Description

Ludwig Mies van der Rohe, one of the pioneers of the modern movement, is reported to have said that ‘hospitals belong in the best and most healthful sections of the city. They belong in parks where the air is purest, away from the smoke screens that smog our cities (…) Hospital planning must be of a piece with city planning.’[97] The hospital has even been described as a public institution which defines the city in the same way cathedrals did in the past![98] It is not hard to see that there is an intimate connection between hospital architecture and urban planning. Large building complexes are often thought of as cities in their own right, posing urban planning issues. The size of traditional large-scale medical facilities marks the areas they occupy as distinct sectors within the larger urban tissue. Like railway stations and department stores, they serve a public function and are open 24 hours a day.[99] Which parts of the city are best suited to accommodate hospitals depends largely on their size and their particular array of medical specialties, which is determined by the models of the distribution of medical services (cf. ‘Distribution of Healthcare Facilities). For large complexes, easy accessibility is crucial. Since the 1940s, planners have preferred to locate them near main traffic arteries. Now, reintegration in an urban setting is increasingly seen as important, since it may help break down the physical, mental and functional barriers between the medical machine and its clientele. The destruction of historic inner city hospitals can be disruptive, disturbing the ‘evolving role of memory, place and sustainability’.[100]

As its link with the outside world, the entrance is a crucial part of the hospital. The current ambition to ‘urbanize’ the hospital and break down the barriers between the world inside and outside is, however, not likely to result in the dismantling of the existing borders. Except for the inpatients, everybody using a hospital has to come from outside, either on a regular basis (people working or studying there) or occasionally, because they need treatment in outpatient departments. Consequently, hospitals have a tendency to become traffic hubs, whose functioning is determined by numerous factors, such as their sites (in city centers, at the periphery or in natural surroundings), the size of the region from which they attract their patients (which tends to become larger the more specialized a hospital is) and the latter’s preferred mode of transport.

Originally published in: Cor Wagenaar, Noor Mens, Guru Manja, Colette Niemeijer, Tom Guthknecht, Hospitals: A Design Manual, Birkhäuser, 2018.