Health New Zealand is tackling a major rejig of Wellington Hospital as one of its first big new infrastructure jobs, amid huge pressures of time, money and construction labour.
The region’s health leaders are trying to fast-track a plan worth up to $250m to move multiple services at the hospital around, including the squeezed emergency department, as the first phase of a hospital network upgrade worth up to $2 billion over two decades.
With the district health boards gone, the hospital managers are now working with the national agency’s new Infrastructure and Investment group at district level, on an investment case to go to Health NZ’s board.
Health NZ, Te Whatu Ora, said the Wellington rejig had already been assessed as a project “that may be prioritised early”.
Major hospital projects have been notorious for taking years and years for DHBs and the Health Ministry and Government to agree on, let alone construct.
When Canterbury DHB tried to add to its major tower blocks, top clinicians took part in more than 300 meetings spanning three years – before being handed a solution in 2020 they did not want.
Documents show the Hutt and Wellington health boards had been trying to get a business plan to Treasury before they were disbanded, but did not make it.
DHB minutes released to RNZ stressed the urgency.
In December 2021 they said: “Some changes cannot wait for the Strategic Infrastructure Plan and Hospital Network programme business cases to be completed.
“Demand on our emergency department and the seismic risk of the building means we are seeking investment in Front of Whare [the rejig project] now.”
They added: “It was noted that infrastructure changes must lead the change as our current facilities impact on the level and quality of care on a daily basis and this is experienced by clinicians (for example, 20 percent of surgeries are cancelled because of lack of theatre capacity).”
The plans, reports and meetings are multiplying: a strategic infrastructure plan, a clinical configuration plan, and a hospital network configuration plan across the Wellington, Hutt and Kenepuru sites are all done or being worked on.
The DHBs said they had “engaged with the Ministry of Health and the Treasury to confirm our strategic intent, the expected investment envelope, and the better business case pathway”.
Health NZ says it is working “at pace”, but also that it was not appropriate to comment on Budget prioritisations for Wellington “at this time”.
The early ambitious timeline suggesting the Wellington Hospital service relocations could be ready by early 2024, could not have predicted what delays might arise from the nationwide overhaul under Health NZ.
Circumventing infrastructure bottlenecks is a huge task facing Health NZ, as it tries to integrate the functions of 20 DHBs.
Its Infrastructure and Investment group takes over from the Health Infrastructure Unit that had been under the Health Ministry.
It has a leadership team for Capital and Coast/Hutt Valley, as for other districts.
“Te Whatu Ora recognises the critical importance of investing in health infrastructure and we are already prioritising this in our action groups set up within the new entity,” a spokesperson said in a statement to RNZ.
Long-term planning like Wellington had done was “essential”, and all regions would be required to do it; some such as the northern region were “well advanced”, they said.
“This is part of Te Whatu Ora’s aim to take a national and regional approach to prioritising and sequencing the Government’s capital investment to ensure replacement, adding capacity to match needs of population growth and enabling innovation are balanced within available resources.”