As New Zealand’s population ages, the demand for better healthcare facilities is skyrocketing. Health New Zealand has outlined plans to build smaller hospitals and reuse existing infrastructure, with a projected cost of nearly $47 billion over the next ten years.

However, the price of both building new hospitals and upgrading older ones continues to rise. A briefing to Health Minister Shane Reti, released to the media under the Official Information Act, further estimates the price of resolving other problems at old public hospitals to be hundreds of millions of dollars.

For older adults, this trend is crucial, as healthcare services will need to expand to accommodate a growing and ageing population. Without adjustments to the current healthcare model, an extra 4900 hospital beds will be needed by 2043, with the majority of those beds occupied by individuals aged 65 and older. This means that hospital infrastructure upgrades will directly affect the level of care older adults receive in the coming years.

 

Meeting the Healthcare Demands of an Ageing Population

New Zealand is expected to see a 15% increase in its overall population over the next two decades, with the number of people aged 65 and over growing significantly. By 2043, nearly a quarter of the population will be 65 or older, placing immense pressure on healthcare facilities, especially hospitals.

Older adults are expected to be the most significant users of hospital services. The average 80-year-old, for example, uses ten times more hospital bed days per year than the average 45-year-old. With the number of people aged 80 and above expected to double by 2043, the existing hospital infrastructure will need to expand and improve to meet these demands.

However, current plans for 300 hospital projects, with an estimated cost of $46.9 billion, may not be enough to serve the growing senior population. This means that older adults could face longer wait times and fewer hospital beds if action isn’t taken to manage these rising costs and demands.

 

The Strain of Ageing Infrastructure

One major issue facing the healthcare sector is the age of New Zealand’s hospitals. According to the New Zealand Infrastructure Commission, half of New Zealand’s hospital infrastructure is over 40 years old, with many buildings constructed during the 1950s, 60s, and 70s. These older hospitals are now reaching the end of their design life, creating the need for extensive upgrades and replacements.

“We built a lot of public infrastructure in the 1950s, 60s and 70s which is now reaching the end of its design life,” said Te Waihanga Chief Executive Ross Copland.

“Hospitals make up around 10 per cent of this. New Zealand’s wider social infrastructure assets, such as our schools, courthouses, and prisons, are ageing, too. It is forcing us to consider how we can extend the useful life of existing assets while reducing the cost of their replacements.”

For older adults, this means that many hospitals might not be equipped with the modern facilities needed to provide adequate care, such as advanced medical equipment or accessible designs. With a projected $115 billion required over the next three decades to renew and maintain healthcare infrastructure, the costs of ensuring seniors receive the healthcare they need are growing alarmingly.

The Building a Healthy Future report saw the New Zealand Institute of Economic Research (NZIER) model hospital building costs 30 years into the future. They found that building new hospitals has become drastically more expensive, costing over $20,000 per square metre.

As the cost of construction rises, it becomes increasingly important to find cost-effective ways to meet the healthcare needs of seniors without compromising on quality or accessibility. Over half of the $115 billion would go towards renewing and upkeeping current health infrastructure.

“This has been driven by alarming increases in the cost per metre to build new hospitals, which are now over $20,000 per square metre. Our design efficiency also ranks poorly in comparison to international benchmarks,” Copland says.

“It’s important to acknowledge that these are estimates based on assumptions and incomplete data.

“But the underlying finding is clear: if we don’t change the way we currently plan, build, and use hospitals, our current levels of public debt would roughly double by 2050 just from spending on public hospitals.

“There is a lot we can learn from other countries about how to build infrastructure more efficiently, including concepts like ‘long-life, loose fit’ – where buildings are planned for the long term and allow for changing uses.”

 

Solutions for a Better Healthcare Future

As healthcare infrastructure costs rise, finding efficient solutions is critical. One approach being discussed is the “long-life, loose fit” concept, which involves designing hospitals for long-term use and adaptability. This means hospitals can be easily modified to accommodate new medical technologies or changes in patient needs over time without requiring costly renovations.

For seniors, this approach offers hope that future hospitals will be better equipped to handle the growing demand for senior care, ensuring that they can receive timely, high-quality medical treatment in modern, well-designed facilities.

Beyond infrastructure, policies that focus on preventive care, home-based healthcare, and community health services could also relieve some of the strain on hospitals, allowing older adults to receive the care they need without overburdening hospital systems.

By understanding the rising costs of hospital construction and the need for better healthcare infrastructure, older adults and their families can advocate for a healthcare system that meets their needs. As New Zealand plans for the future, seniors must be considered in every decision made regarding hospital and healthcare developments.