The scaling back of Dunedin Hospital has been greeted with outrage and protests from the community. Photo: RNZ / Tess Brunton
"Discord" among doctors and the community about the Dunedin Hospital cut-backs are regarded as an "extreme" risk by health authorities.
Health New Zealand was aiming to handle the hostility by identifying "project champions to sell the message", according to the two latest project updates released to RNZ under the Official Information Act.
The updates also reveal that about $20m of extra costs arose from the project being put on hold last September, until it was reactivated earlier this year.
Locals have expressed concern at newly-reported cuts to dementia, psycho-geriatric and intensive care beds.
But the government said it announced the changes in scope back in January.
The latest updates list 10 "extreme" risks around the inpatients block, but eight of them have been blanked out.
One risk that was not redacted had noted discord among clinicians might be sparked by a possible reduction in capacity affecting healthcare outcomes.
The solutions for this and community discord were listed as "clear messaging", identifying champions or a "single trustworthy spokesperson" and "common messaging accentuating the positive aspects of the project".
Tens of thousands of people protested in Dunedin streets in September over the government pausing the project after it said a blowout threatened to push the cost to $3 billion - although three official reports related to cost estimates were withheld by HNZ.
The government hired eight firms of contractors and consultants to rethink the project, which it eventually decided would go ahead at the site already chosen, but scaled back.
The OIA response shows those eight firms have cost taxpayers $3.5m so far.
Costs due to the delay were also mounting and had been running at $3.4m a month, or $100,000 a day. The fees - plus five months of delay - amounted to about $20m, RNZ calculated.
As well as revealing the extra costs, the OIA response showed there was still no revised building programme for the crucial inpatients' building.
"Programme options are being actively considered and prepared, however, the procurement pathway is yet to be decided and therefore is not at the stage where a revised building programme exists," Health NZ Te Whatu Ora told RNZ.
"We continue to work within the approved project budget of $1.88b."
This compares with the $2 billion for five new naval helicopters the government announced on Sunday, as part of $9b in new spending over four years on defence.
In Dunedin, there were renewed protest after reports of the new inpatients having 20 intensive care beds instead of 30 - though with the option to expand.
Large parts of the project updates, which HNZ said were the latest available, were blanked out, including details of how the options for a revised build were assessed prior to January.
HNZ was rebuked last month for its "defensive" approach to OIA requests by the Ombudsman.
Oversight and governance of the Dunedin build has been a "mess" and a "struggle" for years.
The January update said "a single party should be made responsible for preparing and maintaining the overall development programme ... to ensure a consistent level of detail/rigor is applied".
The eight consultants - comprising architects Warren and Mahoney, engineers Beca and Holmes, contractor CPB, and cost estimators RLB and Rawlinsons, and analysts Sapere and TSA Riley - looked at two options. One to go ahead and build on the old Cadbury site where piles had already been driven, and the other to retrofit the old hospital. The former got the approval.
The other part of the project - the new outpatients block - was rated "amber", on a scale from green-to-red.
It was on track to be finished in July 2026, said the January 2025 update, which blanked out one extreme risk and three "high" risks.
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