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Hospital-City

Published online by Cambridge University Press:  11 April 2016

Jonathan Hughes
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Perhaps the greatest contribution made by the industrial town was the reaction it produced against its own greatest misdemeanours; and, to begin with, the art of sanitation or public hygiene. The original models for these evils were the pest-ridden prisons and hospitals of the eighteenth century: their improvement made them pilot plants, as it were, in the reform of the industrial town.

Lewis Mumford, 1961

An association between clinical and civic design has long been suspected — and indeed occasionally explicitly invoked — by commentators on architecture and urban design. Certainly, Mumford is not the only historian to have proposed a symbiotic relationship between hospital and town planning over the last two centuries or more. Yet the twentieth century has surely witnessed an intensification of this relationship, an intensification which points to a definite qualitative — if not even quantitative — shift. This article seeks to reconsider this relationship as it manifested itself in Britain after the Second World War, to investigate the similarities and points of contact between what are often considered by their practitioners to be two quite distinct discourses. It aims to do so through a consideration of a single major project, one which clearly exhibited characteristics of debates which manifested themselves in a more diluted form across numerous other schemes. This building, Greenwich District Hospital (1962–74), was one of two ‘heroic’ hospital projects undertaken in Britain during the 1960s and evidences a plethora of concerns prevalent at the time. Whilst flexibility was a fundamental desideratum, a consideration of the project’s zoning of functions and circulatory logic also reveals a profound affinity with the concerns of modernist urbanism. Moreover, it was not simply a case of hospital design plundering town-planning models for its own use; British urban theory may itself have owed a debt to clinical planning, each discourse involved in processes of specialization, separation and sanitization indicative of capitalism’s need to order and render controllable the phenomena of everyday life. Furthermore, this equivalence of architectural intervention at the level of both the hospital and the city plan raises important questions about modern society’s conception of safety, health and the environment.

Type
Research Article
Information
Architectural History , Volume 40 , 1997 , pp. 266 - 288
Copyright
Copyright © Society of Architectural Historians of Great Britain 1997

References

Notes

1 Mumford, Lewis, The City in History: Its Origins, Its Transformations, And Its Prospects (London, 1961), p. 474 Google Scholar.

2 Stone, Peter, ‘Hospitals: The Heroic Years’, Architects’ Journal (15 December 1976), pp. 1121-48Google Scholar.

3 The other project being Northwick Park Hospital (1960-74) in north London, by John Weeks (of Llewelyn-Da vies Weeks). Northwick Park addressed the same questions of flexibility and change as Greenwich but did so in a radically different manner, proposing ‘indeterminate’ buildings which paralleled (in a less fantastic manner) the work of Archigram.

4 Giedion, Siegfried, A Decade of New Architecture (Zurich, 1951), p. 183 Google Scholar.

5 Friesen, Gordon, ‘Mechanization and Hospital Design’, Architectural Design (January 1961), pp. 7–9 Google Scholar.

6 Fits and spasms being the obvious exceptions.

7 Richard Crossman, Secretary of State for Social Services, inaugurating Greenwich District Hospital, 24 October 1969. Quoted in Sharman, M., ‘Greenwich District Hospital: £6,000,000-Worth of Just What the Doctor Ordered?’, Building Design (December 1969), pp. 13–23 Google Scholar.

8 Sharman, ‘Greenwich’.

9 Four courtyards were originally envisaged but only three built.

10 Noakes, Anthony, ‘Greenwich District Hospital: A Personal Assessment’, Health Service Estate, 41 (March 1979), pp. 11–20 Google Scholar.

11 ‘District Hospital’, Architects’Journal (26 November 1969), pp. 1369-80.

12 ‘Manplan 6: Health & Welfare’, Architectural Review (May 1970), pp. 337-40.

13 Watson, Julian, ‘A Brief History of the Hospitals’, in Greenwich and District Hospital Management Committee, 1973 Annual Report (London, 1973), pp. 14–25 Google Scholar.

14 See for example: ‘Hospital Experiment’, Economist (23 May 1964), p. 843; ‘Experiment at Greenwich’, Architects’ Journal (27 May 1964), p. 1170. The Architects’ Journal boldly noted elsewhere: ‘[Greenwich] may turn out to be both aesthetically and technically the most important architectural contribution yet made by any Ministry research and development group’; see ‘Greenwich District General Hospital’, Architects’ Journal (3 June 1964), pp. 1263-68.

15 Ministry of Health: National Health Service, A Hospital Plan for England & Wales (London, 1962)Google Scholar. See also the subsequent revisions in 1963, 1964 and, most importantly, 1966.

16 It was thought that reduced cross-infection of patients (due to the air-conditioning) would offset this. See Diprose, Alan, ‘Greenwich DGH: Conference and Progress Report’, Architects’ Journal (11 January 1967), pp. 61–62 Google Scholar. Dr J. S. Fairley (Senior Admin. Medical Officer, SEMRHB) confidently stated that ‘the great fund of knowledge gained from the project has already made any extra running costs worthwhile.’

17 Sharman, ‘Greenwich’.

18 ‘The Work of the Research & Development Groups, IV: The Ministry of Health’, Official Architecture & Planning (February 1963), pp. 145-46.

19 Nuffield Provincial Hospitals Trust, Studies in the Function & Design of Hospitals (London, 1955)Google Scholar. The Trust sponsored pioneering research into hospital design after the War in the absence of State-funded research. Its departmental studies were widely influential, but drew short of analyzing the whole hospital.

20 The approach sought to assign building costs to departments via their dimensioning in ‘functional units’, i.e. measuring the capital cost of a central kitchen in terms of the number of meals produced, or a ward in terms of its bed complement.

21 Ministry of Health, The District General Hospital (Hospital Building Note 3) (London, 1961)Google Scholar.

22 For Powell’s career see Cosgrave, Patrick, The Lives of Enoch Powell (London, 1989)Google Scholar. See especially pp. 170-75 on his period as Minister of Health.

23 The expenditure on new buildings in 1961–63 was greater than that of the previous thirteen years. See Cruickshank, Herbert J., Planning, Design & Construction of Hospital Buildings for the National Health Service (London, 1973), p. 9 Google Scholar. The Hospital Plan was itself subsequently revealed to be funded by increasing prescription charges to recoup £65m per annum.

24 Ministry of Health: National Health Service, A Hospital Plan for England & Wales (London, 1962)Google Scholar. See also the subsequent revisions in 1963, 1964 and, most importantly, 1966.

25 William, and Brown, Aileen Tatton, ‘Three-Dimensional Town Planning’, Architectural Review (September 1941), pp. 81–88 Google Scholar, and (January 1942), pp. 17-20. Also correspondence with the author, January 1995.

26 Tatton Brown has attributed the thinking behind the plan to H. de C. Hastings — editor of the Architectural Review (correspondence with the author, March 1995). The plan was part of Hastings’ and the Tatton Browns’ ‘theory of contacts’ (pre-dating the Smithsons’ insistence on ‘association’, outlined at the 1937 CIAM conference (see: ‘Communication du Groupe Anglais’, in Congrès Internationaux d’Architecture Moderne, Logis et Loisirs: 5e Congrès CIAM Paris 1937 (Boulogne-sur-Seine, 1938), pp. 79-80). The plan is illustrated in: Modern Architectural Research Group, New Architecture (London, 1938), p. 12 Google ScholarPubMed. The plan was reworked into its spine-and-branch form by Arthur Korn et al, 1938–42.

27 Brown, Aileen Tatton, ‘Fifty Years Hence’ in Britain and the Beast, ed. Ellis, Clough Williams (London, 1937). pp. 298–308 Google Scholar.

28 Williams-Ellis, Clough, Britain and the Beast (London, 1937), p. xviii Google Scholar.

29 ‘Chief Architect With A Purpose’, Hospital & Health Management (February 1961), pp. 51-56. This may be compared with Churchill’s 1944 description of post-War housing construction: ‘I hope we may make up to half a million of these [prefabs]. The whole business is to be treated as a military evolution ... As much thought has been and will be put into this plan as was put into the invasion of Africa’ (quoted in Jackson, Anthony, The Politics of Architecture: A History of Modern Architecture in Britain (London, 1970), p. 164 Google Scholar).

30 For an early exposition see Oddie, Guy, ‘The New English Humanism: Prefabrication in Its Social Context’, Architectural Review (September 1963), pp. 180–82Google Scholar. See also Saint, Andrew, Towards a Social Architecture: The Role of School-Building in Post- War England (London, 1987)Google Scholar.

31 Ministry of Health job architect: Michael Bench, in association with Liverpool RHB architect T. Noel Mitchell.

32 Ministry of Health job architect John Ward, in association with South West Metropolitan RHB architect Richard Mellor.

33 For the history of the vierendeel see Wickersheimer, David, ‘The Vierendeel’, Architectural History (U.S.A.) (March 1976), pp. 54–60 Google Scholar.

34 On a 1961 research trip to the US, the Ministry architect John Green had noticed that structurally sound buildings were being demolished since they could no longer accommodate changing servicing requirements. The American solution was to use long-span reinforced concrete slab floors and columns (like Le Corbusier’s Dom-ino) with few permanent internal load-bearing walls (See Eden, J. F. and Green, John, ‘The Integration of Building & Engineering Design in Hospital Building: A Review of American Practice’, RIBA Journal (July 1963), pp. 273-76Google Scholar).

35 Illustrated in Ministry of Health, A Traffic and Organization Survey for Hospital Redevelopment: Description of a Pilot Survey (London, 1964)Google Scholar. See also Holroyd, W. A. H., Hospital Traffic & Supply Problems (London, 1968)Google Scholar.

36 Its goals being ‘economy, flexibility, reliability, security and stability’. See Goodman, Howard, ‘Greenwich District Hospital: An Exercise in Logistics’, Hospital Management, Planning & Equipment (October 1966), pp. 574-77Google Scholar.

37 ‘Problems and Solutions — Greenwich — II’, British Hospital Journal & Social Science Review (30 May 1969), p. 1029.

38 Sharman, ‘Greenwich’.

39 A similar plan had been used at Bellevue Hospital, New York, again with an emphasis on large unimpeded floor areas.

40 ‘Ministry Experiment With an Original Design at the New Greenwich District Hospital’, British Hospital & Social Service Journal (19 June 1964), pp. 856-58.

41 On linear cities see, for example, Collins, George R., ‘The Linear City’, Architects’ Year Book, 11 (1965), pp. 204-17Google Scholar.

42 For a discussion see, Starkie, David, The Motorway Age: Road and Traffic Policies in Post- War Britain (London, 1982)Google Scholar.

43 Ministry of Transport: Traffic Signs Committee, Report of the Traffic Signs Committee (London, 1963)Google Scholar, para. 13.

44 Ministry of Transport, Traffic in Towns: A Study of the Long-Term Problems of Traffic in Urban Areas (London, 1963)Google Scholar.

45 For a discussion of Buchanan’s career, see Bruton, Michael, ‘Colin Buchanan, 1907-’, in Pioneers of British Planning, ed. Cherry, G. E. (London, 1981), pp. 203-23Google Scholar. Buchanan’s interest in the car and the modern city had already surfaced in his 1958 work Mixed Blessing (London, 1958).

46 London County Council, The Planning of a New Town (London, 1961)Google Scholar. The Smithsons’ Haupstadt Plan (c. 1958) had already proposed a multi-level circulation system.

47 Ministry of Transport, Traffic in Towns, p. 41.

48 Weeks, John, ‘Indeterminate Hospital Design on Urban Sites’, Hospital Management Planning & Equipment (December 1964), pp. 507-16Google Scholar.

49 Ling, Arthur, Runcorn New Town: Master Plan (Runcorn, 1967)Google Scholar.

50 Designed by Runcorn Development Corporation (Roger Harrison) c. 1967-72. See ‘Runcorn Main Shopping Centre’, Architects’Journal (21 June 1972), pp. 1377-92.

51 Ling’s theory did not rule out the possibility of interspersing discrete residential and industrial areas along the local traffic spine; nonetheless at Runcorn these areas were rigidly segregated on either side of the ‘expressway’.

52 Spencer, Herbert, ‘Mile-a-minute Typography?’, Typographica, 4 (December 1961), pp. 3–16 Google Scholar.

53 Wainwright, David, ‘Boss of Britain’s Airports’, Design (January 1967), pp. 32–33 Google Scholar.

54 Naylor, Gillian, ‘Signs of the Times’, Design (December 1966), pp. 48–51 Google Scholar.

55 ‘Lettering on Traffic Signs’, Design (July 1957), p. 54; and, ‘Experimental Road Signs Reprieved’, Design (September 1957), p. 51.

56 See Ministry of Transport: Advisory Committee on Traffic Signs for Motorways, Motorway Signs: Final Report of the Advisor Committee (London, 1962).

57 See Ministry of Transport: Traffic Signs Committee, Report of the Traffic Signs Committee (London, 1963), para. 25. For an overview see Froshaug, Anthony, ‘Roadside Traffic Signs’, Design (October 1963), pp. 37–50 Google Scholar; also, ‘Designing a System for Britain’s Road Signs’, Design (May 1967), pp. 69-71. See also Richards, J. M., ‘Traffic Signs’, Architectural Review (August 1963), pp. 82–85 Google Scholar.

58 Architects: Richard Mellor, Architect to the South West Metropolitan RHB in association with R. A. H. Ruth and A. Gear.

59 Correspondence from Margaret Calvert, February 1994. Jock Kinneir was unwilling to discuss the signing project.

60 ‘Introduction’, in British Airports Authority, British Airports Authority Sign Manual (London, 1972), n.p. (The Manual was devised by Kinneir Calvert Tubili.) The approach was typical of the post-War Modernist ‘Swiss typography’; as one typographer put it, ‘exacting artistic postulates or creations are no longer involved; the endeavour is simply to find a formally and functionally satisfactory answer to daily requirements.’ See Ruder, Emil, ‘The Typography of Order’, Graphis, 15 (September/October 1959), pp. 404-13Google Scholar.

61 ‘Townscape: The Perfect Symbol’, Architectural Review (August 1952), pp. 127-29. See also, Wright, Edward, ‘The Arrow in the Road’, Typographica (old series), 13 (1957), pp. 18–21 Google Scholar.

62 Price, Cedric, ‘Graphics; Where Next?’, Design (August 1964), pp. 28–31 Google Scholar.

63 Mosley, James, ‘The Nymph and the Grot: The Revival of the Sanserif Letter’, Typographica, 12 (December 1965), pp. 2–19 Google Scholar.

64 Saunders, Hilary, The Middlesex Hospital: 1745-1948 (London, 1949)Google Scholar, title to chapter 6.