RIJNSTATE SUSTAINABLE HOSPITAL CARE

The project entails the strategic investment plans of the Rijnstate Hospital, aimed at optimising its healthcare infrastructure, service delivery and energy efficiency at its main location in Arnhem. Background: Stichting Rijnstate is a top-clinical teaching hospital in the province of Gelderland, in the Netherlands. It operates three locations in the region of Arnhem (Arnhem, Zevenaar and Elst). The hospital serves a population of about 433,000 people, provides about 725 inpatient beds and offers a total of 28 medical specialities including one of the largest pain management centres in the Netherlands. With about 6,600 people (4,100 FTEs), Rijnstate is the area's largest employer and one of the largest healthcare providers in the Netherlands. The promoter faces the typical challenges of EU's health sector including a constant shortage of qualified staff, tightening budget constraints and a gradually increasing demand for care by an ageing population. To tackle these issues, Rijnstate has embarked a major investment programme (2024-2030) to adapt the existing facilities to the current medical requirements whilst increasing service quality and overall efficiency at its main location in Arnhem. Such programme also intends to significantly increase environmental sustainability in the first step (until 2030) and move to a completely carbon-free hospital at a later stage (by 2050), minimising the requirements of fossil fuels.

The project aims to finance the extension and rehabilitation (about 55 000 to 60 000 m2) of the existing main campus in Arnhem including the entrance hall, outdoor areas, offices, laboratories, radiology, clinics and academic areas. In addition, various measures are going to be implemented throughout the campus to improve the energy efficiency as well as to prepare for the move from gas-fired boilers to heat pumps using geothermal power.

The project supports the InvestEU objective of social investments, in particular by creating infrastructure for basic, complex and acute hospital care.

The project covers the last phases of the three-phased long-term strategic investment plan of Rijnstate, a top-clinical hospital in Arnhem, the Netherlands. By concentrating acute and complex care at the main location the Hospital aims to optimise the quality, cost-effectiveness, and sustainability of its healthcare activities. Its other locations, have been already renewed and retain a role in diagnostics, elective and plannable care, ensuring hospital services remain available in patients' direct proximity.

The project will renew and improve care infrastructure and help Rijnstate to cope with the increasing demand for healthcare from a growing and ageing population. In addition, the project will improve the energy efficiency of the Hospital's infrastructure and improve its carbon footprint.

The project supports EIB's health policy objective and aims to provide high quality and accessible healthcare services. The project addresses a sub-optimal investment situation in the healthcare market in general, and in the hospital care segment in particular, as socio-economic returns are expected to exceed financial returns significantly.

The Bank can provide sizeable and long-term financings, aligning maturities to the economic life of the investment, while providing flexible drawdown modalities during the construction phase. In parallel, the EIB adds to the depth of available financing options available to the Promoter, at attractive economic terms, and thereby facilitates and accelerates the necessary investments into hospital infrastructure.

Hospitals are not explicitly mentioned in the Environmental Impact Assessment (EIA) Directive 2011/92/EU as amended by 2014/52/EU, though the project is covered by Annex II of the Directive concerning urban development. The compliance with requirements of the EIA Directive 2011/92/EU, as amended by 2014/52/EU on EIA and Habitats Directive, will be verified during appraisal. It is expected that the project will bear comprehensive benefits to the community, as healthcare is an element of social cohesion and economic development.

The promoter has been assessed by the EIB as being a private company not being subject to EU rules on public procurement or concessions. However, if during the project appraisal stage, the EIB were to conclude that the Promoter is subject to the EU public procurement legislation then this would require the promoter to apply those rules.