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Secrets and whys? The prognosis for hospital design looks poor

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Whatever happened to communication? The NHS Estates website tells you that 'NHS Estates' mission is to advise on and enable a modern environment of care for NHS services'. John Egan, the author of Rethinking Construction, called its Procure21 procurement initiative 'world class' and 'a model for the public sector'. CABE described its 'Achieving Excellence in Healthcare Design' programme as the 'best in government'. So what do you do with such an excellent organisation? Obviously, you get rid of it, with scarcely any consultation and without even telling anybody.

That is what the Department of Health did last week, posting a notice very quietly on the NHS Estates website, and also sneaking it in as item 27 on page 25 of a report, catchily titled Reconfiguring the Department of Health's Arm's Length Bodies. Brilliantly, responsibility for design will now be split between the NHS and the National Patient Safety Agency. Known as the NPSA - number 31 in a list of 42 ALBs (arm's length bodies, do keep up) in an annexe to the report - it will take responsibility for 'work on hospital food, cleanliness and safe hospital design'.

So that's OK then. With hygiene and hospital-acquired infections top of people's list of concerns, responsibility for designing against those will be with a completely different organisation from the one that deals with building design in general. This is an entirely naive view of architecture as a divisible entity, and echoes the way that architecture is already split between three government departments.

So what do architects think of this? Not much at the moment, since neither NHS Estates nor the Department of Health have seen fit to carry out any widescale consultation. NHS Estates says it will spend the next three months (much of it holiday time) running through the detail of the report. But there is no mention of talking to architects. All this is happening at the same time that new parts of the Building Regulations are being sneaked out as quietly as possible, and is eerily reminiscent of the decision to abolish part of the House of Lords and then wonder what to do next. Anybody for open government?

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