Expert says it will take a minimum of Rs. 50-55 cr., doctors estimate double

The new Secretariat building on Anna Salai was certainly not built to accommodate a hospital, but the task of converting what is essentially an office building into a hospital is eminently feasible, say experts.

While the trend these days is to specially design hospitals, it is possible to convert a non-hospital building into a health care unit. “In fact, a number of people do convert ordinary buildings to hospitals, and even diagnostic centres today,” says P.V.A. Mohandas, founder and MD, MIOT Hospitals. Initial investments are necessary for refurbishing and restructuring to render the building hospital-worthy.

Health Department officials said the details were being worked out, and the final plan would be ready in a short while.

Meanwhile, experts in the field have come up with estimates of what it could cost the government to retrofit the building.

The chief architect of healthcare projects of a multinational construction company, who has worked on designing and constructing several hospitals, is confident that it can be done with careful planning to take care of ‘essentials' that a multi super-specialty hospital needs.

He says the thumb rule is to estimate a cost of Rs.1,000-Rs.1,100 per sq.ft. that requires modification. While the entire complex is laid out on an area of 9.3 lakh sq.ft., the architect reckons that about 5 lakh sq.ft. might require modifications. At the rate of Rs.1,000 or Rs.1,100 per sq.ft., the costs would come up to Rs.50 crore or Rs.55 crore, the minimum to revamp the building, he estimates.

Doctors in the employ of the State government, however, expect that a minimum of Rs.100 crore would be allocated to make structural changes to the new complex. Additionally, state-of-the-art diagnostic and therapeutic equipment will have to be purchased, and that is likely to cost another Rs.100 crore, depending on the kinds of specialties chosen.

The changes that would have to be made could be categorised as mechanical and electrical, the architect points out. For instance, the 700 rooms would have to be modified to be suitable, once the bed strength is decided. Builders familiar with hospital infrastructure say a multi-specialty unit will have to house at least 14 departments. At the rate of about 30 beds for each specialty, the new hospital is likely to house a minimum of 400 beds.

Inter-floor communication which is required in a hospital, ramps, lifts and stairs might necessitate changes to the existing structure. Ramps are essential for the infirm and weak, while lifts will have to be able to accommodate stretchers.

The power requirements of a hospital will be much higher than that of an office complex, and these changes will require extensive re-wiring. Also, every bed would have to be supplied with oxygen, and adjustments will have to be made for power supply to other vital parameters-monitoring equipment.

“The internal layering of a hospital is completely different. Every nook and cranny will have to be connected to a central oxygen and suction unit. So, the entire ducting has to be reworked extensively,” explains J.S. Rajkumar of Lifeline Multi Specialty Hospitals. The air-conditioning will have to be of a high standard to ensure infection control.

One operation theatre is required for every 30 beds in a multi-specialty unit, the architect says. These units would have to be highly sterile, with laminar air flow inside, supported by adjoining sterile corridors with positive pressure. For such a unit, the minimum space required is 600-700 sq.ft. (the size of a budget flat in the city) to accommodate 10 people, and about 20-odd machines.

Provision must also be made for safe biomedical waste disposal for the different units in the hospital.

In a 2005 paper on ‘Trends and Dimensions in Hospital Architecture,' Shakti Gupta of the Department of Hospital Administration, AIIMS, along with Sunil Kant, specified that the real requirement was to design a building with universal space modules/grids. Modular design should be utilised to keep pace with the changing needs of function and design. “In today's dynamic environment, healthcare facilities are one of the fastest changing organisations. A hospital has to constantly adjust [itself] to variable workloads, uncertainty and critical situations.”