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PFI healthcare: getting the right diagnosis

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As we are involved in the design and construction of many different PFI healthcare projects, I was alarmed to read Roger Bushby's report (AJ 30.5.02).

Sounds to me that the situation has been poorly diagnosed or CABE has been ill-informed.

Designing healthcare facilities is indeed a challenge. At RTKL we have been working for years to understand the complex nature, not just of the hospital building itself, but also the effect the building has on the staff, the patients and the community it is built to serve.

While architects are not healthcare experts, we are experts in healthcare design. In order that the design meets the needs of the community, we invest much time and energy at the beginning and throughout the development of the project, speaking to every stakeholder - from the cleaners to the senior consultants - to ensure that the final design is as effective and as appropriate as it can be.

Flexibility in use of space is key to our healthcare designs, so the hospital can evolve without becoming obsolete.

PFI has heightened the need for good design within healthcare - it can add real value to the project in terms of staff retention, reduced patient recovery times and flexibility in the models of care, so the building can accommodate fluctuation in patients'medical needs.

While I do not dispute that health centres must be balanced against the needs of the community they are to serve, the article implies that CABE has overlooked the growing trend in the UK to build specialist units, such as ambulatory care centres, major trauma centres, heart hospitals and cancer units, when and where appropriate. A community care centre may be the answer in some cases, but not necessarily for all.

Ron Morgan, vice-president RTKL, London

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