Next generation healthcare buildings in South Africa: complexities and opportunities for sustainability

Abstract

Hospitals are widely recognised to have complex design and engineering requirements. It might be argued that the unique functional constraints and operational demand placed upon the hospital building may counter sustainability imperatives. Yet it stands to reason that, even with this complex building type, there must be opportunity to reduce embodied energy, operational energy consumption, to manage water and waste, and to promote social cohesion without compromising the desired safe, effective, efficient healing environment. In South Africa there has been a commitment to transform the healthcare sector through the introduction of National Health Insurance which is to unfold over a 14 year period from 2011. While this is primarily a funding mechanism, it seems inevitable that over time the principles of universal coverage, eradication of inequity, and accessibility will be reflected in the architecture provided to support service delivery. In preparation for the National Health Insurance the South African government has increased spending on healthcare infrastructure and initiated several support projects to strengthen quality and accelerate delivery of capital projects. This includes the development of a comprehensive set of new national norms, standards and benchmarks for healthcare building. South Africa has adopted a contextual approach to determining its new guidelines, norms and standards. Key concepts which have a bearing on sustainability are discussed in relation to constraints and opportunities. The next generation of healthcare buildings in South Africa has created an opportunity to embed principles of environmental consciousness and sustainability into the policies and practices of built environment professionals in the healthcare sector.