Alison Daniels looks at the project that was plagued by problems from the start

CONTROVERSY and heated debated surrounded every aspect of the conception, planning, and building of the glitzy Health Care International hospital on the unglamorous site of an old steelworks in Clydebank.

Just six months after opening, the project had met with financial disaster. HCI, part funded by #37m of public money, was in the hands of the receivers amid recriminations over the waste of taxpayers' cash.

Four months of negotiations with potential buyers saw a number of cliffhangers before the hospital was finally saved when a deal was struck with the Middle Eastern-based Abu Dhabi Investment Company.

But rescue did not mean the end of controversy. This year the hospital has come under fire over the treatment of NHS patients, occupancy rates, revelations about #220,000 roof repairs, and the departure of over 25 staff.

Yesterday, HCI's current management kept quite, distancing itself from pre-receivership problems and pointing only to a recently signed contract with the Algerian Government to treat around 300 heart patients and the steady stream of patients, mainly from the Middle East, seen since February.

The long-term goals articulated over the past few months in measured terms by Abu Dhabi Investment's chairman, Mr Harab Ali Darmaki, contrast all too sharply with the picture of a thriving international 260-bed centre of medical excellence painted by HCI's American founders, Dr Raphael Levey and Dr Angelo Eraklis, when they unveiled their ambitious scheme in 1987.

Speaking in Glasgow eight years ago the former Harvard surgeons expressed surprise at the hostility vented by health unions and MPs but promised to forge ahead with the five-star hospital designed to cater for the wealthy foreigners from Europe, North Africa, and the Middle East if backed by the Government.

In October they got that backing when the then Scots Secretary, Malcolm Rifkind, gave the official go-ahead for the hospital, attempting to soothe misgivings over private health care with the promise of 4000 permanent jobs, including 1800 at the hospital, for depressed Clydebank.

The decision met with almost universal condemnation. There were fears over a drain on NHS staff, trained at public expense and now to be lured away into the private sector, the impact on the health services in the Glasgow area, and, ironically, in the private sector a concern over further competition.

As the debate raged on, practical problems had already arisen. Following Rifkind's announcement it emerged that the proposed site was an asbestos dump, prompting a public-safety row. The original Scottish Development Agency estimate of #1m to clear the site became #5m. A further #3m was later added to the SDA's bill by severe land engineering problems.

By the summer of 1989 the project had failed to secure the necessary private financial backing amid rumours that the banks were reluctant to commit themselves to the project. Months later, though, it was back on track after US and British private investment was topped up with a Government offer of Regional Selective Assistance totalling #22m.

Finally in March 1994 the state-of-the-art hospital, with its 21 operating theatres, opened its doors to its first Middle Eastern patient. But trouble was brewing. One of the hospital's leading surgeons, Dr Gerald Lawrie, returned to America for ``personal reasons''. West Midlands Regional Health Authority cancelled its contract. While the public debate centred over whether HCI could and should be used to cut NHS waiting lists, behind the scenes the hospital was already in dire financial straits.

By June, round the time of the official opening, HCI was asking its international syndicate of banks for more cash to the tune of #15m. In September the Royal Bank stepped in with loans to pay wages and keep the doors open but within another two short months it was all over. HCI went into receivership.

Salvation for the hospital's 350 staff came in February when the Abu Dhabi Investment Company agreed to a #20m deal with the receivers, leasing the hospital and its adjacent luxury hotel.

The American dream metamorphosed into a more modest Middle Eastern strategy of long-term survival, concentrating on Middle Eastern and UK private markets as well as NHS contracts.

The past 11 months have been a struggle. While the management, now headed by the recently installed chief executive, Mike Hall, and a new development manager, Douglas Trigg, has put occupancy rates at between 60 and 85%, the actual number of beds occupied at any given time has fluctuated from between about 20 and 60.

But against the backdrop of continuing bad publicity over public funding ADIC has soldiered on to attract new patients, announcing the creation of around 100 new jobs, publicising a pioneering heart operation - on an NHS patient - and last month finally clinching a deal with the Algerian Government under negotiation since the summer.