All photos from John Shaw, Sir Arthur Stephenson: Australian Architect (Stephenson & Turner, 1987).
The Australian Modern hospital holds a pivotal place both in the development of Australian Modernism and in the advancement of Australian health. They used a distinctly modern language, drawing upon the latest medical and architectural theories of the time. In doing so, they also introduced Modernism to the Australian public, seeding a fundamental shift in Australian architectural aesthetics.
The hospital now forms the core of medical care but prior to the twentieth century attendance at a hospital was associated with poverty and death: the wealthy were treated at home; only the destitute attended hospitals. Advances in medical technology and treatment techniques in the late nineteenth century saw the role of the hospital change and, as they became a place for medical treatment for both rich and poor alike, they became a symbol of a modern and healthy society. Nineteenth century medical theory, as Goubert puts it, saw hospitals “as a place where miasmas and filth would be driven out by the beneficial action of air, water and sun”. Salubrity was a priority in hospital design, with the roles of sunlight and fresh air in the curing of disease playing a crucial design role, but this alone did not necessarily engender a radical departure from the architectural styles of the day.
Modern architecture came from a desire to reflect the functions of buildings “honestly”. Mark Wigley compares it to “the doctor’s white coat, the white tiles of the bathroom, the white walls of the hospital… It is about a certain look of cleanliness.” Applied whiteness – whitewash – made everything clean, banishing dirt and darkness, and health, both moral and physical, was achieved through hygienic – that is, modern – architecture. The strong connections between hygiene, function and modernism came together explicitly in the hospital and it was not long before the ideals of Modernism found expression in health-related architecture.
In the late 1920s and early 1930s, a new aesthetic in hospital design was driven by a handful of European sanatoria. American and British designs remained conservative, but, with a minor boom of hospital building in the 1930s, Australian hospitals changed quickly to reflect European trends. Promoted in part by a shortage of hospital beds, but provided with limited funds, the new designs were austere and efficient. They were also among the first large-scale prominent buildings to adopt the new modern language.
Rapid changes in hospital designs, coupled with a desperate shortage, meant that hospitals were a promising field of specialisation for architects. Arthur Stephenson, of the Melbourne firm of Stephenson & Meldrum, recognised this opportunity and, in order to foster it, undertook an extensive research trip across the United States in 1927. Stephenson was not alone in seeing great potential in hospitals, Leighton Irwin also cast his firm as hospital specialists, but Stephenson was at the forefront in this country.
The commission for St Vincent’s Hospital, Fitzroy (Stephenson & Meldrum, 1933) was the catalyst for dramatic change in Australian hospitals. More than the building itself, the 1932-1933 research trip Stephenson took for the project laid the foundation for Australian hospital design over the next two decades. This trip, across America, Britain and Europe, included hundreds of hospitals. Stephenson found little new in America or Britain, instead it was the Modern architecture of Europe captured his imagination. He wrote, “in the planning of hospital departments revolutionary developments have taken place. Some of these are due to the advances of science, such as deep therapy and the use of radium, but the greatest development has been in the direction of obtaining more light and air for the patients”. He went on to say, “It is well for us to realise that while American hospitals in many respects are developed on more advanced lines than those of Europe, and the more modern ones are better planned and equipped, Continental thought is more inspiring in aspects of design…” ›› Stephenson found a number of European buildings particularly inspiring. Early in the trip, he visited the Netherlands where he saw and admired Bijvoet & Duiker’s Zonnestraal Sanatorium (1928): “From the traditional forms of old building you swing to extreme originality of thought as exemplified in the now famous Zonnestraal Hospital which is constructed almost entirely of glass. This [is a] beautiful institution… [It is] strangely interesting to see all the machinery beautifully kept through the glass walls of the boiler house.” He was also impressed by a number of Swiss hospitals, including the Loryspital in Berne, where he admired the great semicircular balconies, which were enclosed with moveable glass walls that allowed maximum sunlight into the building.
In Germany, Stephenson noted “evidence of more rational thought and more direct influence of general financial stringency”, and was impressed by the Weissenhofseidlung and by Erich Mendelsohn, whom he met. Stephenson was also greatly interested in Richard Döcker’s small Waiblingen Hospital (1928), near Stuttgart, which allowed patients to be wheeled out in their beds through large sliding window sashes onto terraces, describing it as “an extremely attractive way to build…” In Finland, he was highly impressed by Aalto’s now-famed Paimio Sanatorium (1929-1933). Stephenson heard about the yet-unfinished Sanatorium during his travels and took an arduous detour to see it. He expressed great admiration for European Modernism, describing it as rationalising architecture, “to express in the simplest form the function of the building in the most appropriate materials”.
Although the trip was for St Vincent’s Hospital, in fact it came too late in the design process to effect any real change. However, the effect on subsequent Stephenson & Meldrum hospitals projects was dramatic. Instantly, the language the firm used in designing their large hospitals changed to a strong modernism, which was a synthesis of all that Stephenson had admired on his European trip: the balconies and glass walls of Döcker, Bijvoet & Duiker, Aalto’s sanatoria, Erich Mendelsohn and the Loryspital; and the clean, functionalist forms of German Modernist architecture, especially the Weissenhofseidlung.
Whereas St Vincent’s was a restrained and blocky brick design, the firm’s next commission, the Mercy Hospital (1934) was streamlined, with broad balconies and large windows sweeping across the white rendered facade. The Freemason’s Hospital, that immediately followed it, developed these elements further, within an austere and carefully massed composition. The hospitals Stephenson & Meldrum (later Stephenson & Turner) designed in the 1930s became the foundations for Australian functionalist Modernism, including the Mercy Hospital (1934), Freemason’s Hospital (1936), Bethesda Hospital (1936, alt.), Gloucester House at the Royal Prince Alfred Hospital (1936), King George V Pathological Block at the Royal Women’s Hospital (1939, dem.), United Dental Hospital (1940), King George V Memorial Wing for Mothers and Babies at the Royal Prince Alfred Hospital (1941), the Royal Melbourne Hospital (1942, alt.), and the Yaralla Military Hospital (1942). The later work of Leighton Irwin & Co, helped continue this, including Prince Henry’s Hospital (1940-55, dem.), the Maternity Block at the Royal Women’s Hospital and the Heidelberg Military (now Repatriation) Hospital (1942-45).
The Stephenson & Meldrum/Turner hospitals designed after Arthur Stephenson’s 1933 trip are arguably the most genuinely modern buildings of that era in Australia.
Stephenson chose the Modernist idiom for hospitals as it suited the scientific, medical, programmatic and aesthetic requirements of the institution: presence without ostentation. His approach to architecture, and to hospitals, set the standard in Australia.
The nature of hospitals and medical theory is one of constant change and many of these revolutionary early modern hospitals have been extensively altered or demolished to make way for new ideas and practices within hospitals. Only a handful remain relatively untouched, with Freemason’s Hospital recently added to the register of historic places by Heritage Victoria in recognition of this. These buildings may be key parts of the development of Australian Modernism, but as hospitals they are relics of an era now past and as such are in grave danger of being lost altogether.
Dr Julie Willis is a senior lecturer in architecture at the University of Melbourne
J.-P. Goubert, The Conquest of Water: The Advent of Health in the Industrial Age (Princeton: Princeton University Press, 1986)
Arthur Stephenson, “A Tramp Abroad in the Hospital Field”, c1933, held National Library of Australia ›› Mark Wigley, White Walls, Designer Dresses (Boston: The MIT Press, 1995).