So today I was treated to a lecture by a McGill architecture prof on the history of Montréal hospitals, with a focus on the Royal Victoria Hospital as an interesting perspective on local social history. Among several key themes, the idea of a personal and societal connexion to a particular hospital arose, with the Vic serving as an even better case study on some of the cultural and ethical considerations to make when proposing radical modernization of institutions. As we ought to know, the Vic, along with the Montreal Children’s, a sizable chunk of the General and the Montreal Chest Institute will all be folded into the new MUHC Superhospital currently being excavated at the site of the former Glen Yard, near Vendome Métro.
If you’ve been reading the news for the last twenty years, you no doubt have a vague, intrinsically hostile reaction to the mere mention of the new compound word superhospital; it’s a seemingly endless quagmire of incompetence, delays and, compounding it all, that eerie sixth-sense tingling at the back of your spine nagging as to its fundamental necessity. Unfortunately for those of us not yet completely numbed to the inertia of the Québec government (in any form), we’ve been left to go back and look over the evidence, and its pretty damning. Worse still is that the superhospital project has finally broken ground – literally. They’re excavating about five floors worth of highly contaminated soil to eventually build a 2,500 car capacity parking garage – right at the corner of one of the busiest intersections in the entire country. Atop this vehicular birdhouse will sit the hospital digitally rendered above; easily twenty years behind schedule, both new superhospitals have entered the preliminary stages of construction – that is to say, the demolition, excavation component. I encourage all of you to go see the mesmerizing sight of roughly ten construction towers looming over a massive floodlit pit – it’s truly breath-taking. The problem here is that the MUHC Superhospital is gearing up to be yet another white elephant in a city which has too many as is. Given that the buildings are in such an early stage of development, I think a new round of public debate needs to occur to make sure this project doesn’t become a complete disaster.
Here’s a short list of what’s going wrong. We’ve already covered the toxic soil – a result of the site’s former occupation as a freight railyard, pictured here:
And the fact that it’s located in the worst possible location, adjacent to the Turcot Interchange – which is due for a major renovation. And that they still haven’t factored in connecting this damned hospital to the Vendome Intermodal station (which is beyond incompetence – it seems clear to me that this omission was on purpose so that a contractor could benefit from an inflated price (estimated at $30 million to build a tunnel under the railway).
So on top of these scandals, and that the project is retarded to the tune of twenty years, it also won’t be able to accommodate the number of beds available in the hospitals it will replace – about 800 for the new hospital compared with about 1200 spread out through the current MUHC system. Read all about that here.
And then there are the common sense issues, like why anyone would build one big hospital when the city and province have already had considerable problems containing hospital based disease, such as C. difficile. Then there are the practical considerations: communities require hospitals, and hospitals build and maintain communities. Institutional memory and public reverence for institutions build character and solidify the social solidarity. It builds community consciousness and civic proprietorship. Building a white elephant superhospital, which is what this plan is shaping up to be, will not only result in cost overruns and traffic jams, it may also result in the hospital’s public losing faith in the institution. I don’t think Montréal Anglophones have much left to lose faith in – can we afford to lose important hospitals for the sake of modernization and efficiency?
That last point is another bone of contention. While the argument that a superhospital will save money because expensive equipment can be shared, the idea that the superhospital will be in any architectural or societal fashion ‘modern’ is blatantly false. This hospital was designed and conceived of in the 1980s. And it has been such an ordeal just to get to the point of breaking ground no one has given much thought to finding a more suitable location (ideally, closer to the city and university it is affiliated with and away from a traffic logjam) or what impact the hospital closings may have on the population it is intended to serve.
Among the hospitals slated for closing, the Royal Victoria Hospital is perhaps the most iconic and established amongst Montreal’s anglophone population; a building with far too many memories to be demolished. It has been expanded several times since it opened in 1893, and carries a caveat attached to the donated land and buildings – they can only ever be used for education and healing. A very old woman in Westmount is committed to making sure the wishes of Lord Strathcona & Mount Royal and Lord Mount Stephen are carried out, if it’s the last thing she ever does.
There has been speculation that the Vic may simply be absorbed into McGill University, which could greatly expand its medical school and potentially convert some buildings into student dormitories – an almost ideal evolution of the built environment at the corner of Pine and University.
But what of the Children’s?
If there was ever a hospital population to be segregated from the general population, it is undeniably children. Sick kids require a special environment, one ideally sealed from adult diseases, pain and suffering. A children’s hospital ought to foster the notion of recuperation, rehabilitation and optimism. I always thought the pediatric hospital and the birthing hospital should be in the same place – I can think of no other kind of hospital where the demand for a miracle be as high as in a children’s hospital, and can think of no better provider of miracles than a maternity ward. Our Children’s should be kept where it is – as it stands now it is an anchor of the Atwater/Shaughnessy Village area, and that area has already suffered the loss of the Reddy Women’s Hospital some years ago.
As for the General, it is unclear as to exactly what will happen here; since it will remain a level-1 trauma center and has a significant amount of space, it seems likely that it will be used to handle ‘overflow’, though how this will work is unclear to me. At the end of the day, the MUHC Superhospital is looking more and more like a highly specialized jack-of-all-trades teaching hospital. High specialization. Concentration. Education. Those are a lot of hats to wear simultaneously, and like anything else that tries to hard to be too many things to too many people, it will likely fail at its intended purpose. The Superhospital is probably going to be looked on as a super mistake, and the taxpayers will be left with a supersized bill. Once the project reaches the state of public derision and ridicule, much like the Olympic Stadium or Mirabel International, it will be seen pessimistically as little more than yet another recent failure of a once proud and successful people. Can we afford such malaise?
Hi –
Thanks for the comment – glad to see this article got so much attention.
I think you identified a key problem РQu̩bec is deciding our healthcare infrastructure, and this ought to be a city concern.
I would like to think that public-transit access would have more to do with the people who would work there rather than it being used as a conduit for people who are sick or injured. That being said, those responsible for the project had not originally set aside the funds required for access. I think this has since been taken care of.
But no matter which way you cut it, what our city requires vis-a-vis healthcare is clearly at odds with what the province deems appropriate, and therefore, I think the city ought to investigate beginning to restructure health-care services by addressing key shortfalls in provincial planning. In sum, this would mean that the City of Montréal gets into the public-healthcare game – something which might be a lot easier to accomplish with a larger tax-base (ie – voluntary annexations of independent metropolitan communities). I think the City needs to independently determine whether the superhospital will improve healthcare service on island or not. And if not, then the City should run the ‘slated-to-be-closed’ hospitals to fill in the gaps, for the benefit of the Cititzens.
I agree with Taylor. It is a waste of taxpayers money, will not provide the standard of service it claims that it will. And with all the traffic that will undoubtedly be present how will emergency services work? And do you think if someone has a sick child, let’s say, they’re going to hop on the metro to get them there. The entire area will be a mess, even more so once things get going in the Turcotte yards. Compeltely, ridiculous! I Work at the MUHC as well. And what about the planning of all this? Absence of Doctors and staff to attend meetings to consult on floor plans and the like? How does that affect the “BEST CARE FOR LIFE” motto when patient appointments are constantly being recheduled. This has nothing to do with patient care, it has to do with egos and appearances. Quebec needs to get it’s priorities straight and the MUHC needs to start practicing what it preaches! And how about instead of paying money to build this ridiculous monolith you start paying people what they are worth so we can keep some doctors in the bloody province, instead of paying to educate them and having them leave!
Ok, but that’s not exactly what’s important here:
1. The aesthetic design is secondary to the functional design. It could be a beautiful building on the outside, but it’s the interior design which counts the most. Herein we encounter a major point of contention, namely that a wide-variety of services will be concentrated in one spot. For a large city with a spread-out metropolitan area, centralization – even of primary care services – is still a bad idea. There ought to be multiple hospitals capable of providing primary-care and enhanced community care, in addition to specialist hospitals and separate medical-tourism hospitals. Moreover, concentration of services in one spot could be disastrous if anything were to ever happen to that hospital, such as a natural disaster, an infectious disease, or worse still a terrorist attack.
2. The Vendome Metro connection is being worked out, but its indicative of how little thought has actually gone into this project that this connection wasn’t thought of immediately. Furthermore, why is the connection so costly? And will this connection make expansion at Vendome impossible, in a manner akin to putting the Bell Centre atop the CPR, cutting off access to Windsor Station?
3. The Vic was purposely designed as a hospital. The Vic’s many newer pavilions were all built specifically as part of a hospital. The land was specifically intended to teach and to heal. And we have a proud and noble history of recycling old buildings keeping them modern through renovations. There is no reason why old hospitals can’t be renovated and upgraded to serve new purposes and be every bit as useful as a newly-constructed hospital. Consider as well that the hospital is not detached from its surroundings – entire communities have been built up around them, modern traffic systems have been planned to serve the sites and deep, multi-generational emotional bonds have been created and maintained between these buildings and the people. It seems as though the only people really interested in the Superhospital are those who may have a chance to develop condos on the sites of the former hospitals, which all happen to sit on highly valuable pieces of land.
Montrealers need to take greater control of how health care works in the city and region. We need more hospital beds, more trauma centers and more specialized care facilities, all reasonably distributed throughout the city. Every effort should be made to conserve the Chest Institute, the Vic, the Children’s and the General as medical facilities. Given their locations, the Chest Institute, as an example, could be folded into the Hotel-Dieu. The Vic seems to be an ideal location for long-term specialized care, in addition to providing for the expansion of McGill’s med-school.
Very interesting article.
However i would like to disagree on certain facts that are not very accurate!
I presently work for the MUHC and I can tell you that the drawings you have are very preliminary and do not accuratly portray what the actual hospital will look like! Those drawings are years old. The architectural design hasnt even been presented to many at the MUHC yet and is top secret. As for the VIC, McGill owns it but the family that owned the land and buildings had kept conditions that it was never to b used for other the educational,religious or medical uses! It will b preserved n kept as is architecturaly!
The VIC is not meeting requirements anymore for 21century healthcare and is not living by McGill Best Care for Life anymore! The MUHC is a teaching Hospital a and primary care facility. A primary care hospital is a hospital which offers primary care services to patients. Primary care is the main point of contact for patients entering the health care system, whether they are making an appointment for routine vaccinations or going to the doctor about a chronic cough. A variety of services are offered at a primary care hospital, including referrals to specialty hospitals and providers who can provide advanced care to patients who cannot be treated in a primary care facility alone. The point we now treat patients who shouldnt b treated at our facilities aka(long term, geriatrics care) the focus has to be on primary care! Thisis why you see less beds and more OR rooms and clinics etc. Furthermore, the connection to the Vendome metro is in the works but hasnt officialy been announced it will either be above ground or a tunnel. Finally the general will continue to play a very vital role in the MUHC by offering different services from the glen campus, focusing on Trauma care, Emergency,Ortho, cardiac and Pshyciatry.
very well said, and researched Taylor….cudos