S9 EP6: Mignon Stapelberg, Government Goodies

Mignon walks us through the benefits and challenges of working in the largest States in Australia and the importance of planning for projects in rural Western Australia.

If you'd like to learn more about the AHDC, please connect with us on our website www.aushdc.org.au or on LinkedIn at linkedin.com/company/aushdc.

Transcript

[00:00:00] David Cummins: G'day and welcome to the Australian Health Design Council podcast series, Health Design on the Go. I'm your host, David Cummins and today we're speaking to Mignon Stapelberg, who is now the Director of Health and Infrastructure at the Department of Health in Western Australia.

[00:00:30] We welcome Mignon to talk about Western Australia health infrastructure and the challenges that WA face, while also the opportunities and success that WA have had over the last few years. 

[00:00:40] Welcome, Mignon. Thank you for your time to be here. 

[00:00:42] Mignon Stapelberg: Thanks, David. It's good to be here. 

[00:00:44] David Cummins: I, like many, many people, love Western Australia, love Perth, love everything to do with Western Australia.

[00:00:50] Very, very jealous of your weather in winter or perceived winter over there. It's such a unique part of not only Australia, but the world. How does Western Australian health infrastructure deal with the vast majority of the state being so large?

[00:01:09] Mignon Stapelberg: Yeah thanks David. And that is indeed a challenge especially when it comes to our country health. And there's always there's never never enough money and always too many priorities. But yeah, I think it's just for us going through a process of prioritisation when it comes to investment and infrastructure and ensuring that we look at it from all different angles and not only trying to target a large part of our population, but also on ensuring that we provide services closer to home.

[00:01:42] So, in looking at our infrastructure, we always try and really prioritise based on a number of things in terms of where our dollars goes and yeah, for country health, that's particularly important.

[00:01:53] David Cummins: Yeah, and when you talk about country health, I know you've got WACHS over there for Western Australian Country Health Services.

[00:02:00] Where pretty much, literally your project team, builders and designers must travel hours and hours just to get to site. So that's another complication as well, isn't it? That project coordination? 

[00:02:11] Mignon Stapelberg: Yeah. And with the current pressures in the construction market, getting builders out in the regions has been really hard.

[00:02:21] Had to lengthen certain projects on a number of occasions because there's just not that many people interested in going out to country and delivering and then try and make it attractive for the construction companies to go out there, i. e. bundling certain projects to see whether that attracts some more interest from the market and of course, what we thought projects would cost three or four years ago, is no longer relevant.

[00:02:50] So ensuring that we've got sufficient budgets to attract those companies to go out in the regions is really, of significance for us. 

[00:02:58] David Cummins: And just excuse my ignorance here, but would I also be correct in saying there are some areas in WA where even the technology just isn't up to scratch with what you need to be designing infrastructure and for user groups and planning or is the ICT relevant enough and strong enough that it's not an issue anymore?

[00:03:17] Mignon Stapelberg: No, definitely a gap in certain areas. Again, pretty costly, a lot of need in the digital space, only limited dollars available. 

[00:03:27] We've got a NWI, we've got a Digital Capability Fund that government has set up. It's a bucket of funding across government for certain number of years.

[00:03:39] And all agencies have to apply through that process. And the Digital Government, the DigiGov that we have in WA then makes those goals in terms of priorities. 

[00:03:52] And we've been lucky enough more recently in WA, some support for funding specifically on electronic medical record systems that will be rolled out across the system for new HR systems.

[00:04:06] But I mean, the need in terms of..

[00:04:09] ICT in general, it's massive and it comes at a price, and I guess for us also, when we do our business cases and PDPs is really just to, from the beginning ensure that we get the digital design and input from our ICT guys done properly rather than just applying like a percentage. 

[00:04:27] Because, what we used to apply in terms of business cases for that ICT component in the past has obviously significantly changed.

[00:04:35] So hence we try and get those ICT architects and engineers in really early in the piece to be part of the design and business case development. 

[00:04:46] David Cummins: Yeah, how interesting because most companies would do with their own business case with a standard percentage that may be relevant to metro versus country, but even just thinking about it gives me a small headache because the level of complication with that vast majority of geography If you don't get the figures right, then the business cases goes out the window.

[00:05:07] So, how much due diligence goes around those business cases? Because the mind boggles with some of the areas that you have to provide care for patients. 

[00:05:17] Mignon Stapelberg: In the past, it was just a percentage and especially, I guess when you do the smaller projects it's okay, but it's when you start doing the larger... currently WA we've got quite a bit happening in the, infrastructure space. We've got a new women's and babies hospital. That's currently at the stage where we are finalising the PDP to present to government with the ER out in the market. 

[00:05:45] We define major projects as over a hundred mil and we've got five of them going at once.

[00:05:50] It's the new Women's and Babies, there's Banbury Hospital, there's Geraldton Hospital redevelopment, both of them, obviously, in country and we've got the Graylands old mental health hospital that's in desperate need of redevelopment. 

[00:06:08] And then we also have Peel Health Campus that is about to undergo a significant redevelopment. So five major health projects. 

[00:06:17] First time since we finished the Perth Children's Hospital and Fiona Stanley. So two big hospitals that was done quite a few years ago. I think it was around about 2016, 2017 Perth Children's was done and Fiona Stanley just before that.

[00:06:34] So I haven't done major projects for quite some time. And just to go back and see, how the business cases for these projects was done back in the day and now when we go to PDP to revisit of the, quite a few years ICT and, and design that goes with that has been quite interesting.

[00:06:52] And definitely the amount of effort put into ensuring that what's in the PDP is correct has been significant. 

[00:07:01] But it's also to get the right resources in the market to be able to input into that I'm going to call it ICT architecture for better word, it is quite hard because there's not many of these people around that has the expertise, but definitely significant effort to try and get it right, rather than just the percentage being applied because yeah, ultimately we get investment decisions made based on business cases. 

[00:07:29] And obviously, then there's a number out there that you get hold to account as government and there's an expectation that you deliver the project within that budget envelope.

[00:07:40] So really important that we do get it right from the beginning and definitely what I've seen here in WA for our major projects is that we don't just apply a percentage anymore, we scope it out and ensure that it's part of that design process. 

[00:07:54] David Cummins: Yeah, it's really positive to hear and I think it's certainly best practice these days to be able to, to do that due diligence correctly before the business case is set up.

[00:08:04] You just mentioned five major projects that you're, that are happening in the state of WA. How big is your team? Because that's a lot of projects for what I can imagine isn't the biggest team in Australia. 

[00:08:18] Would that be correct? 

[00:08:20] Mignon Stapelberg: Yes. I think it's pretty small. I joined the infrastructure unit here at the Department of Health two years ago, and we were only 12 people.

[00:08:28] We are now 40 as the system has grown and all these projects have just come online. How we are set up in Western Australia is quite interesting. So we have, similar to some of the other jurisdictions, we have the Department of Health that acts as the system manager and provides that oversight on behalf of the Minister, Director General.

[00:08:48] And underneath the department sits each of the health service providers North Metro, South Metro, East Metro, Country Health, as we've spoken about before, and a few other child and adolescent pathways, our pathology, and them each being managed and overseen by their own boards that are accountable authorities in their own rights. 

[00:09:13] And there's certain projects that the director general then delegates out to the health service providers to, to deliver on behalf of the system.

[00:09:22] Typically how it works in Western Australia, all works over $2 million actually gets delivered by our Department of Finance, who's our delivery agency. So we are the client, Department of Finance delivers. And obviously engages the construction companies and whoever else that inputs into the process.

[00:09:42] So ultimately, agency we start developing a business case as soon as we get the funding in from government, we hand it over to our colleagues in the Department of Finance and they then start working through the PDP process with input from the clinicians across the system. 

[00:10:01] And from there, obviously the process happens.

[00:10:04] So, that's typically how we do it in WA Health. As of today, 106 projects on the run, which is a lot. 

[00:10:12] And, as I said, they do vary, from a couple of mil... all the way till I think our women's and babies currently funded at $1. 8 billion.

[00:10:21] And have just recently moved from one location to another which is quite interesting and involved quite a bit of work. 

[00:10:29] And just given all the delays that we are currently experiencing in terms of projects just due to rising costs and of course Covid, that's happened and unfavourable tender outcomes and having to kind of re-tender and change that.

[00:10:45] It's been quite challenging. And then of course, obviously with workers shortages and material scarcity. Like everything just adds to the timelines and we've got obviously from political point of view, having to deliver on projects. 

[00:11:00] It's just the competing worlds of what the market can do, but what we as government want to deliver and then especially as you can imagine, I'm sure I've heard from other jurisdictions, just in the 24/7 environment and most of our work's happening on Brownfield sites. 

[00:11:17] And you just don't know what you're going to discover until you go in there.... has been challenging. 

[00:11:22] David Cummins: Yeah. I always say it's exciting when you discover surprises, you can only look at it positively.

[00:11:29] I choose not to look at it negatively, because otherwise I wouldn't enjoy coming to work, which I tremendously do. 

[00:11:35] I know the State Government has been prioritising over the last few years mental health. I think it was maybe, maybe eight or so years ago, there wasn't as many beds and now it's in the budget. And so I know they've tried to rectify that as a whole state. So that's something you are been helping out as well with building new mental health facilities. Correct? 

[00:11:52] Mignon Stapelberg: Correct. And it's definitely been a focus of our government. 

[00:11:56] We've got quite a few projects that's adding capacity in terms of new mental health beds in the system.

[00:12:03] We've got Fremantle Hospital that would be a new 40 bed mental health unit. We've just recently finished Joondalup Health Campus. 

[00:12:12] I need to check the number of beds, but there was quite a bit. Brand new mental health unit had quite a few interesting bits of work set out. 

[00:12:20] Specifically doors for that campus, which I think a lot of the other facilities have learned from.

[00:12:28] We've got Graylands, a mental health hospital that's undergoing significant planning works for now specifically around forensic mental health beds. And then we've got Bentley, a secure unit with another 24 beds. That's happening over the next couple of years. 

[00:12:48] We've got some mental health emergency centres that was part of our election commitments in both Armadale and Rockingham.

[00:12:54] It's been a bit challenging in terms of design because they tend to link on to some much older emergency departments. So that comes with, I guess, if you can imagine quite a bit of, again complexity, but as you say, it keeps it interesting so that's good. And then, as I've mentioned before, some of our developments out in country also has a number of mental health beds attached to it. Yeah, that I think I've covered most of the mental health beds. There has been and will continue to be quite a bit of focus in that space, which I think is definitely necessary. 

[00:13:32] David Cummins: And I know we're running out of time, but WA as a whole is obviously Australia's biggest state and there is a strong contingent of Indigenous communities within Western Australia.

[00:13:42] How does connect to country, design, construction, even user groups and consultation impact the department when it does come to designing and building for Indigenous communities? 

[00:13:52] Mignon Stapelberg: Definitely from our end to continue to focus on the consultation and not just as a tick box exercise, but real consultation with the right people out in the community and really listening. 

[00:14:06] Again, not just going out there for the sake of going out there, but really learning from those consultation sessions. And I think it's been super valuable. 

[00:14:15] I know more recently, we've done a bit of work at the Banbury Health Campus and yeah, what we got from the community through that process has been amazing.

[00:14:23] David Cummins: Yeah, I think it's something where it's certainly you would be, well, NNT leaders in Australia with that consultation of . Every design I've seen over in WA, some of the most beautiful architecture I've seen, to be brutally honest, and some of the buildings is phenomenal, but you can always have that sense of consultation with Indigenous communities because it is very prevalent and obvious more so than I would argue, in some of the eastern state hospitals. 

[00:14:49] Happy to be corrected if someone wants to challenge me, but that would be my experience and I'm pretty sure I'm right there as well. 

[00:14:55] Just before we go, just final question, what would be a take home message for listeners who are wanting to bigger projects, over 100 million for the state government?

[00:15:03] What is something that they should be looking at learning from trying to incorporate into their bigger projects when it does come to, especially designing in Western Australia?

[00:15:12] Mignon Stapelberg: Proper planning. I think for me is we tend to want to just get a project across the line in terms of funding. But really important that we, I guess I always call it the Five Ps... Proper Planning Prevents Poor Performance... and really if we put the effort in on the front end, the rest will go easy. 

[00:15:34] David Cummins: I always say 90 percent planning, 10 percent execution, and you can never go wrong with too much planning, but I'm sure we've all got examples of projects that have been rushed without the correct planning that have not been maybe as successful as you would like them to be. 

[00:15:46] So I think it's really good advice. 

[00:15:49] Mignon, I just want to say thank you so much for your time. I know you've been with the department for over 10 years. I think it's people like you who are consistently there to help the department to help the community is why WA Health is so successful. 

[00:16:02] The projects over there are literally mind blowing and I'm so in awe every time I go over there to just look at those projects and I'm almost positive that's not only a part of you but certainly your team's contribution to WA and health infrastructure.

[00:16:15] So thank you so much for your dedication to this industry and keep up the good work and good luck with your future projects. 

[00:16:20] Mignon Stapelberg: Awesome. Thanks, David. It was lovely to meet you. And let us know when you're over here and I will show you the next best thing. 

[00:16:26] David Cummins: You have been listening to the Australian Health Design Council podcast series, Health Design on the Go.

[00:16:31] To learn more about the AHDC, please connect with us on our LinkedIn or website. Thank you for listening.