The Evidence
Scorecards, comparisons, and the questions that should be asked of both governments.
Assessment
Greenfield vs Brownfield — The Case at a Glance
A side-by-side assessment across the criteria that matter most to the community.
Scored 0–10 against long-term community health outcomes
Dual-site maintenance limits clinical integration
Brownfield constrained by existing footprint; 2040 projections unmet
Staged brownfield build = multi-year service disruption
Brownfield costs comparable but delivers less capacity
Both options suffer the same 3.6% federal contribution — structural problem
IGA reform needed regardless of site choice
BMA, 11 councils, 120-doctor no-confidence motion
The Evidence-Based Answer
What Actually Delivers the Best Outcome for the Albury-Wodonga Community
The greenfield case is clinically superior on almost every dimension that matters for long-term community health. But it is not achievable in the near term. The best realistic outcome is a sequenced strategy — making the brownfield accountable while building the case for what comes next.
The key finding
Federal Funding: AWH vs Comparable Hospitals
The single most striking finding. AWH's catchment is larger than Wagga Wagga's, yet receives 6.7× less federal co-investment as a percentage of total project cost.
Wagga Wagga Base Hospital
24%
Federal co-investment
Albury-Wodonga Health
3.6%
Federal co-investment ($20M of $558M)
| Hospital | Project Cost | Beds | Catchment | Federal % | Notes |
|---|---|---|---|---|---|
| Gold Coast University Hospital (QLD) | ~$1.8B | 924 | ~650,000 | ~22% | Greenfield single-site. Built generously for growth. Needed expansion within 10 years. |
| Fiona Stanley Hospital (WA) | ~$2.0B | 783 | ~550,000 | ~15% | Greenfield. Largest ever WA government building project. Single site from day one. |
| Royal Adelaide Hospital (SA) | ~$2.4B | 800 | ~1.3M | ~12% | Greenfield replacement. Largest PPP hospital in Australia at the time. |
| New Bendigo Hospital (VIC) | ~$630M | 372 | ~320,000 | ~18% | Greenfield single-site 2016. Comparable regional Victorian city. No cross-border complications. |
| Wagga Wagga Base Hospital (NSW) | ~$700M | 380 | ~240,000 | 24% | Multi-stage brownfield + new acute build. Similar regional catchment to AWH. Significant Commonwealth co-investment. |
| New Launceston General Hospital (TAS) | $957M | ~400 | ~250,000 | TBC | Greenfield. Best current comparator for AWH — similar catchment, under construction now. |
| Latrobe Regional Hospital (VIC) | $280M | 200 | ~110,000 | ~15% | Regional Victoria brownfield upgrade. Smaller catchment than AWH. |
| New Bankstown Hospital (NSW) | $2.0B | TBC | ~950,000 | TBC | Greenfield, metro Sydney. Largest single hospital capital investment in NSW history. Est. 2031. |
| Albury Wodonga Health (AWH)AWH | $558M | +80 only | ~300,000 | 3.6% | Brownfield. Australia's only cross-border health service. Larger catchment than Wagga or Bendigo. 6.7× less federal co-investment than Wagga Wagga. |
Unanswered
4 Questions the Community Should Be Asking
These are not rhetorical. Both state governments and the Commonwealth should be required to answer them publicly.
1. Why has federal co-investment in AWH been capped at 3.6% when comparable regional hospitals receive 15–24%?
The Commonwealth has never publicly explained this discrepancy. AWH is the most complex cross-border health service in Australia.
2. Will the brownfield redevelopment deliver a functionally single-site service — and if not, why was that language used in the announcement?
The CEO and Board Chair wrote to both ministers in December 2023 warning it would not. That letter has not been released.
3. What is the Phase 2 plan, and when will it be committed to in writing with federal funding?
Without Phase 2 commitment now, there is no enforceable path to single-site care in the planning horizon.
4. What structural reforms to the 2009 IGA are being considered to create clear accountability?
The current governance structure allows each government to shift responsibility. This must change regardless of which site plan proceeds.
Help us get answers. Sign the petition and contact your MP.
Take ActionSources & References
- Hospital project costs — respective state government announcements and health infrastructure project pages
- Federal funding percentages — calculated from confirmed government announcements. Wagga Wagga: $67M Commonwealth ($55.1M HHF + $12M COAG) of $282.1M total (24%). Source: NSW Government Health Infrastructure
- AWH federal contribution: $20M of $558M (3.6%) — 2023-24 Commonwealth Budget Papers; joint NSW/VIC October 2022 announcement
- Gold Coast University Hospital — Queensland Health; QLD Government project documentation. Fiona Stanley Hospital — WA Department of Health
- New Bendigo Hospital — Victorian Government; Health Infrastructure Victoria project records
- New Launceston General Hospital — Tasmanian Government infrastructure project page; $957M total confirmed 2023
- Scorecard ratings are evidence-based assessments by CHART researchers drawing on the 2021 AWH Clinical Services Plan, government project documentation, AMA/BMA clinical submissions, and FOI-obtained correspondence. They represent analysis, not official positions.
- Catchment population figures — AWH official website; ABS Census data; respective state LHD/LHN planning documents