Views And Reviews

Cosiness is not enough

BMJ 1994; 308 doi: (Published 12 February 1994) Cite this as: BMJ 1994;308:480
  1. P Dormer

    During the past 20 years Britain has enjoyed a substantial growth in the art in public places movement. A part of this movement specialises in improving the design and decoration of hospitals, day centres, and similar health care facilities. But the conference Introducing Arts in Healthcare* demonstrated that art in hospitals is not about good art but about people being good to one another.

    Artists argue that they can bring a special knowledge to design and decoration that designers and architects lack. Sceptics say there is no evidence that artists have special skills. And it is indeed doubtful if the professional skills of artists are as deep or as flexible as that of designers or architects. The same artists are also part of a lobby urging the NHS to make it mandatory for new hospitals to spend 1% of their construction budget on art.

    Peter Senior, director of the Manchester based charity Arts for Health, gave the first presentation of the conference. “Art,” he said, “brings smiles to people's faces.” And, forestalling the criticism that not everyone would like the art on offer, he said that those people who disliked certain sculptures - such as the very large “Acrobatic Dancer” by Allen Jones adorning the atrium of the Chelsea and Westminster Hospital, London - were at least made to think. Art is good for you even when it hurts. This argument seems like a sleight of hand.

    That art can be good for you was demonstrated later in the conference when artists Ruth Preece and Vincent Lavelle explained their work in Ashworth Special Hospital (a high security institution).

    Their aim was to help the patients find a voice for themselves by doing art. Preece and Lavelle conveyed the awfulness of being a human and having to live twice removed from society because genes, fate, and life had shaped you to act in a manner that was mad, bad, and dangerous for others to know. Through giving people an opportunity to make things, play with imagery, construct pictures about themselves, their families, their hopes and fears, Preece and Lavelle are putting out a hand to our untouchables.

    Children, of course, are everyone's favourites, and turning sour children's wards into sumptuous playgrounds, sometimes with a gently educational theme, is a specialty of the artist Brian Chapman, who belongs to a team called Hospital Arts. They do this work well.

    Chapman also showed work done for and with elderly people. He explained its participatory nature. If, for example, a bathroom in a day care centre needed brightening up then he involves the users of the bathroom in the production of the art. “Ordinary” people have skills and the elderly have time on their hands.

    A lot of Hospital Arts' work is directed towards making institutional rooms “cosy” by transforming clinics so that they look like parlours. This is unoriginal but understandable. Senior managers often make their offices look like their suburban lounges by furnishing them with sofas, flowers, and photographs.

    Yet I'm not sure I will want to go out of this world cosily. Heroically would be nice, mentally stimulated by fine architecture and design would be wonderful. There's got to be more to the aesthetic dimension of ordinary life than a decorative order based on crochet- cover-for-the-lavatory-lids tactics.

    And we do have some architecture that is too good to be hidden under bad art. For example, I question much of the art that has been put into the atrium of the Chelsea and Westminster Hospital. The Chelsea and Westminster is grand, modern, and confident but its awesome interior is in danger of being humbled with bric-a-brac.

    It is worth reminding ourselves that sometimes - whether we are going to hospital, going to be educated, going to court, going to a professional institution - we want an architecture that we have to live or work up to. Feeling proud, being impressed, and sensing quality is just as valuable as being cosy and a lot more pleasant than being patronised. Being ill or being old does not mean one is thereby necessarily in constant need of “a bit of a knees up” or “a good laugh” (to quote Mr Chapman). The Mrs Tiggywinkles of this world are not the only patients, and even they can turn prickly when they are rubbed up the wrong way.

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