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14 VIEWS


In the health projects we have built, the architect has always been an integral partner


stretch from conventional healthcare for local residents, to opportunities to set up your own business or work with artists, and from support with tackling credit card debts to help with learning to read and write and scaling the career ladder.


Architects should stop designing and building health centres yes, but that is not to denigrate clinical health. On the contrary, we need to design imaginative integrated buildings that position clinical health within a broad range of services that drive well being in communities. Buildings should encourage a locally blended offer, where doctors sit alongside others, including patients and local residents, to provide what people actually need. It’s not about ‘what’s the matter with you,’ it’s all about ‘what matters to you’ – quite different. Our health centres should be more like a John Lewis store, where the customer is welcomed in, and offered a host of choices. Successful department stores know that a diverse product range makes complete sense for the customer and financial sense for the business – and design their stores accordingly. It is the same principle in integrated holistic centres, where health is about life and living, not just disease and illness.


SOCIAL SPACE


The courtyard at Bromley By Bow is one of the features that helps the building feel “more like a monastery than a primary care centre”


opportunities, both economic and social, with businesses.


Our prescription for the future If we are to have an NHS in 70 years’ time, we suggest the following steps, based on hard-won practical experience in east London, and emerging experience in areas across the country covered by Well North Enterprises. First, design teams must return to the fundamental question raised by the Peckham Experiment in 1948, “what is health?” The NHS closed this amazing and well-designed building in 1950 [the Pioneer Health Centre, where the groundbreaking project was based], saying that its services would now be


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delivered by them. They were wrong. Our integrated team discovered many years ago that 50 per cent of patients who used the local GP surgery in Bromley by Bow did not have a biomedical problem, they had a housing, education or employment problem, or they were simply lonely. We’re finding similar percentages in the north of England today. The Bromley by Bow Centre is Peckham mark II, but this time with a business plan. Secondly, we should stop designing and building new health centres. Today Bromley by Bow offers a vast array of services to our local community and 40,000 patients, in buildings and gardens that feel more like a monastery than a primary care centre. They


Whether in the NHS or wider society, it's about developing integrated communities. We have built hundreds of projects, focused around health, housing, education and business enterprise. We run site visits entitled ‘A Place, A Street, A City’ showing what can be achieved and introducing the local people who did it with us. We are breeding a massive dependency culture in the NHS in an institution that is far from well, aided and abetted by architects. Architects need to help us drop the sentimentality about the NHS and return to the fundamental question: what is health in our increasingly fragmented modern society? Our buildings need to reflect a joined-up world where the campus or cluster becomes the integrating norm and people and relationships matter more than process, strategies and plans.


Lord Andrew Mawson OBE is an Independent Crossbench Peer, and chairman of Well North Enterprises


ADF NOVEMBER 2019


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