THE DEPARTMENT OF HEALTH

THE DEPARTMENT OF WORKS

THE INDEPENDENT DEVELOPMENT TRUST

HLABISA HOSPITAL PRESIDENTIAL LEAD

PROJECT

THE PROVINCE

OF KWAZULU-NATAL

THE PROJECT BRIEF & EXECUTIVE SUMMARY

NOVEMBER 2004

HLABISA HOSPITAL PROJECT

STEERING COMMITTEE

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HLABISA HOSPITAL: PRESIDENTIAL LEAD PROJECT BRIEF (WCS 027026/0001) 2004-11-25 PROJECT OVERVIEW: The project was initiated by Presidency’s visit to Hlabisa Hospital on the 14 February 2004. The Visit was part of the Presidency on-going Imbizo between various stakeholders of Previously Disadvantaged Rural Areas and the Government. Hlabisa Hospital was identified by a Presidential Task Team and would serve as a Pilot Project/ Proto-Type for similar events planned throughout the Republic in the next few years. On the 28 February 2004, the Presidency briefed Works Department Officials: on the Identifiable Projects and Priorities, as Identified between the Presidency and the Hospital Management (DOH). A three-legged approach to this matter was identified by the Presidency: Priority One: The Hospital Staff Accommodation:

• Student and Senior Nurses • Medical Officers (Doctors, Radiologists, Medical Technicians, etc.) • The lack of Recreational Facilities. I.e. For communication: Internet Facility, a library, etc.

And secondly Sporting Facilities Priority Two: The Female Ward, as the present situation being housed in the Pediatrics Ward. Priority Three: The Pathology Laboratory - Which is needed as the existing facility is also housed in the Pediatrics Ward The Main Objectives were:

• To Capacity Building within the Hlabisa Municipality & District, • The involvement of Previously Disadvantaged Individuals and SMME’s in the role of

Capacity Building, local skills advancement and training, • To improve the Service Infrastructure at the Hospital, i.e. Roads, Sewer and Water

reticulation and Electricity, • To improve the living conditions of the Staff employed by the Hospital, • Upgrade and improve the working conditions as well as the conditions of bedded patients

at the Hospital. In the Process that followed, a Project Steering Committee (PSC) was established as part of the Project Implementation Plan, under the Chairmanship of the KZNPA Minister of Health and comprises the Provincial Stakeholders: The KZNPA Department of Health, The KZNPA Department of Works, The Presidency and Other Stakeholders. Later included the Independent Development Trust as Part of the implementation strategy and as an integral part of the Tri-Party Agreement (the Programme Implementation Agent Agreement). The Functions of this Body includes:

• Provisions for strategy and policy directions (For the Project), • Budgets and allocations of funds to the Project,

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• Standards and approval of building plans, • Monitoring of expenditure of funds • And overall co-ordination of the Project Provincially.

Subsequent, to the initial brief, the PSC has deemed it necessary to include other projects into the master project as part of the service delivery to the Hospital and the Community at Hlabisa. THE PROJECT IN BRIEF: In order to facilitate the scope of work presented, the project has been broken into various sub-projects: Sub-Project 1: The New Nurses (Staff) Accommodation The scope includes the Construction of New facility to house Students Nurses (Male and Female), Nursing Staff and Senior Nursing Staff. The Building Accounts for a Multi-Storied building inclusive of a Dormitory (130Beds) broken in to Units with each unit sharing its own – kitchen, storage and ablution facilities. In addition the building also accounts for (10) one bed roomed flats and (6) two bed roomed flats. Inclusive into the complex is a small library, Internet roof, general-purpose recreation room and a laundry facility. In addition the One Bed and two Bed roomed Flats includes a freestanding Lock-up carport facility for Private vehicles. The Complex in total comprises a total of 5 039m2. Sub-Project 2: The Medical Officers (Staff) Accommodation A totally new facility and/or facilities to House the varied Medical Officers, employed at the hospital. Provisions include:

A. Small Town House Complex comprising of 9 two Bed roomed family Units, i.e. four semi-detached units and one free standing unit), inclusive of Carports (787m2)

B. Two Double Storied (four One Bed roomed units per block), with one Single storied block

of four One Bed roomed units, inclusive of a central car park area inclusive of carports. I.e. a total of 18 one bed roomed flats (1200m2)

Sub-Project 3: The New Recreational Facility & Tennis Court This project scope includes a new recreational Facility inclusive of a Squash Court, a Multi-purpose Hall (for indoor activities – Badminton, Volley Ball, and half a Basket Ball Court), a recreational Lounge with Tea Preparation Area, Ablution facilities and as well as storage facilities. Second to the scope would be the refurbishment and fencing off of the existing Tennis Court that needs to be re-commissioned. The Complex in total comprises a total of 626m2.

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Sub-Project 4: The Female Ward The scope of work for this sub-project includes the re-planning and upgrading of the existing female ward (S-Ward), inclusive of a link passage to a new extension of the ward. Inclusive would be the refurbishment of the Existing Hi-Care Unit, which occupies part of the existing building as well as reconstituting the roof and the roof Structure. The Complex caters for a total of (35) female medical and surgical patients and in total comprises a total of 382m2. Sub-Project 5: The New Pathology Laboratory and Physio-therapy Department. The scope for the project includes to total demolition of the existing H-Ward and re-building a new building to include the new facilities for a Pathology Laboratory, inclusive of a Chemical/ Hematology Pathology Laboratory, General/ Microbiology Laboratory and a Specialist Tuberculoses Laboratory, Chemical storage facility, storage facility, records room, administration area, office and ablution facilities. Included in the project would be the re-installation of the Existing Physio-therapy Department that is at present occupying part of the existing structure. The Complex in total comprises a total of 274m2. Sub-Project 6: The New Male Ward. This project includes the demolition of the existing Male Ward and the building of a totally new Male Ward comprising a Medical Wing, comprising a localizes Psychiatric Ward and isolation ward and a Surgical Wing, comprising a Specialized and localized Burns Unit. The Complex caters for a total of (35 Medical and 32 Surgical) male patients and in total comprises a total of 1385m2. Sub-Project 7: The New CSSD and Re-roofing and Refurbishment of the Existing Operating Theatre. The scope of the project included the construction of a totally new CSSD (Sterilization Department), a link to the Existing Operating Theatres as well as minor alterations and additions to the existing Operating theatres. Inclusive would be the removal of the existing roof and structure and the totally replacement of the same with a roof structure spanning over both the Operating Theatre and the new CSSD wing. In this project the Operating Theaters would be totally refurbished according to DOH Specifications. The CSSD Complex in total comprises a total of 377m2, new building work and the additions and alteration to the Operating Theatres to be a total of 268m2 in total. Sub-Project 8: The upgrading of Services and Infrastructure. This scope includes new extensions to the internal road network to facilitate vehicular traffic to the New Nurses Accommodation, the new M.O. Accommodation, the recreational facility and the new Pathology Laboratory. Secondly, the scope also includes a new internal sewer reticulation system replacing the existing and in order to facilitate the new building and any future expansions.

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Thirdly, the scope further includes new on-site water reticulation both for domestic/ hospital utilization as well as a new Emergency water reticulation for fire hydrants, etc. Fourthly, the scope also includes the upgrading of the Electrical Supply, reticulation (emergency and domestic supply) as well as part-electrification of steam/ gas reticulation on site. SPECIAL CONDITIONS TO SCOPE OF WORK: The phasing of the above-mentioned projects is crucial in the construction phase of the project due to:

• The hospital is a working-health care facility. Thus minimal interruption is essential during the construction period to ensure that the hospital maintains its level of health care and facilities to the community. Secondly, the hospital also has a residential component that should be considered during construction.

• The site is congested as is. The project would inevitably enlarge the hospital by one third

and as there are 7 identifiable projects in 5 identifiable areas, to happen during the construction phase, in various scattered tough out the site, in these areas it is crucial that adequate co-ordination and project management is done by the main contractor to ensure minimal disruption of the flow of supplies and/ or patients to and from the hospital. Recognisance should be taken of the OHS act regulations, and other regulations, acts and by-laws that may exist in the Municipal boundaries.

• Off-site establishment, bulk storage facilities of the main contractor, is essential to ensure

de-congestion of site. It should be arranged by the main contractor that a site be obtained from the Local Municipality for these purposes, in close-proximity of the hospital grounds.

• Recognisance should also be taken that due to the topography, only one entrance and

exit exists and would be used by both the contractor and the hospital. Arrangement should be made with D.O.H. and the hospital for security purposes. A secondary access road can be accommodated for construction purposes along the Western Fence line of the hospital with a temporary entrance just behind the OPD (Out Patients Department). The purpose is to allow for construction vehicles, materials and workmen to access the Southern Section of the hospital with in the vicinity of the areas proposed for the Nurses Home, Female Ward, CSSD and Male ward, Thus minimizing the disruption of the Working section of the hospital. Special care should be taken concerning security to and from site. The contractor should be responsible for:

– Opening up the fence and building a temporary guard house to be manned and staffed with his own security in liaison with the hospital (DOH) security arrangements.

– Construction Workers should be issued with identification tags for identification – Strict access arrangements and ‘Gate Operation Times’ should be arranged

between the Main Contractor and the Hospital Management. This access road should be arranged by the contractor with the Neighbouring Sites, i.e. the Community Hall (Local Municipality) and the Department of Education (The Local High School).

PHASING, CONTINGENCEYS AND CONSTRUCTION: Taking the above into consideration the hospital will have two identifiable construction zones:

- Northern Construction Zone (NCZ): M.O. Accommodation & Recreation Facility and the Pathology Laboratory

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- Southern Construction Zone (SCZ): Nurses Home, Female Ward, CSSD and Male Ward

The Main Reason for Phasing & Zoning The Site is as described above, to minimize the existing traffic of Patients and Deliveries to and from the Hospital as well as to facilitate the Construction on Site. (Priority Refers to a Priority within the contract.)

1. The First Priority is the construction of the Female Ward – this element is critical, as it has already been delayed in the Master (Multi-year) planning of the hospital. Secondly, the current situation is that the exiting female ward has been inadequate and unsuitable to some time and that the hospital management has relocated these patients to a wing in the Paediatrics Ward as a temporary measure.

However, the wish and philosophy of the hospital administration would be to have the Female ward completed totally so as to accommodate the moving of the Male Patients, from the existing male ward to the new Female ward as an interim measure, so as to allow the demolition of the said, existing male ward in preparation for the construction of the new Male ward. Anticipated Construction Period: 9.5 Months

2. The Second priority is the construction of the Pathology Laboratory. As mentioned above, the pathology lab is also accommodated in the Paediatrics Ward, which currently posses a heath risk to the patients in that ward.

The scope includes the removal of the existing Physio-therapy Department from the building to be effected (Old H-ward), and seeking temporary and/ or alternative accommodation, for this department, until the additions and alterations has been completed. The Hospital Management has suggested moving this Department to the Mobile department, which will be accommodated elsewhere until completion of this building. The area allocated to the Path Lab is vacant as is. Once the structure has been upgraded and added to and once everything is complete in full, the Laboratory can move into their new facilities. The Physio-therapy Department can then also be re-located back to their section of the building. Anticipated Construction Period: 8.5 Months

3. Thirdly, the Male Ward. As mentioned in item no.1, the male ward can proceed once the existing male ward structure has been successfully been demolished.

As part of the critical path, the male ward needs to be completed totally before being handed back to the Hospital Administration. There intention is to move the Male patients out of the New Female Ward back in to the newly completed Male Ward and then to move the female patients out of the Paediatrics Ward in to the New Female ward. Anticipated Construction Period: 13.5 Months

4. Fourthly, the CSSD. This priority will be running concurrently with the construction of the Female Ward (Priority 1) to minimalise the disruption of the hospitals functionality in this node. The contractor also needs to be sensitive to the fact that this building would link to the existing Operating theatres and no-interruption whit this facility would be tolerated.

Anticipated Construction Period: 8 Months

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5. The Nurses Accommodation, M.O. Accommodation and the Recreational Facilities can

be grouped together. Construction of these buildings can happen concurrently with items 1 – 4.

However, recognisance should be taken of the position of the Nurses Accommodation, this could be a possible bottleneck scenario for access to the rear of the hospital (Construction of the New Male Ward).

• Nurses Accommodation: Anticipated Construction Period: 21 Months • M.O. Accommodation: Anticipated Construction Period: 10.5 Months • Recreational Facilities: Anticipated Construction Period: 3-5 Months

THE TENDER PROCESS: The Project was fast tracked from its inception on the 28th February 2004. The consultant team prepared the, design, all relevant reports and construction documentation, within 3.5 months. It was decided by the Project Steering Committee, in order of the fast track nature, to go out on Pre-tender Qualification, so as to short list possible contractors that possess the ability, cash flow, technical ability and the relevant skills to successfully complete the project. Recognizance was taken that the documentation called for a Joint Venture type of Contract, thus providing a platform of sharing of skills and know how with SMME’s. It was imperative for this process to be followed as to allow the tendering period to be shortened and to be in line with the fast-track nature of the project. The Pre-tender Qualification was Advertised in the relevant Provincial News papers on the 3 – 4 June 2004 with a Compulsory Site Inspection of interested parties on the 8 June 2004. The Pre-tender Qualifications Closed on the 24 June 2004. About 19 contractors of various backgrounds attended, however only four contractors responded. The second round of tendering started on the 13 July where the Qualified Pre-Tenderers attended a second Compulsory Site Meeting where the Bills of Quantities were issued to them and the tendering period started. This process was finalized with the tenders closing on the 10 August 2004 with only three contractors whom Pre-Qualified returned documentation. The process then went to the Independent Development Trust, whom adjudicated the tenders on in committee on the 21 September 2004 and recommended that the Contractor to be Appointed to the Project Steering Committee, whom successfully approved the contractor, Messrs. Grinaker/LTA in Joint Venture with SMS Construction on the 15th October 2004. Site was handed over to the Contractor in full attendance of the Project Steering Committee on the 20th October 2004.

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PROJECT COSTS: SUMMARY OF PROJECT COSTS AS PER TENDER DOCUMENTATION GRINAKER/LTA & SMS J.V. 1 Staff Accommodation New Nurses Accommodation R 27,866,797.23 M.O. One Bed Room Units R 8,876,517.08 M.O. Two Bed Room Units R 5,687,945.43 Recreational Facility R 4,650,918.45 R 47,082,178.19 2 New Pathology Laboratory R 6,678,458.64 3 New CSSD & Theatre R 4,834,822.14 4 New Female Ward R 4,464,095.40 5 New Male Ward R 9,285,743.43 6 General Site Works R 6,870,702.21 Total Value of Contract (incl. VAT) R 79,216,000.01

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