506 232,676 248,243 262,434 275,453 287,451 298,543 308,816 318,340 327,172 335,354 342,923 349,907 356,32766,621 71,449 72,591 77,298 82,470 87,184 91,509 95,495 99,180 102,593 105,757 108,691 111,409 113,924 116,244 118,37764,225 64,225 64,225 64,225 64,225 64,225 64,225 11,311 11,311 11,311 11,311 11,311 11,311 11,311 11,311 11,311

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

331,383 350,744 355,322 374,199 394,938 413,844 431,188 394,258 409,034 422,720 435,408 447,174 458,075 468,158 477,462 486,014

1,375,526 1,475,212 1,498,783 1,595,975 1,702,755 1,800,093 1,889,394 1,971,691 2,047,769 2,118,234 2,183,566 2,244,142 2,300,268 2,352,186 2,400,087 2,444,121456,969 490,086 497,917 530,206 565,679 598,016 627,683 655,024 680,298 703,707 725,411 745,536 764,182 781,429 797,343 811,972440,533 440,533 440,533 440,533 440,533 440,533 440,533 77,584 77,584 77,584 77,584 77,584 77,584 77,584 77,584 77,584

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2,273,029 2,405,831 2,437,233 2,566,714 2,708,968 2,838,643 2,957,610 2,704,298 2,805,650 2,899,526 2,986,561 3,067,262 3,142,034 3,211,199 3,275,013 3,333,677

996,498 1,068,715 1,085,791 1,156,202 1,233,558 1,304,075 1,368,768 1,428,389 1,483,503 1,534,552 1,581,881 1,625,766 1,666,426 1,704,037 1,738,739 1,770,640331,051 355,042 360,715 384,107 409,806 433,232 454,724 474,531 492,841 509,800 525,523 540,102 553,610 566,105 577,634 588,232319,144 319,144 319,144 319,144 319,144 319,144 319,144 56,205 56,205 56,205 56,205 56,205 56,205 56,205 56,205 56,205

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1,646,692 1,742,901 1,765,650 1,859,452 1,962,508 2,056,451 2,142,636 1,959,125 2,032,549 2,100,557 2,163,609 2,222,073 2,276,242 2,326,348 2,372,578 2,415,077

806,763 865,230 879,055 936,060 998,687 1,055,777 1,108,153 1,156,421 1,201,042 1,242,371 1,280,689 1,316,218 1,349,136 1,379,586 1,407,681 1,433,508268,018 287,442 292,035 310,972 331,778 350,744 368,144 384,180 399,003 412,733 425,463 437,266 448,202 458,318 467,651 476,232258,378 258,378 258,378 258,378 258,378 258,378 258,378 45,504 45,504 45,504 45,504 45,504 45,504 45,504 45,504 45,504

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1,333,160 1,411,050 1,429,468 1,505,410 1,588,844 1,664,900 1,734,676 1,586,105 1,645,549 1,700,608 1,751,655 1,798,988 1,842,842 1,883,408 1,920,836 1,955,243

281,872 302,299 307,129 327,046 348,927 368,874 387,173 404,037 419,627 434,067 447,455 459,868 471,369 482,008 491,824 500,84793,642 100,428 102,033 108,649 115,919 122,545 128,624 134,227 139,406 144,203 148,651 152,775 156,596 160,130 163,391 166,38990,274 90,274 90,274 90,274 90,274 90,274 90,274 15,898 15,898 15,898 15,898 15,898 15,898 15,898 15,898 15,898

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

465,787 493,001 499,436 525,969 555,120 581,693 606,071 554,163 574,932 594,169 612,004 628,541 643,863 658,036 671,113 683,134

364,322 390,724 396,967 422,710 450,991 476,772 500,424 522,222 542,372 561,035 578,339 594,383 609,249 622,999 635,686 647,349121,033 129,804 131,878 140,430 149,826 158,391 166,248 173,489 180,184 186,384 192,132 197,462 202,401 206,969 211,184 215,059116,680 116,680 116,680 116,680 116,680 116,680 116,680 20,549 20,549 20,549 20,549 20,549 20,549 20,549 20,549 20,549

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

602,034 637,208 645,525 679,819 717,497 751,842 783,352 716,260 743,104 767,968 791,020 812,394 832,198 850,517 867,419 882,957












30 31 30 31 31 28 31 30 31 30 31 31 30 31 30 31

357,913 383,851 389,984 415,274 443,058 468,386 491,622 513,035 532,831 551,166 568,165 583,928 598,532 612,040 624,504 635,962118,904 127,521 129,558 137,960 147,190 155,604 163,324 170,438 177,014 183,105 188,753 193,989 198,841 203,328 207,469 211,276114,627 114,627 114,627 114,627 114,627 114,627 114,627 20,187 20,187 20,187 20,187 20,187 20,187 20,187 20,187 20,187

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

591,444 625,999 634,170 667,861 704,875 738,617 769,572 703,660 730,032 754,459 777,105 798,104 817,559 835,556 852,161 867,425

349,054 374,350 380,332 404,995 432,092 456,792 479,453 500,337 519,643 537,524 554,103 569,475 583,717 596,892 609,047 620,221115,961 124,364 126,352 134,545 143,547 151,753 159,281 166,219 172,633 178,573 184,081 189,187 193,919 198,296 202,334 206,046111,790 111,790 111,790 111,790 111,790 111,790 111,790 19,688 19,688 19,688 19,688 19,688 19,688 19,688 19,688 19,688

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

576,805 610,505 618,473 651,331 687,429 720,335 750,524 686,244 711,963 735,785 757,871 778,350 797,324 814,875 831,069 845,955

916,215 982,614 998,315 1,063,053 1,134,177 1,199,012 1,258,494 1,313,311 1,363,985 1,410,921 1,454,437 1,494,786 1,532,170 1,566,752 1,598,658 1,627,989304,380 326,438 331,654 353,161 376,790 398,329 418,089 436,300 453,135 468,728 483,184 496,589 509,009 520,497 531,097 540,841293,432 293,432 293,432 293,432 293,432 293,432 293,432 51,677 51,677 51,677 51,677 51,677 51,677 51,677 51,677 51,677

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1,514,027 1,602,484 1,623,401 1,709,646 1,804,398 1,890,773 1,970,015 1,801,288 1,868,797 1,931,326 1,989,299 2,043,052 2,092,856 2,138,926 2,181,432 2,220,507

1,881,862 2,018,242 2,050,490 2,183,460 2,329,545 2,462,714 2,584,886 2,697,477 2,801,559 2,897,964 2,987,344 3,070,219 3,147,005 3,218,033 3,283,567 3,343,811625,181 670,489 681,202 725,376 773,908 818,148 858,736 896,140 930,718 962,745 992,438 1,019,970 1,045,480 1,069,076 1,090,847 1,110,861602,695 602,695 602,695 602,695 602,695 602,695 602,695 106,143 106,143 106,143 106,143 106,143 106,143 106,143 106,143 106,143

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3,109,738 3,291,426 3,334,387 3,511,531 3,706,148 3,883,557 4,046,317 3,699,760 3,838,420 3,966,851 4,085,924 4,196,332 4,298,627 4,393,252 4,480,557 4,560,815

1,845,168 1,978,889 2,010,508 2,140,884 2,284,122 2,414,693 2,534,484 2,644,879 2,746,932 2,841,457 2,929,094 3,010,353 3,085,642 3,155,285 3,219,541 3,278,610612,991 657,415 667,919 711,232 758,817 802,195 841,991 878,666 912,570 943,972 973,086 1,000,082 1,025,094 1,048,230 1,069,577 1,089,201590,943 590,943 590,943 590,943 590,943 590,943 590,943 104,073 104,073 104,073 104,073 104,073 104,073 104,073 104,073 104,073

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3,049,102 3,227,247 3,269,370 3,443,060 3,633,882 3,807,832 3,967,418 3,627,619 3,763,575 3,889,502 4,006,253 4,114,508 4,214,809 4,307,588 4,393,191 4,471,884

682,544 732,008 743,705 791,932 844,917 893,216 937,528 978,364 1,016,114 1,051,080 1,083,498 1,113,556 1,141,406 1,167,168 1,190,937 1,212,787226,751 243,184 247,069 263,091 280,693 296,739 311,460 325,026 337,568 349,184 359,953 369,939 379,191 387,750 395,646 402,905218,595 218,595 218,595 218,595 218,595 218,595 218,595 38,498 38,498 38,498 38,498 38,498 38,498 38,498 38,498 38,498

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1,127,890 1,193,787 1,209,369 1,273,618 1,344,205 1,408,551 1,467,583 1,341,888 1,392,180 1,438,761 1,481,948 1,521,993 1,559,095 1,593,415 1,625,080 1,654,189

638,282 684,539 695,477 740,577 790,126 835,294 876,731 914,920 950,222 982,920 1,013,235 1,041,345 1,067,389 1,091,480 1,113,707 1,134,141212,046 227,414 231,047 246,030 262,491 277,496 291,263 303,949 315,677 326,540 336,611 345,949 354,602 362,605 369,989 376,778204,420 204,420 204,420 204,420 204,420 204,420 204,420 36,001 36,001 36,001 36,001 36,001 36,001 36,001 36,001 36,001

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1,054,749 1,116,373 1,130,944 1,191,027 1,257,037 1,317,210 1,372,414 1,254,870 1,301,900 1,345,461 1,385,848 1,423,295 1,457,991 1,490,086 1,519,698 1,546,919

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0











30 31 30 31 31 28 31 30 31 30 31 31 30 31 30 31

19,684,548 20,834,627 21,106,570 22,227,883 23,459,805 24,582,799 25,613,063 23,419,367 24,297,080 25,110,045 25,863,775 26,562,652 27,210,178 27,809,150 28,361,787 28,869,818

368,000 368,000 368,000 368,000 368,000 368,000 368,000 368,000 368,000 368,000 390,000 390,000 390,000 390,000 390,000 390,000699,188 699,188 699,188 699,188 699,188 699,188 699,188 369,520 369,520 369,520 369,520 369,520 369,520 369,520 369,520 369,520

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 10,000,000 0 0 0 0 0 0 0 0 0 0 0 25,000,0000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15,000,000

1,067,188 1,067,188 1,067,188 11,067,188 1,067,188 1,067,188 1,067,188 737,520 737,520 737,520 759,520 759,520 759,520 759,520 759,520 40,759,520

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1,067,188 1,067,188 1,067,188 11,067,188 1,067,188 1,067,188 1,067,188 737,520 737,520 737,520 759,520 759,520 759,520 759,520 759,520 40,759,520

20,751,736 21,901,814 22,173,758 33,295,071 24,526,993 25,649,987 26,680,251 24,156,887 25,034,600 25,847,565 26,623,296 27,322,173 27,969,698 28,568,670 29,121,307 69,629,339




uts - Construction

es















1-Jan-11 1-Feb-11 1-Mar-11 1-Apr-11 1-May-11 1-Jun-11 1-Jul-11 1-Aug-11 1-Sep-11 1-Oct-11 1-Nov-11 1-Dec-1131-Jan-11 28-Feb-11 31-Mar-11 30-Apr-11 31-May-11 30-Jun-11 31-Jul-11 31-Aug-11 30-Sep-11 31-Oct-11 30-Nov-11 31-Dec-11

31 28 31 30 31 30 31 31 30 31 30 31TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUETRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE

0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50%6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00%2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50%4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00%2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50%4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00%3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20%

51 52 53 54 55 56 57 58 59 60 61 62

2.62% 2.66% 2.70% 2.73% 2.75% 2.78% 2.80% 2.81% 2.82% 2.83% 2.83% 2.83%0.79% 0.79% 0.79% 0.79% 0.79% 0.79% 0.79% 0.79% 0.79% 0.79% 0.79% 0.79%0.67% 0.67% 0.67% 0.67% 0.67% 0.67% 0.67% 0.67% 0.67% 0.67% 0.67% 0.67%1.26% 1.26% 1.26% 1.26% 1.26% 1.26% 1.33% 1.33% 1.33% 1.33% 1.33% 1.33%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%0.00% 0.00% 4.35% 4.35% 4.35% 4.35% 4.35% 4.35% 4.35% 4.35% 4.35% 4.35%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%














31 28 31 30 31 30 31 31 30 31 30 310.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 31.95%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 55.91%

2,195,505 2,227,857 2,257,007 2,282,974 2,305,750 2,325,303 2,341,571 2,354,464 2,363,855 2,369,578 2,371,417 2,369,097729,378 740,126 749,810 758,436 766,003 772,499 777,903 782,186 785,306 787,207 787,818 787,048

68,562 68,562 68,562 68,562 68,562 68,562 68,562 68,562 68,562 68,562 68,562 68,5620 0 0 0 0 0 0 0 0 0 0 00 0 604,271 604,271 604,271 604,271 604,271 604,271 604,271 604,271 604,271 604,271

2,993,445 3,036,544 3,679,650 3,714,243 3,744,586 3,770,635 3,792,307 3,809,483 3,821,994 3,829,618 3,832,068 3,828,978

362,199 367,536 372,345 376,629 380,387 383,612 386,296 388,423 389,972 390,917 391,220 390,837120,328 122,101 123,698 125,122 126,370 127,441 128,333 129,040 129,554 129,868 129,969 129,842

11,311 11,311 11,311 11,311 11,311 11,311 11,311 11,311 11,311 11,311 11,311 11,3110 0 0 0 0 0 0 0 0 0 0 00 0 59,980 59,980 59,980 59,980 59,980 59,980 59,980 59,980 59,980 59,980

493,838 500,948 567,334 573,041 578,047 582,344 585,920 588,753 590,817 592,075 592,479 591,970

2,484,403 2,521,012 2,553,998 2,583,382 2,609,155 2,631,281 2,649,690 2,664,279 2,674,905 2,681,381 2,683,463 2,680,838825,354 837,516 848,474 858,236 866,798 874,149 880,264 885,111 888,641 890,793 891,484 890,612

77,584 77,584 77,584 77,584 77,584 77,584 77,584 77,584 77,584 77,584 77,584 77,5840 0 0 0 0 0 0 0 0 0 0 00 0 2,071,481 2,071,481 2,071,481 2,071,481 2,071,481 2,071,481 2,071,481 2,071,481 2,071,481 2,071,481

3,387,341 3,436,112 5,551,537 5,590,683 5,625,018 5,654,495 5,679,019 5,698,455 5,712,612 5,721,239 5,724,012 5,720,515

1,799,822 1,826,343 1,850,240 1,871,527 1,890,198 1,906,227 1,919,564 1,930,133 1,937,831 1,942,523 1,944,030 1,942,129597,926 606,737 614,676 621,748 627,951 633,276 637,706 641,217 643,775 645,333 645,834 645,203

56,205 56,205 56,205 56,205 56,205 56,205 56,205 56,205 56,205 56,205 56,205 56,2050 0 0 0 0 0 0 0 0 0 0 00 0 1,275,423 1,275,423 1,275,423 1,275,423 1,275,423 1,275,423 1,275,423 1,275,423 1,275,423 1,275,423

2,453,954 2,489,286 3,796,544 3,824,903 3,849,778 3,871,132 3,888,899 3,902,979 3,913,235 3,919,485 3,921,493 3,918,960

1,457,133 1,478,605 1,497,952 1,515,186 1,530,302 1,543,279 1,554,076 1,562,633 1,568,865 1,572,664 1,573,884 1,572,345484,080 491,214 497,641 503,366 508,388 512,699 516,286 519,129 521,199 522,461 522,867 522,355

45,504 45,504 45,504 45,504 45,504 45,504 45,504 45,504 45,504 45,504 45,504 45,5040 0 0 0 0 0 0 0 0 0 0 00 0 277,225 277,225 277,225 277,225 277,225 277,225 277,225 277,225 277,225 277,225

1,986,718 2,015,322 2,318,321 2,341,280 2,361,419 2,378,707 2,393,091 2,404,490 2,412,793 2,417,853 2,419,480 2,417,429

509,102 516,604 523,363 529,385 534,666 539,200 542,972 545,962 548,140 549,467 549,893 549,355169,131 171,623 173,869 175,869 177,624 179,130 180,383 181,376 182,100 182,541 182,682 182,504

15,898 15,898 15,898 15,898 15,898 15,898 15,898 15,898 15,898 15,898 15,898 15,8980 0 0 0 0 0 0 0 0 0 0 00 0 103,583 103,583 103,583 103,583 103,583 103,583 103,583 103,583 103,583 103,583

694,131 704,125 816,714 824,735 831,771 837,811 842,837 846,820 849,721 851,489 852,057 851,340

658,018 667,715 676,451 684,234 691,060 696,920 701,796 705,660 708,475 710,190 710,741 710,046218,603 221,824 224,727 227,312 229,580 231,527 233,147 234,430 235,365 235,935 236,118 235,887

20,549 20,549 20,549 20,549 20,549 20,549 20,549 20,549 20,549 20,549 20,549 20,5490 0 0 0 0 0 0 0 0 0 0 00 0 93,711 93,711 93,711 93,711 93,711 93,711 93,711 93,711 93,711 93,711

897,170 910,088 1,015,438 1,025,806 1,034,900 1,042,707 1,049,203 1,054,351 1,058,100 1,060,385 1,061,120 1,060,194












31 28 31 30 31 30 31 31 30 31 30 31

646,444 655,969 664,552 672,198 678,904 684,661 689,451 693,247 696,012 697,697 698,239 697,556214,758 217,922 220,774 223,314 225,542 227,454 229,045 230,307 231,225 231,785 231,965 231,738

20,187 20,187 20,187 20,187 20,187 20,187 20,187 20,187 20,187 20,187 20,187 20,1870 0 0 0 0 0 0 0 0 0 0 00 0 2,033,525 2,033,525 2,033,525 2,033,525 2,033,525 2,033,525 2,033,525 2,033,525 2,033,525 2,033,525

881,389 894,079 2,939,038 2,949,224 2,958,158 2,965,828 2,972,209 2,977,266 2,980,950 2,983,195 2,983,916 2,983,006

630,443 639,733 648,104 655,560 662,100 667,715 672,386 676,088 678,785 680,428 680,957 680,291209,442 212,528 215,309 217,786 219,959 221,824 223,376 224,606 225,502 226,048 226,223 226,002

19,688 19,688 19,688 19,688 19,688 19,688 19,688 19,688 19,688 19,688 19,688 19,6880 0 0 0 0 0 0 0 0 0 0 00 0 310,367 310,367 310,367 310,367 310,367 310,367 310,367 310,367 310,367 310,367

859,573 871,949 1,193,467 1,203,401 1,212,114 1,219,594 1,225,817 1,230,749 1,234,341 1,236,531 1,237,234 1,236,347

1,654,820 1,679,204 1,701,176 1,720,748 1,737,915 1,752,652 1,764,914 1,774,632 1,781,710 1,786,023 1,787,410 1,785,662549,754 557,855 565,155 571,657 577,360 582,256 586,329 589,558 591,909 593,342 593,803 593,222

51,677 51,677 51,677 51,677 51,677 51,677 51,677 51,677 51,677 51,677 51,677 51,6770 0 0 0 0 0 0 0 0 0 0 00 0 466,173 466,173 466,173 466,173 466,173 466,173 466,173 466,173 466,173 466,173

2,256,251 2,288,737 2,784,180 2,810,254 2,833,125 2,852,759 2,869,094 2,882,040 2,891,469 2,897,216 2,899,063 2,896,734

3,398,920 3,449,005 3,494,133 3,534,333 3,569,594 3,599,864 3,625,050 3,645,009 3,659,547 3,668,407 3,671,255 3,667,6641,129,169 1,145,808 1,160,800 1,174,155 1,185,870 1,195,926 1,204,293 1,210,924 1,215,753 1,218,697 1,219,643 1,218,450

106,143 106,143 106,143 106,143 106,143 106,143 106,143 106,143 106,143 106,143 106,143 106,1430 0 0 0 0 0 0 0 0 0 0 00 0 30,349 30,349 30,349 30,349 30,349 30,349 30,349 30,349 30,349 30,349

4,634,232 4,700,956 4,791,425 4,844,980 4,891,955 4,932,281 4,965,834 4,992,424 5,011,792 5,023,595 5,027,388 5,022,604

3,332,645 3,381,753 3,426,002 3,465,418 3,499,991 3,529,671 3,554,365 3,573,935 3,588,190 3,596,877 3,599,669 3,596,1481,107,152 1,123,466 1,138,166 1,151,261 1,162,746 1,172,607 1,180,810 1,187,312 1,192,047 1,194,933 1,195,861 1,194,691

104,073 104,073 104,073 104,073 104,073 104,073 104,073 104,073 104,073 104,073 104,073 104,0730 0 0 0 0 0 0 0 0 0 0 0

4,543,870 4,609,293 4,668,241 4,720,751 4,766,810 4,806,350 4,839,249 4,865,320 4,884,311 4,895,883 4,899,603 4,894,912

1,232,775 1,250,940 1,267,308 1,281,889 1,294,678 1,305,656 1,314,791 1,322,030 1,327,303 1,330,517 1,331,549 1,330,247409,545 415,580 421,018 425,862 430,110 433,758 436,792 439,197 440,949 442,016 442,360 441,927

38,498 38,498 38,498 38,498 38,498 38,498 38,498 38,498 38,498 38,498 38,498 38,4980 0 0 0 0 0 0 0 0 0 0 0

1,680,818 1,705,018 1,726,823 1,746,248 1,763,285 1,777,911 1,790,081 1,799,725 1,806,750 1,811,030 1,812,406 1,810,671

1,152,832 1,169,820 1,185,126 1,198,761 1,210,721 1,220,988 1,229,530 1,236,300 1,241,231 1,244,236 1,245,202 1,243,984382,987 388,631 393,716 398,245 402,219 405,629 408,467 410,716 412,354 413,353 413,674 413,269

36,001 36,001 36,001 36,001 36,001 36,001 36,001 36,001 36,001 36,001 36,001 36,0010 0 0 0 0 0 0 0 0 0 0 0

1,571,821 1,594,452 1,614,843 1,633,008 1,648,940 1,662,618 1,673,998 1,683,017 1,689,586 1,693,590 1,694,876 1,693,254

0 0 0 0 0 0 0 0 0 0 0 0











31 28 31 30 31 30 31 31 30 31 30 31

29,334,550 29,756,909 37,463,556 37,802,557 38,099,907 38,355,172 38,567,558 38,735,872 38,858,471 38,933,182 38,957,197 38,926,914

390,000 390,000 390,000 390,000 390,000 390,000 412,000 412,000 412,000 412,000 412,000 412,000369,520 369,520 369,520 369,520 369,520 369,520 369,520 369,520 369,520 369,520 369,520 369,520

0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 20,000,0000 0 0 0 0 0 0 0 0 0 0 35,000,000

759,520 759,520 759,520 759,520 759,520 759,520 781,520 781,520 781,520 781,520 781,520 55,781,520

0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0

759,520 759,520 759,520 759,520 759,520 759,520 781,520 781,520 781,520 781,520 781,520 55,781,520

30,094,071 30,516,429 38,223,077 38,562,078 38,859,427 39,114,692 39,349,078 39,517,392 39,639,991 39,714,703 39,738,717 94,708,435




uts - Construction

es















1-Jan-12 1-Feb-12 1-Mar-12 1-Apr-12 1-May-12 1-Jun-12 1-Jul-12 1-Aug-12 1-Sep-12 1-Oct-12 1-Nov-12 1-Dec-12 1-Jan-13 1-Feb-13 1-Mar-13 1-Apr-13 1-May-13 1-Jun-1331-Jan-12 29-Feb-12 31-Mar-12 30-Apr-12 31-May-12 30-Jun-12 31-Jul-12 31-Aug-12 30-Sep-12 31-Oct-12 30-Nov-12 31-Dec-12 31-Jan-13 28-Feb-13 31-Mar-13 30-Apr-13 31-May-13 30-Jun-13

31 29 31 30 31 30 31 31 30 31 30 31 31 28 31 30 31 30TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUETRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE TRUE

0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50%6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00% 5.00%2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50%4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00%2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50% 2.50%4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00%3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20% 3.20%

63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80

2.82% 2.81% 2.79% 2.76% 2.72% 2.67% 2.61% 2.53% 2.43% 2.18% 1.97% 0.96% 0.06% 0.06% 0.03% 0.00% 0.00% 0.00%0.79% 0.79% 0.79% 0.79% 0.79% 0.79% 0.79% 0.79% 0.42% 0.42% 0.42% 0.42% 0.42% 0.42% 0.42% 0.40% 0.00% 0.00%0.67% 0.67% 0.67% 0.67% 0.67% 0.67% 0.67% 0.67% 0.41% 0.41% 0.41% 0.41% 0.41% 0.41% 0.41% 0.28% 0.00% 0.00%1.33% 1.33% 1.33% 1.33% 1.33% 1.33% 3.10% 3.10% 3.10% 2.74% 2.74% 1.78% 1.78% 1.54% 0.97% 0.97% 0.97% 1.00%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%4.35% 4.35% 4.35% 4.35% 4.35% 4.35% 4.35% 4.35% 4.35% 4.35% 4.35% 4.35% 4.35% 0.00% 0.00% 0.00% 0.00% 0.00%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%














31 29 31 30 31 30 31 31 30 31 30 31 31 28 31 30 31 300.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 12.14% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 20.13% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%

2,362,266 2,350,469 2,333,114 2,309,420 2,278,324 2,238,337 2,187,278 2,121,757 2,036,021 1,826,986 1,650,826 804,130 52,402 52,402 26,944 0 0 0784,778 780,859 775,094 767,222 756,891 743,607 726,645 704,878 676,395 606,951 548,428 267,143 17,409 17,409 8,951 0 0 0

68,562 68,562 68,562 68,562 68,562 68,562 68,562 68,562 36,737 36,737 36,737 36,737 36,737 36,737 36,737 34,607 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

604,271 604,271 604,271 604,271 604,271 604,271 604,271 604,271 604,271 604,271 604,271 604,271 604,271 0 0 0 0 03,819,877 3,804,160 3,781,041 3,749,475 3,708,048 3,654,776 3,586,756 3,499,468 3,353,423 3,074,945 2,840,262 1,712,281 710,819 106,548 72,632 34,607 0 0

389,710 387,764 384,901 380,992 375,862 369,265 360,842 350,033 335,889 301,404 272,342 132,660 8,645 8,645 4,445 0 0 0129,467 128,821 127,870 126,571 124,867 122,675 119,877 116,286 111,587 100,131 90,476 44,071 2,872 2,872 1,477 0 0 0

11,311 11,311 11,311 11,311 11,311 11,311 11,311 11,311 6,061 6,061 6,061 6,061 6,061 6,061 6,061 5,709 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

59,980 59,980 59,980 59,980 59,980 59,980 59,980 59,980 59,980 59,980 59,980 59,980 59,980 0 0 0 0 0590,468 587,875 584,061 578,854 572,019 563,231 552,009 537,609 513,516 467,574 428,858 242,771 77,557 17,578 11,982 5,709 0 0

2,673,108 2,659,758 2,640,120 2,613,308 2,578,120 2,532,871 2,475,094 2,400,951 2,303,933 2,067,392 1,868,052 909,942 59,298 59,298 30,489 0 0 0888,044 883,609 877,085 868,178 856,488 841,455 822,261 797,630 765,399 686,817 620,593 302,296 19,700 19,700 10,129 0 0 0

77,584 77,584 77,584 77,584 77,584 77,584 77,584 77,584 41,571 41,571 41,571 41,571 41,571 41,571 41,571 39,161 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2,071,481 2,071,481 2,071,481 2,071,481 2,071,481 2,071,481 2,071,481 2,071,481 2,071,481 2,071,481 2,071,481 2,071,481 2,071,481 0 0 0 0 05,710,217 5,692,432 5,666,270 5,630,551 5,583,672 5,523,391 5,446,420 5,347,646 5,182,384 4,867,261 4,601,698 3,325,290 2,192,050 120,568 82,189 39,161 0 0

1,936,529 1,926,858 1,912,631 1,893,207 1,867,715 1,834,934 1,793,078 1,739,365 1,669,081 1,497,719 1,353,308 659,206 42,958 42,958 22,088 0 0 0643,342 640,129 635,403 628,950 620,481 609,591 595,686 577,842 554,492 497,563 449,588 218,998 14,271 14,271 7,338 0 0 0

56,205 56,205 56,205 56,205 56,205 56,205 56,205 56,205 30,116 30,116 30,116 30,116 30,116 30,116 30,116 28,370 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1,275,423 1,275,423 1,275,423 1,275,423 1,275,423 1,275,423 1,275,423 1,275,423 1,275,423 1,275,423 1,275,423 1,275,423 1,275,423 0 0 0 0 03,911,500 3,898,615 3,879,662 3,853,785 3,819,825 3,776,154 3,720,392 3,648,836 3,529,112 3,300,822 3,108,435 2,183,743 1,362,769 87,346 59,542 28,370 0 0

1,567,811 1,559,981 1,548,463 1,532,738 1,512,099 1,485,560 1,451,673 1,408,188 1,351,285 1,212,551 1,095,636 533,692 34,779 34,779 17,882 0 0 0520,849 518,248 514,421 509,197 502,341 493,524 482,266 467,820 448,916 402,827 363,986 177,300 11,554 11,554 5,941 0 0 0

45,504 45,504 45,504 45,504 45,504 45,504 45,504 45,504 24,382 24,382 24,382 24,382 24,382 24,382 24,382 22,968 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

277,225 277,225 277,225 277,225 277,225 277,225 277,225 277,225 277,225 277,225 277,225 277,225 277,225 0 0 0 0 02,411,388 2,400,958 2,385,613 2,364,663 2,337,169 2,301,813 2,256,668 2,198,736 2,101,808 1,916,985 1,761,228 1,012,599 347,939 70,715 48,205 22,968 0 0

547,771 545,035 541,011 535,517 528,306 519,034 507,194 492,001 472,120 423,648 382,800 186,465 12,151 12,151 6,248 0 0 0181,977 181,068 179,732 177,906 175,511 172,430 168,497 163,450 156,845 140,742 127,171 61,946 4,037 4,037 2,076 0 0 0

15,898 15,898 15,898 15,898 15,898 15,898 15,898 15,898 8,519 8,519 8,519 8,519 8,519 8,519 8,519 8,025 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

103,583 103,583 103,583 103,583 103,583 103,583 103,583 103,583 103,583 103,583 103,583 103,583 103,583 0 0 0 0 0849,230 845,586 840,224 832,905 823,299 810,946 795,173 774,932 741,067 676,492 622,073 360,513 128,290 24,707 16,842 8,025 0 0

707,999 704,463 699,262 692,160 682,840 670,856 655,553 635,915 610,219 547,569 494,772 241,007 15,706 15,706 8,075 0 0 0235,207 234,033 232,305 229,945 226,849 222,868 217,784 211,260 202,723 181,910 164,370 80,066 5,218 5,218 2,683 0 0 0

20,549 20,549 20,549 20,549 20,549 20,549 20,549 20,549 11,010 11,010 11,010 11,010 11,010 11,010 11,010 10,372 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

93,711 93,711 93,711 93,711 93,711 93,711 93,711 93,711 93,711 93,711 93,711 93,711 93,711 0 0 0 0 01,057,466 1,052,755 1,045,826 1,036,365 1,023,949 1,007,983 987,597 961,435 917,664 834,201 763,864 425,795 125,645 31,934 21,769 10,372 0 0












31 29 31 30 31 30 31 31 30 31 30 31 31 28 31 30 31 30

695,545 692,071 686,961 679,985 670,829 659,055 644,021 624,729 599,485 537,937 486,069 236,768 15,429 15,429 7,933 0 0 0231,070 229,916 228,218 225,900 222,859 218,947 213,953 207,544 199,157 178,710 161,479 78,658 5,126 5,126 2,636 0 0 0

20,187 20,187 20,187 20,187 20,187 20,187 20,187 20,187 10,817 10,817 10,817 10,817 10,817 10,817 10,817 10,190 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2,033,525 2,033,525 2,033,525 2,033,525 2,033,525 2,033,525 2,033,525 2,033,525 2,033,525 2,033,525 2,033,525 2,033,525 2,033,525 0 0 0 0 02,980,327 2,975,699 2,968,892 2,959,597 2,947,400 2,931,714 2,911,686 2,885,985 2,842,984 2,760,989 2,691,889 2,359,767 2,064,897 31,372 21,386 10,190 0 0

678,329 674,941 669,958 663,154 654,225 642,742 628,081 609,266 584,647 524,622 474,038 230,907 15,047 15,047 7,737 0 0 0225,350 224,225 222,569 220,309 217,343 213,528 208,657 202,407 194,228 174,287 157,482 76,711 4,999 4,999 2,570 0 0 0

19,688 19,688 19,688 19,688 19,688 19,688 19,688 19,688 10,549 10,549 10,549 10,549 10,549 10,549 10,549 9,938 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

310,367 310,367 310,367 310,367 310,367 310,367 310,367 310,367 310,367 310,367 310,367 310,367 310,367 0 0 0 0 01,233,734 1,229,221 1,222,582 1,213,517 1,201,622 1,186,325 1,166,792 1,141,727 1,099,791 1,019,825 952,435 628,534 340,962 30,595 20,856 9,938 0 0

1,780,513 1,771,620 1,758,540 1,740,681 1,717,243 1,687,103 1,648,619 1,599,234 1,534,611 1,377,056 1,244,278 606,097 39,497 39,497 20,308 0 0 0591,511 588,557 584,212 578,279 570,492 560,479 547,694 531,288 509,820 457,477 413,367 201,354 13,122 13,122 6,747 0 0 0

51,677 51,677 51,677 51,677 51,677 51,677 51,677 51,677 27,690 27,690 27,690 27,690 27,690 27,690 27,690 26,085 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

466,173 466,173 466,173 466,173 466,173 466,173 466,173 466,173 466,173 466,173 466,173 466,173 466,173 0 0 0 0 02,889,874 2,878,028 2,860,602 2,836,810 2,805,585 2,765,433 2,714,163 2,648,372 2,538,294 2,328,396 2,151,508 1,301,314 546,482 80,309 54,745 26,085 0 0

3,657,088 3,638,824 3,611,957 3,575,275 3,527,134 3,465,229 3,386,184 3,284,749 3,152,018 2,828,406 2,555,688 1,244,895 81,126 81,126 41,712 0 0 01,214,936 1,208,869 1,199,943 1,187,757 1,171,764 1,151,198 1,124,938 1,091,240 1,047,145 939,637 849,036 413,572 26,951 26,951 13,857 0 0 0

106,143 106,143 106,143 106,143 106,143 106,143 106,143 106,143 56,873 56,873 56,873 56,873 56,873 56,873 56,873 53,576 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

30,349 30,349 30,349 30,349 30,349 30,349 30,349 30,349 30,349 30,349 30,349 30,349 30,349 0 0 0 0 05,008,515 4,984,184 4,948,391 4,899,523 4,835,389 4,752,918 4,647,614 4,512,481 4,286,386 3,855,265 3,491,946 1,745,689 195,299 164,950 112,443 53,576 0 0

3,585,778 3,567,871 3,541,528 3,505,561 3,458,359 3,397,661 3,320,157 3,220,700 3,090,558 2,773,255 2,505,855 1,220,621 79,544 79,544 40,899 0 0 01,191,246 1,185,297 1,176,546 1,164,597 1,148,916 1,128,751 1,103,003 1,069,962 1,026,727 921,315 832,481 405,508 26,426 26,426 13,587 0 0 0

104,073 104,073 104,073 104,073 104,073 104,073 104,073 104,073 55,765 55,765 55,765 55,765 55,765 55,765 55,765 52,532 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4,881,098 4,857,241 4,822,146 4,774,231 4,711,348 4,630,485 4,527,233 4,394,735 4,173,049 3,750,335 3,394,100 1,681,893 161,734 161,734 110,251 52,532 0 0

1,326,411 1,319,787 1,310,042 1,296,738 1,279,278 1,256,825 1,228,156 1,191,365 1,143,225 1,025,852 926,938 451,518 29,424 29,424 15,129 0 0 0440,653 438,452 435,215 430,795 424,994 417,535 408,011 395,788 379,795 340,802 307,942 150,001 9,775 9,775 5,026 0 0 0

38,498 38,498 38,498 38,498 38,498 38,498 38,498 38,498 20,628 20,628 20,628 20,628 20,628 20,628 20,628 19,432 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1,805,561 1,796,736 1,783,755 1,766,030 1,742,769 1,712,857 1,674,664 1,625,651 1,543,648 1,387,282 1,255,508 622,147 59,827 59,827 40,783 19,432 0 0

1,240,397 1,234,202 1,225,089 1,212,648 1,196,320 1,175,323 1,148,513 1,114,108 1,069,089 959,328 866,828 422,239 27,516 27,516 14,148 0 0 0412,077 410,019 406,992 402,859 397,434 390,459 381,552 370,123 355,167 318,702 287,973 140,274 9,141 9,141 4,700 0 0 0

36,001 36,001 36,001 36,001 36,001 36,001 36,001 36,001 19,290 19,290 19,290 19,290 19,290 19,290 19,290 18,172 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1,688,475 1,680,222 1,668,082 1,651,508 1,629,755 1,601,783 1,566,066 1,520,232 1,443,546 1,297,320 1,174,091 581,802 55,947 55,947 38,138 18,172 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0











31 29 31 30 31 30 31 31 30 31 30 31 31 28 31 30 31 30

38,837,729 38,683,712 38,457,148 38,147,816 37,741,849 37,219,810 36,553,234 35,697,846 34,266,671 31,537,691 29,237,895 18,184,138 8,370,216 1,044,129 711,761 339,137 0 0

412,000 412,000 412,000 412,000 412,000 412,000 960,467 960,467 960,467 850,467 850,467 550,467 550,467 478,095 302,000 302,000 302,000 310,000369,520 369,520 369,520 369,520 369,520 369,520 369,520 369,520 227,176 227,176 227,176 227,176 227,176 227,176 227,176 153,929 0 0

0 0 0 0 0 0 0 2,000,000 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 7,600,000 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 12,600,000 0 0 0 0 0 0

781,520 781,520 781,520 781,520 781,520 781,520 1,329,987 3,329,987 1,187,642 1,077,642 1,077,642 20,977,642 777,643 705,271 529,176 455,929 302,000 310,000

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

781,520 781,520 781,520 781,520 781,520 781,520 1,329,987 3,329,987 1,187,642 1,077,642 1,077,642 20,977,642 777,643 705,271 529,176 455,929 302,000 310,000

39,619,249 39,465,233 39,238,668 38,929,336 38,523,369 38,001,330 37,883,221 39,027,833 35,454,314 32,615,333 30,315,538 39,161,780 9,147,858 1,749,399 1,240,937 795,066 302,000 310,000


COMMERCIAL IN CONFIDENCE

Queensland HealthGold Coast HospitalGovernment Benchmark ModelSummary

Input terms Nominal terms NPC terms$M $M $M

Capital costs

ContractorTOTAL Generic Inpatient Unit 134.72 162.13 135.54TOTAL Education & Research 21.31 25.69 21.52TOTAL Division of Medicine 184.36 220.33 182.71TOTAL Division of Surgery & Critical Care 128.38 153.64 127.60TOTAL Division of Family, Women & Children 86.56 104.32 87.34TOTAL Division of Mental Health & ATODS 30.40 36.63 30.66TOTAL Division of Community, Allied Health Aged & Rehabilitation Serv 38.37 46.27 38.77TOTAL Division of Medical Services 82.35 97.03 79.14TOTAL Division of Pathology 41.83 50.19 41.81TOTAL Corporate Services, Amenities and Retail 101.79 122.49 102.39TOTAL Engineering and Travel 187.75 226.96 190.70TOTAL Central Plant Etc 183.40 221.74 186.35TOTAL ESD Initiatives 67.84 82.02 68.93TOTAL External Works 63.44 76.70 64.46TOTAL Spare 0.00 0.00 0.00Total Contractor construction costs 1,352.51 1,626.15 1,357.92

273,640,974Non-Contractor

TOTAL Non-contractor costs 1 265.42 302.76 266.65TOTAL Non-contractor costs 2 0.00 0.00 0.00TOTAL Non-contractor costs 3 0.00 0.00 0.00Total Non-Contractor construction costs 265.42 302.76 266.65

Total Capital costs 1,617.93 1,928.91 1,624.57TRUE 310,981,191

Operating costs

ContractorTotal Routine Building & Plant maintenance 317.85 466.80 189.42Total Grounds maintenance costs 7.01 12.70 5.01Total Cleaning 6.73 12.19 4.81Total Helpdesk 7.08 12.83 5.06Total Utilities 299.12 480.32 192.60Total Lifecycle Building Maintenance 240.23 457.17 128.00Total Other 1 operating costs 0.00 0.00 0.00Total Other 2 operating costs 0.00 0.00 0.00Total Other 3 operating costs 0.00 0.00 0.00Total Contractor operating costs 878.01 1,442.02 524.90

Non-ContractorTotal Non-contractor type 1 costs 0.00 0.00 0.00Total Non-contractor type 2 costs 0.00 0.00 0.00Total Non-contractor type 3 costs 0.00 0.00 0.00Total Non-Contractor operating costs 0.00 0.00 0.00

Total Operating costs 878.01 1,442.02 524.90

Total Contractor project costs 2,230.52 3,068.17 1,882.82Total Non-contractor project costs 265.42 302.76 266.65Total project costs (pre risk) 2,495.95 3,370.93 2,149.47

Risks

Transferred risksTotal Construction period risks 51.97 42.87Total Operational period risks 152.89 65.51Total transferred risk 204.86 108.38

Total transferred risk adjusted contractor project costs 3,273.03 1,991.20

Retained risksTotal Construction period risks 127.42 108.09Total Operational period risks 0.50 0.23Total retained risk 127.92 108.32

Total risk 332.78 216.70

Total Project risk adjusted costs 3,703.71 2,366.17

179.389.3%

Transferred capital costs 1,980.88Retained Capital costs 2,056.33Total risk adjusted capital costs 2,108.30

Transferred operating costs 1,594.91Retained operating costs 1,442.52Total risk adjusted operating costs 1,595.41



September 2008


G Space area reconciliation 1 page

GCUH SUMMARY OF AREAS COMPARSION GCUH ARCHITECTURE

SD Places

Bed Alternatives MD Beds


Places

Consult Rooms

1 Generic Inpatient Unit 20170 19057 11.59% 0 0 400 1 13 17043 1940 18983 74 The difference of 74m2 only.

2 Education & Research 4011 3871 2.36% 0 0 0 0 0 3866 0 3866 5 The difference is 5m2 only.

3 Division of Medicine 24414 24437 14.87% 14 97 76 115 115 26102 240 26342 -1905 This area needs to be read in conjunction with the Division of Family Womens and Childrens area.

4 Division of Surgery & Critical Care 15976 16032 9.75% 40 0 50 39 11 14527 375 15330 702The area allocated for GCUH is 702m2 higher and can be attributed to the higher number of procedural rooms and critical care bays to meet the health service projections.

5 Division of Family, Women & Children 12777 14018 8.53% 20 0 124 26 39 10988 620 11608 2410

Children's ambulatory care being part of this cluster and inclusion of clinical education & training and allied health areas specific to FWC. This are increase also needs to be read in conjunction with Division of Medicine.

6 Division of Mental Health & ATODS 7336 5817 3.54% 8 0 72 0 0 5582 360 5942 -125The differential is 125m2 below Townsville Hospital and is based on a revised model of three 24 bed units inlieu of 4 18 bed units.

7 Division of Community, Allied Health Aged & Rehabilitation Services 7342 7359 4.48% 0 0 28 99 10 6425 240 6665 694

The differential is 694m2. The Allied Health areas within this facility are considerably larger than Townsville and are based on a central hub at present. The Hub is GCUH, with the spockes yet to be developed(Health Hubs) across region.The cluster has additional services provided which including Transitional care services, and clinical education and training areas.

8 Division of Medical Services 5847 5923 3.60% 0 0 0 28 0 5858 0 5858 65 The area differential is only 64m2.

9 Division of Pathology 4612 5039 3.07% 0 0 0 8 0 4493 0 4493 546The area differential is 546m2 and can be attributed towards a a pathology service that services a number of hospital within the health service district.

10 Corporate Services, Amenities and Retail 18305 16556 10.07% 0 0 0 0 0 14513 0 14513 2043

The area difference is 2043m2 and this can be attributed to a number functions at GCUH such as a district wide Central Plate Kitchen, Cafeteria space allowance, increased retail spaces, increased offices and services for Health Service District including Health Promotion, Operational services including Engineering, Information Management and Bio-medical service.

Total 120790 118109 74 97 750 316 188 109397 3775 113172 4937

Travel Level 6 Hospital = 16% 20390 18580 17504 604 18108 472

Plant Level 6 Hospital = 21% 23820 27673 21573 744 22317 5356

Unenclosed Covered Areas 0

Gross Area 148474 5123 10445 164042

Total Gross Area 165000 164362 148474 5123 10445 164042 320

AREA ALLOWANCECyclotron 500

To be considered/advisedArchive StoreChild Care CentreHydrotherapy Pool 398Hyperbaric Unit

Medihotel

Retail Allowance - Not within hospital 5000Carparking Allowance 90000

Total 95000

Beds/ Treatment Places

Planning Units


Area M2

Project Definition Plan


Area M2

Scheme Design


Area % of total gross area

TGFA M2 Townsville

with 750beds total to all Current

guidelines & % Single Rooms.

CommentsDifference

GCUH Scheme Design &

Townsville

TGFA M2 Townsville

with 750beds based on the

AHFG & VHFG..

TGFA M2 Townsville Single Bed implications

TGFA M2 Townsville

with 750beds Allowance for ESD & OH&S implications

3440692_1.xls 19/09/2008


September 2008


H Updated beds and treatment places schedule 6 pages

GOLD COAST UNIVERSITY HOSPITAL PROJECT


MD Beds (PDP = 24

beds)



Places

Consult Rooms

1 Generic Inpatient Unit 0 0 388 400 1 13

MEDICAL INPATIENT BEDS (EXCLUDING CANCER X 56 BEDS)

IPU 1 Inpatient Unit - Cardiology L4W 24 24Includes CCU x 10 Beds, Pot-angio beds x 4 & Class N room x 1

IPU 2 Inpatient Unit - General Medical L5W 24 24

IPU 3 Inpatient Unit - Infectious Disease MCB 5N 24 24Class N x 12 Rooms & Class S x 12 rooms. 100% single rooms

IPU 4 Inpatient Unit - Medical Assessment Unit LLGW 28 28 1 4

IPU 5 Inpatient Unit - Neurology L5S c 24 28Note: 10 beds are to accessed by the Rehabilitation Unit;

IPU 6 Inpatient Unit - Renal Medicine L3S 24 28Includes Class N x 2 Rooms & Store forRenal Fluids

IPU 7 Inpatient Unit - Respiratory Medical L5W 24 24

SURGICAL INPATIENT BEDS

IPU 8 Inpatient Unit - Orthopaedic Surgery (Elective) L6S 24 28

IPU 9 Inpatient Unit - Orthopaedic/Trauma Surgery L6S 24 28

IPU 10

Inpatient Unit - Gastrointestinal Surgery (includes Colo-rectal) L2S 24 28

IPU 11 Inpatient Unit - Short-stay Surgical L2S 24 28IPU 12 Inpatient Unit - Neurosurgery L4S 24 28IPU 13 Inpatient Unit - ENT/Eye/MF/Plastics L4S 24 28IPU 14 Inpatient Unit - Uro/Gynae/Breast 24 0IPU 15 Inpatient Unit - Vascular Surgery L3S 24 28

IPU 16 Inpatient Unit - Cardiothoracic Surgery L4W e 24 24SHARED AREAS PER LEVELLevel Lower Ground LLGWLevel 2 MCB 2 e 2Level 3 MCB 3 2Level 4 CSB4 1Level 5 MCB 5 2Level 6 MCB 6 2

2 Education & Research 0 0 0 0 0 0Education

Education AdministrationIncludes leased offices for Bond University staff

LibraryClinical Placement Unit & Student AmenitiesMedical Illustration/Photograpy & Reprographics. Clinical PhotographyResearch

3 Division of Medicine 14 97 68 76 115 115

3.1 Internal MedicineSleep Studies MCB 5 4Renal Medicine (Clinical Admin) MCB 3

Acute Dialysis Unit CSB 3 16 3

PDP = Acute Dialysis x 24 & Peritoneal Dialysis x 3 places. SD = Acute Dialysis x 16 & Peritoneal Dialysis x 2 places. Mix of inpatient and acute ambaulatory outpatients.

Day Medical Beds MCB L1 14 2 Includes Clinical Trials places x 4 Infection Control (Offices) P& E B L2

3.2 Ambulatory Services & OPD MCB L1 13 80

Includes 80 C/R, including -ve Pressure room x 1, Treatment Rooms x 10, Plaster Rooms x 2 and Non-interventional diagnostics and Nurse Practitioners

3.3 Comprehensive Cancer Service

Planning Units Location Comments


Summary _SD10-Rev 05 Review_20080911-Places only (2).xls/SummaryGCUH Architects

Issue Date:13/05/2008Revision 6: 19/06/2008 Page 1/6



MD Beds (PDP = 24

beds)



Places

Consult Rooms



IPU 17 Inpatient Unit - Cancer L1S 24 28 Includes +ve pressure rooms x 2

IPU 18 Inpatient Unit - Cancer L1S 24 28

Includes Lead-lined rooms x 2, -ve pressure rooms x 2 & Palliative Care Beds x 6

Shared areas - Inpatient Units L1S

Day Oncology/Haematology LGS 29

PDP = Day Oncology x 25 & Apheresis x 4.Includes Holding Bay x 4. SD = Apheresis x 2

OPD LGS 30Shared areas Day Oncology/OPD + Palliative care Outreach Services LGS

Radiotherapy LLLGS 6

PDP = Bunkers x 5 with Linacs x 2, Brachytherapy x 1. SD = Bunkers x 3

Clinical Administration LLGS

3.4 Cardiology

Diagnostics, including Clinical Measurement & Stress Testing 11 1

ECHO, Stress ECHOs, TOE, Holter monitoring, Exercise Stress Testing, ECG, Pacemaker

Cardiac Catheter Labs 18 4

CCL x 3 & TOE Room x 1, RR x 12 places. Plus expansion for CCL/CT Scan x 1 of 200m2

Clinical Administration3.5 Emergency Medicine

Emergency Department 59 PDP = 77 places SD = 59 PlacesSexual Assault Unit

Child Protection UnitDrawn area includes CPU & Sexual Assault Assessment Unit

Short-stay Observation Unit LLGW 20 20 1 Includes Paeds x 6 bedsClinical Administration MCB LG

3.5 OthersDischarge ServicesACIEM

Day of Discharge/Transit LoungeBasement

Level S 30 13.7 Division of Medicine

Clinical Service/Business Unit (C/A) MCB 5N

4 Division of Surgery & Critical Care 40 0 50 50 39 114.1 Department of Anaesthetics

Anaesthetic & Pain Mgt Offices MCB 3NPain Management OPD MCB G e 1

4.2 Infusion Therapy ServicesIV Infusion Therapy Service MCB 4S

4.3 Intensive CareICU/HDU MCB 4 50 50 Includes PICU x 2 beds

4.4 Interventional Suite MCB 2Angiography MCB 2N 2Endoscopy MCB 2S 4Intraoperative MRI MCB 2N 1Perioperative services

Operating Suite MCB 2 20Plus Expansion zone x 2 ORs x 600m2

Post-anaesthetic Care Unit MCB 2 38 PACU Places

Same Day Accommodation MCB 2 40Includes Paeds Surgical/Endoscopy/Surgical Day Stay

DOSA & Day Surgery Admissions MCB 2 10Change Room MCB 3Centre

4.5 CSD MCB 3

MCB LG

MCB LG

5

MCB 4N





MD Beds (PDP = 24

beds)



Places

Consult Rooms



4.6 Ambulatory CareVascular - Vascular Laboratory / Clinical Admin Offices MCB LG c 2

4.7 Division of Surgery & Critical CareClinical Service/Business Unit (C/A) CSB 2

5 Division of Family, Women & Children 20 0 124 124 26 395.1 Maternity Services

IPU 19 & 20 Inpatient Unit - Maternity Services L3W 48 48 Includes Transitional Care Unit x 4

Birth Suite L2W 12

Includes High Acuity Beds x 2, Assessment Rooms x 2 & Ante-natal assessment x 10

Birth Centre 6Ante-natal Assessment Clinic L2W 10 2Clinical Administration L1W

5.2 Neonatal Intensive Care L3 44 44

Includes 14 NICU, SCN x 30 cots. Expansion zone required for 7 additional Level 2/3 cots = approx 420m2

5.3 Paediatric Services

IPU 21 Inpatient - Paediatric & Day Stay LGW 10 32 32 Includes shared areas per levelPaediatric OPD/Allied Health MCB GN 20

5.4 FWC - OPD & Ambulatory ServicesAnte-natal Clinic 10Qld Genetic Counselling 1Fetal -Maternal Assessment Clinic Assessment Unit 4 Ultrasound RoomsNeonatologyGynaecology/Gyn Oncology 2 6 Early Assessment Pregnancy Clinic 2Shared Areas L1W

6 Division of Mental Health & ATODS 0 0 72 72 0 0

Adult Inpt Unit MHU 72 72Includes ECT, Clinical Administration, Consultation Liaison & Research

Alcohol Tobacco and Other Drugs service 0

7 Division of CARAS 0 0 48 28 99 107.1 Allied Health MCB G

Allied Health Management Hub MCB GDistrict Management Directorate to be located off-site

Aids & Equipment (Loan) Basement LS7.2 Community Health

Health Promotion Unit MCB G Locate in/near Front Entry

7.4 Rehabilitation, Aged and Palliative Care Services

Inpatient Unit - Acute Rehabilitation - Neuro L5S 24 28

Includes ABI beds x + ILU beds x 1. Note: Rehabilitation Unit to access 10beds in the co-located IPU (Neurology)

IPU 23 Inpatient Unit - Acute Rehabilitation - Ortho 24 oTherapy Areas MCB 5 28 6Shared area per 48 Beds, Day/Inpt Therapy Areas MCB 5Clinical Administration MCB 5

Palliative Care Services Included in Comprehensive Cancer Services - 3.2Beds x 6 included in Division of Medicine

7.5 HomeLink ServicesCommunity Hospital Interface Program (CHIP)Transitional Care

8 Division of Medical Services 0 0 0 0 28 0

MCB LG

L1W

L1W





MD Beds (PDP = 24

beds)



Places

Consult Rooms



8.1 Medical ImagingNote: Drawn area includes Vascular Labs area

Bone Densitometry 1 Includes 16 Recovery Room baysCT 3 Plus 1 in ED ZoneFluoroscopy 1

General Rooms 3 Plus 3 in ED Zone & 2 Ambulatory CareMammography 1MRI 2Nuclear Medicine 2OPG 1PET 1

Ultrasound 6Plus 1 in ED Zone & 2 Vascular Ambulatory Care

MID - ED Zone MCB LG 5 Includes CT x 1, General x 3 & U/S x 1.

8.2 Pharmacy Main Pharmacy MCB LGProduction Unit MCB LG

9 Division of Pathology 0 0 0 0 8 09.1 Pathology Path Builbing

Shared Areas-Due to separate Building requirements

9.2 MortuaryPath Builbing

B

10 Corporate Services, Amenities and Retail 0 0 0 0 0 0

10.1 District & Hospital AdministrationDistrict Manager Off-siteBoardroom MCB 6Diivision of Corporate ServicesPlanning & Development UnitDistrict - Management (Hotdesks) MCB 6

Disaster Services/ManagementP&E + MCB

LGNAccess ED Training Room and Board Room

Division of Medical AdministrationMedico-legalMedical appointments MCB 6Division of Medical Administration Off-siteDivision of Nursing & Midwifery Services MCB 6Division of Teaching & Research MCB 6Nursing Support Services MCB 6Bed ManagementClinical Resources Coord.Nursing Workforce Planning & Develop MCB 6Administration - GCUHMedical Typists Off-site

Fundraising & Foundation Services MCB 6Foundation Retail MCB G

Volunteer Services MCB GInterpreter Services Off-siteService Improvement UnitCULT LiaisionPatient LiaisonPatient SafetyQuality & Risk ManagementPublic RelationsCommunity & Consumer Advisory Service

10.2 Operational ServicesOperational Services

MCB LG

Off-site

Off-site

Off-site

MCB G

Off-site





MD Beds (PDP = 24

beds)



Places

Consult Rooms



Mail RoomSatellite Operational Services Based on 88m2 x 2 Basement locationsCleaning & Waste ManagementLinen ServicesLoading Dock

10.3 Hospital Co-ordination & Public AreasMain Foyer MCB GOperation Co-ordination Centre MCB GCentral Admissions MCB GRevenue Services MCB GRetail/ Coffee Shop MCB G Includes Health Promotion

10.4 Pastoral Care ServicesChaplaincySpiritual Meditation Unit

10.5 Staff AmenitiesCentral Staff Amenities MCB B

Decentralised Staff Amenities MCB BAccessible toilets located throughout thefacility

Staff Health PromotionGymnasiumFunction Rooms CSB 6Staff on-call accommodationSenior Medical StaffRMO Facilities

10.6 Facilities ManagementFacility Management & Building Engineering & ManagementEngineering ServicesPABX ,Switchboard, MATV MCB LG & GSecurity MCB LG & G

10.7 Food ServicesKitchen MCB GPublic/Staff Cafeteria MCB G

10.8 District Technology Services

Information Technology MCB 6Patient Information Management Services

10.90 Materials ManagementSupply Depart MCB B Distribution centre located off-siteClinical Resource Unit - Equipment/Bed Store MCB B

10.1 Clinical Information Unit

Clinical Information Unit (Medical Records) MCB 1NDecision SupportCasemix

10.12 District Finance Service

Finance Services (District) Off-sitePayroll Off-site

Human Resource Management (District) Off-siteOccupational Health & Safety MCB LG

10.13 Biomecical Technology ServicesBiomedical Engineering MCB G

11.0 Medical Offices - Medical & Surgical Divisions

Clinical Service/Business Unit CSB

Clinical Service/Business Unit CSB 2


Clinical Service/Business Unit MCB 4N


MCG B

MCB G

MCB 1N

MCB 5

CEP

MCB 5





MD Beds (PDP = 24

beds)



Places

Consult Rooms




Total 74 97 750 750 316 188EXPANSION ZONES

3 Division of MedicineCardiac Catheter Labs 4 1 Expansion for CCL/CT Scan x 1

4 Division of Surgery & Critical CareOperating Suite 2

5 Division of Family, Women & ChildrenNICU 5 5

10 Corporate Services, Amenities and RetailClinical Information Unit (Medical Records) if no EMR/Scanning

Total 0 4 5 5 3 0

LocationsMCB Main Clinical Building

CSB Clinical Services Building (Offices)

P & E Pathology & Education Building

W Inpatient Builfding - West wing (FW&C Building)S Inpatient Builfding - Southt wing (Cancer Servces Building)




September 2008


I Definition of Key Procurement Stages The key procurement stages under the proposed procurement process are described in more detail in the following section:

Master planning

The Master Plan will identify and evaluate the entire project planning options for the facility with consideration of the:

• services to be provided

• demographics

• future trends

• existing facilities

• capital and recurrent costs

• implementation strategy.

The outcome will be the preferred development strategy that will enable a GCHSD to deliver its services in the most effective and cost efficient manner, taking into consideration best value and the return on capital investment. The Master Plan phase does not include detailed planning, but rather broad concept planning.

Project Definition Plan (PDP)

The purpose of the PDP is to provide a detailed analysis of a preferred facility development strategy as determined in the Master Plan study. It will enable the GCUH to fully determine the outcome, which will provide the most, cost efficient and effective delivery of its services. The preferred options for developing facilities to accommodate service delivery can then be determined. It includes:

• type of project

• procurement method

• proposed operating policies, both in terms of overall policies and detailed departmental policies. This is required for recurrent cost preparation

• changing work practices

• capital and recurrent cost constraints

• life cycle costing implications

• future planning needs

• ongoing operation of the facility during redevelopment

• changing trends in services provision, models of care and hospital design.

Schematic Design

The preferred planning options are advanced, to ensure that the broad spatial and functional planning requirements can be fulfilled and that critical issues have been addressed including:


September 2008


• review and amendments of Master Plan, and any other relevant documents

• obtaining further information and data as required for design

• preparing schematic designs to accord with the Master Plan and Project Definition Plan (PDP)

• developing the schematic design on the basis of the preferred option in sufficient detail to describe:

- fulfilment of spatial and functional requirements

- building forms

- spatial, functional and design relationships

- access and vehicular and pedestrian traffic routes

- internal circulation, handicapped access

- response to major engineering services requirements

- response to climatic and environmental issues

- response to Environmentally Sustainable Design issues

- response to Lifecycle and Recurrent Cost considerations.

• preparing alternative schematic designs or altering and amending the schematic design as required

• including layouts for major items of furniture and equipment, indicated on 1:50 scale drawings

• updating the Schedule of Areas

• preparing a plan for overall development and phasing to show best utilisation

• conceptual site and building plans

• preliminary sections and elevations (including treatment of internal spaces)

• preliminary selection of building system and materials

• development of approximate dimensions, areas and volumes

• a colour presentation perspective of the new building (s) of at least A1 size showing external views and internal perspectives of the public spaces

• recommendations regarding basic materials and systems

• preferred structural system

• consultation with relevant local, state, regional and federal authorities

• preparation of the project estimate

• amending design as required to meet Schematic Design Cost Plan

• value management studies

• updated project definition plan including room data sheets


September 2008


• preliminary submission for review for Building Act Approval consisting of preparation and lodgement of documents to the relevant authorities for preliminary building approval.

At the end of this stage it is proposed that the Business Case will be updated. The updated Business Case will then be used to brief the Cabinet Budget Review Committee of progress achieved on the project.

Design Development

The schematic design is developed and expanded by the Managing Contractor and their consultants including:

• reviewing and revising the Project Definition Plan including room data sheets and updating to reflect ongoing development of the design including all items of furniture, fittings and equipment

• updating and developing any 1:50 room plans and elevations incorporating room data requirements and showing built-in joinery, all required loose furniture and equipment, services, services outlets and equipment items

• responding to operational constraints

• presentations to and meeting with committees, user groups, staff meetings etc. to ensure their “ownership” of the design

• preparing material for and consultation with relevant local, regional, state and federal authorities, regarding laws, statutes and building codes and regulations affecting the project

• preparing plans, sections and elevations (including treatment of internal spaces)

• preparing typical construction details

• preparing three dimensional sketches

• refining materials and finishes schedule and selections

• amending design as required to meet Schematic Design Cost Plan and Project Definition. Plan

• conducting value management studies including but not limited to value management workshops

• preparing preliminary submission for review for Building Act Approval consisting of Preparation of documents for lodgement to the relevant Authorities for preliminary building approval

• preparing documentation sufficient for the preparation of a developed design estimate and cost plan to enable detailed measurement of elements and trade sections

• revising and updating as necessary 1:50 room plans and elevations, equipment drawing and room data sheets produced at the Schematic Design stage

• preparing room layout plans for each room and space involved in the development including all furniture, fittings and equipment, both existing and proposed

• refining schedules of materials and fittings

• preparing typical construction details and arrangements


September 2008


• identifying all associated building works and interfaces with services

• providing engineering design services comprising the development and expansion of engineering schematic design documents

• revising the schedule of areas to reflect development of the design

• reviewing room data sheets and plans with user groups, in each functional area, amending room data sheets and plans as required

• preparing fully developed site plan showing the relationship of the project site to the building and proposed levels, site services and landscaped features at a scale of 1:500

• preparing fully developed plans of each level of the preferred design showing all existing and altered landforms, paved areas and planting and the location of services at a scale of 1:100

• preparing roof plan to a scale of 1:100 showing slopes, materials and penetrations

• preparing elevations of all aspects and general sections showing roof forms and all projections at a scale of 1:100

• preparing particular plans and sections sufficient to describe the building form through the overall scheme or part of it at a scale of 1:100.

• preparing plans and elevations of typical elements and sections of the proposed construction, clearly showing floor, ceiling and roof heights, construction methods and indicating typical details and preliminary structure sizes at a scale of 1:50.

• preparing a schedule of finishes and a sample board showing materials to be used for external and internal finishes. The board is to show clearly the location in which the materials and colours are to be used.

At the end of this stage it is proposed that the Business Case will be updated. The updated Business Case will then be used to brief the Cabinet Budget Review Committee of progress achieved on the project.


Construction documents including final designs and trade packages are prepared by the Managing Contractor based on approved Design Development Scheme.

Construction

The Managing Contractor tenders and lets sub contract packages for the Works. The Quantity Surveyor audits the cost of the Works. Early works may be required during Schematic Design and/or Developed Design to meet a fixed completion date for the end of 2012.

Commissioning

The Managing Contractor commissions the works prior to Practical Completion and handover. Commissioning includes training and testing of services, plant and equipment. Staged completion dates or separable portions may also be required to suit commissioning timeframes.

Defects liability Period


September 2008


The defects liability period is a set period of time in which the Managing Contractor has to be available to quickly and efficiently resolve any defects that occur with the works completed by the Managing Contractor. The Managing Contractor Contract is likely to include provisions where a level of security (e.g. retention of money or performance bonds) is held by the State until the defects liability is satisfactorily completed.


September 2008


J Managing Contractor procurement paper 17 pages

Gold Coast University Hospital

Managing Contractor Procurement Paper

CONFIDENTIAL DRAFT

Gold Coast University Hospital 8th may (3) 1

GOLD COAST UNIVERSITY HOSPITAL MANAGING CONTRACTOR PROCUREMENT

1 OBJECTIVE

The Infrastructure Cabinet Sub-Committee decided that the current

business case for the Gold Coast University Hospital not consider an option

for delivery of the hospital as a Private Finance Initiative/Public Private

Partnership.

The Committee has also ratified a proposal to procure the Gold Coast

University Hospital via a modified Managing Contractor form of

procurement and endorsed-in-principle the preferred option for contractor

selection being, where clear benefit can be demonstrated, by single select

tender or limited select tender (maximum of three) based on the results of a

two stage registration of interest process.

The purpose of this paper is to provide an update on the detailed

implementation of the joint Queensland Health and Department of Public

Works procurement strategy for the Gold Coast University Hospital project

under the SEQ Infrastructure Plan.

2 BACKGROUND

2.1 Endorsement of Procurement Approach

The Department of Public Works has previously briefed the Infrastructure

Cabinet Subcommittee, Treasury, Department of Infrastructure and Health

on the level of construction activity in Queensland and the likely impact on

the capital works program of subcontract and supplier shortages. The

Department of Public Works obtained endorsement to utilise a greater level

of flexibility and innovation in project procurement and delivery. In

particular the following principles were endorsed:

• engaging industry through early notification of upcoming major

capital works projects, allowing longer lead times for planning and to

source experienced resources, from interstate/overseas. This will

maximise opportunity to secure the best possible team for the project;

• provide an avenue for potential contractors to nominate projects

which best align with their expertise, resource capability and business

development;

• a delivery process whereby the cost to industry of tendering is

minimised, ensuring limited resources are available for project

delivery, rather than for preparation of extensive tender submissions;

• ensuring early contractor involvement through the engagement of a

‘consultant’ managing contractor in the very early design stages to

provide management and constructability input into the design team.

This strategy effectively locks in the major resource for the future

design and construction stages and ensures the longest possible lead

time for a contractor to secure the key subcontract and supply chain

resources required;



CONFIDENTIAL DRAFT


• use of a known contract form such as a Managing Contractor

(Negotiated Guaranteed Construction Sum) contract, specifically

amended to suit each individual project for risk management and

allowing early trades to commence while the design is being finalised.

Inclusion of facilities management and long term maintenance will be

considered for each project; and

• a procurement strategy that seeks the key subcontractors’ input into

the design, allowing amongst other benefits, resources and industry

production rate constraints to be factored into the overall project

duration.

In addition, following consideration of alternative tender options for the

delivery of the projects, the Department of Public Works determined that

the preferred option for contractor selection for the upcoming major

projects, of which Gold Coast University Hospital is one, is where clear

based benefit can be demonstrated, by single select tender or limited

select tender based on the results of a two stage registration process.

.

2.2 Key Procurement Strategy Drivers

2.2.1 Time

The briefing paper by the Department of Public Works identified many of

the industry wide issues that impacted on the selection of the Managing

Contractor procurement method.

In addition to the industry wide issues, the key Gold Coast University Hospital

driver is the Government’s public commitment to a completion date for the

new Gold Coast University Hospital of December 2012. The following table

identifies the estimated project completion dates for alternative

procurement approaches. The accelerated managing contractor

procurement strategy is the only strategy capable of delivering the project

within the required timeframe. A comparison of potential ‘delay costs’ for

these alternative procurement methods is included as Attachment 1.

Procurement Method Phase Estimated Completion

Date

All Procurement Methods PDP December 2007

Site Acquisition September 2008

Scheme Design September 2008

Design Development March 2009

Lump Sum Contract Documentation January 2010

Tender Period/Negotiation May 2010

Contract Award June 2010

Completion February 2014

D&C 1 Tender Period/Negotiation November 2009

Contract Award January 2010

Design Completion September 2010

Completion September 2013

DD&C Tender Period/Negotiation October 2009



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Procurement Method Phase Estimated Completion

Date

Contract Award November 2009

Design Completion July 2010

Completion June 2013

Managing Contractor Tender Period/Negotiation November 2009

Contract Award December 2009

Completion July 2013

Accelerated MC 2 Tender Period/Negotiation April 2009

Early Works (complete) May 2009

Contract Award May 2009

Completion December 2012

Notes

1: D&C program assumes preparation of performance based documentation

following Design Development and commencement of tender process in June 2009.

2: Accelerated MC approach discussed further below, includes early works and

alternative procurement approach for subcontractors.

2.2.2 Resources

It was determined that the earliest possible confirmation of project

commitment is essential to minimise the impact of the volume of

infrastructure spending in south-east Queensland, both from commitment of

resources and in price growth/escalation risk which Queensland Treasury

has agreed with the projected rate, from the Quantity Surveyor’s for the

three major hospital projects, of 6% in the next few years.

The Gold Coast University Hospital is the largest and most complex building

project undertaken in Queensland. The size, complexity and program for

implementation of the project requires the earliest possible commitment of

all project resources:

• the quality of the organisations, ensuring:

− overall capability,

− required experience,

− demonstrated methodology and approach;

• commitment of the best possible resources within an organisation;

and

• commitment of the number of resources, given that the largest public

building project had a maximum peak resource requirement of

approximately 1000, and a projected peak workforce for the Gold

Coast University Hospital exceeding 2500 workers.

The demand for construction workers and the escalation risk are illustrated

by the following graph of historic growth in the gap between work

undertaken and work outstanding in Queensland, which will be further

exacerbated by the upcoming major infrastructure commitments.

This graph illustrates the widening gap between the capacity of the market

(work done) and the work undertaken, which if it continues, and potentially

exacerbated with the introduction of major infrastructure projects, will result



CONFIDENTIAL DRAFT


in significant competition for subcontractor organisations capable of

undertaking the projects, project resources and price escalation risk.

The impact of this ‘widening gap’ between work done (industry capacity)

and work outstanding will also be impacted by the potential requirement

for additional resources in the two other eastern states.

Whilst the growth in NSW work volume/value outstanding is relatively

constant, the increase in outstanding work volume in Victoria will also

increase demand for construction resources, impacting on the potential for

additional resource capability for south-east Queensland projects.



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2.3 Managing Contractor Procurement

The Department of Public Works and Queensland Health have a successful

history of implementation of Managing Contractor projects, both within

time and budget to the required standard and quality. Example projects

include Royal Brisbane Hospital (Centre and West Blocks and Block 7),

Prince Charles Hospital expansion, PA Hospital, Townsville Hospital, Logan

Hospital and Redlands Hospital.

Other significant state projects successfully delivered through this form of

contract include Skilled Stadium and Woolloongabba Stadium extensions

(both single select tenders), Suncorp Stadium, Gallery of Modern Art and

State Library extension, Brisbane Magistrates Courts and Corrective Services

facilities at Townsville and in S E Queensland.

Key characteristics of the Managing Contractor form of procurement are:

• typically successful where an initially undefined brief can be

developed by the Managing Contractor, achieving the benefit of

input from the contractor during the design phase – design

consultants are engaged by the Managing Contractor for the design

development and documentation phases, typically warranting the

design and that the completed facility will meet the client brief;

• can also significantly assist in meeting time constraints including an

earlier start to construction, since the contractor has the capacity to

overlap design development and construction activities, avoiding the

delays of more traditional forms of procurement that require clearer

definition of all requirements and a tender call and evaluation

process prior to award of the contract – early commencement is

achieved through letting of early packages of work, such as site

clearing and bulk excavation, with the overall design, coordination

and interface responsibility resting with the Managing Contractor;



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• for complex projects, where it is essential not to exceed an agreed

budget, a managing contractor guarantees an overall construction

sum (typically referred to as the Guaranteed Construction Sum (GCS),

which will not be exceeded unless the client changes the scope of

the project following contract award; and

• typical Managing Contractor contracts provide for packages of work

to be tendered progressively to suit the overall construction program

and any savings between the actual trade tendered prices and the

trade components of the GCS are shared between the client and the

managing contractor at a pre-agreed ratio.

3 CURRENT STATUS

3.1 Appointment of a Building Consultant

In accordance with the principles of procurement endorsed by the

Infrastructure Cabinet Sub-Committee, the Department of Public Works

undertook a two stage registration of interest process from the major

contractors capable of undertaking the major infrastructure projects,

including Gold Coast University Hospital:

• the first stage being a registration of interest – two organisations

nominated for the Gold Coast University Hospital project: Bovis Lend

Lease and John Holland Group; and

• the second stage, a detailed submission from these two registered

organisations addressing:

− their major relevant project experience and capability,

− resources,

− methodology, and

− value-adding opportunities.

These submissions addressed the requirements for both the early contractor

involvement, through the engagement of a ‘building consultant’ in the

early design stages, and the subsequent managing contractor

implementation role.

Following evaluation of the detailed submissions, Bovis Lend Lease was

appointed as the ‘building consultant’ for the early design stages. This role is

being successfully implemented with positive outcomes for the project.

Bovis Lend Lease’s submission also included the opportunity to provide

advice during the design process on how facilities management and long

term maintenance issues are incorporated into the design of the project,

addressing an additional procurement principal outlined above.

3.2 Preparation of Early Works Packages

Detailed programming advice from both the Program Consultant and from

the Building Consultant has confirmed a requirement to commence on-site

construction activities in September 2009 in order to complete the project

within the Government’s public commitment to a completion date for the

new Gold Coast University Hospital of December 2012.



CONFIDENTIAL DRAFT


Two contracting options exist to achieve the September 2009

commencement:

• award the Managing Contractor contract, and commence works

under that contract; or

• award an early works contract under a Construction Management

(CM) form of contract, and subject to finalisation of the Managing

Contractor contract, incorporation of this CM contract into the

Managing Contractor Contract, when let.

The project team considers that in relation to the first option, for finalisation

of an acceptable GCS within this timeframe, the risk premium that would

most likely be incorporated into a GCS by the Managing Contractor would

be unacceptable, as:

• insufficient definition/documentation currently exists i.e. project scope

is not fully defined; and

• subcontractor/trade tender pricing in support of the GCS would not

be obtainable.

An early works Construction Management contract incorporating the

following elements, is therefore being prepared:

• site establishment including:

− fencing,

− site accommodation;

• demolition of existing buildings;

• services diversions;

• bulk excavation; and

• early structural works, as required.

3.3 Preparation of Tender Documents for Managing Contractor

Currently tender documents are being prepared on the basis of a 2 Phase

Managing Contractor Contract, namely:

• Phase 1: Managing Contractor appointment for design development

and major trade subcontract tender process, leading to submission of

a single Guaranteed Construction Sum upon completion of Design

Development; and subject to satisfactory completion of Phase 1

• Phase 2: Documentation and Construction of the project.

The generic form of the contract is being modified to reflect the detailed

requirement and strategies unique to this project. MinterEllison Lawyers have

been engaged to provide detailed advice on the contract.



CONFIDENTIAL DRAFT


4 FUTURE ACTIONS

4.1 Managing Contractor Tender Process

The process for selection of the Managing Contractor is proceeding in

accordance with the direction endorsed by the Infrastructure Cabinet

Subcommittee and the following key procurement principles:

• finalisation of the MC selection based on the results of the two stage

registration process:

− where clear benefit can be demonstrated, by single select

tender, or

− limited select tender;

• use of a known contract form such as a Managing Contractor

(Negotiated Guaranteed Construction Sum) contract, specifically

amended to suit each individual project for risk management and

allowing early trades to commence while the design is being finalised;

and

• obtaining key subcontractors’ input into the design, allowing amongst

other benefits, resources and industry production rate constraints to

be factored into the overall project duration.

4.1.1 Single Select Tender For Managing Contractor

A two stage submission process for the selection of the Managing

Contractor has been undertaken by the Department of Public Works,

incorporating an initial role as Building Consultant. This process has resulted

in the selection of Bovis Lend Lease as Building Consultant. The second

stage of submissions required details of major relevant project experience

and capability, level of resources, understanding and approach to the

project methodology and value-adding opportunities for both an initial

Building Consultant role and for the subsequent Managing Contractor role.

In the evaluation of these second stage submissions, clear separation of the

assessment for the initial Building Consultant role and for the Managing

Contractor role was undertaken. In all evaluation criteria Bovis Lend Lease

demonstrated outstanding ability and clearly outranked, in all criteria, the

John Holland Group.

This process has established Bovis Lend Lease as the only contractor with

the capacity and capability of delivering the project to the quality and

complexity required under the time and market constraints that exist.

In addition, Bovis Lend Lease has:

• successfully undertaken the largest recent government building

project;

• successfully completed the largest recent hospital development

project in Queensland (under a Managing Contractor contract) –

delivered on time and on budget;



CONFIDENTIAL DRAFT


• a national and state based commitment to health projects including

development and support of health specific project teams;

• international experience on major hospital projects – transferring this

knowledge and experience to the development of a world class Gold

Coast University Hospital;

• appropriate resources becoming available from other projects to suit

the proposed timeframe for the Gold Coast University Hospital project;

and

• recently been successful on comparable large managing contractor

projects in other states (separate delivery teams).

The assessment undertaken for the Managing Contractor role represents

the ‘non-price’ criteria that would be applicable for any competitive

tender process. The non-price criteria typically has a 70% weighting of the

total assessment of a competitive tender process. The remaining portion of

the tender is price, which normally represents a 30% weighting of the total

assessment.

This price component of the tender requires the managing contractor to

tender:

• lump sum fee for design and construction management resources;

• lump sum fee for on site overheads;

• lump sum fee for consultant design and documentation fees; and

• % fee for profit and overheads

Note that all tendered resources are scheduled and costed for the tender

program for the project and must be based on previously competitively

tendered resource estimates from the two stage tender assessment. The

main design consultant fees have been previously competitively tendered

by the Department of Public Works. Physical resources associated with on-

site overheads are competitively tendered later in trade costs as part of the

GCS.

The total of all fees tendered in this stage is typically of the order of 20% of

the project costs.

4.1.2 Why not limited select tender for Managing Contractor anyway?

In undertaking the Building Consultant role, Bovis Lend Lease has developed

a detailed understanding of site issues, client group/stakeholders

requirements, the detailed design, programming issues and subcontractor

industry capability. Therefore:

• Bovis Lend Lease has unfair knowledge/a competitive advantage

over any other tenderer (in addition to the assessed value confirmed

in their tender submission);

• a ‘level playing field’ does not exist;

• undertaking a select tender would be counter productive for the

client project team and for Bovis Lend Lease in diverting their



CONFIDENTIAL DRAFT


attention from the planning and management of activities to

maintain the overall program;

• Bovis Lend Lease will manage the design development process

reflecting partially their proposed procurement

approach/methodology, with the potential for a delay and

associated increased costs for the project for re-design (if they were

not selected);

• any other tenderer may consider that any tender process that was

undertaken was only being done as a ‘check price’, and that the

likelihood of their appointment was minimal, with their involvement a

waste of their time; and

• a fall back strategy is in place should the single select tender process

not be successful, enabling early works to continue under a separate

Construction Management agreement, minimising the program

impact.

4.1.3 Ensuring Value for Money from the Managing Contractor Tender

Process

In following a single select tender process, it is important that mechanisms

are established to continually assess that the two stage tender assessment

already undertaken of Bovis Lend Lease as the best organisation, and the

‘value for money’ for the project, is maintained. This is achieved through the

following mechanisms:

• Managing Contract Fees Issues:

− Profit and overheads – known margins from tendering

organisations from previously submitted managing contractor

tenders against which final margin can be benchmarked,

− On-site overheads (physical resources)– to form part of the trade

contract component for the project, and tendered as part of

finalisation of the GCS,

− Design consultant’s fees – major design consultant’s fees have

already been separately competitively tendered by Department

of Public Works, for defined scope of services,

− Contractor resource management team costs – projected

resource levels already submitted as part of Building

Consultant/Managing Contractor tender process, with required

resource levels benchmarked to suit detailed program

developed during the Building Consultancy role. The proposed

methodology will also be compared against that already

submitted with the Building Consultant/Managing Contractor

tender.

The resource levels and methodology competitively submitted

was assessed as being both the necessary level of resources and

the required experience, for the most complex public building

project in Queensland.

− Rates for resources to be benchmarked against previously

submitted Building Consultant/Managing Contractor tenders.



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The majority of this fee can be benchmarked against previous

tenders/projects and the resource commitments submitted as part of

the Gold Coast University Hospital two stage tender processes already

undertaken.

• Experienced Contract Finalisation Team - the client team includes

organisations and individuals experienced in negotiations of

Managing Contractor contracts:

− Public Works – Procurement Manager,

− Capital Insight – Project Manger,

− Davis Langdon – Quantity Surveyor,

− TBH – Programmer,

− Queensland Health – Project Director.

In summary, it is considered that there is little prospect of obtaining any

significant price advantage in seeking competitive managing contractor

tenders. This is particularly evident given the very limited areas in the tender

where there is actual price competition. It is possible that another tenderer

may seek to “buy” the project with an under resourced proposal and low

margin price. The consequences of such a result is that project outcomes

would be unlikely to be achieved, with the Bovis Lend Lease tender

submission already assessed as providing the required level of resources.

Any delay in tender award and/or delays from introducing another

contractor would result in significant cost increases to budget which would

not be offset by possible reduction in tender costs, if any, for this stage.

4.2 Guaranteed Construction Sum (GCS) Submission and Agreement

4.2.1 Typical GCS Agreement Process

Typical Managing Contractor contract provides for:

• submission of a GCS during the design development phase, based

on:

− scheme design and partially developed design documentation,

− ‘trade cover’, rather than tendered trade package pricing. Trade

cover represents indicative pricing and program projections from

the Managing Contractor’s preferred sub-contractors, rather

than fixed prices and programs,

− an assessment of/allowance for risk including contingency and

escalation;

• finalisation of the GCS following negotiations on the value of the GCS

prior to contract award; and

• post contract award packages of work to be competitively tendered

progressively to suit the overall construction/contract program and

any savings between the actual construction cost (total of all trade

costs) and the GCS are shared between the client and the Managing

Contractor at a pre-agreed ratio.

4.2.2 Proposed GCS Agreement Process

The process proposed for Gold Coast University Hospital includes:



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• tendering key major trade packages during the design development

phase, with price finalisation at GCS submission based on the

completed design development documentation;

• the balance of the trade packages will be tendered post GCs

acceptance, as outlined above for the ‘typical’ GCS process; and

• key major trade contractors will participate with the Managing

Contractor and the design team during design in value adding

opportunities in design reviews, construction planning and cost

planning

A table at Attachment 2 summarises the proposed allocation of pre-

contract competitive trade pricing and those trades where (trade) price

cover is not competitively priced pre-contract i.e. competitively priced post

GCS finalisation.

The target is for approximately 80% of the trade pricing to be competitively

tendered prior to finalisation of the GCS.

4.2.3 Benefits of Proposed Process

The proposed subcontractor procurement process addresses a number of

key risks to the project program and budget:

• Long term securing of resources. The graphs provided earlier in this

paper identify a widening gap between the volume of work done

and volume of work undertaken, which will increase the demand for

construction resources. The proposed procurement method secures

the required level/best and largest organisations and resources for

key trades on the largest and most complex building project in

Queensland, earlier than otherwise possible.

• Secures larger subcontractors earlier – risk that project delay in

appointment of subcontractors could result in more smaller

subcontractors being utilised with increased interface risks, and

associated quality and cost risks.

• Reduction of the risk premium incorporated into the GCS by the

Managing Contractor by including trades into the process of

finalisation of the design and planning for the project. Key trades will

better understand both the project requirements and the project

team, leading to:

− more robust and reliable pricing,

− more accurate project planning/programming, leading to more

accurate prices,

− a lower risk or contingency allowance being incorporated into

the subcontractor tender price and the Managing Contractor

GCS.

• The potential to obtain better design and building efficiency from key

trades through early involvement, also reducing the subsequent costs

for further design development and contract documentation.

• Earlier involvement of Managing Contractor and subcontractors

enables earlier planning and implementation for Local Industry



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Participation Plan, leading to earlier knowledge of the specific project

requirements, planning of resources and commitments.

• Maintaining the competitive pricing of a large percentage of the

trade costs, pre finalisation of the GCS. This will also lead to a greater

likelihood that an acceptable GCS will be obtained from key

subcontractors and therefore the Managing Contractor in a timely

manner, allowing earlier award of the construction stage of the

contract.

• Reduction of the risk of not obtaining acceptable tenders, which

would lead to delays including the need to re-tender trades or

alternatively utilising an alternative form of procurement.

• Less risk of subcontractor default during the project due to better

understanding of the project scope, the project team and their

relationship with the Managing Contractor.

• Earlier understanding of all issues associated with finalisation of the

GCS.

• Should agreement of the GCS not occur the contract will be

terminated and it is anticipated that a competitive document and

construct form of contract would be tendered following completion

of design development.

4.2.4 Ensuring Value for Money

Value for money in the finalisation of the GCS, during Phase 1 of the

Managing Contractor role, will be maintained by the following 2-step

process:

Step 1: Subcontract Non-Price Tender:

• Select list of tenderers approved by the Principal;

• Tender on stated non-price criteria for appointment as ‘preferred’

subcontractor;

• no guarantee of project award;

• select short listed minimum 2 preferred subcontractors for each trade

providing:

− opportunity for price competitiveness at appropriate time,

− options to split scope between more than one subcontractor,

− fallback if a subcontractor withdraws from the process; and

• different trade models available dependent upon market response,

with inherent flexibility.

Criteria for this tender would include the following:

• relevant experience and capability (including financial) statement;

• proposed key team members for the project;

• construction management methodology including safety;

• ability to provide design advice;



CONFIDENTIAL DRAFT


• Value Adding ability;

• demonstration of level of commitment to project;

• fees for services pre subcontract engagement (i.e. pre GCS); and

• capability of delivering long term maintenance for up to 20 years

(services contractors).

A third party probity auditor would be involved to ensure the Government’s

required levels of probity are maintained.

Step 2: Subcontractor Cost Plans for Final Cost Plan Input

Key Issues:

• realistic cost plan provided: in competition until submission of final

pricing on design development documentation;

• competitive ‘tender’ pricing of representative bill of quantities, if

necessary, with rates becoming part of binding contract at post GCS

engagement;

• as progressive design information becomes available, subcontractors

update trade specific cost plans for their prospective works subject to

cost plan review by the client’s QS and the Managing Contractor,

against current cost plan;

• where differences occur, assessment made regarding reasons and

adjustments made to either cost plan as appropriate;

• GCS Offer by Managing Contractor will be based on binding costing

for their works from the appointed ‘preferred’ trade subcontractors;

• competitive pricing obtained from ‘preferred’ trade subcontractors,

subject to formal tender submission process; and

• pricing to be used in determination of final subcontractor for each

area of work.

For those components of the GCS that are not subject to the formal trade

tender process, the Managing Contractor will obtain indicative pricing from

trade contractors. These prices will be used to establish the overall GCS.

During Phase 2 of the Managing Contractor role, these trades will be

competitively tendered (at the appropriate time). Upon completion of all

such tenders, the overall GCS saving would be calculated and allocation of

relevant percentages made.



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ATTACHMENT 1 – DELAY COSTS OF ALTERNATIVE FORMS OF PROCUREMENT

The table in Section 2.2.1 identifies the timeframes for implementation and

completion of the project utilising alternative forms of procurement. The

estimated delay to completion of the project for these alternatives and,

based on the cost of project delay identified in the Gold Coast University

Hospital Business Case of $8.3 million/month, the cost of this delay are

shown below. These alternative forms of procurement are essentially the

’fall-back’ options, should the Accelerated Managing Contractor

procurement model currently being implemented, not be successfully

finalised.

Alternative Procurement

Method Estimated Delay to the Completion Date 1

Cost of Delay (@ $8.3m/month)

Lump Sum 14 months $116.2m

D&C 10 months $83m

DD&C 6 months $49.8m

Managing Contractor 2 7 months $58.1m

Notes:

1: Delay based on continuous program i.e. no delays in changing from Managing

Contractor procurement. Extent of any delay is subject to timing of decision to

change form of procurement. 2: Assumes separate MC tender process commences in April 2009 following

completion of design development.



CONFIDENTIAL DRAFT


ATTACHMENT 2 – PROPOSE ALLOCATION OF TRADE PRICING

The following table summarises the proposed allocation of pre-contract

competitive trade pricing and those trades where (trade) price cover is not

competitively priced pre-contract i.e. competitively priced post GCS

finalisation. The Total Trade estimate reflects the Elemental Analysis of

Functional Area Cost Plan, which forms part of the estimate in the PDP Cost

Plan. This estimate exceeds the budget allowance and a ‘value-

management’ process is currently being undertaken to reduce the

estimated project costs, to the Project Budget allowance. The cost plan

does however illustrate the appropriate trade-by-trade proportion of

estimated trade costs.

The target is for approximately 80% of the trade pricing to be competitively

tendered prior to finalisation of the GCS.

Element rate /m² Cost

Total Trade

Estimate

$'000 % Total

Trade Price

pre-GCS

$ '000 % Total

Trade Price

Post-GCS

$ '000 % Total

Sub structure 14,025$ 1.7% 14,025$ 1.7% -$ 0.0%

Columns 8,250$ 1.0% 8,250$ 1.0% -$ 0.0%

Upper Floors 54,450$ 6.6% 54,450$ 6.6% -$ 0.0%

Staircases 5,775$ 0.7% 0.0% 5,775$ 0.7%

Roof 16,500$ 2.0% 16,500$ 2.0% -$ 0.0%

External Walls & Windows 74,250$ 8.9% 74,250$ 8.9% -$ 0.0%

External Doors 1,650$ 0.2% 1,650$ 0.2% -$ 0.0%

Internal Walls & Screens 54,790$ 6.6% 54,790$ 6.6% -$ 0.0%

Internal Doors 13,356$ 1.6% 0.0% 13,356$ 1.6%

Wall Finishes 14,222$ 1.7% 0.0% 14,222$ 1.7%

Floor Finishes 21,782$ 2.6% 0.0% 21,782$ 2.6%

Ceiling Finishes 14,692$ 1.8% 0.0% 14,692$ 1.8%

Fitments 40,788$ 4.9% 0.0% 40,788$ 4.9%

Hydraulics 41,955$ 5.1% 41,955$ 5.1% -$ 0.0%

Mechanical 80,490$ 9.7% 80,490$ 9.7% -$ 0.0%

Medical Gas 5,207$ 0.6% 5,207$ 0.6% -$ 0.0%

Electrical 64,459$ 7.8% 64,459$ 7.8% -$ 0.0%

Security & CCTV 2,613$ 0.3% 2,613$ 0.3% -$ 0.0%

ICT 11,533$ 1.4% 0.0% 11,533$ 1.4%

Electronic Fire 4,950$ 0.6% 4,950$ 0.6% -$ 0.0%

Wet Fire 9,900$ 1.2% 9,900$ 1.2% -$ 0.0%

BWIC 4,401$ 0.5% 4,401$ 0.5% -$ 0.0%

Trade preliminaries 41,250$ 5.0% 41,250$ 5.0% -$ 0.0%

Sub-total 601,288$ 72.5% 479,140$ 57.7% 122,148$ 14.7%

Central Plant/Engineering 131,605$ 15.9% 131,605$ 15.9% 0.0%

External works / siteworks 50,000$ 6.0% 0.0% 50,000$ 6.0%

Sub-total 782,893$ 94.3% 610,745$ 73.6% 172,148$ 20.7%

ESD Initiatives (Green Star) 46,937$ 5.7% 46,937$ 5.7% 0.0%

Total - Trade Costs 829,830$ 100.0% 657,682$ 79.3% 172,148$ 20.7%


September 2008


K ESD initiatives summary 1 page

PROJECT: Gold Coast University HospitalREPORT: ESD Initiatives Summary - $47 million budget solutionREVISION: 04DATE: 5/08/2008

ITEM Description Comment Recommended Q Health Cost Sub Totals

1 GBCA Greenstar Healthcare registration

Registration in Oct 08 may allow further dialogue with GBCA re: healthcare tool,and keep options open however will require engagement of a consultant by QH tomanage the process. This would require an upgrade to consultant TOR's Y $500,000

2 Undertake Energy modelling

The GCUH Engineering JV is in dialogue with GBCA regarding energybenchmarks. Some additional modelling sevices are recommended to investigatean appropriate level of investment in energy minimisation for the façade Y $300,000

3 Accreditation to Greenstar Healthcare tool not includedNot proposed noting that Healthcare is only a Pilot at present and noting thatadditional costs for compliance will be required even with a 4 star target N

4 Commissioning clauses Include in trade package specs Y5 Building tuning Include in trade package specs Y $1,000,000

6 Commissioning agent

Experience has shown that appointment of an independent commissioning agentcan be expensive due to the scope of service required. Not recommenmded due tocost N

7 Building users guide

To the extent that the design adopts special ESD design features and requiresoperational management upgrade of the usual O&M manuals to a full buildingusers guide could be beneficial. This would require an upgrade to consultant TOR'sand trade specs Y $500,000

8 Environmental management to ISO14001 Recommended and needs to be specified in MC contract Y9 Waste management Recommended and needs to be specified in MC contract Y

10 Construction Indoor Air Quality planRequires building flushout and 2-weeks additional construction time toaccommodate, therefore not recommended due to cost and time N

11 Building Management systemsAdditional metering will be included to achieve a reasonable extent of monitoring,design to budget, not to GBCA requirements Y $500,000

12 $2,800,000

13 Ventilation ratesIncreased for infection control reasons only, in HVAC design however not proposedto suggested GBCA requirements due to energy impact N

14 DaylightingImproved daylighting for inpatient units for comfort is proposed but not to currentGBCA requirements which are not practical for a tertiary hospital N

15 Daylight glare control Being considered in façade design but not to GBCA requirements N16 High Frequency ballasts Included in electrical design Y $0 Electrical Simon Forster

17 Electric lighting levels

Being optimised in electrical design but not to GBCA requirements, which are morealigned to an office environment. Energy efficient lighting is proposed including inclinical areas N

18 External views Being considered in façade design but not to GBCA requirements N19 Thermal comfort Being optimised in mechanical design but not to GBCA requirements N20 Comfort control Being optimised in mechanical design but not to GBCA requirements N21 Low VOC's in: $1,000,00022 Wall & ceiling finishes This is considered to be worthwhile to improve IEQ Y23 Carpet & Floor finishes This is considered to be worthwhile to improve IEQ Y24 Adhesives & Sealants Buildability challenges make this hard to achieve N25 Matresses QH need to consider this in review of their policy on matresses design. Y26 Formaldehyde minimisation This is considered to be worthwhile to improve IEQ Y

27 Mould prevention

HVAC design will consider infection control requirements only, but notimplementing humidity control to GBCA requirements due to energy and costimplications Y

28 Exhaust Riser Dedicated printing rooms not envisaged in SD N29 Air distribution systems Designs will adress requirements of infection control guidelines which meet this req Y

30 Outdoor pollutant controlSome reasonable provision is proposed in mechanical design but not to GBCAfiltering requirements, compliance would require modelling and filtering N

31 Places of Respite Included in SD Y $1,000,000

32 Energy improvement

This is a key issue with the level of energy improvement benchmark improvementstill under investigation. The design is proposed to have significant improvement inenergy consumption from previous similar facilities.

33 Co-generation Separate energy feasibility study in progress Y $14,000,00034 Heat Exchange Proposed in HVAC Y $3,000,00035 Displacement in WBS, WBW, MEH Proposed in selected areas Y $600,00036 Controls Y $500,000

37 ModellingAdditional modelling may be required to achieve energy benchmarks. This will bereviewed Y $250,000

38 Façade design

Façade design is a balance of daylighting, energy efficiency, comfort, externalviews, glare control and a balance of capital and recurrent costs. Extent of façadeESD may be optimised. The design team believes that the opportunity may existfor some of the allowance to be utilised for a solar PV installation Y $16,500,000

39 High efficiency chillers Chiller selection will include as a primary consideration efficiency Y

40 Variable speed controls for pumps and fansVariable speed controls for significant pumps and fans can provide energyefficiency Y Mechanical Kevin Eaton

41 Efficient motor selectionSelection of energy efficient motors optimised for application can provide energyefficiency Y Mechanical Kevin Eaton

42 Electrical sub-meteringAdditional metering, design to budget but not to GBCA requirements, metering ofmajor zones and large plant will be included N $500,000 Electrical Simon Forster

43 Lighting zoning & control Includes lighting dimming and automatic control to appropriate areas Y Electrical Simon Forster

44 High efficacy external lightingEfficient and long lamp life lighting designs for external areas are recommendedfor energy efficiency and maintenance minimisation Y Electrical Simon Forster

45 Peak Energy Demand reduction

Proposed to make space provision only for power factor correction. Not proposedto include peak demand reduction in hospital due to conflict with operationalrequirements. If co-gen adopted then it would effect this requirement N

46 Medical equipment efficiencyQH issue however difficult to enforce, perhaps a policy in equipment evaluation,naturally medical functional requirements will need to be a priority Y

47 Stairs Additional stairs for improved circulation (already included) Y $500,000 $35,850,000

48 Car parking In BOOT but not to strict GBCA requirements due to interpretation issues N49 Fuel efficient transport In BOOT but not to strict GBCA requirements due to interpretation issues Y50 Cyclist facilities Included in design for BOOT but not to GBCA requirements Y

51 Proximity to public transport Good proximity in design but not GBCA requirements as GCRT is a future service Y52 Pedestrian routes Include in landscape design Y

53 Potable water efficiency Impliment to comply with new QDC standards Y54 Water meters Impliment to comply with new QDC standards Y55 Landscape irrigation water efficiency Impliment to comply with new QDC standards Y $1,000,000

56 Cooling tower water consumptionWater treatment of GCCC recycled waste water proposed to minimise impact ofwater consumption Y $1,000,000

57 Fire system water consumption Test water harvesting will be implemented to new QDC requirements Y58 Potable water use for equipment cooling QH issue to be considered in equipment procurement where appropriate Y

59 Extension of GCCC recycled water mainProposed to connect to existing GCCC main. Headworks costs and recurrent coststo be determined by GCCC Y

60 Recycled water for fire systems Being investigated Y61 Rainwater harvesting Extensive rainwater harvesting proposed for GCUH project Y $2,000,000

62 Recycling waste storage Design is including waste storage Y63 PVC minimisation Design to budget but not to GBCA requirements N $950,000

64 Sustainable timber Team proposes to minimise use in design but not following GBCA requirementsdue to implementation problems Y

65 Flooring Linoleum cost is nil ,however other alternatives require further cost investigations N66 Ceiling , walls and partitions Design to budget but not to GBCA requirements Y $2,000,00067 Joinery Design to budget but not to GBCA requirements Y $1,100,00068 Loose joinery QH issue Y $1,300,000 $5,350,000

69 Ecological value of site Site selection has considered ecological value Y70 Re-use of land Greenfield site so N/A N71 Reclaimed contaminated land N/A72 Change of ecological value Site will be effected by development for a hospital. Can not comply N73 Topsoil and fill removal Design has been optimised to reduce extent of cut N74 Sediment & Erosion control To GCCC requirements Y75 Stormwater detention To GCCC requirements Y

76 Refrigerant ODP Low ODP proposed but not to GBCA requirements N77 Refrigerant GWP Low GWP proposed Y78 Refigerant leak protection To be included Y

79 Watercourse pollution reductionRainwater harvesting proposed, extent of WSUD design in landscape to beresolved Y tba

80 Reduced flow to sewer Water efficient fixtures will result in reduced flow to sewer Y81 Light pollution minimisation Lighting design will be tailored to site application to minimise spill Y82 Cooling towers Cooling towers proposed for energy efficiency utilising recycled water Y Mechanical Bill Drake83 Insulant ODP Will be considered in insulant specification Y

84 Trade waste pollution Extent of investment in trade waste treatment expected to be limited due to cost N

85 Airborne emissionsCompliance requires extensive modelling. Filtering unlikely to be cost effective ornecessary for general aplications N $0

TOTAL $47,000,000 $47,000,000

Discipline Leader Responsibility

Emissions

Land use & Ecology

Materials

Water

Transport

Energy

Indoor Environment Quality

ManagementEngineering Discipline Responsible for ESD Initiative

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September 2008


L Interim Demand Management Strategy – 2008/09 proposals 1 page

Interim Demand Management Strategy Proposals for 2008/09

Reference Priority Service Description Fully/Part Funded

Status Capital

Status Operational District to resubmit in a funding submission for 2009/10

Gap

1 Carrara Facility Purchase facility to provide 63 subacute beds, provide recurrent funds sufficient to support increased acuity at Southport Hospital (medical, surgical, cancer)

Part Full Non Recurrent N/A Recurrent funds for 30 acute medical, 7 cancer and 26 acute surgical beds

Backfill of 16 MH beds & 19 Beds IMH RobinaPalm Beach Currumbin Lease (Mental Health)

3 Community Care Units - MPurchase accomodation for 44 non acute mental health beds

Not Not Funded N/A These beds do not contribute to "acute" hospital bed projections

4 Pacific Private Lease (Pallative Care beds)

Lease Palliative Care until Robina Stage 3 completion in 2011

Part N/A Non Recurrent Required until 2011

9 subacute/ medical beds Not N/A Not Funded Required until 2011 or 20125 Coomera Land For Future Health Precinct/ Hospital Full Full N/A

6 2nd Computer Axial Tomography scanner (CT) at Southport

Refurbish and install CT Full Full Recurrent N/A

7 Southport Emergency Expand Emergency Department Full Full Recurrent N/A

8 ICU Expansion 3 Beds Refurbish, 6 beds operationing costs

Part Not Funded Recurrent (part) N/A 3 ICU beds short will delay GCUH commissioning

9 Specialist Private Practice OPD

Provide Outpatient Capcity to support inpatient services

Not Not Funded Not Funded/ Non Recurrent Have a persued a non recurrently funded lease. No recurrent operating budget

GCUH is predicated on a strong community sector to allievate inpatient and ambulatory needs. Without these services the bed numbers and ambulatory services are insufficient

10 Community and Ambulatory Services

Broad service growth to support GCHSD requirements

Part N/A Part Recurrent (1 Community Based Reahb Team)

The bulk of this initiative was not funded

GCUH is predicated on a strong community sector to allievate inpatient and ambulatory needs. Without these services the bed numbers and ambulatory services are insufficient

11 Medical Bed Package Additional beds vis refurbishment and medical support services

Not Not Funded Not Funded Capital Delay now makes these options no longer viable

Increased funds required to commission these services as now unable to easily support locally prior to GCUH opening

12 Gold Coast Surgicentre Day surgery lease and activity Full N/A Recurrent N/A

Source:

2 Mental Health Full N/A N/ANon Recurrent

Funding Submission - Gold Coast Health Service District - Demand Management Strategy: High Priority Strategies

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