Land-they're not making it any more: logistical challenges of hospital development and redevelopment

Abstract

Before the 2019 general election, the Conservatives pledged to build 40 new hospitals (Campbell, 2019). Ostensibly this is good news, but what kind of hospitals were envisaged? The media and politicians often talk about hospitals as if they are all the same, when in reality there is much variation between the size, mix and balance of specialties in different district general hospitals. A new building does not necessarily mean a new hospital; for example, it may instead be built to replace a 19th century hospital that was struggling to accommodate modern medicine. The sign above the front door might say ‘Accident and Emergency’, but this does not necessarily mean that all the required supportive services are behind it. Any such department needs access to beds in a variety of specialties, including trauma and orthopaedics, general surgery, general medicine, paediatrics and intensive care. Many other key specialities are also needed, such as obstetrics and mental health services.