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The Architect's Journal No 23 Vol 229 June 2009 _ Ennobling the ordinary?
The last decade prior to the recession has witnessed an increasingly debilitating polarisation between extravagant ‘iconic’ architecture, laden with poetic, metaphoric references, and commercialised ‘generic’ buildings driven by naked market forces. These amount, in effect, to two branding levels within the system of competitive individualism in architecture – an architectural expression of an economic system that has now collapsed. In the UK, one of the most stereotypically downmarket of all building systems has been the private finance (PFI) programme of social building, whose relentless principle of cost-cutting competition has scattered countless shoddy, banal school buildings across the country.
Hitherto, attempts at reforming the architectural deficiencies of PFI have perpetuated, or even accentuated its competition-led system, by adding design quality as another factor within the competitive process – with predictable results. Reiach and Hall’s newly completed Ambulatory Care and Diagnostic Centre (ACAD) at Stobhill Hospital, Glasgow, suggests a radically different way out of this quandary: not by ‘adding design’, but by curbing competition. In this way, hopefully, many of the best features of the golden age of welfare state building, including its combination of consistency and originality, could be revived, without also reviving the organisational chaos of many projects of that period.
For the 1960s and 70s were years of very high aspiration and debate in hospital architecture, with constant architectural innovation sustained by a system of negotiated building contracts. No sooner had the multi-professional ‘Nuffield’ pattern of the highly serviced ward tower/services podium been generally accepted, than a new generation of architects got to work, devising a more horizontal, courtyard-centred pattern. This pattern was pioneered in RMJM’s Ninewells Hospital in Dundee (commissioned 1956, built 1963-74), the UK’s first new postwar teaching hospital, its low, stately building mass comprising a central concourse flanked by hospital and medical school. But at the same time, these often innovative hospital designs, with their constantly changing values of hospital ‘community’, and scientific management, sometimes proved almost impossible to get built and (if completed) alienated many users. At Ninewells, the project took nearly 20 years to design and construct, including disastrous feuding between contractors and designers, while at RMJM’s contemporary in-situ redevelopment of Edinburgh Royal Infirmary, it took 20 years before the first phase was commenced, whereupon the redevelopment scheme was completely abandoned!
In response to these protracted controversies, UK hospital design in the neo-capitalist age became polarised between PFI projects emphasising slick, hotel-like corporate complexes on greenfield sites, and the absurdly exaggerated stylistic individualism of the ‘Maggie’s Centres’, each thumbing its nose at a next-door NHS hospital – as with Frank Gehry’s puny cluster of jabbing roofs at Ninewells. But the real challenge of 21st-century hospital design is how to ennoble the ordinary hospital, often a haphazard complex requiring partial or multi-phase redevelopment, so that it can project the ethos of humane care expected by all today. Reiach and Hall’s Stobhill project provides an intriguing pointer towards an alternative way forward: to moderate the competitive process of PFI, with its cost-cutting vagaries, by nominating a single contractor, allowing the designers the freedom to develop innovative solutions to the challenges of multi-phase development.
New Stobhill hospital is both the first built example in Scotland of this (originally) American concept of a non-residential hospital, and at the same time the first part of a staged redevelopment of a typical local suburban hospital, originally built in 1901-4 as a poor-law hospital in the form of a grid of low, rather banal brick and timber, with the sole ‘architectural’ accent of a water tower, and now in a state of terminal dilapidation. The site for the ACAD has been created by demolition of the southernmost ‘slice’ of this grid – three Nightingale wards – on a site that, significantly, faces not a bright open view but a featureless embankment, soon to be shielded by tree planting. To the north, a potentially panoramic outlook is blocked by the residue of the old hospital.
The project has to serve both as a self-contained pioneer of a new healthcare building type, and as the first part of a redevelopment. Although originally envisaged as a standard PFI project, with three competing consortia, by a stroke of luck only the one in which Reiach and Hall were involved entered the bidding process, in 2003. Thus the architects were able to start reshaping the project at an early stage. Their overall approach was to design a building that would be ‘distinct’ from a traditional hospital, yet which would also avoid an image-led, gestural approach. And the two parallel purposes of the project – as ACAD unit, and as first-stage redevelopment – had each to be appropriately expressed. As a result, it was decided to design an externally modest and open-ended, even ‘unfinished’ project, allowing for extension, with the main unifying architectural elements reserved for the interior: Reiach and Hall’s own practice heritage, rooted in the Scandinavian and Eastern Scottish modernism of the 1950s and 60s, ruled out in principle any ‘signature’ or ‘iconic’ approach. Structurally, too, a relatively lightweight system of steel framing with cladding would allow for the easy adaptation and extension that seemed almost inevitable: Reiach and Hall had learnt from their first major hospital commission in the 1980s, Borders General Hospital, that a highly self-contained plan, and monumental construction, risked rapid obsolescence.
The New Stobhill ACAD Hospital combines two main blocks: a massive, deep-plan, four-storey treatment block at the north, and a long, three storey linear block of clinics to the south, the two being linked by a full height, toplit concourse, or ‘arcade’. In any future completion of the hospital redevelopment, the potential is obvious for another, matching linear block to the north, with the treatment block becoming the potential core of any completed hospital; the south (clinic) block is in some ways at the ‘back’ of the site. Externally, the two external ‘faces’ of the ACAD straightforwardly reflect their purposes. The more public north face of the clinic slab, and the whole of the treatment block – all overlooking the core of the redeveloped hospital – are treated in a combination of low-cost materials and elements that project a considerable, somewhat ‘Bauhaus’-like elegance: off-white render, horizontal window-banding, and subtle, three-tone grey cladding panels. The north-west and north-east corners of the clinic block, overlooking the concourse entrances, are formed by partly-glazed, partly brick-clad stair-towers of a restrainedly monumental character. By contrast, the ‘rear’ faces of the clinic block, to south, west and east – their only ‘public’ function being a minor injuries clinic entrance – are treated in a more utilitarian manner, rendered and dotted with small windows, and cropped off somewhat harshly at the top: a dark brick ground-floor links this otherwise rather stark rear section round to the two front stair towers. The slightly jarring contrast in external treatment is not a matter of ‘PFI cost cutting’ – the other facades were just as economically built – but an architectural structuring device to focus attention on the ‘public’ north face of the complex, where any future additions will be made: already, a 60-bed ward block has been authorised, using similar materials but emphasising a more ‘domestic’ character through the use of two-storey angled oriel windows.
The Stobhill ACAD project is integrated, above all, from the inside out, through the device of the central circulation arcade. Crucially, this focal planning element emerged directly from the unexpected, non-competitive bidding process: in 2004, during the official bid period, the absence of competitor consortia allowed Reiach and Hall to embark on an ambitious programme of user research, and to propose the abandonment of the standard PFI solution of sprawling, horizontal circulation, in favour of a stacked circulation system arranged intensively around a vertical concourse. To make this arrangement viable, the departments on either side would also have to be stacked vertically, including the novel feature of a minor-injuries clinic at first floor level. The concept of the ‘arcade’ stemmed specifically from the traditional concern of the Modern Movement to design spaces that could encourage community interaction. In contrast to the shopping-mall-style atria of standard PFI complexes, the intention at Stobhill was to design an individualised sequence of spaces that would help calm visitors and patients. And unlike the gestural egotism of the Maggie’s Centres, or the polarisation in US hospitals between showy public spaces and pinched treatment rooms, the architects were determined that Stobhill should not be ‘dressed up as something else’. Their user research convinced project architect Andy Law that ‘people want, in a hospital, above all, light, air and cleanliness – in other words, they want it to “look not like a hotel or shopping centre but a hospital, thank you very much!” So we aimed to give them a sequence of spaces that would provide reassurance though their high general quality. Our hospital emphatically doesn’t want to be a thrusting architectural statement – we simply wanted to design a nice hospital, a quiet place that could help and calm people.’
With this aim in mind, the design of the arcade aimed to lead visitors unobtrusively from the life and hubbub of the central circulation space to the contrasting ‘contemplative’ quiet of the flanking clinics and treatment departments on the first and second floors: the architects were especially influenced by the ‘humanistic’ ethos of the Oslo Rikshospitalet (architects Medplan), although they thankfully avoided the picturesque excesses of its ‘village’ or ‘Italian hill town’ planning. To accentuate this contrast, the arcade was articulated in a forcefully architectonic form, with balconies, bridges and a bold, full height staircase tower in the centre. The unifying effect of the rendered walls is effectively offset by the differentiated treatment of the side walls, with small, banded openings fronting the clinical departments, but a more open, framework-like front to the clinics. The transition from arcade to clinics is particularly cleverly handled, with archway-like openings leading into lower, quieter waiting areas, each overlooking one of the six larch-clad internal courtyards. As part of the effort to alleviate the anxieties of waiting, art-works of an unobtrusive character, such as video installations of imperceptibly moving trees (coordinated by Tom Clark), are dotted around the waiting areas.
Could the new Stobhill Hospital, then, be an indication of a potential post-recession way forward for public architecture, drawing on the best of ‘original’ Modernism while avoiding the pitfalls of its often interminable development processes? In quietly idealistic projects such as this, we can begin to discern a way out of the quagmire of Iconic Modernism, re-ennobling everyday collective architecture.
Miles Glendinning
ISSN 0003 8466 _ copyright The Architect's Journal 2009
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