What is the value of infrastructure investment in securing the future of New Zealand’s healthcare sector?

Health and disability system assets contribute to wellbeing by enabling a better standard of service delivery, which in turn contributes to more equitable health outcomes. Healthcare sites, including hospitals, should be integrated into the broader community, wherever possible, to promote accessibility, societal ‘buy-in’. In parallel, the healthcare system and staff must support effective health promotion, prevention and self care of the whole population. 

NZ's Health Budget 2022 included investment of $1.3 billion of capital funding for a range of new and existing projects to improve hospital infrastructure and catch up on the long period of neglect and deterioration. The physical infrastructure underpinning the health system includes community-based facilities, aged residential care facilities, DHB facilities (including hospitals), and privately funded health care facilities. However, health and disability infrastructure is not limited to physical assets such as buildings and technology. It also encompasses the network of soft infrastructure services required to support effective and equitable service delivery. The sector therefore has dependencies on other sectors, such as transport, water, energy, telecommunications, and education to support both the general health and wellbeing of the population and aid the delivery of services through resilient infrastructure and a thriving workforce. 

Current health and disability facilities have also been found to be not fit-for-purpose due to insufficient facility maintenance and renewal due to decades of under-investment, increasing demand, and the inability to keep up with modern models of care that respond to new and emerging trends. More transparent planning, governance, and prioritisation of investment at a national level will be required to ensure facilities and equipment are safe and fit-for-purpose. Expenditure on maintaining assets and use of depreciation is currently discretionary in the publicly funded health system.

Investments in infrastructure for health can be costly and seem untenable in resource constrained settings. These investments compete with other equally important areas. Nonetheless, infrastructure investments can contribute substantially to alleviating burdens of morbidity and mortality while also providing a positive return on investment in the long term. Although providing poor quality of care pervades even the most well equipped service environments, high-quality care is only possible in settings where key infrastructure requirements are met. Any new infrastructure investments should consider environmentally friendly options durable to the extreme weather conditions resulting from climate change, while also bolstering readiness requirements for current and future infectious disease outbreaks.