The happening precinct: Map of central Christchurch's Health Precinct finally clear
Suddenly, after thinking it might be a bit of a fizzer, three buildings are coming out of the ground at Te Papa Hauora, the promised health innovation precinct by Christchurch Hospital.
"In 2017, I'm incredibly optimistic because I can see cranes everywhere," says Dr Ian Town, the asthma researcher and university manager who now chairs the Health Precinct Advisory Council.
Town admits there are some significant gaps and some changed thinking. For instance an actual Health Research Institute building – a whizzy lab for hot medical tech start-ups – looks off the cards now. It is going to be more a "virtual academy" deal.
Also, the Tuam St car yards – Archibalds and Miles – remain, at least for the moment.
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But three sites are on the go, says Town. Directly across from Christchurch Hospital, the diggers have made their start on the hospital's new $72 million, five-storey, outpatient building in Oxford Tce.
Christchurch residents are going to become very familiar with that, Town says, because it is bringing together a whole collection of clinics – for diabetes, endocrine disorders, ophthalmology and dentistry – and will handle nearly 400,000 patient visits a year.
Then next door – starting the prestige strip of buildings overlooking the soon-to-be pedestrianised frontage of the Avon River – is the $70m, seven-level, Health Research and Education Facility (HREF).
It will be flash if the architect drawings are anything to go by. And it will combine the staff training and research of three institutions – the Canterbury District Health Board (CDHB), Ara Institute, and University of Canterbury. A joint venture that Town says is more adventurous than you might think.
Then third – again showing there is a spirit of working together – is the redevelopment of the earthquake-damaged Archibalds car sales office on the corner of Antigua and Tuam Sts.
Archibalds is keeping a ground floor show room for itself. The car yards really don't want to budge. But on the levels upstairs will be health tenants – a modern space for the likes of the international drugs trial specialist, the Christchurch Clinical Studies Trust (CCST).
So it is all happening just as the Government and the Canterbury Earthquake Recovery Authority (Cera) promised it would. Well actually, concedes Town, it has gone far slower, taken some detours, and become more of a local effort than envisaged.
But really – as a long-term economic driver of the city – the Health Precinct is now in a position to deliver on its promise of being the single most significant development to come out of the earthquakes. It could be the money-maker.
Town says Christchurch has always been a natural laboratory for health innovation.
"There is something very unique about Christchurch in terms of its size. We've got a catchment population of just over half a million. And we've got one tertiary-teaching hospital, the medical school, a leading university and a wonderful polytech, all in a compact region."
Compare that to Auckland with its three rival health boards and spread-out geography, he says.
But despite its excellent reputation and long history of pioneering research, Christchurch has never really capitalised on turning its medical know-how into exportable services and products, says Town. Commercialisation has not been a priority.
And that is what the new Health Precinct is meant to change.
How hard can it be? When the Government announced the Health Precinct as part of its Blueprint redrawing of the central city, there was the impression it might be the kind of Singaporean approach where an agency is formed to slap down a collection of high-tech buildings.
Draw up the pretty pictures, turn on the money taps, make it happen next week. But clearly that is not the Kiwi way, says Town.
The Crown is certainly investing billions in terms of basic health spending – all the money on replacement hospital buildings. And it did impose planning restrictions and carry out some land purchases to make the river-facing precinct possible.
But the threat of the compulsory expulsion of the car yards expired along with Cera's powers. And the hospital and universities are being expected to take any actual precinct developments on to their own balance sheets if they really want them, Town says.
What makes the situation even trickier is that for 30 years, New Zealand has been encouraging competition between its tertiary providers.
For health especially, Christchurch has its rivals in Dunedin and Auckland. And how much does Otago University really want to invest in Christchurch's rising star? What is the whole of Auckland going to say if its sees Christchurch getting some kind of special government treatment?
There are some obvious political tensions to navigate with the Health Precinct having to be effectively a joint venture. And Town agrees that is another reason it has taken five years to get to where the construction has started.
He says since the Health Precinct ambition was first announced in 2012, the advisory council has been constantly workshopping and business-casing the way to an institutional collaboration where all the parties feel like winners, none losers.
"The lesson is these things are very complicated. They take a long time. And it's a coalition of the willing. This is a group of senior leaders saying we are committed to it."
Town says the HREF is a great example – mixing up different workforces in the one building.
Ara is moving its 2000 trainee nurses and imaging technicians there. The hospital will use it for its own senior staff training and health system design lab. Canterbury University has a floor for its scientists and engineers.
Just think what that means in terms of even the petty stuff, says Town. Like who deals with the mess left in the coffee lounges, or sorts out the priority squabbles for a lecture theatre.
"That's not business as usual. That's walking the talk. That's taking risks because they believe in the benefits of collaboration."
So the precinct plans have been moving along. Running a finger over a map of the various buildings proposed, Town sketches how they should all fit together with a careful logic.
The nine prime river-front sites in Oxford Tce are the focus, he says. The car yards in Tuam St behind are now really considered a land bank for the long term.
Of this strip, the first building is already up and occupied as the CDHB's new headquarters.
The story behind that was local developer, Richard Diver of Countrywide Property, swooped in and bought up the old Deloitte building while Cera was still dithering over the possibility of a purchase.
Rather than pulling it down, Diver did a quick renovation, wrapping it in black slats and sheet glass, and throwing it back on the market as an office block.
It wasn't quite how the authorities had imagined the precinct unfolding, but at least the CDHB ensured the building ended up with a health tenant.
Then as part of Christchurch Hospital's general rebuild programme, the Outpatients and HREF buildings were greenlit. Another two sites spoken for.
Town says in front of the HREF is an existing small office block, Terrace House, currently leased by Otago University. This is likely to remain until someone comes along with a grander plan.
The same with the small CCST building tucked behind. Town says you would expect redevelopment once the drug trials shift across the road to the Archibalds site.
Nestled among the high rises is the Pegasus Arms bar and restaurant, a popular haunt for hospital workers. Town says it is natural that it should stay.
Then in the middle of the stretch is the old Tillmans furniture store site – probably the precinct's flagship location. Town says this has been bought by Otago University.
And while Otago still has to sign off on a business case – construction looks several years away – the likelihood is this is where the medical school will make a new home for its researchers and headquarter staff.
Next door is the CDHB building. Beyond that is the only bare site in need of a tenant – the former Oxford Clinic on the corner with Montreal St.
Cera bought the section when the private clinic decided to hop across the city to Kilmore St rather than wait for the Health Precinct plan to take shape – an early blow to public perception of how the precinct project was faring.
And for a while, Richard Diver was eager to add it to his Deloitte development. He was talking of building more offices or a medi-hotel for out-of-town patients and families.
But Town says Cera decided to hang on to the site so as to reserve it for the final crucial component of the precinct – the hope of landing a multi-national health firm as an anchor industry tenant.
Town says if commercialisation is to be encouraged in the precinct, a big company with all its contacts and market knowledge is a must. And existing partnerships with firms like Orion Health, GE Healthcare and Hewlett Packard, show who are some of the possible candidates.
It will not be easy. However the Innovation Precinct down the other end of Tuam St did manage to attract Vodafone. The mobile giant has opened one of its seven global Xone development labs in its new $50m Christchurch headquarter building.
Town says everyone was talking as if the Innovation Precinct was going to be a dog. "Then suddenly Vodafone announced they were going to put a centre of excellence there. That took a massive amount of effort. But it shows it can be done."
So the Health Precinct strip could have been filled up faster and it would have looked like progress to the public, Town says. Yet in fact the ability to hold off until the right tenant arrives is a strength of the project.
Te Papa Hauora has become a reality. It is now known how Oxford Tce will be populated over the next three to five years.
But Town says, in the end, buildings are just buildings. What matters is how the precinct will function in terms of people and relationships. And this is where the tidy scale and pleasant river-front location becomes key.
He says imagine Oxford Tce once it has been pedestrianised and landscaped. Part of the precinct agreement is also that all the ground floors of the new buildings are going to be "activated" – made a public space with meeting places, cafes and shops.
The idea is to create an open campus flow that connects every building to its neighbours. It will become an area where everyone – students, doctors, researchers, business people, even the wider community – naturally mixes.
It is the collision theory of innovation, Town says. "You've got to be bumping into people from all different disciplines and roles in the system to get the ideas bubbling up."
Town says even the Outpatients building is being thought of this way – as the place the public will have contact with the buzz of the new precinct. There will be regular lectures, displays and other events so people feel involved with the innovation going on.
And compactness matters. Town says this became obvious from his visits to other world-leading health campuses like Singapore's Biopolis, Boston's CIMIT, and Melbourne's Parkville Precinct.
"What the international research shows is you need proximity. Even a kilometre is too far. The anecdote is that if you've got a hot cup of coffee, and you go looking for a colleague to have a discussion with, your coffee's still got to be warm when you get there."
And while Christchurch won't match Boston or even Melbourne for scale, he says, the precinct will offer the whole Christchurch health sector in a two minute walk.
Again, it was a reason why the precinct couldn't be rushed. A lot of work has had to go into creating the right social dynamics. Otherwise Christchurch might have wound up with an expensive row of buildings and not much else, Town says.
But now the piles are being driven, the cranes are swinging into action. Christchurch is putting itself in a position to make medical technology and healthcare systems a useful part of its future economy.
PROOF KIWIS CAN FLY
Professor Anthony Butler, head of radiology at Otago University's Christchurch Hospital medical school, is a good example of what everyone is talking about.
Kiwis punching above their weight in world medicine – and perhaps now about to make some money out of it.
Butler's father is Canterbury University physicist Professor Philip Butler. And Butler himself is one of those over-achievers who was doing a PhD in computer engineering while also qualifying as a doctor and radiologist – then wondering what that set him up for exactly.
With his dad, he got involved in the early 2000s with some new cadmium telluride sensors being developed at the CERN particle physics laboratory in Switzerland. The two saw they might be used to develop a colour computed tomography (CT) medical scanner.
"People thought it couldn't be done," Butler says. The rest will soon be history.
The Butler's Medipix All Resolution System (Mars) scanner is a big reason GE Healthcare is circling the Christchurch Health Precinct.
In its temporary home at the Canterbury University physics department, the Mars Bioimaging team is already manufacturing versions of a machine large enough to colour X-ray the internals of a mouse.
And tinkering away behind closed doors, the human-sized version should be ready to be tested at Christchurch Hospital later this year.
Giving a quick technical run-down, Butler says what is special about a spectral CT scanner is that it can see the different X-ray frequencies transmitted by bone and other tissues.
So instead of a black and white picture, it can be used to generate a colour image that shows up diseased organs or subtle deterioration around joints by their variations in spectral hue.
It is the next obvious revolution in medical imaging, he says. And all the big players – Siemens, Toshiba and Philips – are now chasing the same goal.
But building a machine is the easy part. Building a marketable product means discovering how it might actually be useful in a clinical setting.
"It's all very well and good bringing out a colour CT scanner. But what medical problems do you address with it? Because what problems you address will determine what the machine looks like – what image speeds you need, what resolutions you need."
Butler says that kind of field testing in a real hospital to fine-tune the design is exactly where Christchurch, with its tight-knit medical community and a ready supply of patients, has the advantage.
"We're big enough to do the first human trials. We're big enough to do the engineering and develop the project."
And he says if all goes well, Mars will partner with GE to create an international business, giving a reason for the US firm to set up a development base in Christchurch.
Well, in fact it would take more than just the promise of a colour CT scanner, admits Butler. "When you look at multinationals, they need two or three big things to latch on to. With technology, one could fail. So they need to derisk their company's investment."
But Christchurch does have its other attractive ventures now, like Ossis, a Christchurch company taking on the world with its custom artificial joints.
And again, that is a reason for a health precinct, Butler says. "If they can see there's going to be a continuous supply of good ideas, then it's worth a multinational hanging around."
Butler says 20 years ago, investing in the Health Precinct would have seemed silly. Christchurch wasn't there yet. But the earthquakes were "lucky" in creating the greenfield possibility at exactly the right time.
So there is every reason to celebrate Te Papa Hauora now being under construction, he says. In a few years Canterbury will be seen as much more than a large dairy farm or scenic tourist stop. It should be home to smart health tech as well.