What a difference a decade makes. It seems like no time at all since a few maverick voices in architecture were making the contentious claim that a well-designed healthcare environment could have a tangible impact on patient recovery time and well-being. The notion is now so widely accepted that commentators feel obliged to make the argument that enlightened architecture is no substitute for medical expertise, modern equipment and the availability of scientific medicine (page 54).
But it should not be a case of either/or.When Frank Gehry lost sleep wondering whether the £1 million spent on his cancer care centre in Dundee would have been better spent on trying to find a cure for cancer (page 50), he should have been soothed by the fact that the two were never in direct competition. It is extremely unlikely that the funders of a one-off flagship building would have contributed just as generously to the invisible and interminable programme of cancer research. When architecture does compete for its share of a fixed budget, it should, ideally, be a means of improving the efficiency, rather than detracting from, other aspects of healthcare provision. At the most mundane level, dedicated staff, state-of-the-art equipment and modern medicine are of little value if the absence of legibility and storage mean that they cannot be immediately located at the appropriate time. At a macro level, the fight for better hours and pay for healthcare staff has to take into account the fact that many key workers spend time and money travelling to their place of work. ABK's attempt to devise a procurement model which would allow nurses to be housed close to hospitals (pages 22-23) shows how an architectural perspective can be brought to bear on the fundamental strategic inefficiencies of the NHS.
Without wishing to detract from the wealth of research into the calming and healing properties of colour, proportion and light, the single biggest contribution which architecture can give to healthcare is the intelligent application of the adage 'a place for everything and everything in its place'.