The children's ward at Rotorua Hospital will be missing a third of its beds as winter hits because Te Whatu Ora halted an upgrade partway through to review costs.
Doctors and nurses were worried about how they would care for children with the unit not fully up and running until August - well into the peak period for winter illnesses.
Demolition of the old ward had already been carried out when the order to down tools was made in February.
Children were moved to a temporary ward with 14 beds instead of the usual 22.
Work had resumed, but the six-week halt meant the new ward would not open until August, deep into the winter peak when most hospitals were beyond capacity.
Doctors and nurses said at times the temporary space was already overflowing, and some children were being cared for in adult wards.
Clinical staff did not want to speak out publicly but the Association of Salaried Medical Specialists said the issue had come up at a meeting between them and hospital management.
Its executive director Sarah Dalton said clinicians had been blindsided by the decision to stop work.
"They were incredibly shocked. They had had no warning this might happen and of course their natural concern was for the finish date - what does this mean for our ability to provide care for patients?"
Doctors' concerns included:
- children might have to be discharged when they ought to be kept in hospital
- children might not get the same level of nursing oversight if they were in an adult ward
- some children's surgery could be delayed because there was no space for post-operative care
Rotorua Hospital confirmed the construction was stopped so that a "detailed analysis of the future costs of the project" could be carried out.
RNZ understands it was only after protests from Rotorua Hospital staff and management that work started again, in April.
Staff had already been concerned about the original completion date of 1 July - just as winter illnesses ramp up - but by the new date - mid-August - the hospital would have been busy for weeks.
Dalton said project costs had increased, which was not unusual, but she was shocked by the decision to halt for the review.
"It would be different if the build hadn't started and they still had the existing facilities ... but they've really been left high and dry with this approach," she said.
Te Whatu Ora's director of operations for the Lakes area Alan Wilson said if there were not enough beds in the children's ward during the winter peak, "suitable" children over 12 with orthopaedic, ear nose and throat or general surgical care would be cared for in adult wards.
"There will also be a lower threshold for young children who are very unwell to be cared for in Rotorua Hospital High Dependency Unit."