A brand new intensive care unit at Auckland's Waitākere hospital sits empty, fully equipped, but with no money budgeted to run it yet.
No opening date has been scheduled, with no staff and no operating budget.
The unit was previously due for use by the end of this year.
The six-bed unit was heralded as West Auckland's first ICU, when it was announced as part of a $96 million, 30-bed urgent care ward building in 2021.
That Manaaki Hōhonu building officially opened last month, but only half the beds were used, because Health NZ had not employed enough nurses to staff every bed.
No staff were hired for the intensive care unit.
Health NZ advertised for a clinical lead - but on a one-year, part-time (0.4 FTE) contract.
Waitākere Hospital operations director Brad Healey said more staff would be recruited, once the "model of care" was confirmed.
"Intensive care requires a highly specialised workforce, and detailed clinical and operational planning, before services can safely begin."
The union for senior doctors questioned why that recruitment was only happening now.
Association of Salaried Medical Specialists executive director Sarah Dalton said there had been more than five years to prepare.
"There are clinicians and patients who are eagerly awaiting these improved facilities. They take years to plan and build.
"It is not like it's a surprise when they open."
The need for an intensive care unit for the area, which had a population of 250,000 people, had been discussed for years, before it was even announced, she said.
"It's just frustrating that, now it is open, there aren't the people to staff it."
Health NZ had a habit of building facilities, then not staffing them properly, such as the North Shore's Totara Haumaru surgical centre on the North Shore, she said.
Health NZ's Brad Healey said the new building provided the infrastructure to allow the delivery of more critical care services in a phased approach "over time".
A Ministry of Health audit of Manaaki Hōhonu in July this year noted that, when the intensive care unit eventually opened, two beds would have to close at the North Shore hospital ICU.
North Shore and Waitākere hospitals are part of the Waitematā health district, which serviced a population of 650,000 - the biggest in New Zealand.
The audit noted, when the wider, 30-bed ward first opened, it would only use 11 beds, and said, if all 30 beds were used, extra staff would have to relocate from other medical wards.
The practice, known as a 'lift and shift', meant there would be no extra capacity across the hospital by opening the extra 19 beds.
Health NZ said 15 beds were now used in the new ward and there would be 25 by November 3.
West Auckland residents needing intensive care were normally either sent to North Shore or Auckland City hospitals.
Waitākere had 240,000 people and was expected to grow 25% in the next 15 years, a Health NZ document said.
When then-Health Minister Andrew Little announced the new development in 2021, he said the ICU was an important addition that would allow West Auckland people to get care closer to home, but would also boost capacity across the Auckland region.
