Welsh Labour is pledging a £4bn Hospitals of the Future fund to build state-of-the-art new hospitals, including replacing Wrexham Maelor Hospital and University Hospital Wales, and a major hospital development in west Wales.
It would be funded by using a mixture of conventional capital, borrowing, and use of the mutual investment model.
It said a new government would work with health boards on individual hospital details and timelines after taking office in May.
The party said its landmark pledge to build new state-of-the-art hospitals would resolve many of the backlog estate issues “but we will also continue to make discretionary capital available to health boards to maintain their NHS estate”.
Plaid Cymru called the maintenance backlog “eye watering” but it said Labour’s £4bn election pledge to tackle it and also build several new hospitals “simply doesn’t add up.”
Health and social care spokesman Mabon ap Gwynfor said: “It’s nothing more than another empty promise from Labour that once again won’t be delivered.”
He said the party would prioritise tackling the high-risk maintenance backlog and undertake urgent repairs to promote the safety of both staff and patients, assessing the NHS estate on a case-by-case basis.
“Within the first 100 days, a Plaid Cymru government will develop a digitisation strategy to make Wales a world leader in digital health innovation, improving efficiency in the NHS estate, and begin work on a telehealth plan for Wales so that patients can better access treatment to reduce the pressure on the estate itself.”
Reform UK Senedd Member James Evans MS said: “Crumbling buildings, burst sewage pipes and rodents in hospitals are all completely unacceptable.
“Pragmatism and realism are essential for dealing with the substantial maintenance backlog across the Welsh NHS.
“Reform is the only serious and credible party on this issue, because we would prioritise the Welsh government’s capital budget on clearing the maintenance backlog, instead of promising a multitude of brand-new hospitals, like other parties have.”
The Welsh Conservatives said after 27 years of mismanagement and Labour budget deals with Plaid and the Lib Dems, the Welsh NHS estate was “quite literally crumbling.”
A spokesperson added: “Only the Welsh Conservatives have a clear and credible plan to declare a health emergency, restore NHS performance, build four new community hospitals with minor injuries units, including a hospital in Rhyl with 30 beds and ensure people across Wales get the timely care they deserve.”
The Welsh Liberal Democrats said they would prioritise upgrading the worst parts of the NHS estate and deliver modern facilities that support faster diagnosis, shorter waiting times and better patient outcomes. That includes backing a replacement for the University Hospital of Wales.
“Crucially, we would link capital investment with reforms to social care and community services, reducing pressure on hospitals in the first place,” said party leader Jane Dodds.
The Green Party called the maintenance backlog “a disgrace” and said it was undermining both patient care and staff morale.
“We will prioritise a multi-year programme to bring existing facilities up to a safe, modern standard, with transparent national reporting on progress,” said a spokesman.
He said the party would also prioritise a network of local health and wellbeing centres, bringing GPs, social care, mental health and community services under one roof.