The Ministry of Health has released its stocktake report on the critical state of our country’s hospital infrastructure. While DHBs have put the replacement value of hospitals at $24 billion, they will need $14 billion in capital investment alone, the government says, to bring them up to standard over the coming decade.
Hawke’s Bay hospital is comparatively middling (other DHBs fare far worse with their infrastructure), but nonetheless, while the main hospital buildings themselves (built in the 1970s) are in pretty ‘good’ or at least ‘average’ condition overall (with only the laboratory singled out as being in ‘poor’ shape), our emergency department and intensive care unit are not fit for purpose.
Essentially, “… too few key clinical and clinical support spaces [which] are generally inadequately sized and may have a poor layout. The overall configuration of the department or unit does not support the model of care. Repair or renewal is required as facility condition is severely impacting clinical safety and performance. May pose health and safety issues.”
The report specifically points out that to accommodate demand, the Hastings ED’s incremental incorporation of space from adjacent areas has resulted in a piecemeal layout, with cramped conditions, sub-optimal configuration for function flow of care, lack of safe separation between patients and lack of natural light.
While the Hawke’s Bay ICU has “only one point of entry to their units, used for patients, staff, visitors, delivery of goods and removal of dirty linen and waste.” And “significant infection control issues due to cramped units, inadequate negative-pressure rooms and storage issues, along with suboptimal surface finishes and maintenance.”
Two of our inpatient units, wards B2 (acute stroke) and A3 (specialist surgery) also scored “poor” in design, due to factors like infection-control issues related to facilities, lack of privacy for patients, inadequate support for staff-patient communication, inadequate sized and shaped spaces for clinical work.
The DHB’s eight operating theatre suites fare better with an ‘average’, but it’s not overly consoling as average still means there are “Likely to be too few key clinical and clinical support spaces… Layout of key clinical spaces may be compromised. Some elements of the overall configuration of the department or unit may compromise the model of care. Clinical department or unit has deteriorated to a degree where maintenance is obviously due.”
On the upside, from an infrastructure point of view Hawke’s Bay’s mental health units were classed as “very good”. Thankfully, since they’re brand new.
Hawke’s Bay DHB was one of the pilot sites for the National Asset Management Programme, working closely with the team who developed the report.
“We believe [it] provides a fair and accurate assessment of the Hawke’s Bay Hospital facilities,” says the DHB’s financial services executive director, Carriann Hall.
Some of the issues highlighted in the report, for instance, around the electrical system, are already being addressed and the DHB stresses its commitment to maintaining the general condition of buildings and services. “However,” says Hall, “a number of the buildings are very old… and will require sizeable investment to rectify.”
So, lots of work to do! And that’s something we’ll unpack at BayBuzz down the track when the DHB is ready to share their plans and their business case for a substantial overhaul.