“A year ago we set ourselves an ambitious goal,” said member of the cantonal government Pierre-Alain Schnegg at the public event in mid-October. “Together, we wanted to find a solution for basic medical and hospital care in Simmental-Saanenland. This solution would add real value to all communities, people and holidaymakers.” He’s now pleased that it’s been possible “to work out a reliable solution for the future, with a health campus in Zweisimmen and a health centre in Saanen.”

Around 80 people had worked extensively on the project over the past two years. The project group was broad and represented all municipalities, institutions and organizations concerned in the Simmental and the Saanenland, the Bergregion, as well as the hospital STS and the health and welfare department of the canton of Bern.   

A health campus in Zweisimmen
The proposed services for the future Zweisimmen campus will be similar to what exists today with wards, monitoring beds, an operating room, 24-hour hospital emergency, possible outpatient procedures, special consultations, including dialysis and psychiatry, in addition to medical practices such as physio, hospital services, a pharmacy, etc. One particular challenge is the progression of patient numbers, emphasised project manager Stefan Stefaniak. These are falling steadily, which could lead to a reduction in the provision. However, nobody has to worry about health care in the region, he stated.

A health centre in Saanen
At the health centre in Saanen, medical and therapeutic activities could be pooled and strengthened, increasing the appeal for patients and service providers. Various services already exist around the former hospital such as care for the elderly, retirement apartments, and assisted living as well as a rescue service, the home care provider Spitex and a day care.

The group practice needs to be set up – the premises are available along with various therapeutic services. The proposed service includes GP care, laboratory, radiology, ultrasound and ECG diagnosis, specialised consultation hours, emergencies between 7am and 8pm, minor outpatient operations, monitoring facilities, therapies, and complementary medicine.

Integrated care
A central part of the project is the construction of a network. Integrated care means the binding cooperation of all service providers in a network for the well-being of the population. explained Joachim Maier, a registered doctor in Zweisimmen. Over the next three years, the schedule will be intense. A mediator will assist in demanding situations.

“We’d like to start with a core of service providers who work within the Health Insurance Act (KVG) and slowly expand to complementary medicine providers, masseurs, and support groups that already exist in the region,” said Maier. As far as possible, the network connects all health care providers and coordinates patient paths.

Maternité Alpine would also like to become part of the Zweisimmen campus, as well as the MedBase in the new Migros building, a group practice that will be up and running in the spring. They could also be involved if the perimeter were to be expanded. 

Two concepts for the campus
The health network in Saanen is planned in the former hospital. The municipality of Saanen remains in possession of the property and the network will be the tenant.

For the campus, there are two concepts: a complete new construction or renovation of the ward with new construction of the extension/treatment tract.

In the new construction all needs would be taken into account, the technology would be up to date, says Jonas Wanzenried from the infrastructure working group. The investment requirement is estimated at CHF 40m to 45m with annual rental costs of CHF 2m to 2.3m.

The concept for refurbishing the ward anticipates an investment of CHF 30m to 35m and annual rental costs of CHF 1.6m to 1.8m. During the conversion phase, operations would be significantly affected, compared to the option for the new build.

A one-third solution for the deficit
The pressure of costs for hospitals is high. There have been several closures and more still to come, stressed Marc Aellen, in charge of finances. Currently, in Zweisimmen not enough turnover is generated for the accumulating costs, according to Aellen.

The annual deficit amounts to CHF 4m to 6m. A third or more will be paid for by the canton. Another third up to a maximum of CHF 2.5m will be paid for by the STS and a maximum of a third will remain with the region, ie the municipalities. Ultimately, the voters would have to make a decision on this financing and answer the question whether the hospital is worth this amount.

New organising institution
A new organising institution, Gesundheit Simme Saane AG (GSS), was put in place for the network of integrated health care. All eleven communities in the Saanenland, the Simmental and the Niedersimmental are involved. The Simmental and the Saanenland split the share capital of CHF 100,000. The municipality of Saanen’s share is CHF 43,280, Gsteig will cover CHF 3,380, Lauenen CHF 3,340, Zweisimmen CHF 14,310 and Lenk CHF 10,990. An operating budget of CHF 330,000 for the GSS was also guaranteed until the end of 2020. The Saanenland and the Simmental communities will each pay one third, with the remaining third covered by the canton and the STS AG.

Proposal ready for the vote late in 2020
The chairman of the GSS board, Stephan Hill, is looking forward to the challenge. He is aware, however, that it will be a lot of work. The tasks of the GSS include setting up and operating the integrated network. With regard to the hospital services, the two variants would need to be developed still further for preparation for a proposal ready for voting. The voting population would ultimately determine the outcome in both valleys.

"Rather be part of the solution"
It was a special evening for STS AG, stressed chairman Thomas Bähler. “We’ve heard about everything that’s been worked on, and don’t feel quite so alone as a hospital STS”. He particularly likes the fact that the proposed solution from and for the region in collaboration with the STS and the canton.

How much is it worth to the population?
The co-presidents of the organisation Obersimmental Saanen, Toni von Grünigen and Albin Buchs, adopt a cautiously positive outlook and ask the public to get involved, to discuss this vital issue for the regions, and to stay calm and realistic event though the topic tends to cause a stir.

“The communities will have to decide if and how much we want to pay for our healthcare. It’s our chance to have a say in what our health care should look like in the future”, emphasised von Grünigen. Buchs joined his colleague in office: “We now have the chance to have a say in the matter. There will be a cost, but I think our health care is worth it.”

Based on AvS/Anita Moser
Translated by Justine Hewson