By their statements, they are hoping for the support of other government members in securing the hundreds of millions of euros from the state required to fund the project.

That the hospital's size as per plans means once opened it could not only serve Tallinn and its environs, but much of the country, may also help in securing state funds, it is hoped.

The Tallinn coalition agreement signed in spring included an item on completing the design of the planned Tallinn Hospital, and the city is continuing persistently with the activities required for this purpose.

In March of this year, the contract with the previous two design firms was terminated, due to missed deadlines. Last Friday, Tallinn announced a new design tender worth €19 million.

The Tallinn Hospital project's estimated cost comes to approximately €850 million, but Tallinn is unable to cover this entire amount on its own, and, given thanks to its size the hospital could serve almost the entire country in the future, is unwilling to.

At the start of July, Mayor of Tallinn Jevgeni Ossinovski (SDE) unveiled a plan suggesting that the state could return to the city the €250 million to €300 million in tax revenues generated from the construction of the major hospital, rather than paying it into the state budget.

But on Monday, Finance Minister Jürgen Ligi (Reform) dismissed the plan, arguing that the city must find all the money for itself.

When pressed on this, Ossinovski responded on Tuesday that the city acknowledges Ligi's stance.

"He is well-known for such positions," Ossinovski said.

"Of course, any form of cooperation between the City of Tallinn and the state represents a government-level decision, in which the finance minister certainly has a say, but the decision-making process is significantly broader than that. It is not merely financial, but also concerns the entire organization of healthcare," the mayor went on.

"Ligi's comments give the impression that providing specialized healthcare services is the primary responsibility of the municipality, which it is not. This is a task for the state but which Tallinn performs, on behalf of that state. Against this context, the state has every reason to support the Tallinn Hospital construction. We have already had a meeting with Health Minister Riina Sikkut (SDE), and we agree that this project is needed," Ossinovski added.

When asked if opposition from government members like Ligi and Education Minister Kristina Kallas (Eesti 200) meant that cooperation between the capital and the state had not been going smoothly, despite Reform, the Social Democrats (SDE) and Eesti 200 being in both the Tallinn and national coalitions, Ossinovski answered that he had not sensed that.

"We have had very good cooperation with quite a few ministries," he said.

Deputy Mayor Kase: Michal previously supported hospital project

Deputy Mayor Karl Sander Kase (Isamaa), who holds the social affairs portfolio, said he agreed with Ossinovski on pressing on with the hospital plan, stating that it is only the finance minister who has been a hold-out.

He said: "I was sat on the Tallinn City Council with Kristen Michal, who supported, at least verbally, Tallinn Hospital."

Michal had previously been Reform's leader at the council chambers.

Kase implied that Ligi's stance may now be backed by the prime minister, though the latter has not stated as much.

"I will on Thursday be meeting with Minister of Social Affairs [sic] Riina Sikkut to discuss these funding issues. I believe this is not a personal decision from Jürgen Ligi," Kase went on.

"Whereas we have a prime minister who previously supported the project, they have not taken a position on this matter. We will see if they act according to their previous words, or if it is as with the previous government: They say one thing and then do another," Kase continued.

According to Kase, Michal has not reiterated his support for the hospital construction plan since becoming prime minister. "We will first communicate with the health minister, and then proceed to the prime minister," Kase went on.

"The currently announced tender for the project will not go bad over time: with the necessary changes, it can be used for 5 to 15 years," said the deputy mayor.

Kase noted that the activities planned by the city in connection with the hospital are based on the coalition agreement, which all parties agreed to.

"Three of these parties are also in the government at the national level, so one would expect that they would be in sync. It should not be the 'good old' practice where it is Tallinn versus the state. We could still find a common constructive solution to move things forward," Kase added.

As to whether the current situation is one of Tallinn versus the state, Kase answered that coincidences are rare.

"The recent comment by [deputy mayor] Pärtel-Peeter Pere (Reform) that the hospital design tender should be canceled, followed immediately by Jürgen Ligi's statement that the state has no funds for it – then the question arises whether the Reform Party in the city and the state have come to an agreement to let this project fall through, or if it was just a coincidence? At present, I feel this contradiction on several matters, not just the Tallinn Hospital, though it is not exceedingly wide-ranging," Kase went on.

Sikkut: Ligi's reaction as expected

Health Minister Riina Sikkut (SDE), who as noted supports the construction of the planned hospital, said the current debate on hospital funding gives a sense of deja vu.

Sikkut said: "We have discussed this time and again already. It is true that considering the current situation with the state budget, it is entirely understandable that we prioritize defense spending and that there is no coverage for funding needs in any other areas."

"The road construction debt comes to about four billion euros, as has been reported in the media; teacher wages cannot remain frozen for four years, and there is also a need for funding in healthcare," Sikkut said.

"There are no agreements on these, but this does not mean these are not important," she continued.

Sikkut reiterated she also supports proceeding with the planning of Tallinn Hospital.

"Since whenever state support comes, we could agree on funding, but to start construction, it will still take five years as nothing is planned or designed," the minister said.

Sikkut said that the City of Tallinn has not petitioned the state for money as yet.

"The hospital will be built with a loan in any case – both Tallinn and the hospitals have the borrowing capacity to do this," she said.

"Ossinovski has also publicly stated that, since Tallinn Hospital is an object which would not otherwise be built, the tax revenues it generates could be plowed back into the city. This is a rational proposal, and is not currently included in the budget's cost-revenue plan. The plan thus needs further discussion," Sikkut continued.

The government is to discuss the development directions of the hospital network in the fall, and, according to Sikkut, the Tallinn Hospital topic is to be discussed in the context of budget planning.

Sikkut said: "In the current state of state finances, any finance minister [would react like Jürgen Ligi] – I would be very surprised if Ligi said yes to anyone."

"Whether we are talking about the personal state, teacher wages, or Tallinn Hospital. This is entirely logical. He cannot pledge anything to anyone, these hundreds of millions, since then others will come and petition too. The reaction is not strange to me, but rather more expected," she went on.

The cooperation agreement between the state and the City of Tallinn to prepare for the establishment of Estonia's largest hospital complex, Tallinn Hospital, was signed in 2019.

An international design tender for Tallinn Hospital held in summer 2021 was won by the joint offer from Italian firms ATIproject srl and 3TI Progetti, with a design contract signed in November 2021.

In March this year, however, that contract was scrapped by mutual agreement between SA Tallinna Haigla Arendus and the designer, since the former was not satisfied with the latter's work.

Last Friday, Tallinn announced a new international design tender for the hospital.

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