Pregnant women won't be turned away from Middlemore Hospital if the DHB is forced to remediate or rebuild the quake-prone Galbraith Building, the board says.
The Galbraith building houses the maternity, birthing, gynaecology, radiology, day procedures and infusion services at Middlemore Hospital.
The DHB received an assessment this week of the building's seismic risk after years of debate over whether to strengthen or demolish it.
Briefing documents showed that although the Galbraith site was in a zone unlikely to experience a major earthquake, the board must comply with legal requirements to either remediate the building or replace it long term.
Acting chief executive Gloria Johnson said the Galbraith building - and what to do with it - was the board's biggest concern and it was considering whether it was feasible to fix it.
"Is it feasible to do that whilst either keeping all of the services operating within it or decanting some of those services from time to time while we remediate various parts of it?"
The board would also have to look at options for a complete rebuild, and how quickly it could be done if repairs were unaffordable or too disruptive.
She said Counties Manukau DHB already knew there were few alternative options for patients if it had to close parts - or all - of the building.
In briefing documents, it said the other DHBs in Auckland could not cope with the demand from Counties Manukau DHB residents, and travelling out of the region put additional burden and cost on patients.
Dr Johnson said maternity services would be prioritised if that situation did eventuate - but pregnant mothers would not be turned away from Middlemore Hospital.
Medical and surgical services could be reduced to retain maternity service if overall capacity was reduced, she said.
"If we did have to take maternity services out of the building for some reason or we needed to close off some area of maternity services ... we would accommodate those services elsewhere on the Middlemore site," she said.
"We would make that a priority because that's clearly a service that it is critical that we continue to deliver on this site.
"Medical and surgical beds are the ones that we might have to look at being able to accommodate elsewhere, that's where it is possible that there might be some regional capacity to help us out."
Definitive decisions around the future of the Galbraith Building are expected to be made later this year, but the DHB would have to go to the government for extra funding regardless of whether gets fixed or replaced.
The DHB's new chair Mark Gosche was realistic about the share of the funding pie Counties Manukau might get.
"There's not a bottomless supply of money but we'll make do with what we can get and maximise its effectiveness."
Finance Minister Grant Robertson confirmed today the government would invest $42 billion in net capital spending over five years to support its plan to rebuild infrastructure and critical public services like hospitals.
Details about how that money would be divided up will be revealed in the government's Budget next week, but there would be a hefty boost for health and education.