I hadn’t intended to write about Covid ever again, but just at the moment I received my second vaccination, the World Health Organisation announced that six Scottish health boards were among the top 10 worst-hit regions in Europe. NHS Tayside has the highest rate, with 1,146 cases per 100,000 people.

The BBC reported Jason Leitch (Scotland’s national clinical director) explaining that a lack of "natural immunity" in the population has led to Scotland having the highest Covid rates in Europe. A few months ago, we were doing well… not so now. For the next few days, Dundee will probably be the most infectious place in Europe yet when I go down to the city centre there are blithe people walking around, seemingly tourists, who are strangely oblivious.

I received my blue envelope then had my inoculation a few days later in the Caird Hall.  More so than the enormity of NHS Tayside’s task, the thing that struck me was being in a huge concert hall filled with hundreds of vaccination stations spaced out geometrically across the stalls floor – oddly it reminded me of the Central Services Office in Terry Gilliam’s film “Brazil”. A lateral flow kit was thrust into my hand as I left the hall and emerged blinking into the sunshine on Crichton Street.

Bad news, like Dundee’s current infection rate, travels fast – but you rarely hear about the gene technology labs in the city, the cluster of biomedical companies, or the research success of Ninewells Hospital, which was the largest new teaching hospital in Europe when it opened in the 70’s. Or indeed Murray Royal in Perth, which was redeveloped in 2012 as the largest new mental healthcare hospital in the UK, replacing an impressive asylum designed in the 1780’s by William Burn which is the prototype for many that came after.

Because mostly, healthcare and its architecture is a good news story. That prompted me to think about the “capital versus revenue” issue which I’ve heard several times from clients, when the door creaks open a fraction and you get a glimpse into their professional life. Sometimes the frustrations spill out, such as when someone senior at a subsea engineering firm came off the phone after an exasperating negotiation and looked at me: “We’re not selling a commodity product! The things we make aren’t like cans of baked beans!!”

The first time I came across the short term/ long term funding argument was when I worked on a theatre project which won a Lottery-funded capital grant to redevelop on a grand scale. After a long gestation and many battles, they ended up with a much-loved venue – which went bust a decade later. One of the reasons, according to the Press, was a cut in their Scottish Arts Council revenue funding support.

The other side of the capital/ revenue debate was illustrated last month when I went to Perth Royal Infirmary as a visitor. A Canon Medical Imaging lorry trailer was parked in a courtyard, its thick umbilical slinking into the building. This is a mobile CT scanner, brought in to supplement the capacity of hospitals in Dundee, Perth and Brechin.

Having had some experience doing clinical planning, I know that Computerised Tomography suites are complex beasts with large footprints, lots of servicing and if they serve an interventional radiography role, they need air handling units as large as a single decker bus. Short term, it makes sense to use revenue to pay for hiring in scanners to reduce waiting lists, while developing capital projects at Ninewells to permanently increase the scanner “fleet”.

So reading the self-serving Op-Ed pieces in various architecture magazines about how architects can somehow make a difference in healthcare provision, made me consider a fundamental point. What can architecture and design do to improve the natural immunity of Scots – can we build our way out of infection? Or is there only so much buildings can do, and after that it’s down to a lottery of birth with your genetics, background, diet, and so forth dictating your health?

I think the answer may lie with another client I worked for, a few years after the theatre. He was a GP on the verge of retiring from practice, and had spent his final few years developing his idea for a Healthy Living Centre. Conceptually it was somewhere you go in order to stay well – rather than a Medical Centre you attend after you’ve fallen ill. The former Chief Medical Officer, Harry Burns, had similar ideas but sadly the project I worked on didn’t happen. Perhaps the idea will catch on one day.

Hopefully next time I add something to this blog, Covid will be receding in the rear view mirror and we’ll be able reflect on the aesthetics of what you might call “pure” architecture, rather than the everyday necessities of “applied” architecture.

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