Ramsay Health says it is ready and willing to fund a $200 million expansion of Wollongong Private Hospital - if it can get approval from the state's planning authority.
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But Wollongong City Council has raised numerous concerns with the private operator's plans for a nine-storey expansion that will create a new 24-hour emergency department at the Crown Street hospital.
On Monday, the Ramsay board announced it had approved the expansion, which also includes new inpatient beds and operating theatres to service the new emergency department.
The company lodged a development application for the hospital in mid-2022.
With board approval in place, hospital CEO Steven Rajcany said work could start in "a matter of months" if planning approval was granted.
"If we get the go ahead shortly, it can be completed in the first half of 2025," he said.
"When the development is complete we'll be able to offer local residents a 24 hour emergency department, more than 100 new private inpatient beds, on top of our existing 171 beds, four new state-of-the-art operating theatres and a second cardiac catheterisation labs."
"We'll also increase our capacity to help treat local cancer patients with six new oncology chairs and improved oncology radiation services."
The project is currently under assessment by NSW Planning and is classed as a state significant development.
Following the exhibition period for the plans last year, 19 organisations and individuals lodged submissions with 11 objections, three in support and the remaining five making a comment.
The council said it objected to the expansion being approved in its current form, as it was three metres higher than allowed under the city's development controls.
The council also raised concerns about the floor space ratio, and said the design of the building "falls well short of acceptable urban design and design excellence standards at this time".
Council planners also highlighted that the expansion would required the demolition of a heritage item, and noted that the plans did not "take the opportunity to improve the pedestrian access and streetscape connection on Urunga Parade of the existing hospital".
A number of residents from Urunga Parade and elsewhere also lodged their objection.
But RDA Illawarra told NSW Planning it would support an extension that complies with the current Wollongong Development Control Plan.
The development body said the project promised to generate a substantial number of jobs, contributes to the economic growth of the region, addresses community health needs and has the potential to train skilled healthcare professionals in the region.
"The economic assessment for the project indicates that the $163 million project will generate 190- 210 jobs during its 2-year construction period, and up to 295 ongoing jobs (180 of these are direct roles) once fully operational," a letter from CEO Debra Murphy said.
She said the RDA recommended that Ramsay make a commitment to use local construction contractors and sub-contractors.
Mr Rajcany said the multi-million dollar investment by hospital operator, Ramsay Health Care showed the organisations commitment to the people of the Illawarra region.
"We look forward to being able to provide more leading health care services for the local community and alleviating some of the pressures on the public health system," he said.
"Ramsay Health Care is committed to investing in the facilities, technology and people needed to enhance patient experience and outcomes for the local community."