ASMS executive director Sarah Dalton said it was great to see Hawke's Bay Hospital getting some much-needed attention for its cramped and rundown facilities.
"But it begs the question as to why it's so difficult to make money available to address the vexed issue of air-conditioning – or more to the point the lack of it," Dalton said.
Last summer, fans and ice blocks were handed out and tinted window film was installed to help staff and patients cope with peak temperatures reaching 34C.
At the time, families complained to Hawke's Bay Today about the hospital running out of fans, and requesting people to bring in their own, and patients in the surgical wards ending up with heat rash.
Dalton said the hospital "desperately" needed refurbishment but it was difficult for DHBs to access funding to improve building conditions in the short and long term.
"It doesn't seem to make any sense that on the one hand investment is being made to modernise and improve patient care, and on the other patients are being sent back in time to overheated wards where their health and the health of the staff caring for them is being compromised."
Dalton said ASMS planned to seek advice from WorkSafe NZ on the legal requirements around safe building temperatures.
It had also been speaking to other unions including the Resident Doctors' Association and APEX about the potential for joint action under health and safety legislation if there was no progress by this summer.
It would continue to pick up the issue with the DHB's new chief executive Keriana Brooking, who takes up her role next month, Dalton said.
In response, the DHB spokeswoman said Hawke's Bay DHB was very pleased with $14.2m of government funding, formally announced on July 8.
"This will mean two long-awaited projects to increase space, theatre capacity and provide more privacy for patients in theatre and radiology, can now begin," she said.
"Alongside these projects, Hawke's Bay DHB has a programme of work that is ongoing, to implement a range of measures to improve staff and patient comfort in the warmer weeks of the year in the ward tower block.
"These include the installation of permanent bed fans and further window tinting throughout the ward blocks, at all sites.
"While these aren't the perfect solution, feedback has shown these make things more comfortable for staff and patients in the 1950s-built ward tower block."
She said staff worked hard to provide effective services in the ageing buildings, and a new ward block was needed to provide a modern, purpose-built facility.
"This is on the DHB's capital plan and long-term planning for extensive refurbishment of the DHB's facilities has already begun," she said.
"However, this is estimated to cost at least $800 million and is at least 10 years away."