Prince of Wales Hospital, one of Hong Kong's two teaching and research hospitals, should be among the most modern in the city. It should also be adequate to provide quality care for the 1.3 million people living in the area. Instead, there are structural and design-related problems that have led to inefficiency and put lives at risk. Designed in the 1970s and opened in 1984, the hospital is said by frontline staff to be crumbling. Flooding and leaks are serious concerns. The hospital's laboratory can no longer conduct Sars research because it does not meet the required bio-safety standards. The Sars outbreak - during which Prince of Wales was a major centre of infection - showed the need for better infection control facilities. As for design, few recent innovations - such as North District Hospital's vacuum tubes for speeding the delivery of samples to the laboratory for testing - are found at Prince of Wales. Space and layouts are inadequate to deal with an expanded client population or the latest medical equipment, while related services are located far from each other. These factors lend weight to the government's argument that the hospital needs to be demolished and rebuilt, but there are sceptics who need to be persuaded. Their most valid point is that the government has yet to make its case for why a building in use for only 20 years needs to be torn down. The government should provide a full account of its reasoning, and a convincing case for why the $4 billion price tag is necessary. If the structural problems are grave, there is no use continuing to pour taxpayers' money into keeping it standing. But the public, and the legislators who will approve the funding, need to hear a frank assessment on this front. As for the cost, the investment will be worthwhile if the result is a hospital where medical practice and patient care are in line with the community's understandably high expectations. And we should not forget one of the hard-earned insights from the battle with Sars: financial considerations are not the only priority when it comes to public health. Even after the community accepts the need to rebuild Prince of Wales, there will be questions about the project's design and funding. Staff, patients and the community - users of the hospital - ought to be consulted on the facilities and their layout. And if the government presses ahead with its stated intention to bring in private funding and possibly management, the preference will have to be founded on principles of sound governance, not just budgetary expediency. This newspaper is not in the habit of calling for the demolition of 20-year-old buildings. Yet such a move seems warranted for the outdated Prince of Wales structure. The government, however, should state its case clearly, and lay out the alternatives for the Legislative Council and the public to consider.