Health: why so uninspired?

HOSPITAL BUILDERS

By Tony Monk. Chichester: John Wiley. 2004. [pounds sterling]50

With the current level of investment in the British National Health Service it is astounding that there is such a shortage of good books on hospital buildings where best practice with regard to both design and models of care are explained through a series of well researched and illustrated case studies.

This new book opens with a survey of hospital buildings and projects since the inception of the National Health Service in 1947. The book is also a homage in part to the impact Powell & Moya had on hospital buildings in the 1960s and their influence on a generation of young architects who worked for them, before they, as did the author, established their own practices in which health projects became a major specialism.

A book that demonstrates an approach to creating and delivering a healing environment has the opportunity to become a very useful briefing tool. The briefing process is critical in hospital design and generally health service managers who are responsible for it, more often than not place a major emphasis on solving technical matters above everything else.

Solving technical and organizational requirements for modern medical practice has over the period this book covers generally resulted in an uninspiring stock of health buildings in the UK. One reason for this is that, while supporting the technical aspects of the healing environment in the past, most clients have ignored the psychological aspects of a design. The author includes a chapter on 'the therapy of a well-designed environment' but makes no reference to the work of Roger Ulrich or Brian Lawson (see 'Healing Architecture', AR March 2002) or even more recently CABE's work on healthy hospitals.

A more rigorous and careful selection of the hospital case studies (including perhaps cross sector examplars) could have considered in more detail the opportunities of the site and setting, those important contextual matters a number of health buildings of this scale and complexity often neglect.

Unfortunately, the book does not respond in detail to the ongoing debate in healthcare buildings over clinical adjacencies versus deep-plan. Furthermore, the case studies could have been selected to demonstrate and disseminate a particular approach or opinion on the design and clinical model proposed. For example the recent programme of health buildings undertaken in and around the Austrian province of Styria (AR March 2002) would have been a good start.