Healthcare 2025: Buildings for the future
For the fifth time the Netherlands Board of Healthcare Institutions =
(the
Board) has held a competition. In this competition, the Board calls upon
designers to present their outlook on the spatial implications of the chang=
ing
healthcare sector.
The designers were challenged to elaborate on this concept for an
imaginary location in the IJsselmeer in the year 2025.
The healthcare sector in Europe is changing. Many countries are purs=
uing
reforms to enable the supply of care to correspond better with the demand, =
and
to keep care at an affordable level, amongst other things, by bringing about
greater competitiveness and free market operations between care institution=
s.
Simultaneously, it is realized that care should not merely be considered as=
a
cost item, but that investing in care and in a healthy population also serv=
es
the social and economic interests.
Aside from these reforms in the European countries, as a result of
economic developments, alterations in the living patterns and climate chang=
es,
there are also changes in the health of the world's populations. The ageing=
of
the population plays a role in the changing demand for care. Europe has an =
ever
increasing population older than 65 years of age and the number of
‘aged’ senior citizens is increasing: the group aged 80+ is
increasing in relative and absolute numbers. This increases the number of
age-related illnesses (diabetes, arthritis, dementia). There is a major
increase in the number of overweight people. Moreover, due to the climate
changes, there is the possibility that diseases which only come about in
tropical countries, could also occur in the Netherlands. Generally one can =
say
that patients are becoming more outspoken, which results in a demand for be=
tter
quality in the care requirements.
All these changes will lead to new kinds of healthcare facilities. In
the forthcoming era of healthcare facilities, other avenues will be explored
regarding the spread of facilities and more attention will be paid to seque=
nced
healthcare and the supply of customized care for the chronically ill. In th=
is
the affordability and accessibility of the care are, however, continually u=
nder
pressure.
Within the healthcare sector the dynamism is not exclusive; so too a=
re
changes taking place in the circumstances outside. In 2025 consideration mu=
st
be taken into account of a reduced availability of (fossil) fuels and a hig=
her
energy price. Climate changes will have consequences for the spatial planni=
ng,
urban planning and architecture. The pressure on the space in the Randstad =
will
be even higher than at present and mobility issues will possibly be given a
different character. Changing life styles, individual preferences and physi=
cal
opportunities call for a new way of thinking about flexibility in types of
organizations and accommodations, so that institutions and buildings can re=
main
functioning properly in the rapidly changing circumstances. Policy makers a=
nd
care providers will have to find answers to these new major issues, and this
will have consequences for the landscape, the urban planning and for the
architecture.
With this Architectural Competitio=
n for
Designers and Care Experts, the Board want to encourage innovative and
future-oriented thinking about building in the healthcare sector. For the
encouragement of interdisciplinary and unconventional thinking geared towar=
ds
care, policy, entrepreneurship, planning and technology. The Board want to
inspire designers and clients in the Healthcare construction sector by
presenting possible solutions to issues of the future.
With the ‘European Architectural Competition for Designe=
rs and
Care Experts Care 2025: Buildings for the future’=
the
Board want to challenge designers to develop a total concept in this dynamic
context of the Healthcare sector of the future. It will be necessary explore
beyond the reaches of disciplines. Architects, consultants, planners,
futurologists, care providers and managers could jointly achieve innovative
concepts. The Board is awarding prizes to the best three comprehensive plan=
s.
The jury can award two extra prizes for special achievements on certain asp=
ects.
A maximum of three honourable mentions can be awarded.
The European Architectural Competition was open not only to architec=
ts,
but also to students in the Netherlands or Europe who are undergoing higher
vocational education or university courses in building or architecture. In
total 90 candidates registered for the competition. On closure of the
submission term, the Board received 46 entries, including eight entries from
abroad.
Assignment
As was the case for the previous e=
ditions
of the Board's competitions, the focus lies on the search for new forms of a
healing environment. The assignment for this European Architectural Competi=
tion
concerns a hypothetical location. The given situation is that new land will=
be
completed in the IJsselmeer in 2025; enough to build a city for 160,000
inhabitants. After a pioneering phase which can be ignored in view of this
assignment, the new city will reflect a population which corresponds to sim=
ilar
Dutch cities in 2025 of that size. The healthcare for this city still has t=
o be
developed in its entirety. The city requires all the basic facilities, so t=
hat
the residents only need to go elsewhere to top specialist medical care.
The assignment is to develop ideas=
for the
layout of the healthcare sector in this new city in 2025. These ideas must =
be
translated into a spatial and/or organizational design of the healthcare
facilities, and an elaboration of a portion thereof. The full spectrum of t=
he
healthcare sector is broached. The location is bordered by the current bank=
s of
the Markermeer. The type of land reclamation is unrestricted, and likewise =
that
of the city which arises therein.
The jury was chaired by Ms. Drs. H. d'Ancona, former member of the
Board. The other members of the jury are:
Ms. R. Glanville, Head of Medical Architecture Research Unit, London
South Bank University
Ms. Drs. J. Rodermond, Director of the Netherlands Architecture Fund=
Ir. M.A. M. Crouwel, Chief Government Architect of the Netherlands
Drs. J. Hamel, former Chairman of the UMCG Supervisory Board
M. Verweij, Medical Doctor and Member of the Board
Prof. Ir. W. Patijn, Architect and Dean of the Building and Architec=
ture
faculty at the University of Technology Delft
The final adjudication of all the entries took place on 27 August 20=
07
in Utrecht.
In the adjudication preparations, =
Petra
van der Schaaf and Peter Heijmen, who are employed by the Board, tested all=
the
entries on the limiting conditions and the rules of the competition. During=
the
deliberations the jury assisted by Ms. W. van Staalduinen of the Board and =
Ir.
M.A. Visser and Ms. Drs. M. Paulissen from the firm S@M stedebouw &
architectuurmanagement in Amsterdam, who is also responsible for the drawin=
g up
of the jury report.
The jury is enthusiastic about the responses to this competition and
appreciates the amount of energy and creativity that the participants have =
put
into the elaboration of the competition. However, the jury has observed that
the general level of quality of the entries was disappointing. Entrants
apparently had difficulty in providing care and architecture at a high level
all over. There are only a few entries with professionally elaborated desig=
ns
with a surprising, exciting, innovative and visionary character. By compari=
son
with preceding editions, more teams of students have participated in this
competition. It is gratifying to know that the theme of the competition has
drawn interest amongst young (upcoming) designers.
The jury finds that the given competition assignment was extremely
complex which placed a high demand on the entrants. For this competition, a=
fter
all, the assignment was to develop a total concept on the future of the
healthcare sector in combination with a spatial solution on multiple scale
levels (regional, metropolitan, building).
Furthermore, entrants also had to pay attention =
to
changes in the climate, the power supply, efficient use of space and market
forces. It seems that it was awkward for entrants to provide suitable answe=
rs
to all the aspects mentioned. Most of the entrants only paid attention to o=
ne
of two sections of the competition assignment.
The jury thinks its remarkable that the entries
portray a strong belief in the technological progress as well as a strong
belief in a socially involved future society. Many assume that it is possib=
le
to create a healthy society and healing environment, and that people will s=
tay
healthier for longer in a well designed city. Many entrants applied known
spatial concepts and assume that the design in itself already creates a hea=
ling
environment. The jury considers this as old-fashioned physical determinism
coupled to an irrefutable faith that everything will turn out well: a kind =
of
revival of the post-war reconstruction mentality. There's a lack of specific
innovative ideas about the healthcare sector in 2025.
Also, the jury cannot deny the fact that the ma=
jority
of the design teams do not have an overview of the broad scale of the
healthcare sector. For most of the entries only one target group is highlig=
hted.
The pictures and collages presented, predominantly contain relatively healt=
hy
people. The disabled and other users of Healthcare services are hardly show=
n at
all. Among the entries there seems to be more attention paid to prevention
rather than to care and cure.
In its adjudication of the entries, the jury has
maintained assessment criteria mentioned in the competition schedule. The
providing of a directional response to the most important issues that will =
play
a role in the care sector and the built-up environment in 2025, is the
criterion that carries the most weight here. However, it concerns an
Architectural competition for design teams and the jury has thus pla=
ced
an equal amount of importance on the criterion that the concept has an
attractive appearance in the design.
In this respect, the jury has noticed that many
entries got bogged down at the level of the urban development design and th=
at
in many cases, there was an inadequate focus on the level of the buildings.
Many entries emphasized the improvement of the infrastructure, often in
combination with green cities. Especially the cutting back of car-use and
greater use being made of all kinds of original public transport systems, i=
s a
recurrent and much-used theme. Aside from a couple of exceptions, the jury
thinks they are traditional urban development concepts. The jury considers =
the
architectural quality of the entries as being disappointing. They have not
found any architecture which is striking or appealing to the imagination. T=
he
same applies on the level of the interior design.
Prior to the adjudication all members of the jury received copies of=
all
the entries, hence an extensive analysis of the plans could take place. In
preparation of the adjudication, the 46 submitted projects were tested on t=
he
limiting conditions as mentioned in the competition schedule.
Prior to the jury's adjudication the entries were tested for their
completeness, in which the following was noted per entry:
In this preselection nine entries were considered as inadequate. The
jury did examine these nine entries, but then cast them aside. According to=
the
jury they did indeed concern presentations which did not adequately comply =
with
the competition schedule in a number of respects. The remaining 37 entries =
were
accepted by the jury and were then adjudicated with increasing precision in=
two
rounds. In the final round the awarding of the prizes was decided. The atta=
ched
overview provides an insight into the course of the various adjudication
rounds.
In the first general adjudication round 20 entries were rejected. The
remaining 17 entries were then individually adjudicated by the jury members=
, in
which each adjudicator indicated whether there were sufficient qualities
present to advance the entry to proceed to the next round. After a general =
tour
of the various entries and the subsequent deliberations, 6 entries remained.
Two entries did not qualify for the final round in which the prizes were
awarded.
In the last round the jury debated on the four
special entries. These four were then individually adjudicated on the basis=
of
the criteria of the competition regulations. After this strict selection and
the final deliberations, the jury decided to award a prize to two entries a=
nd
to award an honourable mention to two entries.
The jury is of the opinion that the main objectives of the competiti=
on
have largely been complied with. According to the jury the European
architectural competition
=
Mentionable
entries
There are two entries, according to the jury, which deserve a mentio=
n in
the jury report. The one entry's motto is Water of Life and the other entry=
's
motto is Hygiopolis. The entry with the motto Water of Life is one of
the few proposals in which use is made of the unique possibility offered by=
the
chosen location to make use of the surrounding water as a spatial quality
aspect. The designers opted for positioning a number of (copies of existing)
buildings which appeal to the imagination in the water, hence an attractive
image comes about. The jury thinks that the entry conjures up a positive
feeling.
The entry with the motto Hygiopolis is appreciated because of=
the
basic idea behind the design and the attention for a healing environment. T=
he
designers don't only assume that the inhabitants of the city have a healthy
lifestyle but also take the course of life of the residents into considerat=
ion.
Many aspects of the competition schedule are incorporated in the design.
=
The entries with the motto ZorgeNLoos Living put communal involvement
first and foremost. The future healthcare sector, in the entrant's opinion,
will be dependent on a large group of volunteers. So-called ZorgPunten (Care
Points) are established in the city. These are low-threshold neighbourhood
health care centres which provide important additional services on three ca=
re
levels. Counselling for the needy is organised from the Care Points.
Information, courses and preventive advice is given via a system of coaches=
in
the health care sector. In this proposal a large portion of the health care=
is
taken up by a social communal network consisting of family members and
volunteers. Thus the costs for the other (buildings) care facilities, in the
opinion of the entrants, could remain low. The Care Points could be
structurally integrated in existing buildings or in new building projects.<=
b>
Adjudication:
The entry with the motto ZorgeNLoos Living offers a most original
outlook by anticipating the expected increased need for health care in 2025=
. It
is perhaps naive and optimistic to assume a relatively healthy urban
population, who can depend on neighbours, family or volunteers when they're
ill. However, in order to continue guaranteeing the healthcare called for in
the future, offering a greater communal involvement could perhaps be a solu=
tion.
The jury has appreciation for the system of immediate and accessible care w=
hich
is offered via the Care Points. The idea is elaborated for an existing city=
; an
urban proposal for the location suggested however, is missing. The
architectural elaboration is described as effective. For the interior, the
design is realistic and convincing and as far as the jury are concerned, it
could be built as it is. The entry with the motto ZorgeNLoos is given an
honourable mention by the jury.
For the entry with the motto
Care-4U, the welfare of the residents in their own urban living environment=
is
put first and foremost. The driving force behind this design is the placeme=
nt
and space granted to people's various lifestyles.
In this city which is geared towards welfare, health and energy
conservation there is no place for vehicles, but an excellent public transp=
ort
network is constructed, which, according to entrants, will cause the future
residents to feel challenged to keep on the move – which will contrib=
ute
to their wellbeing.
Three living environments are
differentiated in the design: in the centre, urban and suburban. The city
consists of different islands. According to designers, the presence of the
water offers an added quality which is advantageous for the welfare of the
residents and, in an urban point of view, it is the crux of the design. The
design is not a final picture, but provides a spatial structure which can
incorporate future changes in lifestyles and urban transformations. In orde=
r to
enhance flexibility and diversity in the supply of care, housing, healthcare
facilities and general and technical services are detached. The idea is that
changing needs can be anticipated on. The healthcare facilities could be po=
sitioned,
like inserted modules, at different places in the city.
Adjudication:
The entry with the motto Care-4U has been well elaborated according =
to
the jury. The relaxed proposal offers a professional viewpoint on the set
problems and contains innovative elements.
The proposed urban development design, of which the jury associates =
the
architectural elaboration with typical high-rise schedules of the 1960s, do=
es
raise some questions.
The entry clearly differentiates the various users with the associat=
ed
healthcare facilities. The manner in which users deal with their demand for
care in the future is original and well thought-out. The idea of introducin=
g a
flexible system for the healthcare sector in which - unlike many other entr=
ies
- attention has also been paid to the hospital patient, is appreciated by t=
he
jury. The jury considers an honourable mention for the entry with the motto
Care-4U in order.
No. 8. Fair Care – WINNER
Making reference to the ancient Greeks, where the sick and the elder=
ly
were taken care of in an activities centre with cultural and sports facilit=
ies,
the entrants of the motto Fair Care have designed the new city Elysiadam, w=
hich
they call ‘Modern Aesclepions’. An Aesclepion can be situated b=
oth
in the city centre near cultural facilities as well as along the beach. Hou=
sing
for senior citizens is in close proximity. Aside from a system of neighbour=
hood
centres which provides for low-threshold access to healthcare, the designers
also propose a centrally-situated hospital, which is further elaborated in =
the
entry. The hospital is built up of modular units, hence the changing needs =
can
easily be anticipated.
Adjudication:
The jury considers the entry with the motto Fair Care as one of the =
most
complex entries because attention is paid to all the aspects of the competi=
tion
schedule. The entrants envisage providing solutions for multiple target gro=
ups,
including the disabled and the elderly. Even though this is not remarkably
innovative or renewing, the jury is sympathetic towards the proposed system=
of
spreading healthcare facilities.
The urban development plan is well thought-out, realistic and appeal=
s to
the imagination. The atmosphere of the architecture which is conjured up in=
the
outlines of the buildings, is relaxed yet of a changing quality. A relative=
ly
great deal of attention has been paid by the designers on the elaboration of
the central hospital. The entry with the motto Fair Care is marked by the j=
ury
as one of the two winning entries.
No. 26 Big Bang – WINNER
The entry with the motto Big Bang outlines a scenario for a Healthca=
re
system in 2025. The motto refers to the time that the hospitals that have g=
rown
into megastructures as we know them in 2007 - have exploded in one fell swo=
op
into a fanned-out swarm of individual clinics and healthcare facilities, ge=
ared
towards the needs of specific target groups. The scenario assumes a highly
advanced form of free-market operation and a regrouping in the healthcare
sector, in which the client and efficiency improvement stand at the forefro=
nt.
In this new system, DokterPlus (Dr.+) establishes the diagnosis in the
Diagnosis Centre - backed or not by one of the so-called LABS. Then via the
so-called Health Information Centre the patient can orientate himself on the
most suitable Healthcare facility. This new Dutch healthcare system, accord=
ing
to the designers, is so advanced, that it even ends up in the top 10 of
exported products and is also the reason for an increasing number of foreign
visitors.
The city of Molen (160,000 inhabitants) is part of Nieuw Marken (500=
,000
inhabitants) and has been developed entirely by private parties. There are
three 'wings' connected to the main structure of the city which house all t=
he
facilities. There is no traditional city centre nor any large-scale medical
facilities. The transport system is a road system. Prototypes for the vario=
us
care buildings required in the system have been developed by the designers.
These can be elaborated upon dependent on the location, atmosphere or taste=
.
Adjudication:
The entry with the motto Big Bang is complete and convincing. Accord=
ing
to the jury the original layout of the new city, in the form of a windmill,=
has
a strong influence on the imagination. The whole entry can be described as
"smart logo architecture", because the typology of the various
building designs can also, as such, be more or less classified as simplisti=
c.
In respect of the many other entrants who have island structures, this prop=
osal
is considered as one of the most interesting spatial compositions. The prop=
osed
system for the healthcare as such, is not pioneering innovation, but the ju=
ry
does appreciate the clever manner in which the developments of today, such =
as
free market operations and scale-changes in healthcare, have been carried
through to a new model for the future. The proposed healthcare system and t=
he
spatial elaboration, have been integrated in a lovely way. The jury is a bit
unsure about the proposed modernistic architecture, but in an urban develop=
ment
respect it's an innovative concept. The entry with the motto Big Bang is ma=
rked
by the jury as one of the two winning entries.
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NO. |
MOTTO |
1st round |
2nd round |
3rd round |
nominees |
Result |
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1 |
Common care & cure, Common privacy |
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2 |
Health to the people |
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3 |
Strip City |
√ |
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4 |
Cit-Y the Future |
√ |
√ |
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5 |
Wealthland |
√ |
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|
6 |
Blooming up |
√ |
√ |
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|
7 |
Care-4U |
√ |
√ |
√ |
√ |
Honourable menti=
on |
|
8 |
Fair Care |
√ |
√ |
√ |
√ |
Award winner |
|
9 |
Markerwerf |
√ |
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10 |
Well Come City |
√ |
√ |
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11 |
… is half the solution |
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12 |
Carefree 2025 Markerdam |
√ |
√ |
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13 |
We Care |
√ |
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14 |
Holon |
√ |
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15 |
City without a care |
√ |
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16 |
Network Islands |
√ |
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17 |
Leef! |
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18 |
Geheel en al |
√ |
√ |
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19 |
Postcode 1572 |
√ |
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20 |
Healthdome.org |
√ |
√ |
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21 |
Take'25 |
√ |
√ |
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22 |
Access to Fload |
√ |
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23 |
I XVIII XVIII I |
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24 |
Bridge.N |
√ |
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25 |
Blue Heart |
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26 |
Big Bang |
√ |
√ |
√ |
√ |
Award winner |
|
27 |
ZorgeNLoos Living |
√ |
√ |
√ |
√ |
Honourable menti=
on |
|
28 |
New Marken |
√ |
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29 |
Water of Life |
√ |
√ |
√ |
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30 |
Marker Islands |
√ |
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31 |
Kennistempel |
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32 |
Zorg voor jouw leven [Care for your life] |
√ |
√ |
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33 |
Vital Wise Water |
√ |
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34 |
Isle Care |
√ |
√ |
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35 |
A caring network |
√ |
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36 |
Health(y) around the block |
√<= o:p> |
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37 |
Meermarken |
√<= o:p> |
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38 |
Fac unum quotidie quoo
………… |
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39 |
Nobody is perfect |
√<= o:p> |
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40 |
Care in motion |
√<= o:p> |
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41 |
Square=
City
|
√<= o:p> |
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42 |
Red Point |
√<= o:p> |
√<= o:p> |
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43 |
29934 |
√<= o:p> |
√<= o:p> |
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44 |
3 propositions |
√<= o:p> |
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45 |
Hygiopolis |
√<= o:p> |
√<= o:p> |
√ |
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46 |
A Green Archipelago |
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37 |
17 |
6 |
4 |
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