Victoria’s three biggest hospitals need urgent upgrades that could cost up to $8 billion, the state’s infrastructure advisory body says.

(above image: Royal Melbourne Hospital via Walking Melbourne)

Infrastructure Victoria has released the 2025 update of the Victorian Infrastructure Strategy.

Updated every five years, the strategy provides advice for infrastructure priorities over the next three decades.

It is prepared by Infrastructure Victoria, an independent body which provides advice to the government.

All up, the strategy makes 45 recommendations.

These cover transport, health, housing, energy, social infrastructure and the environment.

A key recommendation is the redevelopment of the Alfred, Austin and Royal Melbourne Hospitals.

According to the report, the three hospitals provide critical and complex acute care.

Yet these facilities are aging.

Originally constructed in 1871, the Alfred Hospital is Melbourne’s oldest hospital that is still operating on its original site.

The hospital is Australia’s largest trauma centre and treats more than half of Victoria’s trauma cases.

Meanwhile, the Royal Melbourne Hospital moved to its current Parkville location in the 1940s. Many of its assets are past their useful life.

Increasingly, the hospitals are experiencing problems.

These include issues with heating and cooling, burst pipes, windowless wards, narrow halls and doors (which make it difficult to manoeuvre beds) and small rooms which make patient care difficult.

In its report, Infrastructure Victoria says that all three hospitals have needed redeveloping since at least 2017.

In the case of the Alfred, it says that infrastructure challenges have necessitated the ward closures and rescheduled procedures.

At the Austin – which specialises in in liver transplants and has a state-of-the-art spinal cord unit – infrastructure challenges have meant that the hospital is unable to use some of its facilities.

In 2022, the Victorian Government committed funding to start redeveloping the Royal Melbourne Hospital.

This funding was to build a new facility at Arden and prepare the Parkville site for future upgrades.

However, the facility at Arden has since been abandoned whilst no details have been provided about the updated scope of works or timeframe to redevelop the Parkville site.

Meanwhile, funding has been announced to upgrade the emergency department at the Austin Hospital.

This will help to maintain fire safety, electrical infrastructure and in-patient care.

However, Infrastructure Victoria says that all three hospitals still need urgent capital works.

This would include replacing the Alfred’s operating theatres and redeveloping all three hospitals over the next ten years.

It suggests that this will cost between $6 billion and $8 billion in addition to already announced funding.

To help address challenges with construction workforce capacity, the upgrades would need to be staged.

However, construction on all three hospitals should commence over the next five years whilst completion should occur within ten years.

(image via freepix)

Digital and community health

Meanwhile, the strategy recommended wider use of digital technologies and more investment in community health infrastructure.

In terms of the former issue, it suggests that the government invests in statewide virtual care and a medical image sharing system over the next 5 years.

This would be similar to systems which are in place across other states.

It would enable more patients to see doctors from their own homes and could reduce pressure on hospital emergency departments.

On the latter issue, the strategy says that community health infrastructure needs to be expanded in outer suburbs and regional areas.

It says that community health services provide primary and preventive healthcare targeted to Victorians who are experiencing disadvantage and who have few options to access these services.

This can include dental services, mental health services and support for people to manage ongoing chronic conditions such as type 2 diabetes.

Investment in these services can help to keep the state’s most vulnerable people healthier and out of hospital.

The impact could be substantial.

Across 2023/24, as many as 546,000 emergency department visits in Victoria could have been avoided if they were managed in the primary care or community health sectors.

This could save around half a billion dollars every year.

(image via freepix)

Practical and evidence-based reforms

All up, the 45 recommendations are expected to cost around $60 billion.

However, they would deliver more than $166 billion worth of benefits.

The latest update is the second strategy update since Infrastructure Victoria was created ten years ago.

The strategy will be tabled in Parliament this week.

The Victorian Government is required to respond to the recommendations within twelve months.

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