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John Cooper of Anshen Dyer, speaking at a recent AJ conference on the design of healthcare buildings, outlined the impact that forms of procurement can have on the specification process. He described how PFI can have a beneficial effect on the exteriors of buildings, since the need for rapid construction often leads to the adoption of unitised systems of cladding previously only considered for offices and other commercial buildings. The interiors are another matter. Too often this is where costs are squeezed at the end of the process, resulting in dreadful finishes and furniture going into wellconsidered spaces.

Cooper is adamant that a move to designing all hospital rooms as single rooms is essential as it entirely changes a patient's relationship with the hospital, giving patients ownership of their own spaces. Glynis Meredith-Windle, a health planning consultant and former nurse, also supported this from the point of view of controlling infection. She said that hospitals composed of single rooms do not need to be more expensive to run. But this is only achievable by reducing nurses' travel time, which calls for a radical rethink of the planning of buildings.

Meredith-Windle also showed some scepticism about anti-bacterial finishes, saying she mistrusts the inclusion of materials that could lead to the development of treatment-resistant bacteria. She is happy with the use of inert antibacterials such as silver, and also copper, which was the subject of a recent presentation to the Architects for Health grouping. Not everybody would agree with her but arguments need to be based on knowledge. Healthcare architecture is a notoriously cosy club but one that needs breaking into since there is a shortage of experienced architects in the field. Knowledge is power, and while understanding how to plan the spaces is crucial, so is the specification of materials, furniture and finishes.

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