Gordon Brown is back in his home town, Kircaldy, Fife, on Friday to open the latest Maggie’s Centre for cancer patients. Good news for all: a new healthcare building, on time, on budget (£1 million) — though it won’t cost you the taxpayer a penny (it’s self-funded) — and architecture to blow you away.
Maggie’s consistently commissions buildings not from nicey nicey architects but stellar weirdos such as Frank Gehry and Daniel Libeskind — thereby single-handedly becoming Britain’s bravest architectural patron. And it’s this small charity, not some megarich bank, not some fancy property developer, and certainly not anything remotely to do with, er, Gordon Brown’s Government, that has had the balls to open the first British building by one of the world’ s most exciting architects, Zaha Hadid, after years during which we, her adopted country, have shunned her.
The point of Maggie’s is simple, honed through successive centres built by various architects in the decade since the death of its founder, the landscape architect Maggie Keswick Jencks, who wrote movingly in A View from the Front Line of her experience as a cancer patient in NHS hospitals; how hospital environments say to the patient: “How you feel is unimportant. You are not of value. Fit in with us, not us with you.”
She proposed, instead, the exact opposite of what hospital had become: a “modest” uninstitutional home from home “which will encourage and not intimidate”, where you could pop in, talk through all the information you’re bombarded with, have a cuppa, a bit of peace, a blub, doze off, listen to music, look at views, potter in a garden. Take control.
Hadid has definitely delivered stimulation. It’s what she does, architecture like the mark of Zorro in go-faster stripes. It’s small, just a little pavilion, but it packs an architectural punch, a wee coiled spring of energy thrusting this way and that, proving that she’s the most spatially thrilling architect around.
Whether such immodest, restless and, well, intimidating architecture is quite what you want after chemo, or best suits the Maggie’s spirit, especially delivered in funereal black and entirely plastered in what feels to my grazed elbow like sandpaper, is a moot point.
“People go to extreme landscapes and find them comforting,” Hadid counters. “Elation can soothe.” Maybe. It does at least have the space, the clarity, the quality and the tranquillity common to Maggie’s Centres.
These remain a rebuke to the NHS, their spaces so far removed from the average experience of healthcare as to be absurd. Since Jencks’s death, of course, the Government has kickstarted the biggest hospital-building programme in the world. But you will see little evidence of it in the Victoria Hospital next door to the new Maggie’s Centre, with its low ceilings, natural light rationed like gold dust, soul-sinking labyrinthine corridors, plus a few Blairite sticking plasters — a new logo, a new café.
Talk to many in the profession, though, and there’s cautious optimism that maybe, just maybe, the drum beaten by Maggie’s and others is finally being heard. “It’s not that we didn’t know what might make the experience of healthcare better,” says Professor Bryan Lawson, of Sheffield University, Britain’s leading expert on healthcare buildings and advisor to the Department of Health. Indeed, pioneering research done in the mid-1980s by Professor Robert Ulrich in America found that patients with views recovered faster and with fewer painkillers than those without.
This merely confirmed what Berthold Lubetkin knew in the 1930s when he built his magnificent Finsbury Health Centre: pleasant environs, clear, logical spaces, light, views and a sense of optimism in your surroundings heal you better — and cheaper.
It’s been tough, says Professor Lawson, getting that message through the vast bureaucratic padding of the NHS. “Spending time and money early on on these can save huge amounts in running costs,” he claims — up to 20 per cent. An abrupt about-turn took place in February after the first mega-hospital schemes threatened to be financially unviable, when Patricia Hewitt’s White Paper shifted the programme to smaller cottage hospitals — interestingly after Professor Ulrich’s nine-month secondment to the DoH.
Mega-hospital contracts already under way, such as the troubled Royal London and Bart’s in East London, were redesigned after heavy criticism from the Commission for Architecture and the Built Environment (Cabe), the Government’s architecture and design watchdog, and most scaled down or even cancelled because they threatened to repeat past mistakes “and were not suited to the new community focus”, says Kate Trant from Cabe. “The geography and architecture of how we provide health is changing,” she says, with fewer big specialist centres and more smaller local ones imbued with more of the Maggie’s spirit and rooted in communities.
“There are more pretty good new buildings out there than you might think,” says Mike Nightingale, the head of one of Britain’s biggest health-specialist architects, Nightingale Associates. And it’s success stories that generate public confidence, such as Hopkins Architects’ Evelina Children’s Hospital, shortlisted for this year’s Stirling Prize and winner of the “public vote” for its elegant, back to basics design — lots of light, trees, banning of mind-numbing corridors — all on a good-value design and build contract.
But design, Trant says, is still generally too far down the agenda, “seen as superficial, about paint colours”. NHS trusts are still, says Nightingale, “very patchy” in their ability to manage big building projects and judge good design. PFI contracts, he adds, while getting better, are still too ill-focused and bureaucratically unwieldy.
Trant contends that the joined-up, lateral thinking that Maggie Jencks pioneered has to be the future. Cabe is examining, for instance, how the shape of buildings and cities may contribute to obesity. Health extends from breakfast to bedtime, as well as from cradle to grave.
In the lobby of the Victoria Hospital are models of three rival schemes for its extension. You know what, they don’t look too bad. Progress? Possibly.
