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It took 22 years in the early 17th century to build the Taj Mahal, the awe-inspiring white marble mausoleum in Agra, India.

It will take longer than that for Quebec to build a utilitarian hospital in downtown Montreal in the 21st century.

The Taj Mahal is a glowing symbol of eternal love.

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The "Taj Hôpital" is a shameful symbol of political dithering.

In the latest installment of the absurdist tale, Quebec Treasury Board president Michelle Courchesne announced Monday that construction of the Centre hospitalier de l'Université de Montréal (CHUM) will begin in the spring of 2011 and be completed by 2019. The tentative price: $2.1-billion.

Well, actually she announced that there will eventually be another announcement because bids have yet to be tendered. Not to mention that there are no final blueprints.

And so it goes.

The idea of building a Montreal "super-hospital" - merging archaic institutions scattered around the city into one state-of-the-art facility - was first floated in 1991.

It was an eminently wise plan, particularly in a city where most health-care facilities were built decades - and in some cases centuries - ago.

But in the health field there is no idea, however sensible, that cannot be bogged down by bureaucracy and perverted by politics. The Quebec super-hospital saga is a case in point.

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(In the interest of brevity, I will leave out names and political affiliations: Suffice it to say there have been four premiers and six ministers of health involved in the file to date, and the Liberals and Péquistes have handled it in equally bumbling style.)

In 1995, Quebec's Health Minister announced a merger of the three "French" hospitals - Hôtel-Dieu, Notre-Dame et Saint-Luc - to create CHUM. A similar process happened with the "English" hospitals - Montreal General, Royal Victoria, Montreal Chest Institute, Montreal Neurological Hospital and Lachine Hospital - and that was called the McGill University Health Centre (MUHC).

In 1999, it was finally decided that CHUM and MUHC should be more than virtual institutions. They would become bricks-and-mortar "super-hospitals."

Then the real jockeying began. Where would the facilities be built? What would happen with the existing hospital properties? How many beds would each super-hospital have? And so on.

Forests were felled and tens of millions of dollars spent to produce studies, including a 2003 commission of inquiry headed by former prime minister Brian Mulroney and former Quebec premier Daniel Johnson.

Back then, the super-hospitals were going to be built and operating by 2010. And CHUM was going to cost $850-million.

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But a shovel in the ground would prove to be a pipe dream.

One of the most politically vicious battles was about the future site of CHUM. It came down to 1000 St-Denis (in the heart of downtown) St. or 6000 St. Denis St. (in tony Outremont).

There is enough intrigue in that choice to fill a book - and, in fact, a book has been written.

The travails of MUHC, by contrast, were minor. All they had to deal with was contaminated land and angry neighbours near the planned construction site in Notre-Dame-de-Grâce.

And, oh yeah, the costly foot-dragging of indecisive political leaders.

Plans to have the new facilities built as private-public partnerships (PPPs) - an approach in which private enterprise builds the hospitals then leases them back to government over a 30-year period - added to the controversy and cost and, in the end, private enterprise will play a token financing role so the government can save face.

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The 772-bed CHUM will cost $2.1-billion (don't bet on that being the final number). There will also be a $470-million CHUM research centre. Not to mention the $500-million upgrade of Sainte-Justine, the "French" pediatric hospital.

MUHC will cost about $2.2-billion, including a new 500-bed facility, a new Montreal Children's Hospital and extensive renovations to the 332-bed Montreal General Hospital.

That's $5.3-billion and counting.

This may seem like profligate spending, but all these facilities are needed and overdue. Quebec's flagship hospitals are crumbling, inefficient and increasingly unsafe. (It's no coincidence that Quebec has an inordinate number of hospital-acquired infections such as C. difficile.)

Quebec's political leaders should be getting credit for their bold investments in health care. Instead, they are getting derision because they took too long to do the right thing. They lost sight of who really matters: the public.

There is an endless list of excuses trotted out each time a minister makes a new announcement and revises the timeline for construction. But the bottom line is that these hospitals should have been up and running at least a decade ago.

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The delays served the interests of property developers, construction companies, donors to political parties and various interest groups within the health system, not the needs of the sick and injured who need hospital care.

It's been two decades since planning began, and now we're being told it could take many more years to complete the super-hospitals (MUHC 2014; CHUM 2019). That no premier or health minister ever demanded that the shuffling of paper end and the roar of construction equipment begin is a disgrace plain and simple.

In Canada, we talk a good game about patient-centred care. But it will never be a reality unless it becomes a priority and a guiding principle from the upper echelons of power on down.

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