Antoniou, A; (2006) Innovative primary health and community care models in Britain since 1980. Doctoral thesis , UCL (University College London).

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Abstract

This thesis approaches issues related to primary healthcare and community care buildings in Britain built in the last 25 years, since the beginning of 1980s. An educational visit to the Finsbury Health Centre on 6th February 2006 became the starting point for my decision to begin a search about the architectural history of the modern primary healthcare buildings. A couple of years ago my participation in the biannual studio-based module Architectural Design of Primary Health Care Facilities offered me an initiation to the architectural design and planning of primary healthcare facilities. Four publications were the main source of information for that research together with a number of realized educational visits in modern health and community care centres: a book, focused on the life and architectural work of Berthold Lubetkin, written by John Alan remains one of the most important sources of information for the pioneering establishment of primary healthcare in 1930s' London and particularly for the Finsbury Health Centre and the East Ham Chest Clinic project (1932). A fruitful article, written by James Madge on the occasion of building revisits in 1982 provides considerable information related to the more recent history of the building, as Madge records original photographs and drawings describing the size and the character of previous alterations. A monograph for Owen Williams, written by David Cottam, provides interesting information for the achievement of the Pioneer Health Centre in Peckham. A recent attempt to evaluate the modern heritage in Britain from the perspective of contemporary society testifies the publication of Alan Powers' book Modern. The Modern Movement in Britain. The study of the above-mentioned information, enriched with publications in architectural periodicals primarily in 1980s6 and accompanied by further educational visits in modern and contemporary health and community care buildings in London, gave me the opportunity to record, evaluate and comment on the architectural design, planning and on the changes in uses in two essays These essays may be seen as a collection of recent observations of the changes in uses which occurred in these buildings as well as a collection of interpretations of the reasons why and how these changes took place in the varied conditions of the local societies. In many cases a dysfunction in the centres' operation was observed and was due to an insufficient architectural planning or due to the unexpected and dynamic changes in the socioeconomic structure of the local societies. The Commission for Architecture and the Built Environment (CABE) in an attempt to improve the planning and design of healthcare facilities organized the 'Health Week' in London on 15-19 May 2006. Information and advice through participation in a series of seminars and group discussions were given. The distribution of a special edition to the participants under the title Design and neighbourhood healthcare buildings accompanied the event. This edition consisted of a series of case-studies, nevertheless without a clear approach based on the classification of buildings in relation to the models they serve (for example, the health centres, the community care centres, the healthy living centres etc.) and the level of treatment they offer (for example, primary, secondary or tertiary healthcare). A chronological order of case-studies was indeed helpful but not as much as to reveal the historical evolution of medical models, social programmes and building types. This might be the shortcoming of this edition this thesis will attempt to affront this overlooking by continuing the research from the point which CABE left it. Object of the study and future speculation This thesis will attempt to renew the interest of health and design professionals and of the wider public for the primary healthcare and social care architecture. (Abstract shortened by UMI.)

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