Health
New Zealand's health system, including investment in health-related infrastructure, is mainly funded from general taxation, overseen by the Ministry of Health. Although District Health Boards (DHBs) have devolved responsibility for their capital spending, the Government maintains control over large investment decisions through the preparation of a national asset management plan for health.
Capital spending in health is driven not only by population growth, but by demographic changes such as ageing, improvements in health technology, and the age and condition of long-lived assets. Spending on health infrastructure is subject to the Government's fiscal constraint, so it is vital that funding goes towards the most valuable or necessary projects. For that reason, a new business unit has been established within the Ministry of Health to focus on regional planning and health infrastructure investment.
Aggregate view: demand and capital intentions
DHBs have assessed the impact of health service changes expected within the next five, 10, and 20 years by considering demand (demographics, patterns of need, change in access and intervention rates) and supply (including new health technologies, new models of care, changes in workforce availability, workforce roles, changes in the location of service delivery and information technology advances) factors.
Based on this, current projected requests for additional capital (beyond what will be available from depreciation) total $190 million per annum in the first five years and $127 million per annum for the remaining 15 years. Recalling the limitations of current health sector asset management, these plans should be seen as an indicative starting point for further analysis. They represent requests by DHBs and may well change when a top-down view is taken:
- Figure 4: New health capital budget funding requirements by year of spend
- Source: Ministry of Health, 2009
- Figure 5: Total health capital spending
- Source: Ministry of Health, 2009
Short-term priorities
Projects with construction currently under way:
| Project Name | Description | Project Budget ($M)[24] |
Est. Finish Date |
|---|---|---|---|
| Waikato - Service & Campus Redevelopment | Redevelopment of Thames Hospital and core clinical facilities at Waikato Hospital | 249 | 2013 |
| Bay of Plenty - Project Leading Edge Organisation | Redevelopment and expansion of facilities at Tauranga Hospital | 139 | 2011 |
| All DHBs - Oral Health Projects | Establishment of new infrastructure to implement the adolescent oral health policy | 116 | 2012 |
| NSDP | IT redevelopment | 50 | |
| Waikato - Acute Medical Precinct Project | Creation of a modern acute medical facility of 100 beds over the Emergency Department (ED) | 30 | Mid-2010 |
| Hutt Valley - ED and Theatre Expansion | Doubling of ED and Theatres at Hutt Valley Hospital | 82 | 2011 |
| Lakes - Health Service Improvement Project | Redevelopment of Taupo and Rotorua hospitals. Construction of new Clinical Services Block | 90 | 2011 |
| Total | 861 |
Source: Ministry of Health
Projects committed but construction not started:
| Project Name | Description | Project Budget ($M)[25] |
Est. finish Date |
|---|---|---|---|
| Northland - Whangarei Hospital Redevelopment - Stage 1 | Replacement of Acute Mental Health Unit and upgrade of campus infrastructure | 25 | 2011 |
| Waitemata - Lakeview Extension | Expansion of Emergency Care Centre and additional acute medical beds (48) | 49 | Mid 2011 |
| Taranaki - Project Maunga | Redevelopment of Base Hospital at New Plymouth. Core clinical facilities will be replaced including an increase of 2 theatres |
80 | 2012 |
| Counties Manukau - Towards 20/20 - Future Growth |
Major redevelopment of Middlemore Hospital.Replacement of core clinical facilities including 3 additional theatres. Completion of Edmund Hillary Ward Block |
209 | Mid 2015 |
| Total | 363 |
Source: Ministry of Health
