The new Tallinn coalition is planning to merge the state-owned North Estonia Medical Center (PERH) with the municipal West Tallinn Central Hospital and East Tallinn Central Hospital as well as the Tallinn Children's Hospital.

Well-run hospitals to bail out debt-ridden PERH

We are talking not just about merging municipal hospitals, but those with different owners. There are more than a few reasons why the plan is rubbish.

The hospital reform comes across as yet another plan to dip into Tallinn's wallet in an attempt to remedy financial ineptitude on the national level. Should it happen, the result will be a behemoth managing which would clearly be beyond the government's ability. We can see the four-way coalition trying to move in four different directions even before it has been officially created. Does anyone honestly believe it could successfully run such a monster sowed together from several different hospitals?

It has been tried in Tartu, so why run the same experiment in Tallinn? Estonia's administrative reform experience also tells us that attempts to merge the wealthy and the poor by force will always result in having two paupers instead of making everyone wealthier. It is reminiscent of the [national government's] so-called Robin Hood plan.

Attempt to get it done before development plan lands

Estonia is already working on a hospital network plan to 2040. Because the latter is being put together by specialists, as opposed to politicians, it will quite likely not include what is clearly an arbitrary plan to merge existing hospitals. Something like that would require thorough analysis and consideration.

There seems to be no convincing reason for the planned merger, and it seems that the aim is to get the jump on the incoming development plan and get it done before the expert plan pulls the plug.

Whatever the case, the decision has more to do with the national hospital network than just Tallinn hospitals. I would ask the Social Democrats, who proposed the merger, why they are trying to include a nationwide policy item in a local government coalition agreement in a situation where they've recently criticized Isamaa for doing the same?

People treated in buildings, not spreadsheets

Merging hospitals in Tallinn has long been the plan of the recent Centrist city government, through the creation of the new Tallinn Hospital. It would have been more than merely an administrative change, which is what the planned hospital reform seems to be, but would have seen a new and modern medical complex built to constitute a big step in the direction of higher-quality medical care. The new building would solve the cramped working conditions of medical professionals, which cannot be done in existing buildings, and create better conditions for patients.

The Reform Party has been actively opposed to the plan and even given away relevant European subsidies. Why then do they like the new plan of merging hospitals in the city merely on an administrative level, without any meaningful improvement for patients? People are still treated in buildings, not spreadsheets.

Knowing Reform's affinity for making sure public institutions end up in private hands, as well as that their ranks include more than a few medical sector businesspeople and lobbyists, we should remain vigilant and ask the question of who benefits from this giftwrapping.

The Reform Party likes to talk about mystical food chains in Tallinn, and they probably know what they're saying. By the way, PERH's supervisory board is chaired by Taavi Rõivas, former prime minister and Reform Party leader. Needless to say that the supervisory board chair of the debt-ridden hospital agrees to the plan, having referred to it as a bold and ambitions idea. But it is rather revolting how these words are once more thrown around by someone who only stands to gain from reorganization.

Therefore, Estonia is looking at an experiment where serving in place of an effects analysis is unpractical wishful thinking and a few parties' narrow interests, while the damage caused by it will continue to weigh down Tallinn taxpayers for years to come.

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