Back to index of Nerve 24 - Summer 2014

Birth Defects at the Royal?

Credit: RLBUHTWithin ten minutes of the event, it felt like a scam - a PR and box-ticking exercise. For what it was worth, I gave them my views anyway - why I thought the design of the proposed new Royal Liverpool Hospital was flawed.

The scaled model showed that energy conservation was not very high up on the agenda. No solar panels - whether to power electricity or to heat water. No sign either that the designers or commissioners had taken into account something so simple but ubiquitous as the path of the sun during the day or the year. Designers sensitive to this would orient windows in ways whereby in the cooler months, as much sunlight (and thus heat) as possible would be allowed to penetrate the building, to take advantage of "free" heat. Even if the amount is small compared to the total requirement, it's still something. And just think of the emotional benefit to patients of having some warmth from the sun while in hospital. But forgive me - I stray into matters emotional and spiritual. Conversely, it is desirable to provide as much shading as possible in the summer - particularly on south-facing facades - to reduce the amount of mechanical cooling required. I saw no sign that any consideration had been given to this. Nor to natural ventilation, rainwater harvesting or other energy or resource-saving systems. "The most modern and efficient mechanical systems would be used", I was told, but that just means that vast amounts of energy (and money) would be wasted needlessly, in these times when it is becoming clearer to everybody that we really need to be thinking differently about how we use energy.

Finally, I understand that there will be fewer beds in the new building than there are now - the argument being that fewer people will need to be admitted - as resources will be ploughed into home care. With the population ageing as it is? With all the service cuts going on? Yeah, right! And then every patient will be in a single room. The Stafford Hospital abuse and neglect scandal suggests that one thing that needs to be carefully addressed in the management (and design) of hospitals is the efficient visual supervision of patients by nursing staff. Arranging bedrooms around nursing stations is one way to achieve that; placing them down long corridors (as the design showed) is almost certainly not.

It's sad that the public is going to have to pay through the nose for the foreseeable future for a building that looks like it will provide nothing resembling good value for money. One definition of a hospital is a building where sick people go to be made better. I fear that the Royal may end up suffering "Sick Building Syndrome" itself, and doing little for the public's health or the public purse.

Unless of course they changed the design after the public consultation?

Tayo Aluko, March 2014

Liverpool's carbuncle

I submitted the following aesthetic objection to the planning proposal for the new Royal Liverpool University Hospital, to complement the many submissions regarding the project's wasteful PFI funding and the unbelievably neglectful and discriminatory company (Carillion) selected to run the project. "I have looked at the plans and the videos provided by the Royal. At the presentation I attended, the Royal staff described the current hospital as one of the most unattractive buildings in Liverpool. Not only do I agree with this, but my view is that the proposed new hospital - a classical example of 1960s style 'brutalism' - is every bit as ugly as the existing one. The hospital facade must be redesigned, using a well-regarded, competent architect; Liverpool deserves no less."

Alex Scott-Samuel
Public health lecturer and researcher

Royal Care Package

The Royal is the largest in the country to be built with all single en-suite rooms, which they claim is being done for infection control. However we think it is more about the new rule that 49 per cent of total beds can be used for private patients. If they have a mixture of wards and single rooms, some single rooms will always have to be kept vacant for infection control. If they have all single rooms, they can use 49 per cent of the total number of beds for private patients. This means that when they say the new hospital will have 664 beds, they mean 365 beds for NHS patients and potentially 363 beds for private patients. What's more if the hospital starts running into financial trouble they will have no choice but to maximise the 49 per cent for private patients. Thus you could be stuck on the waiting list as an NHS patient for elective surgery but march right in as a private patient.

Also the Royal claims that the new hospital will help to improve the health of people in Liverpool, which has some of the worst health outcomes in the country and this is due in a large part to the social determinants of health such as housing, employment, etc. This begs the question if a person ends up in hospital with pneumonia because they cannot afford to heat their house, will they really be all that worried about having their own room.

It has been shown that some patients actually do better in wards where they have contact with other patients and a throughput of health care workers. So what will the hospital reply to a patient who says "I don't want to be in a room on my own"!

Sam Semoff
Keep Our NHS Public (KONHSP)

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