Healthcare’s Civic Shift

January 8, 2019

Changi General Hospital

Written by: Narelle Yabuka

Originally published in Cubes Magazine

B+H Architects foresee that it won’t only be greenery transforming the experience of healthcare architecture. Looking ahead, we can also expect a much greater emphasis on hospitals as community hubs for health and wellness.


Visit many of the newest healthcare facilities these days and you’ll likely sense a spatial loosening of sorts – an impression of spaces that offer the reprieve of a garden connection, or a view to plants, or a revitalising wash of natural light. “Maximising access to natural light and views to the outdoors are important objectives in practically every healthcare project we are involved in these days,” says Dr Stéphane Lasserre, France-registered architect and Principal of the Singapore studio of B+H Architects – an international firm (founded in Canada) that’s building up a considerable portfolio of healthcare projects here in collaboration with local firms.

“Research has yielded substantial evidence on the health benefits of access to nature,” he says, “but there are gaps in our understanding. The more recent studies extend beyond the visual aspect to the multi-sensorial benefits of contact with nature and how it’s connected to our evolutionary psychology.” Singapore’s climate, of course, readily allows for the implementation of the inherent suggestion that greenery should be inhabited, not just gazed upon. And B+H has actively pursued the provision of access to landscaped areas in its recent projects here.

For example, the wards in The Integrated Building at Changi General Hospital (with RDC Architects and Mace Studio, completed in 2014) have direct access to green spaces, and a healing rooftop garden is available to patients and visitors. NUCOHS (the National University Centre for Oral Health, with A61, opening to the public in 2019) clusters around a large central landscaped courtyard on the upper levels, and has been designed with high ceilings and large windows on its eastern side that convey natural light deep into the interior. The green spaces at Outram Community Hospital (with CIAP Architects and Silver Thomas Hanley International, scheduled for completion in 2020) will include a rooftop rehabilitation centre.

B+H, which has global studios in nine cities (including Singapore, Ho Chi Minh City, Hong Kong and Shanghai), was one of the first foreign architecture firms to establish a presence in Asia; the Shanghai studio opened in 1992. The Singapore studio was next, opening in 2010, and its first projects were Gleneagles Medini Hospital in Johor Bahru and Quill City Mall in Kuala Lumpur.

Winning five public hospital projects in Singapore necessitated the building of a team of healthcare design experts. But the studio’s portfolio also expands to other sectors; hospitality with luxury resorts and city hotels, education, offices and commercial projects, and mixed-use retail centres around the region have all been on the books.

“As medical technology advances, treatments can take place in a more personalised and patient-friendly setting through community hospitals, nursing homes, community centres or even at home.”

The Singapore studio’s expertise in healthcare design is nevertheless substantial, and supports Senior Associate Maria Ionescu’s observation of another substantial shift that’s underfoot for the sector: a changing model of care that will better integrate hospitals and their services with the surrounding community. “As medical technology advances, treatments can take place in a more personalised and patient-friendly setting through community hospitals, nursing homes, community centres or even at home,” she says. She predicts that in the future, the existing larger urban general hospitals will focus mainly on acute care. Many of the remaining hospitals will become smaller and specialised in focus.

They’ll also become more humanised, she predicts, and better integrated with the community. “They will be mixed-use community hubs for health and wellness – gathering spaces that engage the larger community,” she suggests. She points to the Markham Stouffville Hospital in Ontario, designed by B+H and completed in 2014 in collaboration with Perkins+Will Architects, where a library, community pool and gym are located alongside medical service facilities.

But making the transition from a traditional hospital-centric model to a broader community-based one will require changes in Singapore’s healthcare ecosystem, suggests Ionescu: “There’ll be a need to build stronger links between territory institutions and the primary, intermediate, long-term and home-care sectors.” Singaporeans are living longer but with a greater prevalence of chronic conditions. The promotion of wellness in the community, rather than the invisible treatment of ill health in opaque facilities, makes a lot of sense.