‘HHospitals are the ugliest places in the world,” says Jacques Herzog. “They are a product of blind functionalist thinking, while neglecting basic human needs.” The Swiss architect has a point. With its low ceilings, the windowless corridors and harsh fluorescent lighting, hospitals can sometimes seem consciously calibrated to make you feel sick, if you haven’t already. Attempts to brighten them up with colorful wall panels and art commissions do little to distract from the unfortunate reality of buildings where the human experience – for patients, doctors and visitors – is often an afterthought.
Herzog insists it doesn’t have to be that way. And it has proof. It is located in the courtyard of the circular entrance of the amazing response of his practice to the last century of terrible health buildings. It is a quiet space reminiscent of a forest thermal complex, ringed with carved wooden slats and planted with tall trees and ferns, where the light bounces off marble sculptures that shine in the rain. A wide gallery deck surrounds the floor above, with a touch of Shakespeare’s Globe theater, where the rooms spread out into wide, day-lit corridors. Entering through revolving pink glass doors, you find a concrete staircase that spirals down into the foyer, curling around a core of colorful neon tubes that seem ready to beam you up.
Welcome to the extraordinary new children’s hospital in Zurich, the children’s hospital – or “Kispi” for short – a 14-year effort to revolutionize how we think about healing architecture. It is not trying to be a fancy hotel, like some private hospitals with their plush carpets and room service. It’s just a place where simple things like the quality of light and view, the scale and proportion of spaces and the texture of materials have been thought out with immense care, and refined to make the experience as pleasant as possible. for everyone. Why should this be so unusual?
Herzog & de Meuron may not be an obvious choice to design a hospital. Over the years, its architects have built a reputation as consummate creators of cultural landmarks, crafting fascinating museums, concert halls and stadiums around the world, which revel in their structural and material alchemy. But alongside these glitzy commissions, the 600-strong practice has been quietly dealing with the issue of healthcare for the past two decades. The firm has completed an impressive, but strangely undersung, rehabilitation clinic in Basel in 2002, and now built a huge Amoeba-shaped hospital in Denmark as well as a terracotta ziggurat teaching hospital in San Fransisco. “It’s an incredibly neglected area,” says Herzog. “But I am fully convinced that architecture can contribute to the healing process.”
A walk around Kispi suggests he might be right. From the moment you meet the cartoon-sized gates, splayed open like the entrance to a giant hall, leading to the 16 planted courtyards that dot the building, it’s unlike any other hospital. Spread over three floors 200 meters long and 60 meters wide, the vast building was conceived as a city, with various departmental quarters on the sides of a winding main road that widens and narrows, spreading over the side streets and squares. Rather than the usual identikit wards, the 200 patient rooms were envisioned as individual ‘cottages’, arranged like log cabins around the perimeter of the top floor, with pitched roofs sloping in different directions .
“We wanted to avoid that feeling of being just another unit in a row of stacked boxes,” says project manager Mark Bähr. “Having a sloping wooden ceiling and natural light makes a big psychological difference when you’re lying in bed staring at the ceiling all day.” The rooms have a more domestic feel than typical hotel rooms, like being in the attic of an alpine chalet. They have large picture windows and smart window seats that can be pulled out to become beds, giving tired parents a place to sleep. Fun porthole windows at baby height can be opened for natural ventilation, while each room has a private bathroom – a welcome change from the previous hospital facilities, where 17 parents shared a shower. Wooden floors add a sense of warmth in contrast to the usual rigid vinyl – and they are just as hygienic, coated with ultra-resistant polyurethane.
From the outside, the low-rise complex is designed to look approachable and non-institutional, its long facade gently curving inward to embrace the street. The friendly feeling is emphasized by the rooflines of the room, inclined this way and that like a row of tree houses, stuck on the concrete frame. The architects had originally proposed an all-wood building, but the client wanted something that felt more substantial, and they made the most of the compromise. The frame is treated as a large armature, in which the lighter partitions can be moved, if the hospital needs reconfiguration. “We have already designed the options for future expansion,” says Bähr, including the possibility of an additional floor on the roof, while the offices are future-proofed with services to become medical spaces if necessary.
There are kid-friendly touches throughout, from a low-level reception desk so kids can see above when they arrive, to pillow-filled pillows and corridors wide enough for ping pong and soccer. In a very un-Swiss-minimalist fashion, the walls are also lined to encourage scribbling. “We tried to make the architecture address children’s curiosity,” says Christine Binswanger, partner in charge of the project, who also led the design of The Basel rehabilitation clinic – a timber-framed establishment, which set the pattern for Kispi. “Normally they would expect animal paintings on the walls, but we did things like put the wooden columns on small round pieces of stone, or make a hole in the elevator so you could see into the well.” The next few game areas will increase the fun a few notches more.
Navigation in the previous hospital needed to be accompanied by a guide, but here finding the way is facilitated with simple movements. Large amounts of glass make it easy to see the staff, while the corridors end in large windows, which frame views of the trees, rather than ending in non-violent victories. The rooms are stepped in a gentle sweep, avoiding relentless rows of anonymous hotel-like doors, while the two characteristic staircases help you find your way back to the entrance.
With more than 2,300 rooms, the attention to detail is astounding (a decade-long process that was brought to life in the recent Royal Academy exhibition). The architects designed 700 different pieces of integrated furniture, including folding tables in treatment rooms, so parents can sit and talk with doctors, and tables in waiting areas, attached to pentagonal concrete columns – even the profile of the structural frame in shape to add interest. Just when you think you’ve seen it all, a bright door leads in a celestial space by James Turrellan oval chapel-like room where patients can bathe under an ever-changing rainbow of therapeutic light.
Operated by the Eleonore Foundation, a charity founded in 1868, the Kinderspital is known for its specialties in oncology, cardiology, neonatology and burns – fields whose boundaries are pushed in a dedicated research tower across the street, also designed by Herzog & de Meuron. . Standing like a leaf to the low carpet of the hospital, the research laboratories are housed in a shiny white cylinder, like a stack of Polo mints, where the work areas open to a bright atrium reminiscent of New York. the Guggenheim Museum. Three conference theaters on the ground floor have been cleverly designed with sliding wooden walls, which can retract to allow the whole space to become a single, circular agora, while a pair of corkscrew staircases bring some of the brand theaters of the architects to the processes.
It would be easy to assume that this dazzling media utopia is the product of Swiss exceptionalism, only possible in such a small, rich and resourceful country. But this is not entirely true. The hospital alone cost £517 million to build (or £6,500 per square metre), coming from a combination of private donors and public funds. It is difficult to make a direct comparison, but two recent British hospitals – the Royal Liverpool and the Midland Metropolitan in Smethwick – each it costs at least £7,770 per square metrealthough they contain three times the number of beds. Both were years late and cost hundreds of millions more than expected, and both were the product of failed £1 billion PFI (private finance initiative) contracts with doomed contractor Carillion. Both suffered a litany of problems.
Thoughtful and humane design doesn’t have to cost more. From rigorous procurement, to a properly trained construction force, to understanding the benefits that architecture can bring, Kispi’s story provides powerful lessons that the UK’s hospital building program would do well to learn. Wes Streeting must pay a visit.