Upper Engadine Healthcare: agreements approved through 2029

Context

In brief

• 42% of those entitled to vote went to the polls
• Almost 90% approved the four agreements
• In every municipality, the yes vote reached at least 80%
• Almost 28,5 million francs through 2029

Key facts

• Turnout → 42% of those entitled to vote
• Overall approval → almost 90%
• Minimum approval in municipalities → 80%
• Duration → from 2027 to 2029
• Samedan Hospital → 16,9 million francs
• Nursing homes → 9,9 million francs
• Spitex service → 490’000 francs
• Sanadura management → 1,2 million francs

42% of those entitled to vote in the eleven municipalities of the Upper Engadine took part in the consultation on regional healthcare. Almost 90% approved the four new service agreements with the Sanadura management body, Samedan Hospital, the nursing homes and the Spitex service. In no locality did support fall below 80%.

The vote ensures the continuity of healthcare in the Upper Engadine for the next three years. The agreements cover the period from 2027 to 2029 and, according to the source, offer healthcare providers greater certainty for planning the future. The result comes after a phase in which the future and financing of healthcare provision were submitted several times to the judgment of those entitled to vote.

The package worth almost 28,5 million

The overall package amounts to almost 28,5 million francs. 16,9 million over three years is earmarked for Samedan Hospital; 9,9 million is allocated to the nursing homes, while 490’000 francs are provided for the Spitex service. A further 1,2 million is provided for the management of the Sanadura body. The result therefore brings the hospital, facilities for the elderly, Spitex care and the management body into the same framework, with separate amounts but a common duration.

Services unchanged in Samedan

At the Samedan facility, services will remain as they are today. The provision includes 24-hour emergency care throughout the year, surgery, gynaecology and obstetrics, paediatrics, internal medicine and a semi-intensive care unit. Specialist outpatient services are also planned, as are specialist consultations for dialysis, gastroenterology and oncology, in addition to basic care for emergency and scheduled treatments.

Over the next three years, Sanadura wants to increase bed occupancy, with an expected benefit for the profitability of the infrastructure in St. Moritz and Samedan. The challenge identified by Sanadura Health Council President Isabel Wenger remains the recruitment of qualified healthcare staff.

«Today's result represents a strong sign of confidence in healthcare and means that it can now continue its work. It is also excellent news for the population, guests and staff of the healthcare facilities», Wenger told Keystone-ATS.

Operational details

Comparison with the previous stages

The practical significance of the vote emerges from comparison with the previous stages, not only from the final result. Since April 2025, eligible voters in the eleven municipalities have been called to the polls four times to decide the future and financing of regional healthcare provision. The current decision comes after two rejections and after an agreement approved in spring, valid until the end of 2026.

A different outlook from previous attempts

The first vote rejected the merger with the Ospedale cantonale di Coira. In November, a second rescue attempt was rejected, based on a two-year performance agreement and a cost of nearly 51 million francs. The third vote, held in spring, instead led to the creation of the Sanadura management entity and a performance agreement amounting to 19,5 million francs until the end of 2026.

The new package covers three years and amounts to almost 28,5 million francs. Comparison with the previous proposal therefore shows a longer duration and a different total amount, without requiring further calculations beyond the reported data. Previous votes were repeatedly compared to a bailout because Samedan hospital was drowning in debt. Wenger describes the new outlook as more stable, with funding and services clearly regulated.

A service chain with distinct responsibilities

Sanadura is a public-law entity active since April 1, 2026. Its operating model does not concentrate all services in the same way:

This distinction helps interpret the funding together with the organization. The Board of Directors, composed of seven people and chaired by Michael Rolaz, is responsible for strategic leadership and healthcare management. The Health Council, by contrast, brings together eleven people, one from each municipality, with political and strategic responsibilities.

At the operational level, the source identifies two variables to monitor: increased bed occupancy, linked to the profitability of the facilities in St. Moritz and Samedan, and the ability to find qualified healthcare staff. Those wishing to monitor employment can consult annunci di lavoro, keeping this issue distinct from the decision on the contracts.

Recommended tools

For an updated estimate, use the net salary calculator and the CHF-EUR exchange comparator.

Key points

How to follow the dossier

To track the decision effectively, it is best to turn the material into a checklist. The procedure adheres strictly to the dates, amounts, and responsibilities indicated by the source.

Four steps to interpret the decision

1. Set the reference period. Separate the agreements valid from 2027 to 2029 from the previous agreement, around 19.5 million francs, valid until the end of 2026. This keeps each figure tied to its respective phase.

2. Match the content to the facility. Distinguish between the Samedan hospital, nursing homes, the Spitex service, and Sanadura management. For the hospital, also note that the specified services include both emergency and scheduled treatments.

3. Reconstruct responsibility. Verify whether the service is provided directly by Sanadura or purchased from third parties. For the hospital component, the stated organizational reference is the contract with Spital Oberengadin; for nursing homes, management is directly assigned to Sanadura.

4. Note the two operational indicators. The source links the next three years to the goal of increasing bed occupancy and highlights the recruitment of qualified healthcare personnel as a challenge. These are the two elements to keep separate when assessing the development of the facilities.

On the financial sheet, amounts should be listed next to their respective agreement: 16.9 million francs for the Samedan hospital, 9.9 million for nursing homes, 490,000 francs for Spitex, and 1.2 million for Sanadura management. The total indicated by the source is nearly 28.5 million francs. It is best not to add items not mentioned by the source or turn the overall package into an individual expense.

To complete the overview, also note the governance: Sanadura will be operational from April 1, 2026, with a Board of Directors of seven members and a Healthcare Council of eleven, one per municipality. For the general healthcare framework, consult LAMal/health insurance. To link professional planning to your income, use the salary calculator.

Source: swissinfo.ch