The new Tallinn Hospital complex is planned to be built on a vacant lot in Lasnamäe, but whether and when construction will begin remains uncertain. However, the formation of a single large institution under the name Tallinn Hospital is already a given. The central government has agreed to establish a unified hospital system based on Tallinn's existing hospitals and the state-run North Estonia Medical Center (PERH), but it has yet to commit to participating in the construction of a new hospital complex.

"I hope the state is still considering this reform. The City of Tallinn is ready. It's true that we began discussions with the Ministry of Social Affairs from quite different positions, but the working group of officials and specialists has reached a shared understanding that this is a major opportunity — a significant healthcare reform that frankly should have happened long ago. Tallinn has done all its homework. We've started our processes, and now it's the state's last chance to get on board," said Tallinn Mayor Jevgeni Ossinovski (SDE) on the "Esimene stuudio" political talk show.

At the beginning of May, the mayor sent a letter to Prime Minister Kristen Michal (Reform), urging the government — long delayed in making a decision on the hospital reform — to clarify its position: whether or not the state is willing to invest in the construction of a new Tallinn hospital campus. The state's response was neither affirmative nor negative.

"There's been a bit of a mixed message, and different topics have been thrown together. The reason for setting a deadline was that we have a city council session on June 12 and we want to finalize the decision to merge the hospitals there. That's because municipal elections will be held in October and we don't want to be making such fundamental decisions during the pre-election frenzy in September or October," the mayor said.

Ossinovski confirmed that the city has already launched its own processes but has left the door open for the state to join the project.

The mayor also said he doesn't believe the government's hesitancy is politically motivated by the upcoming elections or by a desire not to hand him a major political victory.

"There is certainly a degree of cynicism in politics, but I believe this is such a significant reform that directly affects the quality of healthcare in the capital. I hope the real motivation isn't about who gets the credit. This is a big and important matter that has dragged on for too long, and as a result, healthcare services in Tallinn have suffered. Now we have the opportunity to finally move forward," Ossinovski said.

Still, the mayor did not deny that if the hospital reform is approved, it may feature in election campaigning.

"When major and important things are accomplished, of course, it's worth talking about them. On the other hand, this is not an easy process. If the goal was to do something popular, then you wouldn't spend a year preparing such a complex reform. There are easier ways to gain attention. But since we've come this far — laying a solid foundation through cooperation between the state and the city — it would be a tremendous missed opportunity not to move forward," Ossinovski explained.

Overall, the mayor believes that Tallinn needs a unified hospital system. He noted that because fully renovating the existing hospitals and building a new facility would cost roughly the same, it makes more sense to build a new complex.

"Tallinn's hospitals have been underfunded for decades, and as a result, they all need comprehensive renovations over the next ten years. So the question is simple: do we fully renovate the existing infrastructure, or do we build a new campus? We've done the cost analysis and found that the numbers are similar. Therefore, it makes complete sense to build a new complex — especially because renovating a functioning hospital is extremely difficult and causes inconvenience for patients," the mayor said.

According to Ossinovski, the architectural layout of the current hospitals also poses major challenges for renovation — a view shared by both the government and the Ministry of Social Affairs.

Despite its promising goals, the hospital reform has received a fair amount of criticism, particularly concerning the proposed location and the size of the complex. Still, Ossinovski insisted that enthusiasm for the project remains strong.

"There's plenty of enthusiasm, but the criticism varies in quality and focus. First, take the question of the location — Lasnamäe. Well, let's say we extend the City Center district past the Song Festival Grounds, and then the hospital would technically be in the city. Lasnamäe was chosen for two main reasons: first, it's in a logistically advantageous spot. Smuuli tee offers quick access to Peterburi maantee and from there to the Tallinn Ring Road, which makes it easy for emergency services from eastern Harju County to reach the hospital," Ossinovski said.

This location would also improve access for residents of Viimsi, who would find it much easier to reach the hospital.

"The area is also well-served by public transport, and in the future, we hope to add tram service. For now, the bus connection from the Song Festival Grounds up the hill is frequent and reliable. It's not a dogmatic choice that the hospital must be there, but the issue is: where else can we find several dozen hectares of land in a logistically favorable area?" the mayor explained.

Ossinovski justified the hospital's large size by saying that a major facility in Lasnamäe could meet nearly all of the city's healthcare needs.

"If we look at a well-functioning European hospital, it typically serves between one and one and a half million patients. From a purely economic standpoint, we could say one hospital is enough for all of Estonia. Of course, our regional development needs and dispersed population require a different hospital network. But the idea that one hospital is enough for Tallinn — it's just common sense. It makes no sense to have more than one," the mayor said.

That said, he emphasized that the North Estonia Medical Center would not be shut down.

"Our vision is that there would be one hospital organization operating two campuses — one in Mustamäe and the other on the opposite side of the city."

Ossinovski also mentioned plans to collaborate with the Estonian Association of Architects, as the hospital project has faced criticism regarding its design.

"There's clearly a bit of a clash between the hospital's logistical needs and good spatial design. I'm not claiming the current plans are ideal, but obviously if we're talking about having more natural light in doctors' offices — that's a very appealing idea. We'll look into these issues with the Architects' Association and try to improve the procurement process to address them as part of the design phase," Ossinovski confirmed.

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