A ray of light

A hospital architect by vocation, Ray Moss' impact on the health estate is immeasurable. James Parker interviewed him as he ended his chairmanship of Architects for Health.

Professor Ray Moss' five-year stint as the chair of Architects for Health was only one of many high points in his career as a leading light in the field of design and planning for healthcare, as he told me in the historic surroundings of the Reform Club in London. Ray is the epitome of the term genial as he recounts his development as an architect, which is itself a revealing insight into the formulation of a research base for planning healthcare buildings.

Ray Moss' life was entwined with hospitals from the start. Born in 1926 in a workhouse near Manchester, he spent his early years living in hospitals due to his parents being hospital staff. "I didn't know about anything else," he says.

Witnessing a meeting between a Sheffield architect and his father over a new hospital wing made Ray realise that he wanted to be a hospital architect. He qualified in architecture from Sheffield University having written his final thesis on a hospital design, and left the UK to study hospital architecture at the University of Tennessee in 1951.

However while those who, like Ray, would emerge as the UK's leading healthcare architects, travelled abroad to discover new ways of doing things, "Over here hospitals and schools were the priority," he says. "It was a good thing too," he adds, "because it gave people a chance to think". The 'make-do-andmend' policy of the government in the early years of NHS facilities meant that architects were merely tasked to modernise lift shafts, toilets and corridors.

He came back to the UK in 1953 as the first assistant regional architect, under Guy Aldiss, regional architect for the East Anglian Regional Hospital Board. Thence to the position of senior assistant architect at the South East Metropolitan Regional Hospital Board in London, under Charles Scott: "Probably the best boss I ever worked for, and who indulged my little passion for research and development".

Perhaps the biggest impact Ray Moss has had on the hospital design was in his bringing hardheaded research-based planning to the centre of the design process, as evidenced later by his work with Howard Goodman on the pioneering Greenwich District Hospital. This meticulous approach produced design for every function that the hospital performs, creating spaces for optimum efficiency, both clinically and in the support services. "It seemed to me that where we were coming unstuck was that there were certain special requirements of hospitals that hadn't been properly codified. The idea that things like consulting and treatment rooms had certain requirements that could be set out and classified as a basis for briefing hadn't been tackled in any systematic way," says Ray.

Moss won a RIBA prize for studies in hospital design in 1956, shortly before William Tatton-Brown was made the first chief architect at the Ministry of Health. Ray applied for a job in his office at the R&D Group. He succeeded, joining on 1 January 1960 along with Howard Goodman and Peter Cowan. It was in the next few years that the pioneering R&D developed by Ray and Howard fed into the development at Greenwich, after Ray moved back to the South East Thames regional authority as assistant regional architect. He led the team of regional boards and Goodman the Department's team on the project, which "put a stop to the high-rise hospital".

Ray also began to put his more individual ideas on R&D into practice: "I'd always had a vision of an independent, post-graduate research and development unit. So much of the research work we were doing was aimed at proving Government policy instead of testing it". He resigned from the regional health authority "unheard of at that level," says Ray. Thus he returned to the Southend School of Architecture, working as a senior lecturer, with the provision of time in his programme to develop research at the DHSS. Here he also worked on the Lakeside primary care health centre at Thamesmead.

When the school looked like closing, the convenient opportunity arose in 1967 to create a research unit at North London Polytechnic, which needed to attract research to attain degree status. Thus the Medical Architecture Research Unit (MARU) was formed. Ray also then realised the opportunity to put the research into practice as a consultant architect with the DHSS, as his friend Howard Goodman became chief architect. It was a "wonderful link," between the two bodies, he says.

The biggest contribution to health building that Ray attributes to this academically-based planning framework was the exhaustive 'databases', which detailed design requirements for each area of a hospital, and the accompanying Building Note guidance which is still in use in current PFI schemes, and without which "they wouldn't have been completed in the time". It led to the cost-saving Best Buy, Harness and finally Nucleus templates which standardised hospital design into the eighties. It is an understatement to say that Nucleus has had its critics, but Ray Moss says "if you don't know how to handle it it's like a baby firing a Howitzer".

These databases paved the way for a multi-disciplinary MARU research project entitled `Designing for Reduced Operating Costs,' ('DROC') which took a theoretical hospital and costed and tested its design down to the smallest elements to model possible efficiencies. However the project was dropped as the DHSS's building directorate became the semi-commercial Agency NHS Estates in 1991- "a major, major disaster," says Ray. "The planning network disappeared".

He bemoans what he sees as the lack of the DROC approach in PFI: "Without it people haven't got a real perspective on the cost of hospitals". "People argue about the capital cost, but it's trivial. It was the first time we had the chance to get the problem really in perspective, and it was dropped".

He believes it still has a major role to play: "Space standards and departmental relationships have been adequately researched; what we ought to be doing is using them as a model, through DROC, and finding out if there are any new ways of arranging things to reduce the operating costs of these monsters".

Ray has also been an expert advisor to the World Health Organisation, as well as an international speaker on design, and now continues in private practice in Southend. He is a true statesman of health building, but is also a fierce critic of many aspects of the current scene. For example he attacks the marginalisation of architects and particularly the "laughable" lack of briefing in PFI schemes, and a perceived lack of attention to reducing total life costs. One can only hope that his brand of integrity will survive.

Copyright Wilmington Publishing Ltd. Jan 1999
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