The $500 million expansion of Canberra Hospital may be delayed by years with documents showing it is not expected to be finished until almost 2025.
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The surgical procedures, interventional radiology and emergency centre (SPIRE) was a flagship election promise from the ACT Government going into the 2016 election.
The concept would include a new purpose built building at the Canberra Hospital site at Garran connected to building 12.
Labor's 10-year health plan states the $500 million centre will be operational by around 2022.
The 2017/18 budget allocated $236 million to the project over four years, meaning the majority of the funding for the SPIRE centre was pushed beyond last year's budget's forward estimates.
$6 million over two years was allocated to undertake the planning for SPIRE as well as $230 million in capital over the following years with construction to begin in 2020.
Unlike the election commitment, the budget documents did not specify an estimated completion time.
But a tender document released last week calling on applications for the centre's preliminary design says the "delivery of SPIRE is not planned to be completed until late 2024".
The document says the government aims to appoint a contractor by June this year to make early planning and forward designs for the hospital, with that work expected to last for two years.
The government has asked for a consultant with experience in the redevelopment of at least two major tertiary hospitals valued over $300 million.
ACT Australian Medical Association president Steve Robson said possible delays came at a time of increasing demand for public health services across the country.
"It was an election promise and we look at election promises with a ceratin amount of scepticism," he said.
"It was always going to be the case there would be more delays, so it is not unexpected.
"It's disappointing this infrastructure looks like it will be delayed but it's not surprising."
Dr Robson said many years of underinvestment in health infrastructure in the ACT was making it hard to keep up with other jurisdictions.
"I think at the moment with all the information we have about demand it is critical there are as few delays as possible," he said.
"I've said many, many times that Canberra Hospital is creaking bit of ancient infrastructure.
"Canberra is a growing place and demand for health services is not going to get any better and the population is not getting any healthier.
"All the delays just make things worse."
The SPIRE centre was the first announcement of the official election campaign in 2016 and a counter to the Liberals' promise to build a $395 million hospital building.
At the time questions were raised about the lack of detail around the centre and the long time before it was operational - then expected to be open around 2022.
The planning principles in the tender document said SPIRE will focus on acute services with a focus on complex care, emergency services, intensive care and surgery.
There would be an expanded emergency department, 48 beds in the intensive care unit, a 32 bed cardiac care unit, 13 operating theatres with shell space for an additional 10 theatres, three cardiac catheterisation laboratories and 100 carparks.
It would include two inpatient wards with 64 beds and new critical care and imaging facilities.
The government said SPIRE will have dedicated theatres for emergency surgery and elective surgery, so elective surgeries are not delayed or cancelled as a result of emergency surgery.
Health Minister Meegan Fitzharris' office was contacted for comment and clarification about the opening of the SPIRE centre but was unable to respond by deadline.
