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Horrible hospitals

Speaker: Henry Marsh
19 February 2005

The true function of a modern hospital is as much care as cure. Modern technological medicine has cured all the easy illnesses, or has made it possible to treat them rapidly, often on a day-case basis in a minimally invasive fashion. As a slightly paradoxical result, patients who still need to be treated as in-patients in hospital are increasingly sick and vulnerable, with less chance of cure than in the past. Care is therefore all the more important in how we treat these patients. Furthermore, there is an increasingly strong body of evidence that the way in which patients respond to treatment is significantly influenced by the environment in which that treatment is delivered. This environment is both physical and social, and the quality of the design of the building has a critical effect on both.

Patients will recover more quickly if their room has a window with a view. Hospital staff will work more effectively, have lower absenteeism rates, and treat patients more kindly if they work in buildings which permit an all-important sense of community.

Henry Marsh is the senior consultant neurosurgeon in the Atkinson Morley Department of Neurosurgery at St. George's Hospital in London. Before studying medicine, he read Politics, Philosophy and Economics at Oxford University. He specialises in operating on brain tumours and is the leading expert in the UK on the technique of 'awake craniotomy'. This involves removing tumours from patients' brains while they are awake so as to give the surgeon early warning of any damage that might be occurring as a result of the operation. He was the subject of a major BBC1 documentary earlier this year in which he was seen operating in this way.

He believes passionately that the built environment has a major effect on human behaviour, and has delivered many lectures in recent years (for instance at the Royal Institution, the Prince's Foundation, and NHS Estates conferences) on the influence of hospital architecture on patients and their illnesses, and on the way staff behave in these 'total institutions'.