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The Government has brought in former Labour MP Clayton Cosgrove to get the project back on track, as chairman of the Ministry of Health's Partnership Group, which is in charge of the rebuild.
The $77.8 million hospital had been due to open about now. The first delay came after the Kaikoura earthquakes, pushing back the opening to midwinter, and now the delays have compounded.
Mr Cosgrove gave a frank interview after walking through the half-finished hospital.
He also met lead contractor Fletchers and "myriad" Ministry of Health consultants.
"You are going to get a fabulous facility, I'm told it's world class," he told the Greymouth Star.
"My biggest concern is timeframe. We are shooting for the end of the year. I'm not convinced that will occur."
Realistically, though, it could be the first quarter of 2019, or mid-year -- or even the end of next year, he said.
He has asked for a review of where everything is at now.
Mr Cosgrove blamed a "generally lax attitude" and historically a "lack of discipline in the Ministry of Health in terms of oversight of the various contractual players".
"Deadlines shift and everyone stares at everyone else. My message is more co-ordination, more discipline, less excuses and less finger pointing."
He has asked for weekly reporting and will personally visit Greymouth once a month to get it back on track.
The Partnership Group may also meet here more frequently, although they were mindful of the cost to taxpayers.
Mr Cosgrove also stressed that all Fletchers sub-contractors would get paid and those interested in supply could have confidence.
He noted problems with housing workers, and anyone with a room, or Airbnb not booked out over winter was encouraged to leave details with the site office on Water Walk Rd.
Asked what the delays would cost, Mr Cosgrove said that was "complex" as there were penalty clauses in the building contract.
However, West Coast District Health Board chief executive David Meates, who was part of the interview on Friday, said the cost of the new hospital would be "greater" than the initial budget.
The DHB now has to patch up the existing buildings at Grey Base Hospital that it had expected to have vacated about now, for up to another 21 months. Mr Meates said it would cost "significantly more operationally to sustain services" the longer the new building project dragged on.
The need for a replacement hospital at Greymouth was originally fast-tracked because staff were working in earthquake-prone buildings.
"A quite major concern is that the facilities are high risk," Mr Meates said on Friday.