NZ must invest in small health needs before big roads – Infrastructure Plan

2026-02-16 - 23:20

Analysis: How do you plan and prioritise investment, when so much of our communities’ built environment is tired and broken and often spewing excrement into our once pristine waters? That was the extraordinary challenge that was faced by Te Waihanga, the independent Infrastructure Commission, whose long-awaited National Infrastructure Plan has now been tabled in Parliament. If anyone should appreciate this difficulty, it’s fifth-term Wairoa mayor Craig Little. His community is one of those in Hawke’s Bay that’s been smashed repeatedly by storms; Cyclone Gabrielle devastated one side of town, then another storm inundated the other. Scores of homes were yellow-stickered. It’s costing millions to repair shattered infrastructure like Te Reinga Bridge, whose pier was washed away in Cyclone Gabrielle, and $425 million to build a replacement for the Napier-Wairoa Road that bypasses the troubled Waikare Gorge – the most expensive highway project in Hawke’s Bay history. Wairoa is similarly stricken by aging water assets that are vulnerable to extreme weather. After Gabrielle, the drinking water failed and 8000 residents had to rely on stored water for days. The community’s wastewater discharge consent expired in May 2019, and a condition of its renewal is the council transition from discharging into the Wairoa River to land-based irrigation. Underpinning all this is the more fundamental question of mitigating and adapting to climate risk, moving endangered communities and transforming unsustainable energy and water infrastructure, so that we don’t have to repeat these repairs to broken road, water and power networks again, and again, and again... One might think Little and his community would struggle to identify any one priority, when all their infrastructure problems are so intermeshed. But he does. “The number one priority for me is health,” he replies, straight away. “Mate, we have so many sad stories. Old people now have to live the rest of their lives out of Wairoa, because there’s no aged care here. We haven’t got a dentist, we’ve got no dialysis, we’ve got real mental health issues. It just goes on and on – and then trying to get down to Hawke’s Bay for your bloody appointments.” Little needed a knee replacement in December. He drove himself 130km down to Hawke’s Bay Memorial Hospital in Hastings – but even that facility is substandard. For years, Hawke’s Bay has been first priority for a new hospital to serve a population that’s now topped 175,000; Labour promised a new hospital if it won the 2023 election, but it didn’t win. And there was never a plan to pay for it, anyway. The mayor read an article the other day on Palestine: “They’re training more doctors over there than we are in New Zealand, despite being under absolute constant bloody war. It seemed incredible. And at the moment, our medical centre is open only for emergencies because they can’t get doctors.” The commission has been working up to its National Infrastructure Plan for some time, first establishing a pipeline of nearly 12,000 of the country’s big projects, costed at $275 billion. Last year they began a programme to rate priority projects – thus far 42 have been endorsed to some degree, ranging from new Linton Military Camp barracks to the Ruakura Eastern Transport Corridor around Hamilton, to lesser priorities like upgrading Auckland’s Eden Park. A replacement Hawke’s Bay hospital has been endorsed on the list, costed at more than $1 billion. “Lack of hospital capacity means the hospital cannot provide an acceptable level of care, and population ageing will increase this problem,” the commission’s assessment report says. “Some current buildings on the site are in poor condition, including earthquake prone buildings.” Now the commission’s work culminates in a comprehensive plan for the next 30 years of investment, by the private sector, local and central government. Part of the problem is finding the money to invest – not aided by the Govt’s perverse strategy to constrain revenues for the backlogged local govt sector. But the plan must also, inevitably, recognise that this is not about spending more – it’s about spending smarter. Both the commission and Infrastructure Minister Chris Bishop make the point that we actually spend a lot on infrastructure: more than 5.8 percent of GDP, more per capita than any other OECD country. But the bang we get for our buck is dismal, among the lowest in the OECD. This conundrum has been variously attributed to difficult terrain, a small population spread over a large area, complex planning/consenting regulations, and a “stop-start” approach to project delivery. So for Te Waihanga, the challenge will remain to not just plan which needs New Zealand should address, but plan how we can manage the work to get even a half-decent return on investment. Bishop says the plan does not sugar coat things: New Zealand has real challenges ahead. “Many central government agencies do not properly understand what they own or have long-term investment plans. The assurance system for new projects and long-term investments is fragmented and inconsistent.” It’s encouraging, he adds, that the Government already has work underway on many of the Commission’s top 10 priorities for the decade ahead. He points to Health NZ’s long-term capital infrastructure plan, with record investment in both capital and maintenance spending for health. Bishop has already admitted some tough decisions will have to be made about which Roads of National Significance the country can afford, and when. He says the Government will soon publish a Major Transport Projects Pipeline, and in June it will publish its response to this week’s National Infrastructure Plan. As part of that response, Bishop says he intends to engage with other political parties in Parliament. Infrastructure Commission officials will make briefings available to parties who wish to take a deeper dive into the detail behind the recommendations, and Bishop will be writing to Parliament’s Business Committee seeking time for a special debate on the plan. “Infrastructure lasts for generations. Where we can build durable consensus, we should,” he says. “Now it is up to all of us to do the hard work required to turn ambition into delivery.”