Cost, design of new Civic hospital campus still being hammered out
Ottawa city council will eventually debate contributing $150M or more
Anyone passing by Dows Lake and Little Italy in Ottawa will have seen a new multi-storey parking garage being erected for the future Civic campus of The Ottawa Hospital.
But the final cost and design of the brand new hospital itself are still being hammered out, one year after EllisDon and PCL submitted the only bid. No construction contract has yet been signed.
That's because the hospital project is following a different kind of public-private partnership model — one the province implemented to try to encourage more bids and competition after the market interest in its complicated infrastructure projects dipped.
It remains to be seen if the original $2.8-billion price tag or 2028 target opening date for the new Civic campus will hold. Construction was at one point supposed to start in 2024.
For now, the construction schedule and price are being updated. Risks such as the effects of tariffs or any difficulties on the site are being analyzed, said Joanne Read, The Ottawa Hospital's chief planning and development officer and the lead on the Civic campus construction.
"All of that is occurring now and should be finalized, I would say, toward the end of this year," said Read.
Single, sunny rooms
For years, The Ottawa Hospital has planned to replace the century-old Civic campus located a few blocks away on Carling Avenue, one of its three hospital sites.
"This new campus has really been the catalyst behind how we can actually reshape health care for our community," Read told CBC News. "We get to think outside the box. You get to design new."
Patients will no longer have to share rooms. All 641 in-patient rooms will be singles, with floor-to-ceiling windows that let in natural light. That's in part to control the spread of infection, but also for a family member to stay overnight.
The rooms will have accessible washrooms that don't require someone using a wheelchair to do a three-point turn.
The Civic is the trauma centre for patients as far as Barry's Bay, Cornwall and Nunavut.
The future emergency department will have direct access for patients arriving by ambulance and helicopter to take them down to state-of-the-art operating theatres, said Read.
Designs take months or years
Unlike Ottawa's light rail system, where competing builders gave their price and one consortium got a big contract, EllisDon and PCL first signed on to a smaller contract for a "development phase" back in February 2024.
In the year since, the companies have been working on designs and prices, then went back to refine each version. It's meant to be more collaborative, and Read says it is.
Eventually, EllisDon and PCL would sign the main construction and maintenance contract with The Ottawa Hospital and Infrastructure Ontario, the Crown agency that leads procurement in the province.
This two-step process is called a "progressive public-private partnership," or a progressive P3, and Infrastructure Ontario had to try it as a way to encourage more companies to bid, wrote Ontario's auditor general in a December 2024 report about provincial procurement.
The market has changed. There are many infrastructure projects to bid on, and companies can be more selective about whether to take on big, complex projects that involve risk. Tenders using the traditional P3 model — where bidders quote a price for their work — simply haven't been drumming up as much interest for projects, the auditor said.
Meanwhile, some procurements across the province were even called off in the past decade. Among them was a redevelopment at the Kingston General Hospital site near Lake Ontario. Kingston Health Sciences Centre asked the Ministry of Health and Infrastructure Ontario to cancel that procurement in December 2023 as costs climbed, the auditor said.
The Mississauga experience
The Ottawa Hospital is actually following in the footsteps of a bigger, more expensive hospital project in Mississauga, which was described in detail by the auditor general.
This progressive P3 model was used for Trillium Health Partners' Peter Gilgan Mississauga Hospital, but that tender still drew only one bid. It came from the same group chosen in Ottawa: EllisDon and PCL, using Parkin Architects and Adamson Associates Architects.
CBC News contacted EllisDon for comment, and it deferred questions to The Ottawa Hospital.
The Mississauga hospital has been in its development phase for almost two years. The auditor found its costs have jumped $4 billion from the approved budget to over $16 billion.
The auditor general report gave insight into the behind-the-scenes analysis at Infrastructure Ontario. Hospital construction costs have increased mostly because of the price of materials, as well as higher interest rates.
"According to Infrastructure Ontario's analysis, private partners are incorporating significant cost escalations into their bids to protect themselves against the risk of the further rise of construction costs," the auditor wrote.
Mississauga rejects 'local share'
While the Ministry of Health pays the lion's share of hospital construction costs, there's been a policy for many decades that sees the local community contribute, too.
The amounts asked of local hospitals used to vary considerably. Since 2006, the Ministry of Health has covered 90 per cent of construction costs. Hospitals, however, must cover the other 10 per cent, along with the entire cost of most equipment, parking, and retail.
That means a big fundraising campaign. Municipal councils are also asked to do their part for their local hospitals.
In the case of Mississauga's hospital, though, when the request from Trillium Health Partners came in October, Mississauga city council was adamant and unanimous that it simply couldn't afford to hand over $450 million.
Mississauga is staring down rising policing costs and had to raise property taxes by more than nine per cent this year, Mayor Carolyn Parrish explained. That sum represented two-thirds of the city's annual operating budget.
"We just kind of dug in our heels and said, wait a minute, this is over the top," Parrish told CBC News. "This is not by any stretch of the imagination our responsibility. This is the responsibility of the provincial government."
She wrote to Premier Doug Ford saying the expectation property taxpayers could provide $450 million was "excessive" and "punitive."
Mississauga council received a letter back from the health minister, Sylvia Jones, who said if the city didn't contribute, Trillium Health Partners would be responsible for the entire local share. Jones wrote the province had to take the same, consistent approach for every hospital project in Ontario.
Parrish said it's unfair and unreasonable for municipalities to continue to have to donate to their hospitals, and suggested Ottawa city council follow Mississauga's lead.
$150M request
Here in Ottawa, the city council under former mayor Jim Watson was asked back in 2022 to contribute $150 million of the estimated $700-million local share for the new Civic hospital campus, while a fundraising campaign would cover most of the rest.
City staff were supposed to produce a report with options, and chief financial officer Cyril Rogers says it will come sometime before this council term ends in fall 2026.
Asked whether Ottawa city council might now decline making a contribution to the hospital project, given its own financial pressures, Mayor Mark Sutcliffe said that will be a debate when the time comes.
"There are lots of ways that we can work together to support this really important health-care institution that will be game-changing for our city," he told CBC News. "That will be our state-of-the-art hospital for the next 50 to 100 years, so we're ready to work with the hospital."
The Ottawa Hospital Foundation, meanwhile, has been busy fundraising and has hit 71 per cent of its $500-million fundraising goal.
If the final cost is higher than expected, however, the dollar figure assigned to the local fundraising campaign and local property taxpayers would also go up.
Party positions
On the campaign trail this Ontario election, when health care is discussed the focus is indeed on the need to ensure Ontarians have access to a family doctor.
- ANALYSIS | Ontario parties are promising family doctors for all. Compare the plans
- Ontario Votes 2025
Asked about funding for hospital construction, the Progressive Conservatives said it was important to keep costs down by maintaining a competitive economy.
"We will continue to work with our hospital partners throughout this uncertainty, ensuring they have the tools
they need to provide high-quality care," the party said in a statement.
The NDP wrote that "hospitals are in a terrible condition," and said it has plans for upgrades and repairs.
"The province should pay for provincial responsibilities," the NDP write. "It's not fair that communities must pay for a new hospital because the government neglected maintenance for so long."
The Greens acknowledged that capital costs for new hospitals are a major barrier for many communities, especially smaller rural ones. They said they would cut the cost of the local share in half.
The Liberals did not address the local component of hospital construction per se, but said rather than spending billions on a tunnel as Ford has proposed, it would build hospitals. Read pointed out the province already shoulders the majority of construction costs, and The Ottawa Hospital is fully expecting to have to support its project through retail or parking.
Construction of that parking garage is well underway. It should be finished by early 2026, said Read, so it can provide parking for the people working to build a hospital.
Eventually, though, Read says the plan remains to put a publicly accessible park and green space on the roof.
ABOUT THE AUTHOR
