These intense functional requirements must be reconciled with architectural qualities. Reassuring, healing environments are craved by patients, who feel at their most vulnerable while undergoing treatment. What's more, hospitals are likely to be the largest public buildings in any town or city, so they need to maintain a certain civic pride of place.
It's no wonder that hardly any major new hospital has succeeded in pushing all these buttons. As Prince Charles has said: "The patient is almost an afterthought in hospital design." He, Tony Blair, CABE and a succession of health ministers have all campaigned for improvements in the design of health buildings. So why should these buildings fail on their architectural design? Well, one reason is that British architects have steered clear of them. Think about it – which major British architect, other than Sir Michael Hopkins, has designed a hospital?
It's not as if the prospects of work are limited. Hospital development is now more than just healthy – it's positively glowing. As well as 100 hospitals planned by 2010, there will be health facilities of all sizes, right down to refurbished GP surgeries (pages 42-48). But so far, it's mainly American architects who've recognised the unprecedented dynamism of the British health sector, and have walked in through an open door. It is now up to those British architects who are most proud of their design skills to start pumping some life into British hospital design. And it is up to the NHS to cut through PFI procedures and the other red tape that is tying their hands.
The racism in our back yards
Who could fail to be repulsed by Najjif Shah's story (see news section)? The Muslim site worker won £18,575 from an employment tribunal after being racially abused in the wake of 11 September. He was even accused of being a spy for Osama Bin Laden. WPB, who employed Shah's tormentors, is to appeal. But the timing of the case couldn't be worse, coming a week after calls for 300,000 industry recruits. These must include ethnic minorities who still account for less than 2% of the workforce. People, in other words, like Shah. But, despite being on the dole with a family to support, who'd blame him if he never set foot on site again? Contractors won't eradicate racism while it is commonplace in society at large, but they can at least show moral courage by banishing the abusers. The bitter irony of Shah's maltreatment is that it occurred on the CTRL – a project dedicated to improving Britain's connections with the wider world.