Ancient problems new ideas

Peter Scher reports on an international architects' seminar in Greece that heard views on possible directions for hospital design in the next century.

A visit to the peripheral general hospital of Papageorgiou, West Thessaloniki, made a telling start to this year's Public Health Seminar of the International Union of Architects. The brand new modern hospital complex was bathed in glorious sunshine while its extensive facilities were inspected by a large band of architects from around the world, all of whom were experts in healthcare building design.

The 750-bed hospital was undeniably impressive and upto-date, thanks in part to some useful EC funding and to a full array of the latest high-tech medical gear. When we saw it in June this 60m project, located on a sunny hillside, was ghostly and silent however, having been unoccupied ever since completion in 1996, with no date set for staffing and putting it into service. `Political reasons' was the only explanation given.

The seminar had the broad theme of "Hospital design at the beginning of the 21st Century". About fifty presentations were made and, while not all of them sparkled or focused sufficiently on looking forward, the most thought-provoking was that of George Mann of Texas A&M University. He dramatised both the threat of a booming world population and also some of the exciting and effective new ways of delivering the ever more desperately needed healthcare. Only real imagination coupled with determination can supply the latter. One such example was George Mann's Orbis project; an aircraft fitted up with a self-contained and professionally-staffed opthalmic operating suite to go to remote third world airfields.

A number of papers threw some light on topics that are currently under discussion in the UK. "The hospital in the 21st century - a hotel?" was the title of the exploration by the German architect, Peter Pawlik, who, perhaps unintentionally, revealed the real inadequacy of this popular but absurdly uninformed approach. Jan Liman and Tomas Jung described the formal evaluation procedure applied to hospitals in the Czech Republic which appears far more sophisticated and open than any that we have. In Japan Yasushi Nagasawa has usefully added to our professional knowhow, and at the seminar he presented some results of his careful and painstaking observations of the environmental consciousness and behaviour of patients in hospital settings.

Among the many contributions from Greek architects at the seminar I was interested by Elpida Tsouriadou's exposition of the challenges to western-style healthcare, Vasilis Tsitomeneas on the provision of social and welfare services entailing more refurbishments and conversions than new buildings.

The explosion of intelligent thinking about health services and healthcare architecture to be seen in central and eastern Europe now is certainly more significant than the cashfocused approach that seems to dominate us here and in the US. Meanwhile the health service needs of most of Africa, Asia and China were neither represented nor discussed at this international gathering.

If these problems have solutions at all it will be little thanks to hospital design as we have known it in the NHS. Seeing the ambitious but still unused Papageorgiou Hospital was a sure indicator of that.

Copyright Wilmington Publishing Ltd. Aug 1998
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