Hospitals Do Not Fail Overnight, Systems Are Allowed to Decay

As a practising GP and Member of the Legislative Council, I have spent decades inside the WA health system. Hospitals do not suddenly fall into disrepair. They reach that point after years of deferred maintenance, reactive decision-making, and the absence of basic governance discipline. The findings now reported confirm what many frontline clinicians have known for a long time.

This is not simply about ageing buildings. It is about a system that has lacked the tools to care for them properly.

I have watched extraordinary clinicians do their best for patients while working around leaking roofs, failing infrastructure, and systems that respond only after things go wrong. That takes a toll. Not just on buildings, but on people.

A maintenance regime that is predominantly reactive is not maintenance. It is managed deterioration. When there are no benchmarks, no asset risk intelligence, no renewal programme, and no clear performance indicators, failure becomes inevitable. Leaks in intensive care units and mould in clinical spaces are not unfortunate surprises. They are the predictable outcome of neglect that has been normalised over time.

From a clinical perspective, what troubles me most is the gap between official infrastructure planning and what actually happens in wards. Delayed care because rooms are unusable. Vulnerable patients exposed to environments that no patient should face. Staff stretched not only by workload but by working conditions that corrode both morale and safety. These are not abstract policy failures. They are lived realities that affect patient outcomes every day.

Patients have no capacity to choose whether the ceiling above their bed leaks. Staff cannot opt out of unsafe environments. Those with the least agency bear the greatest risk when infrastructure fails. Any health system worthy of public trust must take that seriously.

The Government says this report is a wake-up call. I hope it is. Endorsing recommendations is not the same as delivering change. A short-term maintenance blitz is not the same as building long-term capability. What matters now is whether we see durable reform rather than another cycle of reaction after public exposure.

There are three basic expectations the public is entitled to hold.

First, transparency. If taxpayers paid for this review, the report should be published by default, with any redactions clearly justified. Ongoing reporting on the condition of hospital infrastructure should be routine, accessible, and written so that a lay reader can understand which sites are at highest risk.

Second, measurement. Western Australia must adopt clear benchmarks and key performance indicators for hospital maintenance and renewal, and report against them openly. Asset condition, risk ratings, and progress on the backlog should be visible, not buried in internal documents that only specialists see.

Third, capability. We need a properly structured hospital infrastructure renewal programme that prioritises planned maintenance, uses risk-based asset data, and ensures routine repairs are not trapped in procurement processes designed for major capital works. Capital works, minor repairs, and day-to-day maintenance should be aligned so that clinicians are not left working around the same failures year after year.

Redesign, not blame.

As a doctor, I am not interested in assigning personal blame. I am interested in whether the system is finally redesigned to prevent harm rather than repeatedly manage its consequences.

Dignity, safety, and care are not slogans. They are outcomes. Our hospitals should reflect that every day, not only when failure becomes impossible to ignore.