Medical Aspects of Hospital Planning

"I AM living in an ideal world of lifts, gas, baths, and double and single wards," wrote Miss Florence Nightingale (Woodham-Smith, 1949) just over one hundred years ago. She was then 33 years of age and was to live to 90 years, and she had already made her impact on hospital design and had done battle with architects and engineers. Her influence is still to be seen in our hospital buildings today , and it is only since World War II that any successful effort to break with tradition has been accomplished. The point emphasised is that buildings new today will require to be adapted and altered within the next fifty years to meet altered therapies and developments in medical science. Flexibility of design is imperative. It is essential that the architect should have freedom and encouragement to develop the artistic interpretation of his instructions if we are to keep our place in the new era of modern design. An escape from barrack block institutionalism is now on its way and we must keep in the forefront of our minds that these buildings are for patients-anxious, apprehensive people-and that design can contribute much to their sense of security and provide a sympathetic, as opposed to a disinfectant, atmosphere. Since 1948 some £5,500,000 has been spent on hospital buildings in Northern Ireland-new buildings, adaptations, land purchases-and our Government is committed to capital expenditure of a further £15,000,000 on this work during the next ten years. Never in the history of Ulster has so much new work been contemplated and never have so many people been involved. Apart from architects and engineers, doctors and lay members of hospital management committees are vitally interested, and they have much to contribute. A simple discussion of modern ideas from a medical point of view seems opportune and may stimulate interests and intelligent appreciation and enquiry. Many points may touch the controversial and there is no field where the fixed personal ideas of the user and the architectural fight against utilitarianism and functionalism are more likely to conflict. It is proposed to describe some of the work planned or in process of building at the present time in terms of general hospitals. Much is being done for the other half of our patient responsibility-mental illness and deficiency-and as here the interest is more limited, it is not germane to this paper. Something will be said about …