Health spending advisers have suggested Palmerston North Hospital is looking too tidy to warrant a proposed $120 million makeover.
Members of the National Health Board's capital investment committee visited last month for a tour of the campus looking at areas proposed for redevelopment.
MidCentral District Health Board investment and planning executive director Helene Carbonatto said in a report of the visit that there was some useful discussion.
However, the committee gained an overall impression that the facilities looked in "good shape" compared with other hospital redevelopments that it was considering.
It said the board would have to "build a persuasive argument" to justify the project.
Even though the board intends to pay for the rebuilding itself, it still needs government approval.
MidCentral chairman Phil Sunderland took a swipe at the committee for expressing an opinion on the hospital's condition based on "a quick walk around".
"I find it very difficult to accept from a responsible organisation, the comment that ‘it looks OK to us'," he told yesterday's board meeting in Feilding.
National Health Board acting national director Michael Hundleby said the comments were meant to be positive.
"The Capital Investment Committee is impressed with the progress on the MidCentral District Health Board's business case for upgrades to the Palmerston North Hospital.
"The committee also complimented the MidCentral DHB's property team for how well even the older parts of the hospital had been maintained and how well the DHB is managing its assets."
He said the committee looked forward to continuing to work with the board on development of "an important regional project".
Board deputy chief executive Mike Grant said the committee probably did not have enough information yet about the extent of seismic strengthening to be addressed in the rebuild.
An estimated $54m would be needed to upgrade the buildings housing the emergency department, theatres, radiology, intensive care and the high-dependency unit.
Grant said the committee had also missed out on seeing operating theatres that were no longer fit for purpose and were inefficient.
But he said the board should heed the advice.
"As guardians of $200m to $300m of capital spending, they are saying, here is the challenge, and that we need a robust case presented in a professional manner, and that is how we are approaching it."
The rebuild would be likely to provide more space for the emergency department, outpatient clinics, cancer day services and cardiology, procedure rooms and theatres.
It would overcome problems with caring for seriously ill patients in a variety of locations.
Some of the wards are more than 35 years old, with limited options to reconfigure them to meet modern standards and improve productivity.
- Manawatu Standard
Are you enrolled to vote?Related story: 8000 still to enrol