Recently, I have been thinking about some of the broad issues about our hospital systems. It seems that the reality of hospital redevelopments in 2026 is that we’re not just rebuilding buildings or expanding precincts. We’re trying to future-proof moving models of care.
Across Australia, recent policy directions appear to be emphasising system efficiency, equity, and integration (not just “more beds”), alongside stronger links among hospitals, primary care, and community-based pathways.
Internationally, highly developed health systems are accelerating the shift of appropriate activity into ambulatory / same-day settings, supported by specialised surgical suites and redesigned patient flows.
That creates potential planning pressure in four places:
- The inpatient/outpatient balance (and how quickly it’s changing)
- Specialist perioperative environments (efficiency, infection control, turnover, recovery models)
- The “right beds” problem: different wards for different physical conditions, sub-acute, and mental health settings with very different safety and operational needs
- Adjacencies: co-located specialist consulting and diagnostics can make or break the pathway
Now overlay the public–private interplay: not just who funds what, but how specialists practise, how outpatient services are organised, and where incentives land. OECD work increasingly warns that outpatient care can be subject to “financialisation” pressures when governance is weak. This is the tension, I think.
My view: health systems work best as mixed, but with a strong universal public core that sets access, standards and planning discipline; and a private role that is explicitly governed to add capacity and innovation without fragmenting pathways or driving long-run operating costs.
Because in hospital redevelopments, poor masterplanning doesn’t just blow capital budgets; it can lock in higher maintenance and operating costs for decades.
What do you think?
Lytton Advisory 