More Government investment in Hawke's Bay Hospital may come as soon as a couple of years away - but it may not be enough to fix its problems.
Health Minister Andrew Little said Hawke's Bay was now one of the highest priority regions for hospital investment and could expect some commitments in the Budget for its hospital in the next couple of years.
"In the most recent Budget we made commitments for Whangārei and for Nelson, so we're now moving down the list."
"I've been through the Hawke's Bay Hospital, so I know the age of it, I know the state it is in."
Kevin Atkinson, elected member of Hawke's Bay District Health Board, said he would be disappointed if there was not "a significant amount of money", up to $1 billion, invested in Hawke's Bay Hospital in the next five years.
"Particularly the emergency department, ICU, the main tower block, which is the ward block. It's no longer fit for purpose and needs to be replaced."
"When you look at having to achieve that, you're going to have to do a lot of other work on the campus as well."
He said he didn't think the idea of building a second new hospital was justified, with the size of Hawke's Bay's population. He would prefer to see the existing facilities and land utilised and upgraded.
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Little said the slow process in getting Hawke's Bay hospital up to date with earthquake standards was linked to historic underinvestment in hospitals and infrastructure nationwide, which the Labour government had been working to rectify over the last five years with around $7 billion invested into hospitals across the country.
"We are behind where we should be in terms of replacing hospital buildings. We are going as fast as we can, but we don't have unlimited resources so we have to prioritise."
Tukituki MP Anna Lorck said many of the Hawke's Bay hospital projects planned from the $100 million in funding already invested by the Government have not even started.
"We've already seen the greatest commitment of capital investment into our regional hospital, in over $100m in new capital investment from the Government.
"Last year our Government increased capital funding, giving our DHB $35m to get it built faster, and yet there is still not a sod of soil turned."
"The health reforms can't come fast enough. This will streamline projects, and hopefully see projects that should have been under way now getting the focus they deserve."
Little said regional hospitals would have more dedicated project managers and designers to work on buildings and infrastructure under the health reforms, which will help areas like Hawke's Bay.