Government Minister for Social and Health Affairs Stephane Valeri has announced that the location of Monaco's new hospital will be known before the end of the year.

Speaking at a meeting of the press club last week, Valeri once again expressed his preference for constructing the new hospital on SNCF derelict land. One of 4 possible options, the site is close to the current Princess Grace Hospital (CHPG), but its narrow footprint will put constraints on the shape of the building. President of the Administrative Council for the CHPG Jean-Joseph Pastor has said he would like to see construction at the current location, although this would mean several years of disruption for staff and patients. The other two potential sites are Annonciade and Testimonio, both considered to be too far from the CHPG. Although Testimonio has the advantage that the ground is already available, the area is better suited to residential buildings. Annonciade would not be available until the school that currently occupies the site is transferred to its new location, which would delay the hospital project by up to 3 years.

Although there's no agreement yet on the location, the need for a new hospital is not disputed. The CHPG was inaugurated in 1902 with a capacity of 120 beds, which had grown to 363 in 1984, and today contains around 400. Expansion took place in successive phases, with little central planning, resulting in dispersed services. In 2000 a decision was taken to build a new hospital on the current location using a plan chosen in 2008 and with an initial budget of 350 million euros, which didn't take into account staff salaries. As cost estimates grew to 705 million euros, and considering the worsening economic climate, the project was deemed too expensive and scrapped in June this year.

The CHPG's catchment area contains a population of 125,000, with the number of emergencies increasing from 17,00 to 32,000 in the past 5 years. However, with an operating budget of 188 million euros, the hospital has been losing money since 1998. At the beginning of 2000 the deficit passed 7%, improving to 1.15% in 2008, and 1.18% the following year, representing losses of around 1.8 million. However 2011 estimates show a 5.2 million euros deficit of 3%.

Financing the new hospital is a major concern, especially with the future introduction of France's Hopital 2007 health care plan, which aims to cut state health costs. Negotiations are under way with France for compensation under T2A (tarification a l'acte) and will be applied in Monaco by 2014. If introduced today the changes would lead to a 30 million euros deficit. The need to cut costs has led to a reduction in the planned number of beds from 482 to 402, and is likely to cause a freeze on new staff recruitment.

Future hospital : decision at end 2010

New hospital : we can't wait any longer

Hospital : Valeri prefers the derelict land