ABSTRACT
The chapter examines the increasing functional, technical and mechanical servicing of the modern hospital. As hospitals grew in size and complexity, considerable emphasis was placed on the efficient use of resources. Taylorist ideas of production – exercises in the scientific management of labour – encouraged centralising services to a single point of operation, such as huge central kitchens and laundries. Other services were similarly centralised: a single boiler house to provide steam and hot water, and reticulated gases to the wall, such as oxygen, from a remote location. Appropriate ventilation, whether natural or forced, and ultimately air conditioning, became drivers of form and façade. The efficient provision of supplies, storage and removal of waste were also key concerns, and all demanded spatial responses. The modern mechanical plant became part of the architectural expression of the modern hospital, sometimes expanded to heroic proportions. Architects and hospital administrators were deeply involved in the operation and design of each of these systems and spent considerable energy researching and refining their functionality. This chapter examines the evolution of the modern hospital as a system and explores the different ways that hospital experts and designers responded to the challenges of formulating and designing systems that could be both fully integrated and, by the 1960s, as flexible as possible.
