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It was an offer Pete Hodgson knew would come if Labour won the 2017 general election — to play a role in the rebuild of Dunedin Hospital.
As the former MP for Dunedin North — the electorate which houses the hospital — and as a former minister of health, there was plenty to qualify Mr Hodgson for the job.
So, a few weeks ago when Dunedin North MP and Minister of Health David Clark called Mr Hodgson and asked him to become chairman of the Southern Partnership Group, it was far from a surprise.
It was also an offer he could not refuse.
"It is attractive because it is a way of helping to cement the future of this city," Mr Hodgson said.
The scale of the hospital rebuild goes far beyond just wards and operating theatres.
For a start, a workforce to construct those buildings has to be found, and housed.
The city’s transport system will probably need to be reconfigured so patients and family — let alone the percentage of Southern DHB’s 4500 staff who work at Dunedin Hospital — can get to the new facility.
Along with that comes all the infrastructural requirements for a facility the size of a hospital: water, sewerage, electricity, broadband, parking ... Mr Hodgson is also considering the potential impact of a new hospital sitting alongside Dunedin’s historic architecture, the part the hospital rebuild will play in Dunedin City Council’s inner-city development policy, its role in the economic development of the city and how it will work alongside Dunedin’s existing health research industry.
The list keeps growing, as Mr Hodgson found out this week when Otago mayors demanded their voices be heard on a newly established Local Advisory Group formed to bring community voices in to the rebuild process.
It was also a reminder — as if Mr Hodgson needed one — that steering the rebuild will be as much a political as a constructional job.
The obvious criticism was levelled on day one by former health minister Jonathan Coleman: that Mr Hodgson was a parochial Labour appointment.
It is one which Mr Hodgson bats away ("I don’t think you need to be partisan to run a hospital rebuild") but it is obvious he has been brought in to shake things up.
The Local Advisory Group is the first step in accelerating a project which after months of debate has yet to decide what will eventually be built, where it will be built, and at what cost.
"It is a shame the obvious things, such as getting early and solid engagement with the city and the region and the university didn’t occur at the outset," Mr Hodgson said.
"This is a process which is now two years old and some very fine work has happened, but the process to date has been suboptimal."
While it is too soon to say the rebuild process is now jet-propelled, tangible progress has been made since Mr Hodgson took the helm.
He immediately focused debate on the future home of the hospital by saying it would be somewhere between the University of Otago and the Octagon, eliminating much-discussed options such as Wakari, Hillside or Carisbrook.
"I don’t know where it will be ... but I think there are a number of opportunities on the flat land between the hospital and the Octagon."
However, Mr Hodgson would go so far as to say "we are getting closer" and that he expected to make a recommendation to the minister by the end of March.
"It is possible we will use bits of more than one block; it is possible we will build over streets — I want people to think broadly about the site, rather than thinking it will be one rectangle or a certain other rectangle."
The final call on the hospital site will be Dr Clark’s. Mr Hodgson said his role and that of the SPG was to ensure the minister had the best information when making that and other decisions about the rebuild.
Time will be of the essence: delay makes a project which will top $1 billion more expensive as build costs go up and the cost of keeping the current hospital patched up escalates.
However, Mr Hodgson said it was also important not to plan too quickly, and for rebuild plans to be subject to a review process.
Once the land was bought, Otago needed to discuss the type of hospital to be built upon it, he said. Problems with the current hospital, such as an inadequate emergency department, proximity of services to each other, the number of wards and in what configuration were considerations which architects should address, with input from staff.
Building a new Dunedin hospital is one thing: paying for it is quite another.
Mr Hodgson calls the project six times bigger than the stadium; $1.6 billion is one cost estimate which has been made.
While Labour has pledged to rebuild the hospital, Mr Hodgson says that does not automatically open the cheque book.
"If people think this rebuild is not going to be subject to budget pressure then they are mistaken," he said.
"Every project has a budget and the budget for this one won’t be discovered until the major tenders have closed, but the way in which we are putting this together is to build a building that is going to be thoroughly adequate for the next however many decades — and yet we have to take every chance we can to make it cost-effective."
As well as where, Mr Hodgson has already turned his mind to what.
Otago is sensitive about losing health services — the campaign in 2010 to retain neurosurgery services at Dunedin Hospital is exhibit 1 in that respect.
However, "reasonable" cost savings will need to be made, Mr Hodgson said, giving the Oncology Unit as an example.
"The building will not be rebuilt. It is too new and in far too good a shape."
Medical sub-specialties will continue to be provided at Dunedin Hospital — given its relationship with the University of Otago they have to be — but the manner in which they are provided remains to be decided.
"The issue of about whether or not they should be available 24/7 or not, I think is up for debate in the case of some of those subspecialties, because it is important to make efficient use of the resources you have," he said.
"There is a case for doing something very thoughtfully and very well, and I think that’s what we can achieve."