A remedy for sick buildings

 

Bright ideas: colourful graphics by Studio Myerscough

The Pioneer Health Centre in Peckham opened in 1935

Daylight floods the interior of Kentish Town Health Centre

Healthy competition: the simple and elegant facade of the new building, which is a contender for this year’s Stirling Prize

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Some of the ugliest blots on London are places built to make us better. The grim tower of Guy's Hospital rises over London Bridge Station like a medieval fort, smoking ominously from its incinerators. The Royal Free squats blockily on Hampstead's dainty skyline. The new-ish tower of University College Hospital stands in Euston Road, white and clunky as a Seventies kitchen appliance. Places of human health they may be but these buildings are blisters and cancers on the body of the city.

When it comes to designing hospitals, good architecture is considered a dangerous decadence. There can be no suspicion that a single pound has been spent on aesthetic frippery, which might otherwise have been spent on medicine or medics (and never mind that it would probably have gone on administrative paper-shuffling and disastrous IT projects). Whenever anything is invested in art that isn't framed floral prints, tabloid fury will be unleashed on the alleged wastefulness of it.

Yet hospitals and health centres are places where we and our loved ones experience drama and stress. They merit some dignity and delight: do you really want your last days on earth, or your child's first, to be spent in a space as dull as a branch of Boots? If we accept that some fraction of the gross national product is spent on the pleasure rather than the mechanics of staying alive, why should this principle stop at the doors of a hospital? And wouldn't the people who work in the NHS be happier, better motivated, more productive and less likely to defect to private medicine or to foreign countries if they had decent places in which to work?

There is, at least, one new health building in London that strives to be more than a machine for giving and taking treatment. This is the £10 million Kentish Town Health Centre, a contender for this year's Stirling Prize, designed by architects Allford Hall Monaghan and Morris and opened in June. Its principle is that “health, art and the community” should come together. According to Dr Roy Macgregor, one of the main driving forces behind the project, it aims to be “a health centre, not an ill-centre”.

The health centre contains GP practices, facilities for treating teeth, minds and children, and for spotting dangerous diseases early, and a library, offices and meeting rooms. Its architecture is simple enough, mostly white and cuboid, treated with a certain crispness, and animated by touches of lime green metal and the brightly coloured signs and images of the graphic designers Studio Myerscough. Big letters and numbers tell you where to go, and bold outlines of things to do with bodies and health — such as eyes, hands and thermometers — spread over the walls. There are also, for some reason, giant rabbits and butterflies dotted about.

Down the middle of the building runs a long “street”, open to passers-by and strollers as well as people with appointments, that opens into something roughly like an internal town square. From the street and square you can see the windows, bridges, balconies and stairs, the places of work of the multiple specialisms that occupy the building.

The usually opaque machinery of health is made visible and intelligible, and you sense that this is a place where human beings work — not always the case with health buildings. There are also spaces hollowed out, external terraces as well as the internal bridges and balconies, where staff can meet and exchange ideas. Here the boundaries between disciplines, between GPs, paediatricians, psychologists and dentists, are relaxed a little.

You feel connected to the outside. Daylight bounces around the walls and you have sideways views of the mature trees that stand close to the building, of a garden, and of the Victorian villas that surround it on Bartholomew Road. The idea is that the health centre takes on some functions of a village hall, with space available for local yoga groups or exercise classes or even things that have nothing to do with health — bridge clubs, perhaps. A request to use the centre for dog training was regretfully turned down on hygiene grounds.

And there is art. With the help of a modest Arts Council grant of £20,000 over three years, a programme of exhibitions is being put on of work ranging from the output of local schools to pieces by grown-up artists. “People are not quite sure if they are arriving at a health centre or at an art gallery,” claims Dr Macgregor, and he is happy about this confusion.

The Kentish Town Health Centre is, in a word, nice. It is thoughtful and clear-headed and humane. The graphics might come close to being a bit patronising or playschool, yet in practise they avert this risk. The building sits well in its surroundings. It is not fancy, with details of the basic type that the NHS's way of getting buildings built dictates, but it makes the best of what it has.

Once, health buildings were architectural masterworks, or polemical visions of a better world. The Finsbury Health Centre, completed in 1938 to the designs of Berthold Lubetkin, or the Pioneer Health Centre in Peckham, built in 1935, advertised both modernist architecture and a brighter, healthier future which a decade later would become the welfare state. Amid fir-covered plains in Paimio, Finland, stands a tuberculosis sanatorium by Alvar Aalto. Built in 1932, it is a graceful manifesto for the more civilised wing of modern architecture.

The Kentish Town Health Centre is not trying to change the world but it is radical enough. Despite the many billions spent recently, and still being spent, on buildings for health, it is hard to find many others with the simple virtues of this one — the Evelina Children's Hospital in Lambeth being one exception.

Yet good design and art don't just make us feel better, they help make us physically healthier. Dr Macgregor cites research that shows that if people like the environment of their surgeries and hospitals they “are more relaxed, more confident, more receptive to advice, more likely to retain advice, more likely to keep appointments and more likely to turn up for follow-up treatment”. In many cases this will make the difference between being more or less ill, in some between life and death.

Nor, even, do buildings like the Kentish Town Health Centre have to cost more. It was built to standard budgets for buildings of this kind, augmented only by the small grant for the art, and another to run the architectural competition which led to the appointment of AHMM.

As swine flu stalks the land, even the fittest of us will be thinking about health. Assuming we are not wiped out by the impending plague, we could take the moment to consider the places built for our wellbeing. In most of them successful treatment happens in spite of architecture, not with the help of it. The Kentish Town Health Centre is the exception, not the norm. Yet there is no good reason why this should be so.

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