GREENWICH VERSUS PADDINGTON
Phil Gusack and the late John Weeks argue about hospital design in the Architects Journal in January, 1974
Greenwich no general model
John R. Weeks RIBA
Liddleson's note (AI 12.12.73 p1447) on the DHSS Greenwich Hospital, and its suitability as a general model for new hospitals on urban sites is rather simplistic. The Greenwich project is an excel¬lent one-off test bed, in which some elegant ideas have been tried.
But one of the reasons why the DHSS has not pursued t is that it is expensive to build by com¬parison with the DHSS costing standards. If the interstitial space system - the most creative idea and an important ele¬ment in the test programme - was developed to the scale at which it becomes workable costs rise, again. In the US and ¬Canada where it has been so 'developed the ratio' of built volume to usable volume can be as high as 2:1 (at Woodhull in Brooklyn): this method gives no advantage in terms of essential flexibility over a much simpler servicing system and a much cheaper building.
Another reason why the Greenwich plan has not been developed here is that the whole usable floor area needs full air conditioning and 'the inter¬stitial spaces need artificial ventilation. Economies, even if they include a reduction in cleaning costs, cannot be shown, by any stretch of figuring, to pay 'handsomely', or even at all. The use of air conditioning has not resulted in any measurable effect on the rates of cross infection. High running costs are one of the reasons why the DHSS I will not repeat the experiment here. There are others.
The building proposed for Paddington has to be designed to be acceptable within the DHSS functional and costing systems, as well as the local authority's planning regulations including those which limit plot ratio.
At present it has air condi¬tioning restricted to well under seven per cent of the total floor area and 56 per cent is ventilated naturally. No one is being 'absurd' in the present situation.' At Paddington there is a real and tragic confrontation between environ¬mental concern and concern for hospital services and medical education. During the second year of delay consequent on this, patients and staff at two hospitals continue in overcrowded discomfort. The canal basin remains unused and unvisited.
Hospital Design
Phil Gusack
After Robin Liddleson’s abbreviated suggestion of ‘prototypes for Paddington (AI : 12.J2.73 p1447) it comes as no surprise that John Weeks : defends his plans for St Mary's hospital. Reading between the lines, there is far more to Liddleson's comparison of Greenwich, McMaster and Lorna Linda. These projects highlight the development of the compact deep--plan in the typologies of hospital design. They incorporate interstitial service space to provide not only air-conditioning and internal flexibility but more importantly to achieve integration of structural and mechanical and electrical engineering systems. It is the refinement of the 'servo-system' (Zeidler) which permits fast-track scheduling, for McMaster and Loma Linda that have four-year programmes for briefing, design and construction.
Lorna Linda Veterans Administration hospital also reinforces the value of compact plan organization. This project is based on the VA Hospital ! Building System (Architectural Record, June, 1972), but the plan incorporates the finding of a current study of transport systems for the VA. It provides a methodology for evaluation of whole hospital configuration, and it is at this scale that circulation planning must be integrated with the construction and engineering systems. It may well be that indeterminacy in whole hospital planning is illusory and a barrier to efficient organization.
Liddleson is right to propose Greenwich as a prototype for Paddington, not only because this is compact, but also because it makes for better planning anyway. As things stand Paddington Basin is threatened by hospital design folklore and a decade of construction for want of an imaginative proposal and modeling techniques.