$47b for new hospitals and renovations over the next decade – Health NZ

The cost of building new hospitals and renovating old ones is expected to rise to about $47 billion over the next decade, according to a report by Health New Zealand.

That equates to two or three new Dunedin Hospitals every year for the next 10 years.

An interview with Health Minister Shane Reti – obtained by RNZ under the Information Act – also shows the bill to fix broken pipes, old wiring and other problems at aging public hospitals could be in the millions. hundreds of millions, 82 “very high. significant risks” identified.

The Nationwide Service and Campus Planning The report, which was signed by the Te Whatu Ora board in December and went to the Minister in April, shows:

• 300 existing infrastructure projects are on track to cost $46.9b over the next decade
• The cash injection requested by hospitals before each Budget for new buildings and improvements has grown from $15b in 2020, to $24b in 2022, to $34b this year.
• 82 “Very High Severity” accidents, 399 “High Severity” accidents and 118 “Moderate Severity” accidents in 32 areas of the hospital.

Unless the “model of care changes”:

• Another 4900 beds needed by 2043
• The average 80-year-old spends 10x more hospital days than the average 45-year-old.
• Nine out of 10 hospital beds will be filled by someone aged 65 or over by 2043.

Even that huge investment will not be enough to meet “projected demand” from a growing aging population, officials said in the report.

“At best, were all existing capital projects to be funded over the next decade, new energy provision would lag behind existing demand projections.”

It cites the number of nationwide goods and services plans prepared by the previous government last year.

The Campus Risk and Comprehensive Infrastructure Project – based on assessments of 34 hospital campuses – put the cost of reducing 82 “Highly Critical” risks between $140.4m and $372.5m.

Fixing a further 399 “High Severity” and 118 “Medium Severity” risks will require “significant investment”.

The campuses with the highest numbers of Very High, High, and Moderate risks were Gisborne, Hawke’s Bay, Palmerston North and Kenepuru hospitals.

Drinking water equipment, medical gases, electrical and mechanical equipment were among the goods in the poorest condition.

“The average age of healthcare buildings is 45 years, and many buildings are nearing the end of their useful lives,” officials wrote.

Decades of under-investment in the health service mean hospitals will need a “major overhaul” to meet the demands of future patient influxes.

The hospitals are very old and very small

Across the country, there are 86 public hospitals – from two to 1000 beds – about 11,000 beds in total.

In 2019, it was estimated that an additional 680 beds would be needed by 2022/23 on top of the 9549 beds in use at that time, but Te Whatu Ora was about 500 beds short. according to the introduction.

Despite collaborating with private hospitals and investing in home support, the hospitals were already “blocked”.

The completion of major projects submitted for funding – 300 of them, including major improvements to more than 10 key sites, and a new campus in South Auckland – will create an additional 2150 beds by 2045.

But based on current care models, hospitals would need an additional 4,900 beds by 2043 that would be “unpurchased”, according to the building and staff.

“We have to improve the resources we have as we build teams and infrastructure.”

NZ cannot build hospital capacity fast enough

New Zealand’s population is expected to increase by 15 percent over the next 20 years, and the proportion of those aged 65 is expected to increase from 17 percent to 22 percent.

By 2043 the number of people aged 80 and over is expected to double, creating “greater demands on health services”, as they use ten times more hospital beds than people they are 45 years old.

Under the current diagnostic, treatment and rehabilitation care model, nine out of 10 beds will be filled by someone aged 65 or over by 2043 – 28 per cent for those aged 65-80 ( 1400), 59 percent for those. 80+ (2900 beds).

Proposed solution: ‘community’ care

A shift to “community-based forms of care” – allowing older people to stay at home – could reduce that by two-thirds.

However, the report warned that the capacity demand model is based on the pre-Covid 2019 environment of “intensive residential and primary care”.

“If these services do not grow and strengthen together with the aging population, more hospital beds will be needed to provide care to people as they become increasingly frail.”

Other treatment options will include:

• Virtual and digital health systems to remove barriers to professional care
• Effective primary care and social services
• Urban and rural health care settings
• Specialized health care delivery is linked locally, regionally and nationally
• Hospital care is reserved for those who need “very special support”

“Implementing Pae Ora’s reforms and adapting them to modern models of care will help us deal with the growth of demand, improve the balance of experience and outcomes, and provide quality health care for money.”

But the Department of Hospitals and Professional Services, which produced the report and was tasked with implementing it, has been disbanded.

RNZ asked Health New Zealand what this meant for the report’s recommendations.