The New Comox Valley Hospital Location – Part 2 – “Is there another way?”

This post is Part 2 of my thoughts on the proposed site for the new Comox Valley Hospital.  In Part 1 I provided a critique of the proposed site from the point of view of the Living City Challenge, a design competition that asked communities to re-design themselves using the seven petals and twenty imperatives of the Living Building Challenge.  There were a number of different responses to this criticism.  Some people skipped over the details of my comments and were disappointed that after all the Comox Valley has been through, anyone would give VIHA any more reason to delay this project.  “We need this new hospital so let’s just get on with it.”  Others seemed content with where the new Hospital was NOT going to be located.  “As long as it is not in Cumberland or Mt Washington, I’m OK with the proposed site.”  This blog post addresses a last group of comments that centered on a question: “If not there, where would you suggest it be located?”

I had hoped to at least find out what the terms of reference were for the team hired to review site location options and what the site selection criteria was.  I have not been able to engage in any dialogue with VIHA prior to this post so I will have to make some assumptions.  We have read in the newspapers that 21 sites were proposed initially.  Then 3 sites were short listed, and presumably negotiations were held, in camera, with the land owners.  The gleeful comments of the winning proponent, Crown Isle, tell us the rest of the story.  We know that the selected site is 15 acres in land area with an additional 5 acres available for expansion.  This is a lot of land at just over 650,000 square feet.  Based on my reading of the latest VIHA reporting on the Hospital project, some crude “rule of thumb” estimating, and finally a few “back of the envelope” calculations, I have determined that approximately one quarter of the site will be required for the new hospital and the remainder of the site will be used for circulation and parking.  The actual building, or buildings, will require about 4 acres of land with the remaining 11 acres needed for parking the cars used by patients, doctors and Hospital Staff.

Is there a better site than the proposed one on Ryan Road?  Perhaps not, but without the terms of reference, we can only speculate.  Why not release the terms of reference and the locations of the other 21 proposed locations?  Again we can only speculate.  Keeping the public in the dark, for what ever reasons VIHA feels are necessary, will only fuel the passions and raise the ire of the local people that care about our community as a place to live.  They are not against the Hospital project – they just want the wonderful and significant investment to provide the greatest benefit to the widest swath of people.  There will no doubt be many that will speculate on the reason various decisions have been made.  Politics and back room deals with the “old boys” of the Comox Valley will be high on the list for sure but I want to steer clear of this line of thinking in this post.  I am certain there are other blogs out there for that.  I want to look at other sites in terms of urban infrastructure including transportation and municipal services.  This perspective is critical to economically sustainable city planning.  Yes – I said “economically” sustainable!  We have a big problem with the current thinking that is used in developing most of our cities.  A short term gain is welcomed without long term planning to ensure that the projects we undertake today are affordable 25, 50 and 100 years down the road.  Imagine the young couple with a new born child, or a retired empty nesting couple on fixed income winning one of the big TV lottery $2.8 million dream homes and locating it on a big lot on the edge of Comox, then going broke during the first winter because of the huge heating bills and then finally bankrupt paying the taxes.  Remember that nightmares are dreams too!  We are told that this Hospital will serve us for the next 100 years but I see little evidence in the development approach that understands what this actually means.  A Hospital out in the middle of nowhere is a pretty big gamble that will require a lot to fall into place if it is to succeed.  It is part of vision for Courtenay that will require tremendous growth, beyond what is predicted, and an outward sprawl over undeveloped land with consequences we are unwilling to face.  Is it possible to make this location succeed and what would it actually take?  This will be the subject of another installment of this blog.  For now, let’s look at some other sites.

I took a quick look at some other Hospitals that I have been to in the last few years just to give myself some perspective.  I was actually a bit surprised to discover that they occupied a lot more land than I imagined.  Size does matter!  Close to home I zoomed in using Google Earth (the pro version for those that want to try this at home) on the two existing local Hospitals in the centre of this issue.  St. Josephs Hospital in Comox occupies 12.6 acres of land and the Campbell River Hospital occupies 8.8 acres.  Each of these sites contains multiple buildings.  I then moved southward and measured the Nanaimo Hospital at 20 acres and it also has multiple buildings on the site.  Going all the way to Victoria General Hospital where we once drove there and back for a 15 minute treatment, I measured its site to be 33 acres with two buildings.  Looking at this relatively new hospital in a remote location in a sprawling suburb miles from Victoria adjacent the highway one gets the sense that this is the model that VIHA is looking at for the Comox Valley.  The Royal Jubilee Hospital in Victoria occupies 41 acres of land and it contains an entire campus of buildings.  To complete my survey, I looked at St. Paul’s Hospital in Vancouver which occupies 6.4 acres and Vancouver General Hospital which occupies 21 acres.  Both Vancouver hospitals are very dense, urban facilities with multiple buildings located on land that is woven into the existing grid network of streets and public spaces.

From this quick desk top study I determined a couple of things.  The first is that all but one of these sites is situated within the core of the community, surrounded by the existing fabric of development that includes in varying degrees a full mix of other uses.  The second is that all of these hospitals contained multiple buildings ranging from two buildings to entire campuses containing dozens of buildings where it is difficult to determine where the transition occurs from hospital precinct to city.  The third is that of the seven existing hospitals I looked at, 3 occupy less than 15 acres including a big city hospital.  Lets see how these points can inform an alternative evaluation of a hospital location in the Comox Valley.

A quick review of urban land in the core areas of our three communities reveals that there are no 15 acres parcels undeveloped, awaiting the arrival of a new hospital.  Only at the edges and boundaries of our core areas are there large undeveloped parcels of land.  It is likely that the VIHA site selection terms of reference were based on one preferred model for a new hospital and land parcels smaller than 15 acres were never even considered.  However, lets use this article to expand our vision to include alternative models for a new Comox Valley Hospital facility.  What if it were a requirement to locate the new hospital within the core of one or more of our communities?  What if the new hospital was developed in pieces within separate buildings located within the existing grid of our infrastructure?  What if off-street parking were required underground as it is for most other buildings in our core areas?  Using this approach, we would be more consistent with almost all of the other existing hospitals and we open up a lot more possibilities that would result in a benefit to a lot more people across the Comox Valley.  Now when we look again at the urban land in our core areas, we see it differently.

In Comox we actually have a couple of interesting options that would provide a starting point for the new hospital development.  We could build over top of the 2.6 acres of the surface parking lot at the Comox Mall and if we built overtop of the Mall as well, we could make use of a full 6 acres to create an amazing mixed use complex.  We could also build over the 2.6 acres of the surface parking lot at the existing St. Joseph’s Hospital.  As well, the as yet un-built project next to Quality Foods has a site area of over 5 acres that could accommodate all of the proposed building area.

In Courtenay East there are a couple of options that would meet our new criteria.  There are approximately 11.5 acres of Crown Isle land across from Home Depot and another 11 acres at the rear of North Island College.  Both parcels are adequate to accommodate the proposed building area and future expansion.

In Courtenay City there are many options that would help transform the City in a positive way.  We could build over the Driftwood Mall surface parking lot that occupies 6.5 acres and could be expanded to 12 acres if the adjacent properties were to be included.  The City of Courtenay Works Yards on either side of Cumberland Road occupy 12.1 acres.  The School Board offices and Old Courtenay Junior site occupy 3.6 acres and could be expanded to 7 acres by including the adjacent park.  There are a number of other areas with un-developed and under-developed lots in the City of Courtenay that could be transformed into a new medical wellness precinct with the addition of new hospital and services buildings.

Far be it for me to challenge the needs of VIHA in providing hospital services on Vancouver Island and I cannot begin to understand the complexities that must be involved, but I do understand the way that cities go together and I can objectively observe how existing hospitals interact with them.  I believe that our set of three requirements would result in much greater benefit to more of the Comox Valley by spreading the investment across a greater area and over a longer period of time while adding to the vibrancy and livability of the city.

By building within the cores of our existing municipalities, less money would have to be spent on new infrastructure services and what is spent could be used repairing and upgrading existing services.  Land values in neighbourhoods around the new facilities would rise for many land owners as entire communities benefitted in the short and long terms.  By default the new facilities would be located closer to where people already live and work which would reduce the amount of travel required for patients, doctors and staff, increasing the viability of cycling and walking and their related health benefits.  The new facilities would add to the densification of the cores and that would increase the viability of more functional transit.

By building multiple buildings on existing city blocks, there are a many benefits.  The hospital could proceed more quickly, one piece at a time.  Smaller, multiple approvals would be easier than one big all encompassing approval.  Smaller, multiple approvals would be quicker individually and the community would benefit by spreading the project out over a longer period of time rather than one big boom period.  The resulting facilities would be consistent with the existing street scale and likely more human in scale.  The land could be acquired from multiple sources, as required over time, spreading the benefit to more over a longer period.  Infill development would be possible as well as redevelopment of large surface parking areas, both beneficial to the creation of more livable communities.

By building within the cores and on existing city blocks, closer to where people already live and work and where existing transit is already in place, the total required parking for the project would be drastically reduced and underground parking would be feasible.  The total amount of land required for acquisition, without the big need for surface parking, would be much less.  This strategy has been successfully employed at the University of Victoria where their last three major building projects were constructed over existing surface parking areas.  Reducing the number of parking stalls and putting them under the building, innovative buildings and site designs incorporating green roofs rain gardens, and aggressive public transit programs have made this part of Victoria a leader in the creation of communities that are moving in a progressive direction.

This large investment in the Comox Valley is welcomed by everyone.  It can be leveraged many times over to the benefit of everyone, or simply funneled through the coffers of an elite few.  Despite the drawn out process that is moving at a glacial pace, it appears that that VIHA is taking the easy and opportunistic road.  I believe that more open minded alternatives could get us more of what we want and what we need, and perhaps be even easier to deliver.  We need to express our views and our visions about what we want this place to be.  I look forward to your thoughts and comments.