Healthcare has been often described as the most complex human organization ever devised.
The life of hospitals has been supplanted many times by an aseptic compliance with norms, regulations, procedures, protocols, and hyper technologies. Hence, there is no longer any trace of the old sacred enclosures, the Greek temples, the Roman valetudinaria, hospices, of the home of the sick, or cathedrals and abbeys equipped to host people in need. The hospital as an inflexible monument of civic pride was to remain until the second half of the twentieth century.
We often perceive the hospital as a place adorned with hard light, bare corridors, with no personal or interesting features. As Mukherjee wrote in The Emperor of All Maladies, “Science begins with counting. To understand a phenomenon, a scientist must first describe it; to describe it objectively, he must first measure it.” Hence, to describe the future of healthcare is necessary to understand the forces shaping it.
Aging and growing populations, greater prevalence of chronic diseases, and exponential advances in innovative—but costly—digital technologies are the developments that continue to increase demand and expenditure. The future of healthcare is also much less centered around institutions; it is rapidly becoming decentralized, dematerialized, demonetized, and, ultimately, democratized. As healthcare becomes more data-driven, it is also becoming more personalized.
This is the story of families moving to Gibraltar. This is the story of a new hospital—the ultimate housing for births, souls, hopes, and dignity. This project proposes Gibraltar as a healthcare destination. In the tradition of Swiss mountain open-air sanatoria, it has a strategic location, boasting effective local healthcare legislation, economic incentives, and continued infrastructural development between southern Europe and youthful north Africa. It is isolated from chaotic cities, with a positive climate (300 days of sunshine a year), green slopes, sea views, fresh air, and quieter streets.
Gibraltar is the perfect set because of the current and forecasted importance of healthcare in its economy. Based on Gibraltar's budget between 2017 and 2019, a forecast envisions a growing expenditure in the healthcare field. The forecast demographic increase suggests almost 30% of the new population will be composed of children under 18.
In the peaceful ambience of the mighty Rock, only a short walking distance from the Royal Naval Hospital, a block of sheltered housing with primary health facilities (emergency, occupational therapy, and imaging departments) aspires to renovate, making the transition from home to hospital imperceptible. By all measures, in fact, the home is the future of healthcare.
Specifically, the proposal focuses on the design of a long-term residential paediatric centre, targeting young patients and families who normally travel far from their homes to specialized hospitals. Hence, the design for Gibraltar's 2050 hospital envisions the city-state as a place for treatment, healing, and recovery, strengthening the economy by serving the population expansion and strengthening Gibraltar’s position as an attractive and pleasant place to live.
Architecturally, the bottom-up complex provides an experiential journey from medical processes and foyers, common spaces, and a public healing garden (the Rock itself), to rest, healing, and independence. The new social and architectural melting-pot attempts to combine the notions of domesticity and hospitality in a secluded area on the Rock.
In summation, this social-architectural project aims to reach a point of privacy and dignity, especially through its small, human scale. Families and residents of all ages and origins can enjoy much-needed breathing space, and carry on their normal and dignified lives.