2010-10-16: On Friday afternoon (15th October 2010), between 16.00 hrs and 18.00 hrs … I attended a Joint Session of the Health Care Design Committee of the Royal Institute of the Architects of Ireland (RIAI). An e-mail blurb, which was sent out beforehand to the RIAI Membership, described this Joint Session exactly as follows …
‘ The RIAI Healthcare Design Committee has organised a joint session by Norwegian and Irish Healthcare Architects and other professionals in order to review and discuss healthcare policies and design practices in Ireland and Norway.
There will be 6 Speakers (3 Irish and 3 Norwegian) each talking for 5-10 minutes. Each speaker will outline a point of interest in the field of healthcare policy and design, which will be followed by a general discussion.’
It was a very interesting event … and well worth the time spent attending. I did not wait for the Wine Reception afterwards !
One of the important lessons for me, however, was that Health Care Buildings should be Low-Rise, i.e. no higher than 3 Storeys above ground level. In this context, a considered relationship between people inside the building (whether patients, medical staff, visitors or non-medical employees) and a carefully designed external environment with grass, trees, colourful landscaping, sunshine, birds chirping merrily in those trees, water rippling in the background, etc. all play a critical role in the restoration and maintenance of health.
Many years ago, as a long-stay patient in Dublin’s Mater Hospital … the continuous view of only overcast skies above was very depressing. And, looking down … it was worse. At ground level, the sight to behold was shabby outbuildings, badly maintained hard surfaced areas and, of course, cars parked anywhere and everywhere.
As a recent short-stay patient in the Accident & Emergency Department of that same Mater Hospital … I was shocked to see the overcrowding, the confusing and disorientating maze of cramped corridors and spaces, the inefficient and time-wasting administrative practices and procedures, the frustrating pre-dominance of medical ‘protocol’ over patient needs … and the almost total disregard for the Patient’s Charter, which I know for a fact, is hanging somewhere on a wall within that vast medical complex. I know, because I once saw it … and having read it, I promptly almost keeled over at the enormous gulf between what was written down … and what was the grim reality ! Little or no value is attached to Patient Dignity within Ireland’s Health Care System.
On no occasion, during the RIAI Health Care Design Joint Session, was the Proposed High-Rise National Children’s Hospital on the Mater Hospital Site even raised … never mind discussed. Most strange for such a Joint Session ! A modern, properly designed Children’s Hospital is desperately needed in Dublin … existing medical facilities for children are clapped out. Also desperately needed … substantial innovative thinking on the design of Health Care Facilities ! BUT … there are serious problems within the existing Mater Hospital Complex which must be sorted out … and solved … before a Major New Project is grafted on !
During the General Discussion which followed the Joint Session Presentations, the first person from the floor asked a very pertinent question regarding Post Occupancy Evaluations (POE’s) of the Health Care Buildings which had earlier been demonstrated by the speakers. This question was laughed off … I kid you not !
My view is that Post Occupancy Evaluation is an essential component of the process of ‘design’ … if an architect has any sort of serious intention that he/she will not repeat design errors. Feedback from building users is an exceedingly rich resource ! It should not easily be squandered.
A little later … I ventured to comment, also from the floor … that the Session had been very interesting, but the Presentations had been concerned merely with the nuts and bolts of architecture. Not once had any of the speakers raised the following issues … which was disappointing …
1. Human Health – Speakers, during the Session and perhaps in the course of their everyday design practice, were working with an outdated concept of Human Health, i.e. it being an absence of injury or disease. On the other hand, the World Health Organization (WHO) has long ago defined Human Health … in the WHO Charter … as:
‘A state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity.’
While some elements of this wider concept could be discerned … this comprehensive understanding of Human Health had not fully and coherently informed any of the work, either in Norway or Ireland, which had been presented.
2. A Trans-Disciplinary Approach to Design – Many times in the past, I have really enjoyed working as part of a Multi-Disciplinary Design & Implementation Team … it can’t be beaten. Furthermore, I would expect that cutting edge breakthroughs in Fire Engineering Design for Building Evacuation will result from a close collaboration between Fire Engineers, Architects and Cognitive Psychologists. How disappointing, therefore, to be presented with a typical design approach which is a generation out of date !
3. Person-Centred Design – One of the Speakers stated that Architects must have empathy … for whom, exactly, I wasn’t quite sure. Whoever that person was, or those people were … this idea falls very, very far short of the concept of Person-Centred Design …
‘ That design process which places ‘real’ people at the centre of creative endeavours and gives due consideration to their responsible needs, and their health, safety, welfare and security in the Human Environment.’
In Conclusion … I witnessed a Stunning Lack of Innovative Thinking on Health Care Facility Policies and Design at the RIAI Joint Session between Norway and Ireland !
That experience … together with the OTT ‘Performance’ this morning (Saturday, 2010-10-16) of Health Minister, Ms. Mary Harney T.D., on the Marian Finucane Radio Show (RTE Radio 1, from 11.00-13.00 hrs) … listen back at http://www.rte.ie/radio1/marianfinucane/ … have, together, increased my concern about the National Children’s Hospital Project !!
Life is short … and I am no longer prepared to accept Public Relations Spin, Withholding and/or Concealment of Vital Information, Individual Incompetence, and Lies … from our Politicians and Senior Civil Servants !!!