A re-elected Baird government would inject an additional $19.3 million into the Bulli Hospital upgrade, but the new facility won't have an emergency department.
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Health Minister Jillian Skinner and Minister for the Illawarra John Ajaka made the announcement at the hospital on Wednesday.
The extra cash - from the health budget - brings the government's commitment to build an "Aged Care Centre of Excellence" to almost $34 million.
The balance is the previously allocated $14.5 million from the Restart Illawarra Infrastructure Investment Fund.
Mrs Skinner said a new facility would be built opposite the existing hospital and was expected to include a primary heath care centre, inpatient and aged care facilities and onsite clinical support services, such as medical imaging, pathology and pharmacy.
"I have visited this hospital many times in opposition and it was a hospital that really had a lack of identity," Mrs Skinner said.
"During those years, the former Labor government took elective surgery away, then put it back; closed the emergency department, then put it back; they didn't really know where they were going."
It is expected a 60-bed high-care residential aged care facility will be co-located on site, to be funded by $10.8 million from the Illawarra Retirement Trust.
Questioned why the upgraded facility wouldn't have an ED, Mrs Skinner said consultation had determined aged care was an "appropriate role" for the hospital.
When asked about provisions for an ED, Mrs Skinner said: "No, this will be a centre of excellence for aged care ... there will be a primary health care centre, but no emergency department."
Chairman of the Illawarra-Shoalhaven Local Health District Board Denis King said Bulli Hospital had been a "place without a plan, without a future" for about 25 years.
Professor King welcomed the extra money, saying much of the $14.5 million would have been spent on trying to "resurrect a building that was very decrepit".
Health District clinical director of emergency services Thomas Carrigan said the purpose-built facility would meet the needs of the northern Illawarra into the future.
Shadow Minister for the Illawarra and Keira MP Ryan Park said the community was waiting for work to begin.
"Whilst we welcome the commitment, we do want to see some action on the money that's already been allocated," Mr Park said.
andrew.pearson@fairfaxmedia.com.au