The reports flagged centrally that the hospital build size and specification can only be determined in the context of a wider programme of health service reforms across the South that need fixing at the same time.
A June 2020 report said the build project "needed to be formalised as one component of an overarching programme", which would be expected to include improvements to primary and community healthcare and computer systems.
A December 2021 report said "due to the lack of clarity in the current governance arrangements, senior stakeholders and decision makers do not have an overall view of the risks or the full scope of the investment required to deliver the benefits of the new Dunedin hospital".
The report hinted at cutbacks. People involved in the new build had "low confidence in budget containment, but while this may not achieve the original desired outcomes, it may result in a more fit-for purpose hospital".
The reports are by the Gateway unit, a division of the Treasury responsible for auditing progress of major public investments.
As reported by the Otago Daily Times earlier this month, the build’s leadership has chopped and changed, including different health civil servants managing the project both in Wellington and Dunedin, as well as three different governments in charge.
Governance committees have also been set up and disbanded - the Southern Partnership Group (SPG) (2015-20), the Executive Steering Group (2020-23) and the Project Steering Group (2023-).
The June 2020 report described ongoing confusion about "who was responsible for what" and a "critical need for clarity".
People who worked on the project and wider programme described the governance as "a struggle", "a mess", "lacking delegation", having "contested accountabilities" and "suffering from a lack of trust".
The report argued that normal governance was not possible by the committee anyway because decisions were being made by ministers and their ministries. The committee should revert to an advisory-only role.
Another Gateway report, dated November 2020, identified that people in the SPG and in health board roles in Dunedin had not been shown the June report.
There was a "high degree of frustration at the apparent ‘secrecy’ being kept over the Gateway report and this has served only to further deepen a culture of distrust that appears to exist between the Ministry and the Southern DHB".
Pete Hodgson, a previous Labour health minister and former chairman of the SPG, said Dr Reti’s move to release the reports now was "in the hope of besmirching those who have been involved in the past".
Some of the reports’ commentary had come from him and others involved locally, who had been the project’s "harshest critics".
He blamed past delays on central government and a lack of "confidence to crack on with the project".
Richard Thomson, who also sat on the SPG, said Dr Reti’s decision to release the reports showed the new Dunedin hospital campaign was "getting under his [Dr Reti’s] skin".
"I find it fascinating - and somewhat endorsing of the pressure Reti is being put under by the campaign to get the hospital built properly - that the minister needs to defend himself by criticising the past rather than talking about the future."
Dr Reti responded last night that the government had released the reports because "it’s the right thing to do, to be transparent about the long-standing challenges this project has faced and which we have inherited".
It was "unclear" why former leaders of the project did not release the reports, he said.
"As the then-health spokesperson I would have found them very useful - as would the people of Dunedin."
Following a review of the hospital build published this year by Robert Rust - a former chief executive of Health Infrastructure New South Wales - the Project Steering Group has appointed chairwoman Rebecca Wark, who also previously held the top job at Health Infrastructure NSW. The senior responsible officer is HNZ’s head of infrastructure Blake Lepper.
Mr Rust had complained that the arrangement before that, which placed Auckland building expert Dr Tony Lanigan in both roles, was "clearly not tenable".
