The National Reconstruction and Resilience Authority (NaRRA) is being lined up to deliver four new public hospitals with a combined 1,370 beds. It takes on that role while still in its planning phase, with its own staffing and systems not yet in place.

Health Minister Dr Christopher Tufton told Wednesday’s post-Cabinet briefing that the ministry’s proposed collaboration with NaRRA should shorten the path from design and construction to equipping and maintenance. He also said a new hospital takes about three years to design, build, equip and commission.

The case for a fast track rests on the authority’s design. Prime Minister Dr Andrew Holness said when the legislation was tabled in March that NaRRA would hold special powers to speed up development approvals and procurement, and would act as a single point of coordination to remove the fragmentation and delay that have held back public projects. Hospitals involve land, planning approvals, specialist equipment and several agencies, so they are exposed to each of those delays.

The case for caution rests on the calendar. NaRRA became operational after its Act was passed in May, and chief executive Major General (Ret’d) Antony Anderson took up the post on June 1. In his first JIS interview, he said work on critical projects would start by year-end. In early September he told residents in Parottee, St Elizabeth, that the following months would go to examining and sequencing the projects Cabinet had referred.

Later that month, he reported that the organisational structure had been settled and job descriptions written, with recruitment underway. Offices had been secured, and ICT systems were still being scoped. He was speaking at the signing of a US$5 million grant agreement with the European Union and the World Bank, money intended to develop the authority’s institutional capacity.

Put plainly, the body expected to accelerate a 720-bed Kingston Public Hospital campus is still hiring the procurement and project management staff who would run it.

Procurement is the second open question. Holness told the House in April that the NaRRA Act does not contain a procurement framework. Instead, the Minister of Finance would issue an order under the Public Procurement Act, 2015, exempting the authority from the standard regime and setting the terms that apply in its place. Until those terms are public, contractors cannot know how hospital contracts will be tendered, and taxpayers cannot judge how awards will be checked.

The Government has argued that the safeguards are sufficient. Senator Aubyn Hill told the Senate in May that the law provides for full auditing and reporting, along with Cabinet oversight, and that Parliament’s committees, an independent auditor and the Integrity Commission all have a role.

The hospitals will show which reading is right. Signs of a fast track would be a signed agreement with the health ministry, published procurement rules and a costed schedule within months. Signs of a bottleneck would be Cabinet referrals arriving faster than the authority can staff up to handle them.