Queensland’s hospitals are the backbone of the health system, helping our hardworking health workforce to care for more than a million people each year.
When the Capacity Expansion Program (CEP) was announced in 2022, it followed eight years of underinvestment in health infrastructure in Queensland. As our population grew, our hospitals were struggling to keep up with demand. The health system was in crisis.
Infrastructure suffered, needing $2 billion in maintenance and repair alone.
Ambulance ramping was the highest it has ever been, and unprecedented numbers of people were left lingering on surgery wait lists.
Ambulance ramping
| Year | Year average | Jan - March | April - June | July - September | October - December |
|---|---|---|---|---|---|
| 2015 | 16.2% | 14.8% | 14.6% | 19.1% | 16.4% |
| 2016 | 19.2% | 19.4% | 18.7% | 19.6% | 19.2% |
| 2017 | 21.5% | 21.1% | 19.4% | 25.4% | 20.0% |
| 2018 | 23.0% | 22.3% | 20.9% | 24.1% | 24.6% |
| 2019 | 27.3% | 26.2% | 25.1% | 31.0% | 27.1% |
| 2020 | 26.6% | 26.6% | 19.3% | 27.6% | 32.8% |
| 2021 | 39.2% | 38.3% | 40.9% | 39.4% | 38.3% |
| 2022 | 43.1% | 42.6% | 44.9% | 43.7% | 41.3% |
| 2023 | 43.5% | 42.7% | 44.9% | 43.3% | 43.1% |
| 2024 | 42.7% | 45.5% | 44.7% | 41.6% | 39.1% |
Elective surgery waiting lists
| Year | Year average | Jan - March | April - June | July - September | October - December |
|---|---|---|---|---|---|
| 2015 | 37,022 | n.r.* | n.r.* | 36,427 | 37,617 |
| 2016 | 41,651 | 38,202 | 41,142 | 42,541 | 44,720 |
| 2017 | 50,095 | 47,096 | 49,369 | 51,410 | 52,506 |
| 2018 | 53,411 | 52,533 | 52,959 | 53,582 | 54,570 |
| 2019 | 54,899 | 53,793 | 53,482 | 56,145 | 56,176 |
| 2020 | 54,816 | 55,829 | 54,137 | 54,377 | 54,922 |
| 2021 | 56,834 | 55,388 | 56,745 | 57,343 | 57,858 |
| 2022 | 58,667 | 58,895 | 57,914 | 58,553 | 59,307 |
| 2023 | 59,025 | 58,446 | 58,362 | 59,014 | 60,278 |
| 2024 | 63,066 | 60,038 | 61,421 | 64,171 | 66,632 |
The decision to develop the Capacity Expansion Program (CEP) was a hurried attempt to address the state of crisis gripping the health system.
As issues emerged across the CEP, including significant project delays and increased costs, the new Queensland Government announced an independent review in 2024. The Independent Review into the CEP (the Review) found extensive evidence that the planning and execution of the CEP lacked in many critical areas.
Poor planning
- The CEP was assembled in around six weeks, a process that under regular circumstances would have taken around six months of detailed planning for each project.
- Business cases were not completed prior to announced budgets.
- Projects were developed without consulting clinicians and considering local priorities.
- Critical services were left out of projects due to a lack of consultation and planning.
Low productivity
- Contractors and subcontractors were required to apply Best Practice Industry Conditions (BPIC) – a major contributor to project cost blowouts and delays.
- Because of BPIC, Queensland construction sites are less productive than the rest of the country.
- On just one project, the impact of BPIC is estimated to contribute more than $130 million in additional costs.
Rushed delivery
- Rushed contracting without proper planning saw projects blow out by 75% within months, requiring an additional $1 billion.
- The plan unrealistically attempted to deliver all major projects in a single stage.
Delays
The Review found that every project in the CEP was underfunded, delayed, did not deliver on critical service needs and was ultimately undeliverable. In some cases, projects had doubled in cost and were delayed from anywhere between six months to more than three years. Without major intervention, none of the projects were able to be delivered in their current form.
Cost blowouts
Because of poor planning, low productivity, rushed delivery, and delays, costs blew out by approximately $7 billion.
| Project | Announced budget | Actual or forecast cost | Blowout |
|---|---|---|---|
| The Prince Charles Hospital Expansion | $300 million | $788 million | $488 million |
| New Queensland Cancer Centre | $750 million | $1.8 billion | $1.05 billion |
| Redcliffe Hospital Expansion | $1.06 billion | $2.122 billion | $1.062 billion |
| New Toowoomba Hospital | $1.3 billion | $1.98 billion | $680 million |
| New Coomera Hospital | $1.3 billion | $2.254 billion | $954 million |
| Mackay Hospital Expansion | $250 million | $520 million | $270 million |
| Townsville University Hospital Expansion | $530 million | $1.029 billion | $499 million |
| New Bundaberg Hospital | $1.2 billion | $2.306 billion | $1.106 billion |
| Cairns Hospital Expansion | $250 million | $628 million | $378 million |
| Hervey Bay Hospital Expansion | $40 million | $94 million | $54 million |
| Logan Hospital Expansion | $530 million | $875 million | $345 million |
| Ipswich Hospital Expansion | $710 million | $925 million | $215 million |
| QEII Hospital Expansion | $465 million | $621 million | $156 million |
| Princess Alexandra Hospital Expansion | $350 million | $761 million | $411 million |