Cospital? Old Costco site will be one-stop shop for health care but won't increase system's capacity

The "ambulatory care hub" that will eventually open at the site of the abandoned Costco building in St. John's will serve as a one-stop shop for outpatient testing, therapy and surgeries, the provincial health minister said Friday,

But Tom Osborne clarified the new centre, slated to open in early 2025, won't increase the number of health services or appointment slots on offer in eastern Newfoundland.

Instead, it'll simply shuffle them around — in hopes that more space will improve wait times.

"This will not only remove vehicular and foot traffic at our acute care sites, it will make those sites more efficient and it will provide a better option for individuals who are requiring ambulatory care that doesn't have the necessity of overnight care," Osborne told reporters Friday. 

That means anyone with a physiotherapy appointment, for instance, will no longer be directed to St. Clare's Mercy Hospital or the larger Health Sciences Centre. 

"We're in a situation now where we do not have enough ambulatory clinic space as it exists," said Greg Browne, senior medical director of the provincial health authority, Newfoundland and Labrador Health Services.

In hospitals now, he added, the health authority has "multiple services that are trying to expand, and we just don't have the room for them to do so."

Just like its former tenant, the hub will house facilities for an array of services.

That includes outpatient testing, such as X-rays, ultrasounds and blood work, as well as physical therapy, medical clinics and same-day surgical clinics.

Osborne said moving those services out of hospitals will free up space to expand the Health Sciences Centre emergency room down the road.

He also said the hub, which will be located off the Trans-Canada Highway in the city's east end, will be accessible to patients from across the province.

"It's all located in one site. It makes it easier for patients, it makes it easier for health-care professionals," he said.

"In terms of recruitment and retention for health-care professionals, people want to be working not in the basement of St. Clare's … but in a modern facility."

Renting lends flexibility, province says

The province is renting the old Costco building, which hasn't been used since 2019, rather than buying it outright. Costco vacated the premises when it opened a larger warehouse in the city's Galway neighbourhood, near Mount Pearl. 

It awarded a contract of $4.1 million annually to the Newfoundland and Labrador Health Alliance — a not-for-profit social enterprise — for a 20-year lease, which will cost the province more than $80 million.

Osborne says leasing allows the hub to open faster, as opposed to waiting several years to construct a new building, and places the costs of maintenance on the landlord.

"We need this space today, not five years down the road," he said.

It also offers more flexibility for the province to later expand as medical technology evolves, Browne said. 

"Health-care facilities are highly specialized buildings, and they have lifespans," Browne said. 

"When St. Clare's was designed, for example, there was no such thing as the internet. There was no such thing as CT scanners. There was no such thing as laparoscopic or keyhole surgery. And yet we've had to make that old building adjust to fulfil these modern needs."

Browne said he believes governments are moving away from owning health-care facilities on a larger scale.

"I think in the future you will see health-care facilities that are owned by third parties, and it will be the third parties
that modify the buildings to meet new needs. That will give health care in general more flexibility," he said.

"It's a trend that we're seeing everywhere."

Some outpatient services will remain in hospital, such as allergy desensitization therapy, which require quick access to emergency care.

But the health authority says the move will ease pressure on hospitals now bursting at the seams.

"At the moment we are chocked to the gunwales, and we really have no room for anything else. This will give us some flexibility that we do not have now," Browne said.

"The last few years has proven that we need flexibility. We need to be able to pivot."

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