The Future of St. Paul’s Hospital

A big move, a big project, a big conversation

On September 17^th people gathered in one of SFU’s downtown classrooms for a special City Conversation event that focused on the relocation of St. Paul’s Hospital. The hospital is proposed to make the move from busy Burrard St. in the West End of downtown Vancouver to the False Creek Flats (an emerging eco-industrial hub) by the year 2021 or 2022.

The conversation was introduced by two lead presenters. Darlene MacKinnon, RN, chief clinical planning officer for Providence Health Care, and Neil MacConnell the Chief Project Officer for the hospital's redevelopment, provided a technical briefing on some of the preliminary plans for the new site.

Darlene explained how the new hospital will transition services more towards primary care, and away from emergency care. She explained some of the research supporting this shift, such as the stats on who the hospital currently serves, who it is projected to service, and the geographic patterns of these clients.

Neil introduced some of the infrastructural considerations for the new development. The hospital will be larger and on a parcel three times the footprint, and all service provision will “remain the same”. The new hospital will provide residential care for the frail elderly, mental health and addiction services, research facilities, and a 24-7 integrated care centre that will divert patients away from emergency departments. The new site will also aim to optimize design to the fullest potential.

The announcement of St. Paul’s move came earlier this year. However, this proposal stems further into Vancouver’s history. The proposal to move the hospital was first brought forward over a decade ago. In 2004 the parcel of land was purchased by the Vancouver Esperanza Society (VES). In 2005 Vancouver City Councilors received this memo about some of the issues related to the sites and the relocation process. However, the move was postponed when a conflict of interest scandal materialized in 2010, regarding the accusation that province had paid property taxes on the behalf of VES to help it maintain control of the land.

While the history of the proposal was not a major focus of the conversation, the participants came well prepared with many engaging questions. The range of inquiries included:

• What health care facilities will St. Paul’s keep in the West End?
• What will happen to the existing buildings at St. Paul’s?
• What will happen to the land in the West End? What is the impact of the land use changes?
• Will Mount St. Joseph Hospital be merged into St. Paul’s?
• Will there be adequate long and short term stay facilities nearby the new site?
• What drives the purpose of relocation?
• What are the local and regional transportation considerations are being made–will this facility focus on automobile infrastructure or multimodal transit integration?

Another question was related to climate change and safety mitigation strategies. Moving St. Paul’s hospital from the highest point in the downtown peninsula to a low lying area in the False Creek Flats (with land made up of fill from the levelling of Burnaby Mountain and other waste materials) had some participants, including City Councillor Adrianne Carr, concerned. Liquefaction in the event of an earthquake, and sea-level rise are two very real–physical–concerns tied to the new site. As the False Creek Flats Area Profile highlights:

While the gradual shifts in sea-level rise is something that we can plan for and address over a number of years, an earthquake could happen at any moment. The False Creek Flats, as an area built almost entirely on filled soil, is vulnerable to the risks of liquefaction caused by a major seismic event. Addressing these challenges will be a key consideration for planning the Flats and the future of its infrastructure.

Beyond the core questions that grew out of the conversation (whether or not the hospital should be moved, and what implications this move would have), I think there is a great opportunity to meditate on Vancouver’s history and future development patterns.

The one-million-square-foot hospital would be the most expensive health care project in B.C.’s history, and the largest in terms of floor area. Is the relocation of St. Paul’s a megaproject in the making? If so, we must think about what role megaprojects have played in Vancouver’s history. Are megaprojects valuable city building initiatives? Who benefits and who loses? And what knowledge of past projects can we leverage to help us build a better Vancouver moving forward?