by Takero Shimazaki
Fourth Door Review is a publication that I have never come across before. It tackles complex and diverse issues with simply written yet inspiring text and beautiful imagery. It is actually more enjoyable and informative than some straight architectural and design publications, mainly due to its holistic approach to each subject. It mixes ecology, design, technology, fashion and music with healthcare.
Issue seven focuses comprehensively on the Architexts section, discussing the complex themes of Architecture, quality of environment, sustainability and health. It draws on examples from some of the recent ‘target-obsessed’ NHS healthcare projects, as well as Charles Jencks and Maggie Keswick Jencks’ Maggie Caring Centres movement:
My own studio has recently completed main entrance buildings at York and Birmingham Heartlands Hospitals, and is working on a new timber hospital project. So I read these articles with both optimism and caution. We know that attitudes towards healthcare buildings are changing, and that various groups have been set up to both promote and monitor better design in this sector. As the articles mention, however, there is still little consideration given within the sector to ‘a holistic approach’ where issues such as ‘time, identity and lived memory’ are weighed alongside function in the architecture’s realisation.
In this sense, the Maggie’s Cancer Caring Centres movement is a ground-breaking attempt to connect the thread through ‘ideas of intimacy and friendly home-like architecture’, as Charles Jencks himself puts it in his article. He explains that ‘it is the service, which the architecture and art enhance, that is the main focus’. He also argues that these centres, designed by his friends, can enhance ‘the will to live, or live better’.
Articles such as The Tenderness of Wood; Craft over Software; Gehry, Craft and Computers; and Prognosis for a New-Build NHS, discuss better healthcare design from a variety of angles. The transformations described In a journal like this and the ‘friendly home-like’ atmosphere achieved by the efforts of Maggie’s Centres are fantastic and must be filtered through to influence the thinking of other organisations at both national and local levels. One still hopes, however, that the projects to follow will be approached very carefully indeed, focusing more on ‘privacy, dignity and company’ and patients control over their own environment, as described in the Softening the Blow article.
The notions of ‘accessibility’, and ‘place-making’ should be more central to the debate. The current health system treats patients only if they are diagnosed as ill. A hospital is a destination where one goes when ill. Frankly, it is difficult to sense a holistic route towards the notion of ‘health’ in the world of medicine. Healthcare environments should be accessible – they should be places where people can go to obtain information about how to stay healthy, and most of al where people would actively want to go to recuperate. They should be the best and most accessible buildings in a city, as can be seen in Austria and Switzerland.
The healthcare sector cannot afford to make architectural statements for
the sake of it, or more commercially oriented, office-lookalike spaces.
Put together with careful attention to ecology and craft, this publication
begins gentle but penetrating debates and achieves a valuable bridge in
connecting together the complex pieces for designing with care.