Arriving at the pale, arabesque sweep of the reception desk, patients must think they have accidentally strayed into the foyer of a television production company or a Swedish health spa. Gone are the orange polypropylene chairs and drab green walls of the classic NHS waiting room. They are replaced by wicker chairs, leather upholstery and subtle dilutions of restful colours (ochres, lavenders, terracottas) that complement the pine furniture and hardwood floors. In one ward, copies of House Beautiful are scattered on a table; in the common room, a pyramid-shaped candle burns in an alcove. Then there is the gym with its slatted blinds, and the landscaped grounds with a pool, a herb garden and works of art.
In fact, the Glasgow Homeopathic Hospital is a work of art - designed by the architects Maclachlan Monaghan in response to a competition in 1995, and interior-designed by artist Jane Kelly to create an atmosphere of harmony.
Wherever possible, the materials are natural and the lines "organic" rather than angular - right down to the gracefully curved door handles and wastepaper baskets. It's inspiring, especially for an NHS hospital. Though built with £2.2m of private money, Glasgow's architectural showpiece is run by the health service and offers 15 inpatient beds as well as facilities for outpatients. All the wards face outwards, in recognition of the fact that patients with a view of nature recover more quickly than others.
Like many of the design innovations at Glasgow, this is a theory backed up by science - in this case in a study by Professor Roger Ulrich, an environmental psychologist at the Texas A&M School of Architecture. Between 1972 and 1981, he compared the recovery rates of two sets of patients at a Pennsylvania hospital after gall-bladder surgery - one in a ward with a view of trees, the other overlooking a brick wall. The first group recovered more quickly, used less medication and suffered fewer post-operative complications than the second.
Since 1984, when Ulrich's findings were published, more than 100 studies have been conducted in the US looking at the links between good hospital design and patient wellbeing. Researchers have considered everything from lighting, to room orientation, to ventilation; from the proportion of wall surfaces, to the exact positioning of windows and the healing effects of music, colour and plants. In one extreme example, based on another Ulrich study, patients were shown to have quicker recovery rates if their rooms were decorated with "bedscapes" - fabric wall hangings depicting scenes from nature. Health administrators in the NHS have been so persuaded by "evidence" from what they see as a legitimised, scientifically quantifiable, western version of feng shui, they have turned their hospitals into hotels. At the Hackensack University Medical Center in New Jersey, patients are greeted by a uniformed doorman and led into a lobby with a crackling log fire, floor-to-ceiling windows and views of the granite fountains outside. In a soaring atrium called the palm court, nine petrified palms stand in pots on the polished marble floor. In North Littlerock, Arkansas, every patient at the Baptist Health Medical Center has a veranda with a forest view, while the foyer of the Woodwinds Hospital, in Minneapolis, is furnished with rocking chairs and the operating theatres feature backlit photographs of woodlands and rushing rivers.
"In America, they have embraced those ideas," says Roy Maclachlan, architect of the Glasgow Homeopathic Hospital, "but our design wasn't based on hard scientific research. We were responding to a specific brief from the client, who told us that natural lighting, natural materials and ventilation should be high on the agenda." However, Maclachlan Monaghan did speak to research scientists about the benefits of full-spectrum lighting, which mimics natural light and eliminates the yellow cast often seen in hospitals. Studies on oil rigs and at air-traffic control centres have shown that it aids concentration and promotes wellbeing. "We also drew on scientific research into colour," says Maclachlan, "and we knew that lavender - the colour you first see when you approach the hospital - has a particular emotional effect. All good design is instinctive, but that instinct is there because of certain psychological responses that we all have."
Though keen to distance himself from it, Maclachlan met a feng shui expert from the Prince of Wales Institute of Architecture in London and read a book called Feng Shui by Derek Walters. "It reminded me that feng shui is just a way of measuring design," he says, "and putting it in language that people understand. A good architect responds to colour, uses shapes as foils, balances one area of reflected light against another. In feng shui, you might say instead that this is an earth shape (which is flat and round) or that is a fire shape (pointed), and talk about positive chi or conduits of energy. Why do people find certain colours and shapes harmonising? It may not be totally scientific, but there is a system there."
In these days of PFI and public-private funding, NHS trusts need something more concrete before splashing out on Mulberry sofas and matching Merlot cushions. Isn't the cash better spent on a new MRI scanner?
To address the question, a new industry has sprung up to prove that a pleasant environment can save the health service money. At the Chelsea and Westminster Hospital, Dr Rosalia Staricoff has completed the first part of a study looking at the therapeutic effects of decor, ambiance and art. The second and third parts will measure physiological changes and effects on patient recovery. In south Teeside, where four hospitals are being merged, £250,000 of the budget (plus £250,000 of private sponsorship) has been allocated for improvements to the environment. These include "a healing palette" of colours, natural light and courtyards featuring works of art. "We will be doing a full evaluation," says Margaret McGloin, assistant director of planning, "to show the positive, tangible results." At Durham University, a department has been set up to explore the links between wellbeing and the built environment. Cahhm (pronounced "calm" - the Centre for Arts and Humanities in Health and Medicine) is assisted by Newcastle architect Geoffrey Purves. "Good design is mainly about instinct," he agrees, "but there is a growing body of evidence that reinforces those instincts to a point where policymakers are taking them onboard."
One such piece of evidence will be published later this year - an NHS-funded study conducted by Brighton architect John Wells-Thorpe. "With the University of Sheffield," he says, "we took two groups of patients - one psychiatric, one orthopaedic - and transferred a sample from each to a brand new hospital where design was a priority. Length of stay was reduced dramatically in the psychiatric patients, by about 14 days. In the orthopaedic group, it was three days shorter and there was far less dependency on analgesics than in the control group. The psychiatric patients in the new building actually believed that the entire therapeutic experience had been better - and that the staff were better."
With so much "hard" research under way, is it possible to draw up guidelines for the perfect healing environment? Peter Scher, a former NHS architect and practising consultant, believes the process is too subjective to be quantified scientifically. "At the Glasgow Homeopathic Hospital," he says, "I knew it was a place I wanted to be in but I couldn't pin down precisely why. There is no word for it in the English language other than 'nice'. Colour seemed to be the key, with barely perceptible dilutions that were calming rather than dramatic. I have never used the word 'organic' - and I never would - but the gentle curves seemed to make sense. Use of daylight is important, with windows placed high up or low down - very agreeable, but not extraordinary. Agreeable is all you want, because the design shouldn't be too challenging for patients who haven't chosen to be there."
