ABSTRACT

This chapter shows that providing universal healthcare for free or for very little money has always been difficult. The seeds of the NHS were sown in reform of healthcare for the poor during the Victorian era, and from ‘the anxiety of medical men to come to grips with the most glaring problems of diseases’. An inventory of English healthcare buildings from 1660 onwards contains several types of buildings – general hospitals, cottage hospitals, hospitals for armed services, specialist hospitals, hospitals for infectious diseases, mental hospitals, and convalescent homes and hospitals. Ironically, charitable hospitals generally refused access to those suffering from chronic illnesses, dying patients and the destitute – perhaps due to the lack of staff needed to care for them. The design for the 1,000-bed hospital which took Brunel six days to complete had a ridge-tile ventilation system, openable windows and forced ventilation using fans. The Co-ordinated Use of Building Industrialised Technology for Hospitals introduced performance standards and dimensional coordination.