I'm writing this letter both as a concerned citizen, and as a member of the healthcare profession who once served in this venerated hospital in Sabah.

The tower block of Hospital Queen Elizabeth was a relatively late addition being built in 1981 at a cost of RM20 million.

The tower block, as I remember it, housed the operating theaters, surgical disciplines, the ICU/CCU as well as the First Class wards, in addition to the Radiology Department.

On October 25, 2008, a mere 17 years after completion, parts of the tower block of Hospital Queen Elizabeth were declared unsafe, this, too, after it had already been suspect for over two years.

Services were distributed to ‘nearby’ district hospitals and ward space was rented from a private hospital. Interestingly, this private hospital had sold their previous building to the ministry of health around three years ago and this is now the site of the Women and Children's hospital and the Likas Specialist Hospital.

A short three days later, the Sabah chief minister declared that the QE Hospital would be relocated to a new site. By November, the plan appeared to have been changed to that of purchasing the private hospital, no doubt for a premium, though no steps have been taken in this direction either.

On Dec 2, a media report quoted an expert saying that a new tower block would be the best option for the QE Hospital. Thus far, no definite plan has surfaced; and I have no doubt that patient care has suffered as a result.

The administration of the hospital and the state health department should be held accountable for the lack of progress towards a definite solution for the past five months or so.

Let's consider the last of three options first; building a new tower block. A second tower was already proposed and planned for even in 2004. The reason for construction of the second tower was to help cope with an increased patient load that the QEH was already facing, and to bring it up to par with other tertiary referral centres in the country.

The logic was simple. When compared to hospitals in Peninsular Malaysia, where care of a patient can be transferred from state hospitals to HKL or other referral centres via ambulance, transferring an ill patient from Sabah to the Peninsular is both costly and dangerous what with a three-hour flight.

Building a new tower block would necessitate the demolition of the old tower block, which would invariably affect the stability and safety of patients in the adjacent medical wards in the old 1957 block.

Leaving the old tower intact while building the new tower is simply asking for trouble. Where would these patients be moved to? At present, there is no viable option to decant patients to a safer area. Building the new tower after demolition of the old building will also take up much time, during which patients will continue to suffer.

The new tower will not solve the bed shortage problem that has plagued this hospital for the past decade and should not be considered a long-term solution.

The second option is purchasing the private hospital. No doubt this seems like a fantastic short- term measure. You solve the problem of having no hospital by buying a ready-made building that has already been designed as a hospital.

You have a new hospital at the stroke of a pen and everyone's happy. However, I'm sure the cost of buying the hospital will be astronomical and disproportional to actual cost of constructing a new one.

There will be terms and conditions, I'm sure, that will ensure that the private hospital moves out in stages, while their new building is completed, and hence although you might end up buying a 200-bed hospital, you might only get 100 beds for the next two years.

Another case in point is that private hospitals tend to cut corners when they build and the facilities available, although impressive looking, may be just that - impressive looking.

Renovations might have to be done to bring it up to specifications and to the present level of new hospitals such as hospitals in Ampang, Sungai Buloh or Serdang.

Finally, there is the option of building a new hospital. This is by far the best option in my opinion but likely the most expensive as well. Building a new hospital, preferably within the town or in adjacent areas like Dongongon would be the perfect solution with both ends of the town covered by either the new Hospital Queen Elizabeth or by Likas at the other end.

There would be little sense in placing such a hospital far away from Kota Kinabalu in a place like Kinarut or Tuaran. The powers-that-be should plan for a hospital to suit the needs of the population.

Perhaps instead of a 600-bed hospital, build a 900-bed hospital with proper facilities for sub-speciality services, better operating theaters, better CT and MRI machines and a cardiac catheterisation lab.

Steps could be taken to computerise the hospital as well. The plan to build a cardiac centre should be forgotten for the time being and steps be taken to sort out the mess that the main hospital is in at the moment.