Q1: You are an architect with a busy day job and you probably had some idea of how huge the job of researching a history of health design in New Zealand would be. When and why did it all start?
It’s hard to say when this project started. Working on hospitals around the country, I kept coming across names on drawings, plaques, etc that I hadn’t seen in general architectural histories. My curiosity was piqued and led me to try to find more information on them. As this material accumulated, I was encouraged by several people, including my colleagues Darryl Carey and Anner Chong, to bring it together in one document. I really had no idea of the work that would be required and am grateful to the team at Massey University Press for helping me through the process.
Q2: 416 pages and over 500 images later, it’s an impressive achievement. Was piecing it all together and tracking the information down a bit like doing of those thousand-piece jigsaws?
Yes, except that most of the puzzle pieces weren’t readily available and it took some time to track down where they might be found. And as in any historical research, some of the information was contradictory and required further digging to see how the pieces really fitted together. With architectural history, there is a tendency to attribute a design to one, well-known figure, whereas with health facilities, the design of which tends to be more evolutionary and collaborative, the authorship is often more complex.
Q3: Of course, advances in health design run in parallel with advances in medicine. What sorts of treatments were offered in those picturesque but humble early colonial hospitals?
Society generally expected that people would be cared for by their own families and there was a stigma associated with seeking hospital treatment, as well as a real risk of greater harm through infection from other patients. Hospitals were often seen as a place of last resort for the seriously injured and the destitute. Many early settlers were young, fit males. However, as they aged, they often had no family support due to the early gender imbalance. The governors of Christchurch Hospital decreed that it would not admit ‘women in an advanced state of pregnancy’, children under six years old except in extreme emergency, or ‘those apprehended to be in a dying condition’. A history of Wellington Hospital considered it to be mainly an old persons’ home as ‘surgery as know today was not practiced’ there.
Q4: By the time we get to the late-Victorian era the big city hospitals and certainly the so-called mental asylums were almost baronial in appearance. Most of their architects were British-trained: what hospital design ideas did they apply here?
The Nightingale ward concept, with its emphasis on good natural ventilation, dominated hospital design during this period. The siting of hospitals was often a balance between making them accessible to the community they served, while being sufficiently distant to minimise the spread of disease. The asylums had different drivers, often being located well outside urban areas to keep their patients away from the ‘respectable’ public. With surprisingly large numbers of patients relative to the general population, they were of a far larger scale than any general hospital. Sited on large areas of land, they became almost self-sufficient communities in their own right.
Q5: And they were so versatile. As well as hospitals, they were turning their hands to grand merchant residences, banks, shearing sheds and even prisons. The book includes some of their beautiful early drawings. Were those a delight to come across?
Yes, they are exquisitely drawn and often beautifully water-coloured. But many of these drawings seem to have spent quite a bit of time on site, and have been embellished with builders’ calculations and sketches of details, so they are working documents, not just static works of art.
Q6: Do you have a favourite nineteenth century building?
That’s a difficult one. Christian Toxward’s 1881 Wellington Hospital was rigorously planned and seems to have accommodated expansion well. However, as the first purpose-built public hospitals in the country, I am intrigued by the evolution in design of Frederick Thatcher’s hospitals and their relationship to his better-known church buildings.
Q7: The architect biographies at the back of the book are fascinating. So many of them had such long careers and moved in and out of so many partnerships and practices. So many, also, had a big impact in one city or one region. Who are some of those?
The term ‘Architect to the Board’ appears in many hospital histories, and some hospital boards did have architects on their staff from time to time. However, in many cases a local practice would build significant institutional knowledge and good will, and was trusted by the board to design new buildings and improvements over long periods of time, sometimes resulting in quite large commissions. Examples include Sanderson & Griffiths, succeeded by Frank Messenger then Laurenson Robinson and Jim Boon in Taranaki, Davies, Phillips & Chaplin in Hastings, and Turnbull & Rule, succeeded by O. W. MacDonald in Timaru. Mason & Wales, the oldest operating architectural practice in New Zealand, designed most of the buildings at Dunedin Hospital for more than a century.
Q8: By the post-war period hospitals were certainly scaling up as both medical, architectural and engineering technologies advanced. What are a couple of standout buildings from this period?
Internationally, most hospital buildings in this era were one of two types. On tight, existing sites, large monolithic blocks were built, enabled by new technologies such as air conditioning and lifts. The main block at Auckland Hospital by Stephenson & Turner is a good example of this. Where more land was available, such as at the new hospital in Gisborne, another typology was often adopted, consisting of low-lying pavilions with landscaped courtyards between and accentuated by a vertical element such as a ward block tower.
Q9: We all know that we are living on the capital of that era of building, when we were a wealthier nation, and many of these buildings are now past their use-by dates. But when we can get a new building up out of the ground and running, what is it that health designers and architects are delivering?
There is an increasing, and justified, emphasis on affordability and a consequent push to greater standardisation. Why, for example, should a hospital bedroom or operating theatre look any different in Auckland or Invercargill, or even Sydney? At the same time, models of care and medical technology will continue to evolve, so that some freedom to innovate needs to be maintained. Designers continue to explore how health facilities can best promote the healing process, and are aiming to make them more culturally responsive. Hospital buildings, as large users of energy and other resources, are also being made more environmentally sustainable.
Q10: What do you hope readers — both architects and health designers — will take away from the book?
I hope the book highlights the challenges and opportunities of health design, and encourages people to see it as a valid and valuable strand of architectural (and engineering) design, both historically and into the future.
