Iopportunities, 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
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. Theystretch 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.
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 EnterprisesIn the health projects we
have built, the architect
has always been an
integral partnerSOCIAL 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”
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