Health bosses have started implementing an innovative plan they hope will fix the parking problems at Hawke's Bay Hospital.
The move also aims to improve community health and save hundreds of thousands of dollars.
The plan has started with car-pooling for staff who are being encouraged to travel to work by means other than alone in their cars, and making the hospital a cycle-friendly destination and place of employment.
Improved bus services will start late in September and parking fees of $1 a day for staff - or up to three-and-a-half hours for patients and visitors - should be in place by the end of the year.
DHB chief executive Kevin Snee said the board did not want to "downplay" the parking problem, which he said was "unacceptable".
It is also considering reconfiguring current carparks - but with the public showing it wants health dollars spent on health services not parking buildings, the board hopes the future need will be for less parking space than more.
Mr Snee said the board had been aware for a long time about parking congestion in and around the hospital in Hastings, and was now implementing the Go Well Travel Plan in conjunction with the Hastings District and Hawke's Bay Regional councils. Mr Snee believed the scheme would be watched nationwide as the first time such an approach had been undertaken by a health board.
The plan was approved last year after consultation with staff, other users and councils, and a project manager had been appointed to implement the plan over two years.
Parking difficulties had been identified in several ways, and the key "drivers" of the plan were increasing complaints, illegal parking, and increasing numbers of people missing clinic and other appointments.
The hospital has just more than 1000 parking spaces and the board believed the creation of more would simply mean more people would travel to and from the hospital by car.
The hospital has Hawke's Bay's biggest workforce, but a survey found 91 per cent travel to work by car - more than three-quarters of that number driving alone.
It also found 10 per cent live within 2km of the hospital, a 20-minute walk, while 27 per cent are within 5km, considered a reasonable cycling distance.
Of patients, 18 per cent lived within 1km of the hospital, 23 per cent lived within 5km, and 11 per cent lived with 800m of a bus stop. Mr Snee said the board wanted to improve access to the hospital, and at the same time try to meet health goals by encouraging walking and cycling to and from the hospital, or bus stops, as an aid to good fitness. He said hospital use was increasing, evidenced by Emergency Department figures increasing over 7 per cent in a year, and the board wanted to take steps that were "good for the environment and for public well-being".