So-called medi-hotels formed a key part of Mark McGowan's pitch to voters at the 2017 election, but five years on there is little sign of them.
Sold as a way to solve what was then labelled a "crisis" in the health system, three facilities were promised to free up hospital beds and ease strain on the system.
It was imagined they would mostly be used by regional patients who no longer needed the care of a full hospital bed but were not yet ready to go home.
Three were promised, but so far, the only one to open is a four-bed facility at Royal Perth Hospital.
Work on another, being built by a private provider in Murdoch, is underway with hopes it will be open in the next year.
But the third, promised for Joondalup, appears to be no more, with the Health Minister yesterday telling parliament for the second time that plans had changed.
"We've actually made a bigger investment in Joondalup Health Campus, an even bigger investment than a medi-hotel, by expanding the bed base and [adding] 102 mental health beds," Amber-Jade Sanderson said.
"In discussion with the local community, and with the local provider, that's what they wanted."
On Thursday morning, a government spokesperson said a medi-hotel was still being considered for Joondalup, but the focus remained on the current expansion.
They also said the government had taken a range of other steps to address pressures, including a commitment to add 530 hospital beds to the system, of which more than 420 are now online.
Joondalup plan changes
Cracks started to show when what was planned to be the first facility, near Fiona Stanley Hospital, was already a year behind schedule before the pandemic.
But plans for others remained alive, including when then-health minister Roger Cook told parliament in September 2021 that development approval had been received for a 110-bed mental health unit at Joondalup, with 90 inpatient beds also on the agenda.
Mr Cook said while the focus was on completing the first phase of the expansion, "ambitions" remained for a medi-hotel in the future.
But just eight months later his replacement, Ms Sanderson, told budget estimates the now 102-bed mental health facility would be a "far greater contribution" than a medi-hotel – a sentiment she echoed yesterday.
Not all of those 102 beds are new or will open at the same time though.
The Joondalup Health Campus website notes the project contains only 30 additional beds, the same as was initially promised in 2019.
Of the remainder, 47 are described as "replacement" beds, while 25 will be "shelled to meet future demand".
Ms Sanderson said at the time that all would be operational by February 2026.
The 90-inpatient-bed promise remains unchanged from three years ago, with the website revealing that will comprise 30 in an inpatient ward and 66 "shelled" for future demand.
Row over what beds are best
The original aim of medi-hotels was to free up hospital capacity by giving people somewhere else to stay when they did not need a full-blown bed.
Ms Sanderson said the new mental health beds at Joondalup would be even more effective at achieving that outcome.
"Those mental health beds will take pressure off the beds within the main hospital, and will provide a much more appropriate place for those patients to be treated and recover from their episodes," she said.
But opposition health spokeswoman Libby Mettam questioned that claim, saying it was "simply not true" to say the mental health beds would replace the medi-hotel promise.
"Medi-hotel beds play a very different role to mental health beds, and quite clearly the McGowan government have stepped away from this election commitment," she said.
"The purpose of medi-hotels is to be an alternative to the more expensive hospital beds and address the very real issue of bed block across our hospital system.
"[It's] disappointing to hear confirmation in parliament that it is no longer part of the McGowan government's strategy for delivery, probably because they are struggling to deliver the current sets of projects under their books."
Talks on Fiona Stanley medi-hotel
The Fiona Stanley medi-hotel remains under construction, with the private developer's plans including an urgent care clinic and consulting rooms.
Ms Sanderson told parliament she expected it would be operational within the next year.
"That will provide really important relief, particularly for Fiona Stanley Hospital, and we're in contract negotiations with that contract provider now," she said.
But Ms Mettam said that was time an already strained system could hardly afford to wait.
"This points to why our emergency departments and hospitals still struggle with bed block and the highest level of ambulance ramping on record," she said.
Australian Medical Association WA president Mark Duncan-Smith said while medi-hotel beds did have a role to play, they were no replacement for proper hospital beds.
"Medi-hotels are really a second-tier lever to pull on trying to increase capacity of the health system," he said.
"I would rather see that money be redirected to actually create extra tertiary hospital beds, which is a more direct lever to increase capacity of the system."
