When it comes to the design of a major hospital building, should aesthetics take precedence over what is deemed to be an optimal functional design for healthcare?

During a heated meeting earlier this month that evaluated the design of the new St. Paul’s Hospital campus, the City of Vancouver’s Urban Design Panel (UDP) chose the former by voting to have the hospital’s applicant team re-work the hospital’s aesthetic form.

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The UDP is a rotating advisory board comprised of a dozen members who are largely private sector architects, landscape designers, engineers, and artists — all charged with the responsibility of reviewing the architectural designs of development proposals and urban design policies.

Their opinion on design is usually respected by the municipal government, but a rejection by the UDP can result in lengthy delays and significant financial costs to developers and other proponents. Sometimes, a rejection even leads to a complete redesign of an architectural concept.

On the matter of the new St. Paul’s Hospital campus in the False Creek Flats, according to an account of the meeting by City Duo, a blog that covers local development open houses and UDP meetings, the panel took issue with the bottom-heavy, bulky form of the hospital and wanted the applicant team to design slimmer but taller buildings, with the added height avoiding the loss of any healthcare space. But this would necessitate the municipal government approve a relaxation of the view cones — limiting building heights to around 200 ft — that cross over the 18.4-acre campus site.

City staff present at the meeting reaffirmed their position to both the UDP and the applicant team that they would not consider any intrusion into the view cones.

The Providence Health Care (PHC) team, for their part, informed the room they had zero interest with building a taller hospital even if they were allowed to. A redesign of the lower floors of the $1.9-billion hospital building was not an option as it would contravene with modern sound hospital design principles, effectively negatively affecting hospital operations, efficiency, and patient care.

The applicant team reasoned their position by explaining the large floor plates of the hospital cannot be reduced and repositioned with slimmer, additional floors because the emergency room needs to be connected and within close proximity to medical imaging, operating rooms, and patient and technological services. These connections are far more important for St. Paul’s Hospital than Vancouver General Hospital, as the new facility will focus more on research services than trauma care.

Other issues raised by the UDP included the design of the outdoor public spaces and the need for further street activation measures, such as street front retail.

Nevertheless, the UDP still voted against the rezoning design and requested the applicant team to resubmit their proposal after their suggested recommendations have been implemented — a decision that shocked both the applicant team and city staff.

“The process at the UDP usually doesn’t facilitate much interactions between the applicant and city staff. While I have seen heated debates between individual panellists, this is the most passionate exchange that I can recall seeing between an applicant and city staff,” Darren with City Duo told Daily Hive.

In their blog post, they went on to describe how the meeting devolved: “A heated conversation ensued when the applicant essentially told the panel that, because of these limitations, their opinions wouldn’t have any effect on the design of the healthcare campus.”

After the applicant team told the panel it was the UDP’s “job to comment on urban design, not to redesign the hospital,” they “half expected a brawl to break out.”

At the time, PHC said “they couldn’t select a design team before it was determined whether it was possible to construct the hospital.” And just last Friday, the bidding process for a private contractor to conduct detailed design, build, and partially finance the new medical campus was launched.

Shaf Hussain, the spokesperson and vice-president of public affairs and communications for PHC, issued the following statement when Daily Hive inquired what transpired during the meeting.

“Providence Health Care doesn’t have any formal position regarding any recommendations, decisions or issues between the UDP and the City of Vancouver regarding the new St. Paul’s. We have stated and it is our continuing position that we will work with the city with the zoning requirements that are approved by city council. We participated in the meeting you mentioned in order to provide an update on the project and we answered questions posed to us in a factual manner,” said Hussain.

“The current conceptualizations and massing of the buildings at the site all adhere to city regulations and View Protection Guidelines, in accordance with the Policy Statement approved by city council in 2017. We will continue to do our planning within council-approved View Protection Guidelines and other requirements.”

Jason Olinek, Acting Assistant Director of Development Planning for the City of Vancouver, also commented on the UDP meeting, asserting that the project’s timeline will not be impacted by the panel’s decision.

The UDP is expected to re-review the design this summer, and city council is scheduled to consider the rezoning application in the fall of 2019.

“On May 3, the panel discussed many aspects of the application, including massing and height. The main conversation centred around open space and the importance of creating a variety of public spaces, connecting the main plaza to Thornton Park and the SkyTrain station, and ensuring adequate sunlight,” said Olinek.

“The panel brought up view cones, which constrain the proposed buildings’ heights to around 62 metres, and city staff pointed out that the public reaffirmed the importance of view cones to city council in 2010 after a comprehensive review by city staff. The panel then moved on with other comments.”

It remains to be seen whether the UDP will continue to evaluate the hospital with the same lens it uses for condominium and office towers.

By 2026, if all goes as planned, St. Paul’s Hospital will shutter its existing location at the 6.5-acre property on 1081 Burrard Street, and relocate to the significantly larger facility at 1002 Station Street — just north of Pacific Central Station and SkyTrain’s Main Street-Science World Station, and south of Chinatown.

There will be a total of 548 patient beds, which is a net gain of 115 beds over the existing location. It will be the new home for several major provincial programs and referral centres, including heart and lung care, renal, eating disorders, and specialty surgeries and transplants.

Other specialized care units entail HIV/AIDS, chronic disease management services, emergency and critical care, mental health and addictions beds and programs, ambulatory services and outpatient clinics, end-of-life care, Indigenous health, maternity, colorectal and gastrointestinal services, and community care and outreach programs.

The existing Burrard Street location will be sold for its redevelopment potential, with proceeds — estimated to be well north of $1 billion — going towards covering the hospital’s construction costs.

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