Annex A

Q. While there is a pressing need for movement on a number of important capital build schemes, there is particular public concern about the delay in the building of the new Cancer Centre. What are the reasons for the delay? [Ms McWilliams]

A. The reason for the delay has not been primarily with the testing of PFI but more to do with the fact that we were still getting to grips with the new concept of a modern oncology centre and what such a model should look like. There has been a steep learning curve to reach consensus on what is needed. Significant additional work has been done to add to our knowledge of the Centre's long-term needs in terms of physical specifications and equipment. It is very important to ensure that the building is appropriate to fulfil its function as a major user-friendly Cancer Centre, as there will only be one chance. We are confident now that we have decided on the right scale for the Centre.

Q. Can you comment on the deep public concern about the ever-weakening state of cancer services at Belvoir Park Hospital (BPH) and its ability to cope until such times as the new Cancer Centre is up and running? [The Deputy Chairman]

A. We recognize that BPH is an issue, and we are actively looking at the scope to replace one or two linear accelerators to ensure the service is maintained. Also, as the staff at the hospital have no experience in modern cancer technology, appropriate interim training will be arranged for them in preparation for the move.

Q. The situation is clearly urgent. What is the timescale for a decision on the Centre? [Ms Hanna]

A. As stated, we are content with the specifications for the Centre, and the revised cost of £56m has been determined. A business case is currently being developed by Belfast City Hospital, for which approval will subsequently be sought from the Department of Finance and Personnel. A decision on procurement is the key question, as this will have significant resource implications. The Department will be able to present its case at the Comprehensive Spending Review. It will then take approximately three years to build the Cancer Centre from when the funding decision is made.

Q. You mentioned the figure of £56m in respect of the capital costs of the new Centre. If the PFI option is selected instead of public sector procurement, what will be the cost spread over a number of years? [The Deputy Chairman]

A. PFI would involve estimated annual resourcing costs of £10m over 25 years. This would include equipment replacement programmes, which tend to run on 7- or 10-year cycles.

Q. Is this cost purely in respect of the capital costs? What are the estimated additional revenue costs for the Centre? [Mr McFarland]

A. The £56m does not include the cost of clinical and professional staff, but would cover those staff needed to maintain the equipment. The annual costs for the extra specialist staff and the increased drugs bill are estimated at £10m. It is possible, though, to combine PFI with public procurement capital payments in order to reduce the revenue costs stream to a more affordable figure.

Q. If the decision is for public procurement, can the proceeds from the sale of, say, the land at BPH be used to offset the overall costs of the Centre? Is there a big difference between an Oncology Centre and Maternity Centre in terms of undertaking a PFI test? [Ms McWilliams]

A. As BPH is one component of the large health estate, any proceeds from sale of its land are considered for the common good of the health sector and are available for re-investment accordingly. I should emphasize that there are major demands on the annual capital works budget of £50m for new projects, with basic maintenance of the health estate accounting for 50% of the funds.

Planning for the Cancer Centre was uniquely complicated, as evidenced by the length of time developing the business case. Both Centres will be tested for PFI, and considerable work has already been done in that context with the planned new Maternity Centre.

Health and Social Services Minutes 12 September 2001