Building a new Southampton Hospital on the Stony Brook University campus in Southampton makes good sense both for health care on the East End and for better use of an underused campus. It would knit together the skills of a major teaching hospital with the community ties of the existing Southampton Hospital, which would retain its own identity. It's a complex transaction, but one that could be the start of higher-quality care for the medically underserved East End.

For years, Sen. Kenneth LaValle (R-Port Jefferson) pushed for a hub-and-spoke approach, linking East End hospitals with Stony Brook. Then, in 2006, the state's Berger Commission on restructuring hospitals and nursing homes recommended just that. The result has been various levels of collaboration between Stony Brook and the three hospitals of the East End Health Alliance: Peconic Bay Medical Center in Riverhead, Eastern Long Island Hospital in Greenport, and Southampton.

Now, under the letter of intent that outlines the plan, ties between Stony Brook and Southampton would get much closer. The smaller hospital would operate under Stony Brook's license, which would mean far better reimbursement rates than Southampton now gets. And it would do this in a new building on the Stony Brook Southampton campus, to be built with private money to be raised by Southampton Hospital.

Can that money be raised? Assemb. Fred W. Thiele Jr. (I-Sag Harbor) has no doubts. But money isn't the only issue. That new building's design should take account of a trend toward a greater percentage of ambulatory care in relation to inpatient care in hospitals.

Thiele is also convinced the hospital will bring new energy to the campus. Thiele and LaValle now seem to have patched up differences with Dr. Samuel L. Stanley Jr., the Stony Brook president, from two years ago, when fiscal and academic realities forced the university to close dorms on the campus that it had bought from Southampton College in 2006. Along with the hospital building, there's also the possibility of students living in dorms and studying the health sciences.

Though a revived campus would be a benefit, this is primarily about better health care, which this part of the Island needs -- the staff of a community hospital treating community-level illness, backed up by the tertiary care resources of Stony Brook. This step for Southampton should lead later to stronger ties with the hospitals in Riverhead and Greenport, to further the integration that the Berger Commission had in mind.

But getting this new structure from a long letter of intent to a final agreement between Stony Brook and Southampton Hospital won't be easy. Both have plenty of due diligence to do. Stony Brook is a state institution, which means this arrangement will need multiple approvals. There's also the fundraising, the delicate issue of retaining private sector union workers at Southampton, board approvals by Southampton College, and the future of Southampton's 16 satellite locations.

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Stanley, Southampton Hospital's president, Robert Chaloner, and Dr. Kenneth Kaushansky, the dean of Stony Brook's medical school, have done a lot of work to get this idea this far, and they have plenty of complicated work remaining. But for the health of our East End, this is a tremendously important start.