A short literary-inspired rant on lifeless, grey hospitals.
There’s endless stuff I could say on Orwell in 2026. Most of it probably isn’t for this Festival.
But a chat the other day about radical spatial acts being political (with a big and little P), made me think of 1984. Find that conversation with Dr. Aisling Rusk here.
Orwell understood and articulated what we keep ignoring - control isn't just political.
It's spatial, sensory, and it’s linguistic.
There are parallels everywhere, but let’s look at modern health infrastructure, and specifically at the hospital.
We trade green space for tarmac. We replace natural daylight with LEDs, and fresh air with sealed windows. We design out the very things that connect us to the world beyond the institution.
Orwell’s Ministry of Love had no windows so nobody could tell day from night. Obviously our hospitals are nothing like the Ministry of Love, but there is a principle here worth pausing over.
If sensory deprivation, disorientation and disconnection affect how people experience a place, why do we treat them as incidental to healthcare - or as a nice to have to be value-engineered out?
And then there is the language.
The ‘Doublespeak’ of health estates.
Orwell gave us:
War is Peace.
Ignorance is Strength.
Freedom is Slavery.
Health estates seems to give the world:
Beauty is Waste
Concrete is Care
Bland is Safe
We reduce a patient's arrival to being greeted by ugly blue plastic seating, even blue-er vinyl floors, overly cold and sanitised décor, and hostile security glass at reception – all the joy and the warmth scrubbed away somewhere along the way. Then we slap a glossy poster on the wall those same patients pass proclaiming the organisation’s commitment to ‘patient-centred care’.
Beauty and functionality are not opposing priorities. Infection control, durability, accessibility and tight budgets are all constraints, but beauty isn't expensive by default. Often, it's not about spending more, but making better choices with the budget we already have.
Yet, we so often seem to accept that environment doesn’t matter that much. Perhaps that’s the most Orwellian thing of all - that we don’t even recognise that as a problem.
How on earth did these sterile, lifeless boxes become our universal places of healing?! Why did environment and estate get so far pushed down the list of ‘what’s important’ to health?!
….and why aren’t more people shouting about it?
