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    Reference: 20200572
    Release date: 11 May 2021

    Promoter – Financial Intermediary




    The project will finance the construction of the new emergency department for the San Martino hospital in Genoa (Italy).

    Additionality and Impact

    This project concerns the construction of the new emergency department of the San Martino hospital in Genoa (Italy). It addresses the sub-optimal investment situation in the European health infrastructure due to market failures originating from the public goods nature of hospitals and the large health externalities they generate. The project generates benefits through the provision of improved hospital  and emergency care and the reduction of energy consumption. The project will bring benefits to the infrastructural capital of the local and regional healthcare system, allowing for increased resilience and effectiveness in addressing the evolving needs of the population regarding rapid ageing and epidemiology. The investment  is consistent with the local authority and region's efforts to continue the sustainable delivery of medical services as requested by a national health system centred on the universal access to basic, guaranteed levels of care. The plan will contribute to the reorganisation strategy of the hospital, including logistic, clinical, care and economic dimensions. The immediate outcome will be an improved quality, safety and efficiency in the service delivery. A more resilient healthcare system will also contribute to the maintaining of social, living and working conditions for the affected population.
    From a financial point of view, the Bank's loan will provide a valuable contribution to complement available resources. The tenor and other terms of the Bank's financing are currently not available at comparable conditions on the financial market and ensure that the tenor of the loan aligns to the economic life of the asset to be financed. In addition, the lower cost of the Bank's financing improves the affordability of the project as a whole.


    As a healthcare project aiming to improve, upgrade and stabilise the infrastructure capital of the Italian regional public health system, the project responds to the EIB's main infrastructure policy objective, under the subheading of "Integrated territorial development." The project is therefore eligible under Article 309 point (c) common interest.


    • Health - Human health and social work activities

    Proposed EIB finance (Approximate amount)

    EUR 20 million

    Total cost (Approximate amount)

    EUR 40 million

    Environmental aspects

    Hospitals are not specifically mentioned in the environmental impact assessment (EIA) Directive 2014/52/EU amending the Directive 2011/92/EU, though the project is covered by Annex II of the Directive in relation to urban development. The EIB's services will verify during appraisal the screening decision of the competent authority. In line with Directive 2010/31, the building will have to meet at least the relevant national targets on energy efficiency. The energy performance of the new hospital block and any specific related targets to be met will be verified during appraisal. It is expected that the project will bring wider 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 subject to EU rules on public procurement or concessions. However, if at the project appraisal, the EIB were to conclude that the promoter is subject to EU public procurement legislation, then the European Commission will be duly informed, which will require the promoter to apply those rules. The project has been procured by the public health authority (San Martino Hospital) as a public private partnership (PPP) arrangement, under the article 180 and 187 of law decree 50/2016 regulating public contracts, using a 'leasing in costruendo' arrangement. Decree-law 50/2016 (Italian public contract code) constitutes the national transposition of EU procurement legislation: Directive 2014/23/EU, 2014/24/EU, 2014/25/EU, 92/13/EEC or 89/665/EEC. The project will be implemented by the private consortium explicitly set up to jointly bid for the tender and which was awarded the Public-Private Partnerships (PPP).


    Signed - 15/03/2022


    Before financing approval by the Board of Directors, and before loan signature, projects are under appraisal and negotiation. The information and data provided on this page are therefore indicative.
    They are provided for transparency purposes only and cannot be considered to represent official EIB policy (see also the Explanatory notes).

    Related tags

    Italy Health