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I’m on holiday with friends and we’re driving through a picturesque little town, all cobbled streets, grey stone gables and slate roofs. One building, though, stands out like the proverbial sore thumb – only picture a thumb where necrotising fasciitis has set in and is tracking rapidly towards the elbow.
‘What would you guess that is?’ asks my friend. She’s local and knows perfectly well, and she winks at me – the party’s only medic – to keep quiet.
‘Toxic waste processing facility?’ says someone.
‘Battery farm?’ someone else suggests.
You’ll have guessed where this is going. Of course, it’s the local hospital. Like so many others, it’s an uncompromising concrete block, looking like something a pathologically unimaginative child might build out of monochrome Lego. Its stark lines are relieved only by an incinerator tower, and its blank greyness only by livid stains of water-damage and mildew.
Why are hospitals often so ugly, and should we care? Surely, when it comes to healthcare, a practical, functional building is worth any amount of aesthetic frills? Maybe so, but all too often these hideous hospitals aren’t even functional.
We’ve all worked in wards which are freezing in winter and stifling in summer, or where rain and condensation puddle at the bottom of ill-fitting windows. And anyway, hospitals are frightening and dismal enough (if you’re the patient) without going out of their way to look like the set of a 1980s horror movie.
The Victorians built handsome mock-gothic castles to house their sick, sometimes complete with turrets. Sadly, their narrow corridors, cavernous ‘Nightingale’ wards and inopportune flights of stairs rendered many of them unusable for modern medical care. More recent buildings remedied these defects, but often at the cost of any consideration for the pleasantness of the environment, or the impression the building might make on an anxious patient approaching its doors.
There is a new generation of hospitals with glass-walled atria, wood panelling and fake-marble floors, but for other reasons I find them no less distressing to look at. These are the fruits of the private finance initiative, a cunning wheeze whereby new hospitals were built with some of the upfront costs met by private corporations, with the NHS undertaking to pay back the money over time – often the next 30 years – together with a hefty profit margin for the company.
These hospitals may not be the eyesores their 1970s counterparts were, but they equally represent bad, short-termist decision making. Sometimes – whether it’s putting up cheap, ugly buildings or falling for too-good-to-be-true financial schemes – the thing that saves money straight away turns out not to be the best idea.
By the Secret Doctor
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I recently revisited the Liverpool Royal Infirmary, a Victorian building. It is astonishingly beautiful.
The Mendip Hospital in Wells opened in 1848 as the Bath and Somerset Pauper Lunatic Asylum. The architect was George Gilbert Scott. It closed in 1991 and was converted into flats and houses
uninspired leadership, and third rate housekeepers in the NHS of today......
Lack of sense of worth and community commitment. There is evidence that a pleasing environment aids recovery .It is also important for morale of patients, visitors and importantly staff. Good quality design is part of caring and should be part of all NHS facilities and not viewed as an indulgent extra.
Even if the entrance looks smart, chances are the elderly are in wards with plain white walls no pictures or tv nor even a clock so they can orientate themselves to the time of day.
New Dumfries and Galloway Royal Infirmary at western end of Dumfries bypass resembles a collection of warehouses. Lovely bright atrium, miles of glass sided corridors and entirely single bedded rooms. Fine if you are feeling really ill, but observation poor. Friend had fall and lay on floor unable to summon help. On other occasion accidentally pulled out drip whilst shaving and again couldn't attract attention. Was anticoagulated and bled profusely but fortunately had presence of mind to apply pressure to stop bleeding . Single rooms can be very isolating and that does not help morale and well-being. "If a patient is fit enough to socialise shouldn't be in hospital"!
Alder Hey Children's in Liverpool is true example of a well designed hospital, in fact designed by children. A pleasing environment does indeed aid recovery and boosts staff morale.
The external appearance is relatively unimportant so long as it is well maintained to make it well proofed against the elements - unlike in this example. It is vital that the inside is fit for purpose:- clean, well maintained, functional, well lit, good lines of site on straight corridors, and compact as possible to allow elderly relatives easy access without exhaustion requiring admission alongside their relatives. I have worked in an array of hospitals around Britain since the 1960's, Victorian, EMS, 1970's flat pack, conversions etc. but don't ever recall anyone patient or staff commenting on the external appearance.