Outbreaks of pests and fungus dating back more than a decade that were never reported have also been unearthed after NSW Health Minister Ryan Park detailed the results of a snap maintenance review on Monday.
The reckoning of the state's health facilities comes after two patients died of fungal infections triggered by construction work at a major Sydney hospital.
There are 38 non-routine maintenance issues still unresolved from the last year, Mr Park said.
These include ongoing pigeon infestations at Tamworth and Royal Prince Alfred hospitals, and five hospitals needing roof repairs.
"I can never pledge that there will never be maintenance issues. Any government that does is not being realistic or truthful," Mr Park said.
"Sometimes an issue may require different expertise to ... consider if any further building maintenance work is required, which can take time."
As well as current maintenance problems, the snap probe identified a number of major infestations in the past decade that were never reported.
Flies, cockroaches, birds and possums were all found in major Sydney hospitals, including Westmead and Royal North Shore, between 2012 and 2019 without being reported in the press.
The spotlight on the state of NSW hospitals has intensified after two patients died and several others became ill after being exposed to a fungal outbreak at Royal Prince Alfred hospital.
The cause of the infection was Aspergillus, a common mould found in soil, dust and damp environments.
The hospital confirmed six patients in its transplant unit were affected by the fungal cluster in late 2025.
Health authorities indicated that construction works linked to a $940 million redevelopment at the hospital were the cause of the fungal infections.
People are unlikely to become unwell from Aspergillus but it can be particularly damaging for certain individuals with weakened immune systems, a Sydney Local Health District spokesman previously said.
Security failures at the Cumberland Mental Health Facility connected to the deaths of three people in violent incidents are another symptom of a health system in crisis, the state opposition says.
Setefano Mooniai Leaaetoa, 25, absconded from care and allegedly mounted a murderous stabbing spree in February.Â
Another patient, Luke Peter Francis, 31, reportedly fled after threatening a nurse and taking her access card, before he was allegedly involved in a police pursuit that left two women dead on February 14.
"Our public health system is literally falling apart on Ryan Park's watch," opposition health spokeswoman Sarah Mitchell said.
"Patients go to hospital for treatment and care, not to be put in further danger due to toxic mould, or conditions caused by bird droppings and dead pigeons."
A new independent oversight body will oversee the running of Cumberland Hospital and extra security staff will be added, the government announced last week.
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