LAST November I wrote expressing astonishment at the apparent lack of a sterilised water supply in the new Children's Hospital cancer unit. I had anticipated this being cleared up by the Queen Elizabeth University Hospital Review published last week, but it wasn’t ("Superhospital report branded ‘whitewash’ as investigators say site defects not cause of deaths", The Herald, June 17. Nor was it addressed by last night's Disclosure programme on BBC 1 (June 24). I am therefore still no wiser as to whether this was a contributory factor to subsequent events.

As for the QEUH review itself, a few observations might be worthwhile, starting with the water supply. The review states that the project team did not consider disinfecting the main water supply but could not produce written evidence to verify this.

The Employers Requirements describe the health board’s requirements for the hospital’s construction and form the basis of the contract. Volume 2: paragraph 8.2.8 deals with water systems and states: “Treatment of potable cold water supplies is not acceptable and the provision of a wholesome supply from Scottish Water’s mains with the minimum of storage and handling is required.” In other words, there was a prohibition on disinfecting the supply. To me that’s the written evidence.

As regards ventilation provision and infection, this is covered by paragraph, whereby the contractor must “demonstrate how their proposals facilitate the control and management of an outbreak and spread of infectious diseases in accordance with SHTM 2025 and SHFN 30 and HAI-Scribe. The Contractor Demonstration is to cover all aspects of the building, its services, spatial relationships, maintenance regime proposals, and incorporate requirements of the Board’s Infection Control Team.”

According to the review the health board inexplicably gave the responsibility for verifying compliance to the contractor. And guess what, the contractor failed to involve infection control, lost much of the test documentation, and refused to hand over reports. Given the contractor appears to have failed in almost every testing aspect, how did the board then come to the conclusion it was safe to open the building?

The review’s authors also describe “ambiguities” in the interpretation of NHS Standards and other guidance such as BREEAM (Building Research Establishment Environmental Assessment Method), claiming that this led to confusion as to what had priority.

Within the contract there are sections specifically designed to eliminate such ambiguities under “Minimum Design and Construction Standards”. There the board states unequivocally that the contractor must comply with NHS guidance. These are described as "mandatory" and they include ventilation standards. In the event of a conflict either with building control or any other information source, the contractor has to notify the board of this. It then decides which standard is to be followed, not the contractor.

As for the alleged conflict with energy requirements, you cannot put an energy target ahead of patient safety. That’s unheard of. Even within the BREEAM section (which deals in part with energy issues) clinical requirements take precedent. For instance, the section dealing with indoor air quality states "all clinical areas with controlled environmental conditions to comply with HTM 03-01 – Specialised ventilation for Healthcare Premises”. There was therefore no ambiguity in my view, just incompetent management.

Robert Menzies, Falkirk.

HAVING watched Disclosure and considered reports and information in the public domain, the conclusions, or lack of conclusions, in the latest Independent Review asks more questions than it answers. Also, why out of hundreds of people that there probably are in the main contractors project team – designers, consultants, health board project managers and many other stakeholders did the programme only manage to get three people to come forward for comment?

No doubt most gave the usual response of “we cannot comment on individual cases” or when “on-going inquiries/investigations etc are under way”. This will drag on for years and peter out with vague conclusions and amendments to contracting and managing of such projects in the future that will have little impact on the current culture of major public infrastructure projects.

And of course Quality Assurance (QA) will continue to be a forgotten element of the procurement procedure, only ever addressed at the build stage when it is too late as contractors, subcontractors and suppliers have not been committed to QA at the tender stage. I generalise of course, but it is a major factor much under-looked.

Again whistleblowing is desperately resisted at all stages and every hurdle is used to discourage, if not block it ("Health board to review whistleblowing procedures after super-hospital row", The Herald, June 25), which is quite depressing given the apparent increase in policies by Government and organisations to make whistleblowing a positive thing with new policies in place.

Niall McTeague, Giffnock.