Struggling Starship Hospital doctors are hoping for an early Christmas present after proposing a radical revamp of the building.
Under the plan, which is scheduled to be presented by the Auckland District Health Board behind closed doors next week, another floor would be added inside Starship's central atrium to create much-needed operating theatre space.
The hospital is only 20 years old but is already showing its age, with the key problems being poor facilities for parents staying over and a shortage of operating theatres.
Dr Richard Aickin, Auckland Hospital's director of child health, said the aim was for two more theatres in addition to the existing six, plus a new procedure room.
"One way to do it would be to go up one level and use the space in the current atrium."
Material would be presented to the board this month and Aickin hoped for a decision by March.
Population growth and technology changes had put pressure on theatre space but another way Starship would boost capacity and save money was with some day surgery - such as grommets, tonsils and minor orthopaedics - at a new theatre suite opening at Greenlane next year.
One senior surgeon, who spoke to the Herald on Sunday on condition of anonymity, said a shortage of theatres was "our biggest problem" at Starship.
"Normally a children's hospital of this sized town would have 10 or 12 theatres," he said.
The doctor claimed medical staff had been kept in the dark on plans and relied on chat among colleagues to keep up with what was proposed. "I can't say this officially, but what we all think is, we should build a brand new hospital."
Aickin has said a rebuild had been considered, but at this stage the DHB was committed to the existing building.
He said Starship's core role was to deal with the "most complex high end" cases such as haematology, oncology, transplants and intensive care from throughout the country.
North Shore, Waitakere and Counties Manukau patients may be seen locally rather than at Starship.