Build a new hospital, don't patch up an old one.
That's the sentiment from scores of senior Illawarra doctors, who have renewed their push to get Shellharbour Hospital rebuilt on a new site, rather than redeveloped on its current site.
Almost 60 doctors from across the Illawarra Shoalhaven Local Health District (ISLHD) are signatories to a letter to the editor of the Illawarra Mercury which outlines why their preference is for a greenfield site.
In the letter, the specialists welcomed the additional $128 million promised this month by the Morrison government - and matched by Labor - for the hospital's redevelopment.
With the NSW Government's commitment of $251 million to the project - which is already in the early stages of construction - total funding already committed now exceeds $370 million.
"We do however have concerns about redeveloping Shellharbour Hospital on its current site," the doctors' letter stated. "The current site is landlocked and will be very costly to prepare for a new building.
"It is poorly located for public transport and street access. Redevelopment will be highly disruptive to hospital activities during construction."
Dr Geoffrey Murray, director of the region's rehabilitation network and one of the letter's signatories, urged the state government to consider the benefits of a new site.
"Shellharbour Hospital was built as an autonomous community hospital but its role has changed vastly since 1985," he said. "We now deliver health as a district, and the current Shellharbour site can't fulfill that role very well.
"It's meant to be the southern Illawarra hub, but it's less than half a hub. Wollongong Hospital is sinking under the weight of demand, meanwhile Shellharbour Hospital sits there with many empty beds as it's not up to the job.
"Building a new hospital on a greenfield site - close to public transport and the highway - would improve community access, and be far more efficient for ambulance and hospital transfers between the region's three acute hospitals."
Dr Murray said locations in areas such as Shellharbour Junction and Dunmore would fit the bill: "Let's start from scratch and build a hospital for the future - not just patch up an old hospital".
ISLHD board chair Denis King said the total budget for the project was now around $600 million. This included the additional $250 million signalled - but not yet budgeted for - by the state government for stage two of the redevelopment.
"The extra federal funding has given us the opportunity to explore different options with the government and the ministry," he said.
"One of those options is a greenfield site where we would be able to double the size of the hospital in the short term, as well as have room to expand well into the future.
"Things have changed in the last five years, and Illawarra and Shoalhaven hospitals are seeing large increases in activity. The workload, and complexity of workload, is increasing at a greater rate than the population.
"That's partly because people who might once have sought treatment outside the district are now staying here. That's a good thing, but we need to cater for that."
As well as keeping up with demand, Mr King said it was also vital to get all services in one spot. For instance, the rehabilitation and aged care services at Port Kembla Hospital would be better placed within a larger Shellharbour site.
"With an ageing population ... we need to be as clinically effective as we can in the management of those conditions needing rehabilitation and extended care."
Mr King said he expected a decision would be made on whether to remain at the current site, or move to a new location, within four to six weeks.
"Any new site would have to be in the southern Illawarra - we wouldn't put it 20 or 30 kilometres up or down the coast," he said.