The big C of Cancer, formerly the great unmentionable, now stands for Cause Célèbre. A global industry has sprung up round the disease, encompassing publishing and lapel pins, internet drugs and alternative therapies. Yet it remains the most terrifying of diagnoses, a sentence handed out in the strip-lit consultation rooms of under-funded hospitals, a coming to terms in the endless corridors of Britain’s struggling health service.
It was the shattering experience of cancer and the profound unsuitability of its setting that Maggie Keswick Jencks, who succumbed to the disease 11 years ago, sought to address. Her idea was for an independent cancer centre staffed by sympathetic, knowledgeable professionals, a respite from the sterility of hospital waiting rooms, of hard plastic chairs, dog-eared magazines and views on to car parks.
The latest manifestation of Maggie’s vision was opened last week by Gordon Brown, chancellor of the exchequer, in his own Kirkcaldy constituency. It is a serious building and a powerful vision but it also raises deep questions about the reach of architecture, the nature of disease and human response to space, light and form.
The building was designed by Zaha Hadid, an architect who has achieved extraordinary international renown yet has remained unrepresented in the country she has made home. This tiny structure in Scotland is her first UK building: although it is to be followed by the Aquatic Centre for London’s Olympics, a small building for the Architecture Foundation and a transport museum in Glasgow, for now it stands alone as representative of one of the most significant architectural imaginations of our time.
Like most other architects who have designed Maggie’s Centres, Hadid knew Maggie and her husband Charles Jencks, the critic who virtually defined architectural postmodernism. Frank Gehry (architect of the Bilbao Guggenheim Museum) was one of the couple’s oldest friends and was responsible for a centre in Dundee (also his only British building to date); Richard Rogers is currently also building one outside Charing Cross Hospital in London.
These are buildings that have somehow to embody the intimate, the tragic and the practical. They are intended to be domestic in scale, a reaction to the institutional nature of the hospitals on whose doorsteps they sit, and to be accessible and social but also contemplative, a retreat. They attempt to resolve the paradoxes of a range of human responses to illness. It seems an almost insurmountable brief, and one that each architect has approached differently. Hadid has gone for drama.
The building is a remarkable piece of folding and wrapping: it looks as if the asphalt of the Victoria Hospital’s grim car park has risen up in reaction to the aesthetic dumbness of the old building and decided to form itself into something better. It is theatrical and intriguing, a futuristic piece of tarmac origami that folds the visitor surprisingly gently into its angular embrace.
There has been criticism of the building as harsh and unsympathetic, as angular and coarse. Certainly it is not a cosy cottage; it is far from any familiar image of contemporary caring, but it is being called upon to address an unsettling new world of uncertainty, a world post-cancer.
Once you are inside, the harsh black envelope gives way to a softer, more fluid setting, to white walls washed with light, to views on to an improbably green sunken garden, to complex shadows cast by triangular windows and canted walls and, as in all the centres, to a kitchen-table intimacy at its heart. It is an unforgettable building – simple yet sophisticated and fascinating, aesthetically radical yet never attention-seeking.
Since it is still new and unpopulated, it is hard to tell how it will work – the gleaming whiteness and relentlessly modernist fittings still impart the whiff of a swish furniture showroom. But perhaps that is as it should be. These buildings are there to create a visible, accessible presence but they need to be able to let go and hand over to the staff and patients. And this perhaps is where the debate around the Maggie’s Centres is capable of being skewed.
Many commentators have latched on to the architectural glamour of these places. “Look,” they say, “this is what hospitals could be.” It isn’t. This is an almost dangerous fallacy.
It is true that the UK is in the midst of a huge hospital building programme, run off-balance-sheet under the Private Finance Initiative that will burden our grandchildren with huge debts and rotten buildings. It is also true that new hospital buildings should be better by far – but these Maggie’s Centres are not clinical buildings. They can exist without the crushing logistical and bureaucratic burden of even the smallest hospitals; they are purely complementary, with running costs funded entirely by voluntary donations, and there is no question of their taking over general healthcare. They exist to provide services that the National Health Service can never provide. They aim to promote a culture of self-help, whereby those with experience of the illness talk to and help those who come to the centres afresh. They address isolation, frustration and helplessness.
These buildings, remarkable as they are, should not be used as a stick with which to beat the NHS. Endless reports and research papers attest to patients making better and quicker recoveries in pleasant spaces with nice views but none transgresses the most basic common sense. Good architecture should be a foregone conclusion. The hospitals in which we spend our most precious and tragic moments, in which we are born, in which we watch our loved ones die and in which we ourselves will be spending an increasing amount of time as we age as a society, remain a dumb disgrace.
Hadid’s Maggie’s Centre is an exquisite thing, a new jewel in a string of humane and hugely worthwhile projects. Architecture will never cure us but it can make lives that may have been brutally shortened, or in which we linger in a limbo of unknowing, more pleasant, sharper, more memorable. A verdant view, a beam of sunlight, a minute spent with friends in a building that has enticed you into a moment of relaxation and forgetting you would not have had: an architect could not ask for more reward.