Building Australia's Future: Why We Need Alliancing for Hospital Infrastructure

Australia has relied on alliancing for over 30 years to build its civil infrastructure. Roads, bridges, tunnels, and railways have benefited from this collaborative approach, delivering projects on time and within budget while fostering innovation and shared responsibility. Yet, when it comes to hospital infrastructure, the traditional procurement methods still dominate. It’s time to ask why we don’t apply alliancing to hospitals as well, especially given the critical role healthcare facilities play in our communities.

What Is Alliancing and Why Has It Worked for Civil Infrastructure?

Alliancing is a project delivery method where the client and key contractors form a single team with shared risks and rewards. Instead of working in silos or competing against each other, all parties collaborate closely from the start to the finish of a project. This approach encourages transparency, trust, and joint problem-solving.

In Australia, alliancing has been used successfully for over 200 major civil projects such as the Northern Sydney Freight Corridor project and Melbourne’s Western Ring Road Widening. These projects faced complex engineering challenges and tight deadlines, yet alliancing helped deliver them efficiently. The result has been infrastructure that meets community needs while controlling costs and timelines.

Why Hospital Infrastructure Needs a New Approach

Hospitals are among the most complex buildings to design and construct. They must meet strict safety standards, accommodate rapidly evolving medical technology, and provide a healing environment for patients and staff. Hospital projects are often built in brownfield operating environments and demand extensive and complex stakeholder consultation. Many hospital projects in Australia face delays, budget overruns, and design flaws that affect functionality and sometimes, patient care.

Traditional procurement methods often pit designers, builders, owners and operators against each other, leading to misaligned priorities and finger-pointing when problems arise. This fragmentation can cause:

• Cost blowouts due to unforeseen issues

• Delays that impact patient care availability

• Designs that do not fully meet clinical needs

• Limited flexibility to adapt to future healthcare changes

  
  

Given these challenges, Dr Holly Dinh, in her article "Building Australia's Future: Why we need alliancing for hospital infrastructure", poses the argument that hospital infrastructure needs a delivery method that encourages collaboration, shared responsibility, and innovation — just like alliancing has done for civil infrastructure. She cites first hand experience of using alliances in British Columbia, Canada to deliver some of their most complex hospital projects.

The Future of Hospital Infrastructure in Australia

Australia’s healthcare system faces growing demand and rapid technological change. Hospitals built today must be adaptable, efficient, and patient-centred. Alliancing offers a proven way to deliver these outcomes by fostering teamwork, innovation, and shared commitment.

By applying the lessons learned from 30 years of alliancing in civil infrastructure, and drawing on the experiences of British Columbia's hospital alliances, Australia can build hospital facilities that truly serve communities now and into the future.

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