Many of the reasons for Paddington's failure could have been averted if some additional design work had been carried out at the beginning of the process. The Report by the Comptroller and Auditor General1 identifies the way in which the Campus partners organised and carried through the scheme, including the failure to secure adequate land for the scheme, as a major reason for its failure. Early design work would have enabled better-informed discussions about the project based on a more comprehensive site analysis.
The earlier report by the Paddington Health Campus Independent Review Panel2 similarly identified an absence of reliable processes and united leadership throughout the management chain (responsible for sponsoring, managing and delivering the project) that allowed the project to continue as long as it did before the final decision to terminate the scheme was taken, by which time building costs had risen by some 18%. Early design work and a better advised, more client-focused process would have allowed more accurate cost projections to have been made.
The Paddington Health Campus scheme did not reach the procurement stage due to the lack of a robust, approvable business case. Continued uncertainty over land requirements was cited by the Independent Review Panel as a major reason for the worsening affordability of the scheme, as each time there was a change to the land solution being pursued, significant work was involved in developing building designs to the new land configuration. The Panel said that poor decision making, delay and unproductive effort were all consequences of this weakness; and that without mutual consistency between core clinical activity, land, urban planning requirements and income, the scheme could never be viable.
Following sustained lobbying by the Royal Institute of British Architects, HM Treasury has recently announced it intends to introduce significant changes to the way PFI projects are designed and procured. We believe that the proposals would represent a major step towards achieving better schools and hospitals and-hopefully-preventing a repetition of the Paddington saga elsewhere.
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1 The Paddington Health Campus scheme: Report by the Comptroller and Auditor General HC 1045 Session 2005 -06, 19 may 2006.
2 Final Report to the North West London Strategic Health Authority from the Independent Review Panel: Lessons Learned from the Paddington Health Campus Project, 30 September 2005.