Edinburgh Sick Kids hospital: Last-minute discovery of ventilation problem was 'bolt from the blue'

Former Scottish health secretary Jeane Freeman has said she was "furious" at the last-minute discovery of safety issues at Edinburgh's new Sick Kids hospital, blaming it on a "failure of governance".

Ms Freeman said it came as a "bolt from the blue" when she was made aware of concerns around the new Royal Hospital for Children and Young People on July 2, 2019, days before it was due to open on July 9. She halted the move from the existing site after final compliance checks revealed the ventilation system in the critical care department of the new building did not meet the necessary standards.

The opening of Edinburgh's new Sick Kids hospital was cancelled just days before it was due to take place, after the ventilation system was found not to meet the required standards.

Ms Freeman told the Scottish Hospitals Inquiry she decided the new hospital could not open as planned because she was not confident that it would be a safe environment to put patients and staff into. She also had concerns about whether other aspects of the new hospital building, which was also to accommodate the Department of Clinical Neurosciences (DCN), would be up to standard given that the ventilation issue had been discovered at such a late stage.

Checks had found that the ventilation system was only delivering four air changes per hour in the critical care rooms, well below the 10 changes per hour set out in guidance.

John MacGregor KC, senior counsel to the inquiry, referred to a report by auditors Grant Thornton, commissioned by NHS Lothian, which described what happened as a "collective failure". The report found that an "environmental matrix" spreadsheet in 2012 wrongly stated the air change rate in critical care rooms should be four changes per hour, rather than 10, and that the mistake was missed from the outset.

Mr MacGregor asked Ms Freeman whether she agreed that it was a "collective failure" over the course of the whole project. She replied: "In part. I don't think it's fair to pinpoint the blame on any one individual. I think it is a failure of governance and that means either the right people weren't in the room when governance was being practised or the right questions were not being asked or pursued.

"You can ask the right question but if you just then sit back and accept whatever answer is given that's not really governance either. So in that sense I think there are a series of failures but they are for me primarily around governance."

In her written statement to the inquiry Ms Freeman said that after the issues emerged in early July there was a suggestion from NHS Lothian (NHSL) that they could migrate some of the departments from the existing hospital to the new building on July 9, 2019 as planned but that she did not agree.

She wrote: "Putting to one side the fact that I was furious about this situation, not least because this was the first that I was hearing of it, I do not believe there was any point at which I thought there was a safe and credible option other than not migrating patients over to the new hospital on July 9, 2019."

Giving evidence to the inquiry on Tuesday, Ms Freeman also said there was "no option that is risk free" when deciding whether or not to migrate patients from the old hospital to the new one but that at least the risks were known at the former.

She said: "We know what the risks are there and we know how to mitigate and manage those and we have the data and information to support that. That's on the one hand and on the other hand we have a new build, not yet open, that in one critical area we know is not meeting the standard which is a standard of best practice and therefore it cannot be considered to be safe." The new facility opened fully in March 2021.

The inquiry is considering the planning, design, construction, commissioning and, where appropriate, maintenance of both the Edinburgh hospital and the Queen Elizabeth University Hospital Campus, Glasgow. It was launched in the wake of deaths linked to infections at the Queen Elizabeth, including that of 10-year-old Milly Main.

The inquiry, before Lord Brodie, continues.