New Zealand's not getting good bang for its infrastructure buck, according to some.

The Infrastructure Commission has released a 30-year plan with 16 recommendations, and 10 top priorities for the next decade - including health spending. 

Infrastructure Commission chief executive Geoff Cooper says we rank high on spending in the OECD, but our outcomes are in the bottom 10 percent.

He says New Zealand has unique problems we need to solve. 

"The geography is very difficult and we have a dispersed population. That means more pipes, more roads, more transmission lines and so on - and that costs, if you're going to do that." 

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