The closest ever look at the country's hospitals reveals many intensive care units, operating theatres and emergency departments are in "poor or very poor" shape.
The Government is releasing the stocktake of hospital infrastructure today, putting the fix-it bill at $14 billion over the next decade, in a repeat of an estimate first given in 2018.
The stocktake shows 17 of the 32 intensive care units, emergency departments and operating theatres assessed are rated 'poor'.
And 15 out of 24 mental health units assessed were deemed poor - or very poor.
Association of Salaried Medical Specialists Executive Director Sarah Dalton says a fix needs to come from the Government.
She says DHBs have a lot asked of them and in a country of five million people, surely there could be central control of what fit for purpose hospital buildings look like.
Health Minister David Clark told Heather du Plessis-Allan that the report makes clear that the $3.5 billion that the Government has put into the system so far is well-needed.
"When I was in Opposition, I realised we didn't have a stocktake across all our assets, we've never had one as a country, and I found that shocking. I think most small businesses would know where their assets are and when they need to be replaced. We need a system in place."
"That's not acceptable or desirable for the current of level of care we expect to give our vulnerable people. We need to upgrade them, we need to update them."
He says that the stocktake will help them prioritise what needs repairs, with new hospitals and buildings are strong possibility.
When it comes to specific areas of the country, Clark says that the work needed is spread across the country.