George Walford: The Reforms to ‘Round and Round

There is an abiding temptation to confuse change with progress, and a recent book by W. Paul James and William Tatton-Brown, Hospitals, Design and Development (London, Architectural Press) draws attention to one example of the fallacy. What we have come to think of as the old-fashioned hospital ward, with a line of beds down each side, was introduced by Florence Nightingale; she thought it safer for sick people to be out where they could be seen. Aneurin Bevan, among others, reckoned that what was provided for the poor must be bad, and a private room in hospital has come to be associated with a higher standard of medical care. But experience has shown that occupants of single rooms are three times more likely to have accidents than patients in a ward. There are other factors involved, and debate continues, but it is clear that single rooms are not an unquestionable improvement upon wards, and a return to open wards will not necessarily be an advance, either.

from Ideological Commentary 31, January 1988.