In the debate over expansion at Yale-New Haven Hospital, it is hard to have sympathy for either side. On the one hand, there are those who are now holding up the hospital’s new cancer center, a project that promises to bring jobs to New Haven and make its residents healthier. On the other hand, there is the hospital, which has alienated its neighbors to such an extent that blocking a state-of-the-art medical facility could be politically popular.

There is little question, then, that the state of the relationship between the hospital and its critics has reached a new low. In New Haven Mayor John DeStefano Jr.’s State of the City address this week, he suggested that a new “collaboration” was needed for construction of the cancer center to move forward. Whether the mayor or the Board of Aldermen is truly willing to block construction remains to be seen, but there is little doubt that the next few months will see intensified sparring between Yale-New Haven and its adversaries.

Of course, the reasons for the hospital’s unpopularity are complicated. The focal point of contention has always been the question of whether a large percentage of the hospital’s service workers should be able to unionize. Even as Yale and its unions have moved slowly toward better relations, and despite a new contract signed last year by the hospital and its dietary workers’ union, the struggle between hospital organizers and administrators has grown more and more bitter. And now, that struggle has spilled over into an all-out media war about how well the hospital serves the New Haven community.

But the hospital cannot blame union organizers alone for its problems. The hospital’s alleged misuse of so-called “free bed funds” — charitable donations intended for indigent patients — and its aggressive debt collection practices have created an image of a miserly institution that profits by squeezing the sick and the poor. Likewise, before its police force lost arrest powers in 2002, the hospital demonstrated an unsettling willingness to suppress dissent. Facing legal and political efforts, the hospital changed its ways, but it did so kicking and screaming, complaining that the mismanagement charges were simply the product of union complaints. True, they may never have come to light but for the hospital’s labor troubles — and unionization is not a cure-all for them — but that doesn’t make them any less worrying.

At the same time, it is hard to stomach the stonewalling of the cancer center. This project is the kind cities fight to get, promising economic benefits and a top-flight extension of one of the nation’s best hospitals. If New Haven’s leaders are willing to sacrifice the cancer center out of spite for the hospital, they will be doing their constituents a great disservice.

That’s why it’s time for the hospital to begin repairing a badly broken relationship with its workers and the New Haven community. A first step is for the hospital and labor organizers — perhaps with a push from Yale President Richard Levin, who holds a powerful seat on the institution’s board — to agree on the procedure for a fair, secret election on unionization that will be free from intimidation on either side.

The struggle between Yale-New Haven Hospital and its critics is enough to make us give up and declare a pox on both their houses. But in this case, the city has too much at stake for this deadlock to continue.