A damning review of the Garran Surge Centre said it was a "fundamental problem" that the facility had not been built to meet the standards of a ward.
Issues with the design, revealed by The Canberra Times, showed the centre was not suitable to treat infectious COVID patients.
The opposition has slammed the ACT government for not publicly revealing concerns about ventilation and airflow at the centre and has questioned why upgrades were not pursued.
But Health Minister Rachel Stephen-Smith has said it is "absolutely ridiculous" to suggest the facility was not fit for purpose.
The territory government has doubled down on its defence that the pop-up health facility was never meant to be a "ward area" and has, subsequently, downplayed the concerns in the review.
Despite this, Ms Stephen-Smith could not say whether the centre could have been used for an emergency department, which was its original purpose, without undertaking further assessments.
Documents, released to The Canberra Times under freedom of information, revealed a review, undertaken in 2021, showed concerns about ventilation and airflow within the centre.
The review was undertaken to explore whether the pop-up hospital could be a "ward area".
"The facility is generally not suitable for treatment of COVID-19 infected patients as it is," the review said.
However, authorities have sought to defend the centre on the basis that it was never meant to be a ward for overnight patients. It was designed to be an emergency department, which had 50 beds including six resuscitation bays.
"There's some really disturbing revisionist thinking about the way that the surge centre both was built in the first place and has been used over time. It was never intended to be a ward facility or an intensive care unit," Ms Stephen-Smith said.
"To suggest something went wrong because the design wasn't appropriate for a ward or an intensive care unit is absolutely ridiculous.
"It was only ever intended in its initial construction to be a supplement to the emergency department."
But the 2021 report also suggested the centre should have been built to have a "ward area".
"The fact that the facility has not been delivered as a 'ward area', provides limitations to the functionality," the report said.
"This seems like a fundamental problem for the effective use of this facility as a COVID-19 surge centre and it seems that the expectation of how the facility can be used has not been met by the end product."
When asked whether it could be used for an emergency department in the wake of that report, Ms Stephen-Smith said further assessments would have been needed but she said it was never needed for that purpose.
"If we had been intending to use it as an emergency department, if we had needed that capacity and had thought that was an appropriate thing to do of course further work would have been done at that time to understand whether that was going to be able to be done safely," she said.
The report also said the centre contradicted guidelines from the World Health Organisation. The guidelines provided information on how to set up a treatment centre for severe acute respiratory infections in low- and middle-income countries in a limited resource settings.
"This also seems to contradict [the guidelines] that clearly sets out the need for short stay, moderate and severe critical wards," the report said.
Ms Stephen-Smith was never given this report about the centre, which recommended a series of upgrades that could have cost up to $75,000.
She said she was comfortable about the fact she was never given this report given health authorities made the decision to not progress was upgrades as the centre would not been used as a "ward area".
Opposition health spokeswoman Leanne Castley said the government should have spent this money to upgrade the centre, given concerns about Omicron and a winter surge.
Ms Castley also slammed the government for not revealing the concerns about the centre.
"If people knew about this report and the surge centre wasn't fit for purpose and that's the reason it couldn't be used in the capacity it was built that is something Canberra needs to know about," she said.
"We trusted there was this centre that Canberrans could go to when there was a surge in COVID."
The $14 million Garran Surge Centre was built in 2020 by Aspen Medical in just 37 days. It was built to specifically handle COVID patients in the scenario where existing emergency departments did not have enough capacity to meet demand.
Instead, it served as a vaccination centre, a testing centre and a COVID-specific walk-in centre.
Both the ACT government and Aspen Medical defended the centre by saying it was built during a medical emergency when global health systems were overwhelmed. They also said it was built at a time when the spread of COVID was thought to be largely from droplets.
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