Run-down Crawley Hospital needs £3.2 million in repairs to bring it up to scratch, according to a new report.
Consultants who carried out a survey on the 50-year-old building say the main structure is sound and could last another 50 years.
But the inspectors say a massive cash injection is needed to reverse the effects of years of underspending.
In particular they say the windows all need to ripped out and replaced at a cost of £1.6 million because their condition is "irretrievable".
The report is now in the hands of the South East and North West Sussex Health Review panel, which is deciding the long-term future of health services in Crawley and Horsham.
The group is looking at six options. One is to build a new hospital at Pease Pottage and close Crawley.
Another is to expand North East Surrey Hospital, Redhill, and close Crawley or further downgrade it into a community hospital with day surgery and outpatient facilities.
The survey was commissioned because of the importance of the fabric of the building to the final decision.
The report says it could be preserved but continues: "To achieve this, better monetary budgets must be provided to ensure that proper planned maintenance is undertaken for the building's remaining life, than, perhaps, has occurred to date."
The group is expected to make its decision known by the end of the year.
Crawley Hospital Campaign spokesman Chris Bird said underspending on the building was consistent with underspending on health care in general in the town.
He said: "The window frames are falling to pieces. It's not just Crawley Hospital which is run-down but the patients as well."
A spokeswoman for Surrey and Sussex Healthcare Trust said it had spent £600,000 on repairs to the hospital in the three years it had been responsible for it.
She said: "It is the trust's strategy to concentrate on redeveloping Crawley Hospital and a great deal of planning is going on and budgeting for this."
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