The debate on the future of the Island's hospitals should be welcomed, not least because the Bermuda Hospitals Board is actually inviting public input on the question, and might actually take some ideas up.

That's healthy. Public involvement and support on the issue is key, especially if the BHB does go ahead with plans for a new hospital, which is certain to be remarkably expensive.

The BHB itself does seem to have decided one thing, which is that King Edward VII Memorial Hospital is past its sell-by date and needs to be replaced.

There may be a wide consensus on that point. Certainly medical technology has changed dramatically since the 1960s when the hospital was built, and the infrastructure demands and changes in how hospitals are run have changed too.

The second issue for the BHB concerns the cost of keeping up plumbing, air conditioning, electricity and the like. Assuming that most of these things are decades old, they will be harder and harder to maintain, and unlike schools, offices or homes, you cannot just move out for a few months - albeit with some inconvenience - while the building is rewired and re-plumbed.

The BHB faces the same in terms of gutting and renovating the current structure, which may well be quite sound. What do you do with the patients, nurses, support staff and so on in the meantime?

It could consider doing a floor by floor renovation, but this may not be possible for major infrastructure work. The other alternative is to build on a new site and keep the current hospital going until the new one is completed. Based on Tuesday's public meeting, that seems to be what the BHB has in mind.

That's fine as far as it goes. The major question will be where to build a modern hospital, which must be centrally located and will require some space.

Three potential sites were identified on Tuesday: King Edward's current site, the Botanical Gardens and the Arboretum. Environmental groups have, rightly, reacted with horror to the idea of either the Botanical Gardens or the Arboretum being used, while the current site of the hospital poses its own problems, which have already been cited.

The other alternative is to demolish the "old hospital" on Point Finger Road, where parts of the Education Ministry and the Health and Family Services Ministries are located, and to then incorporate the current site of the Nurses Residence to build a new hospital.

This seems to make the most sense. It is a reasonably big site and is already built on. The Ministries using the building could be rehoused elsewhere. There would, inevitably, be inconvenience during construction, especially for parking, but it still seems to be a better alternative than building on parkland.