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Full text of "Hospital beds by design: a socio-historical account of the 'King's Fund Bed',1960-1975."

32 



CHAPTER ONE 

THE KING'S FUND BED PROJECT 



Origins 

In 1967, a Report entitled The Design of Hospital Bedsteads y^as published 
by the King's Fund in London/ The Report, which contained a specification 
for 'a bedstead suitable for general purposes', was the result of a four year 
project which had cost in the region of £35,000.^ Many accounts of the 
origins of the project, especially those provided by participants, begin with 
a situation described in January 1964 by the then Minister of Health, 
Anthony Barber, in a speech to the Doncaster Branch of the Royal College 
of Nursing.^ Barber pronounced himself horrified to find that manufacturers 
offered 'more than three hundred different patterns of hospital bed.'"^ Later 
in the speech he went on to extol, cautiously, the virtues of a degree of 
equipment standardisation within the NHS. 



King Edward's Hospital Fund for London, Design of Hospital Bedsteads, 1967. 

2 

Figure compiled from 'Notes of a meeting at the Hospital Centre', Roberts, Hall and Archer, 
AAD/1989/9, Job13. 

3 

For accounts of the project by participants, see Bruce Archer, 'Designing a hospital bed', SIA 
Journal, 152/153, October/November 1965, pp.1 -7., Gillian Patterson, 'Hospital Design: 
equipment and buildings'. Official Architecture and Planning, July 1968, pp. 905-908. For 
other accounts, see James Cousins, 'A general purpose bedstead for hospitals'. Design, 
195, March 1965, pp.53-59., David Crawford, 'What happened to the hospital bedstead?'. 
Journal of tfie Society of Industrial Artists and Designers, January 1 968, 1 79, pp. 4-5, Irfon 
Roberts, 'Design of Hospital Bedsteads', Hospital Management, Planning and Equipment, 
May 1967, p. 244. 

"^Transcript, speech by Anthony Barber, 17.1.64, AAD/1989/9, Job 7. 



33 



Although, as noted above, the 1960's was a decade of relative 
buoyancy, with the £500 million Hospital Plan not only underway but to be 
officially speeded up in 1965, attention to cost saving had increased 
steadily from the outset of the Service.^ The Public Accounts Committee 
for 1961-2 had turned its attention to the NHS, pointing out wide 
discrepancies in the prices paid by different hospitals for similar goods: for 
example, sums ranging from £16 to £50 had been paid for hospital beds, 
and from £8 to £34 for bedside lockers.^ The Committee returned to the 
subject the following year, noting that 'arrangements are now being made 
to secure greater economy in the purchase of equipment by hospital 
authorities . . . however . . . much remains to be done before these 
arrangements will be fully effective; and in the meantime considerable 
sums are being spent.' They regretted the delay in the preparation of 
standard specifications and urged their introduction at 'the earliest possible 
date'/ Large orders for hospital equipment of the same design would save 
money, especially in the fit-out of ninety projected new hospitals in the Ten 
Year Plan, which it was estimated would cost between £60 and £85 million. 
Barber assured his audience that he had just set up 22 study groups, 
comprising architects, engineers and quantity surveyors, working on 
designs for hospital components to allow for bulk production.^ 



5 

Webster points out that after the 1956 Guillebaud Committee (who commissioned an 
economic analysis by Brian Abel-Smith and R.M. Titmuss) refuted claims of excessive 
costs, 'no subsequent administration has dared to set up an independent enquiry into the 
cost of health care in the UK', Webster, The National Health Service, p. 33. This did not of 
course prevent scrutiny by the Public Accounts Committee. 

^Civil Appropriation Accounts (Classes l-V) 1961-2, HMSO. 

''civil Appropriation Accounts (Classes l-V) 1962-3, HMSO. 

op. cit. note 4. 



34 



The choice of this episode in 1964 to open the narrative is in line 
with a portrayal of the King's Fund Bed Project as a rational exercise in 
variety reduction to permit the economies of large orders and large 
production runs. In fact the MOH had been involved with the question of 
hospital beds since at least 1962. And although it had been their policy 
since 1949 to encourage joint and central contracting for NHS hospital 
supplies because of the potential financial savings brought by bulk 
ordering, this was not, in 1962, their only concern.^ A visit to the Royal 
Hampshire Hospital that year had prompted the then Minister of Health, 
Enoch Powell, to direct attention to what was dubbed 'the mechanization of 
the nurse's task'. 'I should like to feel sure', Powell wrote to his Private 
Secretary, 'that before we advance far on the hospital building programme, 
the attempt has been made to envisage as boldly as possible the 
mechanisation of nursing and patient care generally which may be possible 
in the next decade or two'.^° Powell's immediate concern was not cost 
saving, but labour shortage. The protracted and serious shortage of nurses 
in the NHS, identified since the outset of the Service, showed no 
immediate signs of improving. This was despite numerous initiatives during 
the 1950's on issues of recruitment, training, pay and the high 'wastage' 
rate of student nurses. In Parliament, Powell asserted there were more 
nurses than ever before, which was true, but hardly the point.^^ In private 



g 

Supplies Division memo, 1 3.7.49 : 'HMCs and BGs are encouraged to consider tlie 

advantages of joint contracting not only for food and common services eg laundry which 
can be covered centrally by the Ministry, but also for equipment and stores which are not 
for the present under central supply through the Ministry.', MH 1 36/1 7. 

^°Powell to Brandes, 5.10.62, MH. 136/12. 

^^Rivett, From Cradle to Grave, p. 189. See also Webster, The Health Services since the War, 
pp.1 70-1 77. 



35 



he was deeply concerned and insisted that the IVIinistry consider other 
ways of alleviating the situation. 'Should we not ask,' he continued to his 
Private Secretary,' . . . what mechanical and powered assistance would be 
necessary if the same quantity of care and attention had to be given with 
half the present quantity of woman-hours?'^^ Powell called a meeting which 
included the Chief Nursing Officer, a Principal Medical Officer, the 
Controller of Supplies and the Chief Architect at the Ministry 'to discuss 
ways of conserving nursing time' in July 1962. At this he decided that five 
reviews should be initiated. They were: 'methods of disposing of waste 
products of the human body, methods of handling the immobile patient (to 
include the bed), feeding procedures, ward supply and replenishment 
systems and the documentation of patients. '.^^ 

According to the Controller of Supplies, the Minister 'made it plain that he 
thought it was quite possible to apply to the hospital modern technological 
advances which had transformed industry in the last ten years'. He felt that 
'without any loss of human touch it was possible and sensible to regard the 
seriously ill patient as a 1501b. job passing through a planned series of 
modern processes.' When it was pointed out that some of the proposed 
ways of saving nurses' time, such as the use of disposables, were unlikely 
to save money, the Minister told the meeting that this should not be of 
undue influence in considering the introduction of new methods. 'The most 
precious commodity to be saved was manpower and particularly nursing 
manpower.' 

As a result of this meeting it was clear to the Controller of Supplies 



^^op. cit. note 10. 



^^Davies to Hollens, 13.10.62, MH136/12. 



36 



that 'among the various assignments we are likely to secure . . . will 

certainly be a study of hospital beds'. The head of the equipment section, 

F.R. Howes, was deputed to run this. It was suggested that: 
Faced with the bewildering range of beds now on the market a useful way 
of proceeding would be to ask the various experts in the office for 
their opinions on what functions a bed should discharge and the 
features which it should contain. It may be that we will find the need 
for, say three beds ranging from a simple apparatus for lying and 
sleeping on, to a fully motorised suspension equipment with a wide 
range of devices for diagnosis and therapy. The idea might then be 
to draw up user specifications for each of the types of bed and if we 
are not satisfied that an adequate bed is already commercially 
available, then to consider letting a development contract to a 
suitable firm - Vickers? I would be glad if you would commence 
thinking about this in advance of our receiving further direction. ^"^ 



It was somewhat fortuitous for the Ministry, therefore, that the King's Fund 
was on the point of setting up a working party to look into the design of 
hospital beds.^^ In January 1963 the MOH asked the Fund to act on their 
behalf, thereby relieving themselves of at least one part of the huge task 
which Powell's review potentially involved. The King's Fund working party in 
question, however, was shortly to come under the influence of a 
researcher, Bruce Archer, whose interest in standardising hospital beds 
was not, primarily, saving the NHS money, alleviating the nursing crisis, or 
even increasing patient comfort, though all these factors would later be 
invoked in support of the concept of a 'bedstead suitable for the majority 
(say 60%) of patients being nursed in the ordinary wards of general 
hospitals'. ^^ 

^"^Davies to Howes, 13.10.62, MH/136 

^^The Working Party on Hospital Beds first met on 19 February 1963. A/KE/PJ/1 7/1 9 KFWPHB 
Minutes, 19.2.63. 

^^Royal College of Art, Studies in the function and design of non-surgical hospital equipment, 
Report No 12, General purpose hospital bedstead, user specification, April 1964. 



37 



The origins of Archer's project predated any IVIinisterial initiative to 
the King's Fund, and indeed the setting up of the King's Fund Worl<ing 
Party on Hospital Beds. They lay in approaches to the other major 
charitable foundation then supporting British hospitals, the Nuffield 
Provincial Hospitals Trust. Founded in December 1939, the Trust provided 
funds for 'the creation, carrying on or extension ... of hospital and ancillary 
medical services' throughout the Provinces.^'' Like the King's Fund, it 
received a steady stream of suggestions, applications for funding and 
requests for advice from hospital staff. In late 1960 however, the Trust had 
received an approach relating to hospital equipment design, including 
beds, from a less usual source. The Rector of one of London's foremost 
schools of art and design, the Royal College of Art in Kensington, was 
concerned to interest them in funding research in this area.^^ 

The research was to be done in the School of Industrial Design 

(Engineering) created at the RCA two years earlier in 1 959, under the 

professorship of the Armenian emigre, Misha Black.^^ By the 1960's, Black 

was a prominent figure in British cultural life. Since arriving in London in the 

1930's his design projects had included the South Bank layout for the 

Festival of Britain in 1951 and work for the London Underground's new 

Victoria line.^° Well placed to lobby wealthy foundations. Black, together 

with the RCA's Rector, Robin Darwin, succeeded in persuading the Nuffield 

^^For a history of the Trust, see Gordon McLachlan, A History of the Nuffield Provincial 
Hospitals Trust, 1940-1990, London, Nuffield Provincial Hospitals Trust, 1992. 

^^Royal College of Art, Studies in the function and design of non-surgical hospital equipment, 
Preliminary report, 1 June 1962, Appendix A, p.1. 

^^Frayling, The Royal College of Art, pp.1 78-1 79. 

^°For a short account of Black's career up to 1965, see 'Designer's honour for Misha Black', SIA 
Journal, 152/153, October/November 1965, p.1 2. For his collected writings, see Avril Blake 
(ed), The Black Papers on Design, London, Pergamon, 1983. 



38 



Provincial Hospitals Trust to fund, initially for one year, a proposed four 
year project to investigate the design of 'non-surgical' hospital equipment.^^ 

It was apparently envisaged that a publication complementing, and 
comparable to, the influential 'Studies in the Function and Design of 
Hospitals' by the architect Richard Llewelyn-Davies would result.^^ The 
NPHT had sponsored this volume, published in conjunction with Bristol 
University in 1955. It comprised a comprehensive study of the 
requirements for hospital accommodation, the physical environment, 
heating, lighting, ventilation, noise control and fire risks, together with 
detailed designs for individual departments. The ambitious, four year 
scheme which Black now proposed appeared to offer similarly 
comprehensive coverage of the fitting out of hospitals once building was 

complete. It was to result in: 

1 . A report describing how equipment schedules and specifications 

are prepared, how the selection of equipment is made, where 
equipment deficiencies are, and where future research and 
development would best be directed. 

2. The classification and preliminary evaluation of types of 

equipment as part of the procedure for the selection of 
equipment for a new hospital. 

3. Some equipment designs offered as better solutions to some of 

the more pressing needs. 



^^ The stress on 'non-surgical' equipment was intended to reassure medical staff that laymen 
were not about to become involved with diagnostic or therapeutic devices. Interview, Bruce 
Archer, 14.5.98. 

^^Royal College of Art, Studies in the function and design of hospital equipment, Preliminary 
report, 1 June 1962, p.2. Richard Llewelyn-Davies' investigation was published as Studies 
in the Function and Design of Hospitals, London, NPHT/Oxford University Press, 1955. 
Llewelyn-Davies was head of a Division of Architectural Studies at the Trust from 1954- 
1960. For an account of hospital building at this period see Jonathan Hughes, 'The 
"Matchbox on a Muffin": The Design of Hospitals in the Early NHS', Medical History, 44, no 
1, pp.21 -56. 



39 



These designs would culminate in recommended ranges of equipment and 
furniture, developed in conjunction with selected manufacturers, to be 
made available for purchase by hospitals. ^^ 

To run the project at the RCA, Black intended to appoint a research 
fellow, Bruce Archer.^"^ Originally an engineer by training. Archer was 
coming to prominence in design circles because of his interest in design 
methodology and his early publications on the subject, largely in the 
magazine Design.^^ Archer was to become central to the issue of hospital 
bed design as carried out in the King's Fund Bed Project and his career 
prior to joining the RCA is therefore covered in some detail. It provides 
another alternative starting point for an account of the King's Fund Bed. For 
although Anthony Barber's remarks in 1 964 or the criticisms of the Public 
Accounts Committee in 1963 have often been used to open narratives of 
the project, (including Archer's own), he was already heavily involved with 
hospital equipment prior to these dates. It was a field particularly suited to 
his interests and aspirations. 



^^Royal College of Art, Studies in the function and design of non-surgical hospital equipment, 
Preliminary report, 1 June, 1962, p. 2. The Hospital Equipment Group was the forerunner of 
the Industrial Design (Engineering) Research Unit at the RCA, which became the 
Department of Design Research in 1967. For an historical account, see Jean Maclntyre, 
'The Department of Design Research at the RCA - Its Origins and its Legacy, 1956-1988, 
unpublished MA dissertation, Victoria and Albert Museum and Royal College of Art, 1995. 

^"^For a biographical note up to 1971, see L.Bruce Archer, Technological innovation, a 
methodology, London, Science Policy Foundation, 1971, (no pagination). 



25 



A series by Archer entitled 'Design and Stress Analysis' appeared in Design as follows: 

'Intuition versus mathematics', 90, June 1956, pp.1 2-1 9; 'Design Research', 91, July 1956, 
pp.31 -34; 'Analytical Methods for product designing', 93, pp.29-33, September 1956; 
'Photo-elasticity for the product designer', 96, December 1956, pp.42-46. 



40 



Bruce Archer^^ 



Archer had been invalided out of wartime service in the Scots Guards. 
Aptitude tests applied by a resettlement board of the Ministry of Labour 
directed him into training as a mechanical engineer, and in engineering 
design. From 1945 he worked in production machine design, first in the 
cigarette industry, then with electronic products. An opening to teach 
production design on the new industrial design course at London's Central 
School of Art and Design led to increasing part time work there, which 
Archer supplemented by setting up his own consultancy in 1953. One early 
client was the eminent British designer Michael Farr, who employed him to 
manage projects. At the time, Farr was editor of the magazine Design, and 
Archer became a regular contributor. 

As a mechanical engineer. Archer had no 'aesthetic' training. He 
was however of a mathematical and theoretical bent and had become 
increasingly interested in the process of design. Some of his earliest 
published papers, which appeared in Design in 1956 - 7, began to explore 
the relationship between aesthetics and function, and the role of 
mathematics and science in the design process.^'' His account of the 
prevailing attitude in mechanical engineering to 'user' factors, such as 
comfort or safety, and the whole area of what later became known as 
product design, is that they were regarded as 'rather fey'. He judged that 
the milieu of an art school would allow him to capitalize on the general 
loosening of interdisciplinary boundaries which characterised the 



^^This section relies on interviews, Bruce Arclier, 14.5.98, 10.5.99, 9.5.00. 
^^op. cit. note 25. 



41 



immediate post-war years. It might be possible to involve graduates from 
disciplines such as psychology on his projects in a way which would not 
have been open to him in a department of engineering. For it seemed 
increasingly clear to him that the art of design was, if not actually a science, 
certainly amenable to scientific enquiry. He lamented the absence of 
'examples of form which is genuinely the product of reliable calculation 
based on scientific principles'.^^ 

Increasingly frustrated at 'not being heard' by the design 
establishment. Archer began to move in what he saw as the less 
reactionary circles of contemporary art, in particular those centred on 
London's Institute of Contemporary Art (ICA). The ICA had been a focus 
for the so-called Independent Group, an association of artists, architects 
and theoreticians who began to meet there during the 1950's.^^ The Group 
actively promoted a more interdisciplinary approach to art and design, 
being particularly concerned with (largely American) popular culture, and 
with science and technology. Leading members included Rayner Banham, 
Lawrence Alloway and Richard Hamilton, the originator of 'pop art'. Archer 
was introduced by Hamilton to the Argentine painter and intellectual, 
Tomas Maldonado, at that time co-Rector of the experimental German 
design school, the Hochschule fur Gestaltung at Ulm.^° Maldonado had 



^^Archer, 'Intuition versus matliematics', p. 12. 

^^Anne Massey, 'Tlie Independent Group as Design Tlieorists', in N. Hamilton (ed), From 

Spitfire to Microctiip: Studies in the History of Design from 1945, London, Design Council, 
1985, pp.54-58. 

^°The most extensive account of the school at Dim is in Herbert Lindinger (ed), Ulm Design: Tlie 
Morality of Objects, Berlin, Ernst and Sohn, 1990. Robin Kinross, 'Hochschule fur 
Gestaltung, Ulm: recent literature', in Journal of Design History, 1, 3-4, 1988, pp.251 -256 is 
a review article which considers this and five other publications on the Hochschule. See 
also Heiner Jacob, 'HfG Ulm: A Personal View of an Experiment in Democracy and Design 
Education', Journal of Design History, 1, 3-4, 1988, pp.221 -234. 



42 



been impressed by Archer's interest in design as process, writing 
appreciatively about his series of articles in Design .^^ Anxious to heal 
widening internal disagreements at Dim as to the 'true nature of design', 
Maldonado invited Archer there for a year as a guest instructor in 1960. 

The 'extraordinarily small, almost monastic college', known as the 
Hochschule fur Gestaltung (HfG) at Dim, in Swabia, has been widely 
identified as the successor to the Bauhaus. Like the Bauhaus, it came to 
have 'almost legendary status' for some designers, though its existence 
was short-lived and its precise legacy much debated. ^^ Founded in memory 
of two students executed for political activities by the Nazis in 1944, the 
HfG was a privately supported postgraduate school of design run on lines 
unprecedented in the German education system. With forty to fifty percent 
foreign students and a huge preponderance of guest instructors over 
faculty staff, it was intended to be an international centre for teaching, 
development and research into the design of industrial products. Explicitly 
anti-fascistic, the school was to participate in the making of a new culture, 
from spoon to city. A large donation from the US government enabled the 
HfG to open formally in 1953. 

However, this short-lived experiment (it lasted only fifteen years) 
was beset for much of its existence by disputes between different factions 
among the staff, ostensibly about the true nature of design and how it 
should be taught. Later, the growing student unrest of the late 1960's 



^^ Maldonado wrote to Design magazine in April 1958: 'In my opinion it is necessary to free 

design criticism from the numerous misconceptions of art criticism terminology and to turn 
design criticism into a new scientific design analysis. I appreciate especially in the 
magazine the contributions of Bruce Archer and Christopher Jones.' Quoted in Maclntyre, 
The Department of Design Research, p. 15. 

^^This account relies on the sources in note 30. 



43 



further de-stabilised the Hochschule. Its funding, often precarious, received 

a fatal blow when the regional Baden Wurttemberg parliament withdrew 

financial support, the culmination of an ever worsening relationship 

between the conservative local community and the fiercely intellectual and 

reformist 'Ulmers'. 'In the rosy haze of the Adenauer years . . . and the 

kidney shaped coffee table, the inhabitants of Dim considered the products 

of what they called the 'hochschule fur ungestaltung' to be a standing 

provocation - or at least a farrago of incomprehensible aberrations.'^^ The 

HfG was disbanded in 1968, the staff voting against a merger with Stuttgart 

University Architecture Department which offered state funding but loss of 

autonomy. ^"^ 

When Archer arrived in 1960 the HfG was still vibrant, although 

factional disagreement among the staff was intense. He identified two main 

factions: the 'mathematician/scientists' and the 'designers'. Since each 

apparently considered that he had been brought in to support the other 

side, he was able to do little to diminish their differences of opinion. But the 

year of intense discussion with the mathematician/scientists, and 

observation of the designers at work in their ateliers at Dim, gave him much 

food for thought. Reyner Banham, musing much later on what it was that 

took a 'devoted band of Britons', including himself. Archer and Richard 

Hamilton to Dim in the late 1950's and early 1960's, concluded that it was: 
... a peculiar combination of interests that were mostly transient on the 
British side but more permanent at the Hochschule, more concerned 
with its basic orientations and its long-term patterns of intellectual 
growth. Both sides sought a way out of the local impasses into 
which design theory had fallen, but whereas the British impasse was 
one of almost total vacuity, the exhaustion of the 'gentlemen's 

^^Lindinger (ed), Ulm Design, p.1 18. 

34 

Jacob, HfG Ulm: A Personal View, p.234. 



44 



agreements' of the 1930's and the lack of anything but the arts and 
crafts to fall back upon, the German situation seemed to us, as 
revealed by Tomas Maldonado, to be one of excessive rigidity, a 
cast iron system of categorical imperatives. But this was impressive 
to us visitors because of its relentless logic and intellectual clarity. I 
used to wonder why anybody bothered to speak to me at Dim; I felt 
so stupid in my lack of dialectical method, and my head ached from 
having to find intellectual justifications for observations like 'Yes, I 
would like another bread roll'. Yet it was profoundly exciting to be in 
a milieu where issues about design could be discussed so 
intensively, especially if one had just come from London where there 
was at the time no intellectual discussion of design at ali.^^ 



For Archer, who had also been frustrated by the profoundly 
unintellectual state of the London design world, and whose aspirations 
towards a more 'scientific' approach to design had much in common with 
the theoretical position adopted by Maldonado at that time (this later 
changed). Dim was an ideal environment in which to refine his ideas on 
design. Increasingly, he was preoccupied with the possibility of devising a 
new, systematic method of design. This led him into complex areas of 
mathematics which he discussed at Dim with a mathematician and 
planning theorist, Horst Rittel.^^ Perhaps not surprisingly. Archer found he 
inclined more to the 'mathematicians' camp, (which also included 
theoreticians and scientists from other disciplines, such as applied 
psychology) rather than to that of the 'designers' such as Hans Gugelot and 
OtI Aicher. The latter asserted to him that their work was creative and 
expressive of fundamental truths, a view they substantiated with reference 

35 

Lindinger (ed), Dim Design, pp.57-8 . 

Rittel was subsequently at the Institute of Urban and Regional Development, University of 
California, Berkeley. His faculty seminars there were published as The Universe of Design, 
Berkeley, University of California, 1964. Archer discussed with Rittel the problem of 
modelling decisions which involved qualitative variables. Rittel advised him that a solution 
would be found in pure, rather than applied, mathematics, 'since non-quantitative 
relationships were at the heart of pure maths'. Interview, Bruce Archer, 10.5.99. 



45 



to Platonic philosophy and Gestalt theory. Their characteristic 'Dim' style, 
often described as 'pure' or 'clean', became closely associated with Braun 
and several other companies who commissioned the School's designers 
around 1960. Particular features were the use of Platonic solids, the 
elimination of colour except for 'functional' purposes, and the adoption of 
the new sans-serif typefaces then being devised in Switzerland. 
Observation of the designers at work in their studios, however, led Archer 
to the view that they were in fact formulaic, rather than creative, using 'rules 
of thumb which gave a family likeness to different products.'^'' These Dim 
designers had little sympathy for Archer's growing concern with elucidating 
what they saw as the essentially creative process of design. Others at Dim 
were not so dismissive, however, and Archer's work there was influential. It 
formed the basis of the design method taught at the Hochschule after he 
left, and a student project there constituted the earliest trial of his new 
method.'^ 

Archer left Dim at the end of the academic year in 1 961 . Other 
commentators bear out his account of intense factional disputes. The 
period 1960-62 was identified as witnessing the height of a controversy 
over theoretical versus practical courses at Dim, and 'the exact role that 
analytical methods should play in the design process'. ^^ By the time the 

37 

As an example he cited the detailing of the rectangular Platonic solids favoured by the Ulm 
designers. They showed him that if both horizontal and vertical edges were given the same 
radius, where they met at the corners formed a hemisphere, looking 'as though a ball 
bearing was trapped beneath the casing'. They therefore routinely used a different radius 
on the vertical edges. Interview, Bruce Archer, 10.5.99. 

OQ 

This was the design of a wristwatch by Reinhart Butter. Archer subsequently defended 
criticism of the design on the grounds that it had been developed 'on the basis of 
legibility experiments conducted under the supervision of an applied experimental 
psychologist'. Bruce Archer, letter, The Architect's Journal, September 21, 1966, p. 728. 

39 

Lindinger (ed), Ulm Design, p. 143. 



46 



controversy abated somewhat, Archer was back in Britain and already 

working on hospital equipment. This was perhaps fortunate. The direction 

in which resolution occurred would not necessarily have been congenial to 

him. Maldonado's early views on the role of rationalism and science in 

design lost ground and the syllabus at Dim was revised by the sculptor 

turned graphic designer, OtI Aicher. Topics such as 'operational research' 

were 'discreetly dropped', although the role of science in design continued 

to be hotly debated.^" 

Analytical or systematic design methods such as Archer was 

devising were initially received rather less critically in Britain and North 

America than in Continental Europe. And as another Ulm Faculty member, 

Gui Bonsieppe, later remarked: 

Anyone who works out rational criteria of decision making, and 
who prides himself on optimizing design solutions, is by that very 
fact presenting himself as a solid, serviceable sort of person, just 
what an industrial system requires. "^^ 

The comment, while certainly not directed at Archer personally, was 
apposite. After completing his year at Ulm, Archer needed a job, preferably 
in a field where he could perfect and try out his method. Before he left Ulm, 
Archer accepted Misha Black's offer of a research fellowship at the RCA to 
run the hospital equipment project. The socially relevant nature of the 
project suited the RCA, anxious at that time to rebut charges of ivory tower 
elitism. "^^ It suited Misha Black, who was engaged in dragging his new 
Department into a closer involvement with industry."^^ And it very much 

40 

Lindinger (ed), Ulm Design, p. 145. 

41 

Lindinger (ed), Ulm Design, p.1 12. 

42 

Frayling, The Royal College of Art, pp.1 78-9. 

43,. .. 
Ibid. 



47 



suited Archer, for whom hospital equipment design appeared to have 'a 
near perfect combination of quantifiable and non-quantifiable variables. '"^"^ 



Studies in the function and design of non-surgical hospital 

45 

equipment 



Archer began work on the hospital equipment project in September 1961, 
bringing with him Reinhart Butter, one of his students from Dim, as an 
assistant. So convinced was he that 'as soon as you have put something 
away in a filing cabinet you have embarked on a particular way of working', 
he resolved that he and Butter should have only a temporary office with 
temporary furniture, away from the future project team and indeed outside 
the College altogether, until they had drawn up the methods they would 
adopt. "^^ The RCA, through an arrangement with the Science Museum, 
found them an office tucked away behind the Aeronautics Gallery of the 
latter institution. The products of their discussions were recorded, partly in 
English and partly in German, in a series of lengthy working documents.'^'' 
In general these were couched in abstract terms and exhibited a 
preoccupation with methodology, with rigorous, often self-referential, 



44 

Interview, Bruce Archer, 14.5.98. 

45 

This was the official title of the hospital equipment project. 

46 

Interview, Bruce Archer, 6.8.98. 

47 

This was because each used his first language in discussions, on the basis that it was harder 
to express complex ideas in a second language than it was to understand them. Curious 
observers of their intense lunchtime conversations in the Victoria and Albert Museum 
cafeteria often concluded that both were speaking Dutch. The documents are in 
AAD/1 989/9, Job 1, Working Documents 5-14. 



48 



definition and with stepwise progression that was to characterise most of 
Archer's published worl<. For example, 'Task four' in the initial breakdown 
of work outlined by Archer and Butter was 'to prepare a system for locating 
and identifying all relevant information'. It had seven parts: part three was 
'to set out a procedure for preparing an authoritative list of sources of 
information', part four was 'to prepare the authoritative list of sources of 
information', part five was 'to set out a procedure for preparing an 
authoritative list of existing information and current investigations' and part 
six was 'to prepare an authoritative list of existing information and current 
investigations.'"^^ 

Their concern with 'thorough and conscientious organisational 
preparation' was manifest, as was their insistence that the wide ranging 
investigation should only proceed 'stufenweis" (in steps). While Working 
Document Two was an 'Overall programme of work for the investigation'. 
Working Document Three was a 'Report on Task 1'. Working Document 
Four was a 'Report on Task 2, parts one and two', and Working Document 
Five was a 'Report on Task 2, part three'. This last contained a typical 
example of the way in which the style aspired to the abstract and 
mathematical even when considering the most mundane and practical 
affairs. The following analysis was provided as a justification for the list of 

office equipment required: 

1 . For the purpose of this report the key to the basic organisation for 

the investigation is figure 4 and para 3.31 in Working 
Document 4. 

2. The establishment of staff for the first year's work is laid down in 

Working Document 3 para 3.13 as follows: 

48 

Task 1 for the investigation liad been described as 'tlie codification of terms of reference for 
tlie investigation', Task 2 was 'tlie creation of a basic organisation for tlie investigation'. 
AAD/1 989/9, Job 1, Working Document 2, Appendix B. 



49 



one full-time research leader 
one full-time assistant 
one part-time secretary. 

3. An examination of possible systems and equipment offered by 

various potential suppliers is described in Working Document 
1 , para 3. 24. 

4. The list of requirements is therefore obtained by equating the 

factors described in paras 2.1 , 2.2 and 2,3 above. 



The resultant list of requirements was tabulated against 'particulars of the 
equipment ultimately supplied'. Despite the elaborate statement of the 
method used to arrive at the list, a somewhat Spartan picture of the office 
equipment emerges. It comprised 'a typist's table, rack (stationary, light 
oak), broom, stamp (rubber), pad (ink), cups (white, four), together with 
eight books. In addition to Webster's Dictionary, Roget's Tliesaurus and 
the London A-Z, these were the Hospitais Year Book, a copy of the 
l-iospital Plan for England and Wales and the Fifth Report of the Nuffield 
Provincial Hospitals Trust, together with two nursing texts, A General 
Textbook of Nursing by Pearce and Practical Notes on Nursing Procedures 
by Britten.^^ 

Archer's contact with the hospital milieu was not limited however to 
the perusal of these volumes. It was during the preliminary year of this 
project that he first came into contact with senior administrators on the 
Regional Hospital Boards, and with senior civil servants at the Ministry of 
Health, including the Undersecretary for Hospital Services, Raymond 
Gedling, and W. E. Tatton-Brown, who held the newly created position of 



49 

AAD/1 989/9, Job 1 , Working Document 5. Evelyn Pearce, A General Textbook of Nursing, 
London, Faber and Faber Ltd., 1959., J.D. Britten, Practical Notes on Nursing Procedures, 
London, E. and S. Livingstone Ltd., 1960. 



50 



chief architect at the IVIinistry.^" Apart from these meetings, Archer, with 
Butter and later a project team, spent the year's work almost exclusively 
concerned with information, its sourcing, organisation and processing. The 
management systems devised might well have been applied to any sphere 
of design, or indeed any field involving research and information 
handling. ^^ 

It was not until these systems were drawn up that other members of 
the team were appointed. Gillian Patterson, originally employed as Archer's 
secretary, was an arts graduate who rapidly became a key member of the 
'core' research team. She was mathematically adept and took on special 
responsibility for information handling. Subsequently she ran entire projects 
when they inclined more to this field than to actual design and engineering, 
and became a Research Fellow in the Unit. Apart from a period spent 
obtaining an MA in the Department of Fine Arts at the RCA, Patterson 
worked for the Unit until she retired in 1988. 

Kenneth Agnew, newly graduated from the Department of 
Engineering Design at the RCA but originally trained as an architect, was 
also to become a central figure in the Unit, leading many subsequent 
projects in both the medical and non-medical fields. He left the RCA in 
1978, having been deputy head of the Department of Design Research, to 
become Professor of Design, University of Ulster. 

A nurse, Doreen Norton, was the fourth member of the core team. 
Norton was unusual among her contemporaries in that she had a sustained 

50 

Creation of a Chief Arcliitect's post at tlie Ministry of Healtli liad been anotlier attempt at cost 
reduction. See Webster, The Health Services since the War, p. 39. 

51 

It was in fact described as tlie 'Design of a researcli management system' in a list of jobs 
undertaken by the Department of Design Research compiled much later by Archer. Bruce 
Archer, 'List of Active Jobs', personal communication, 1998. 



51 



interest in nursing research and had published in the field. She was a co- 
author with the geriatrician, A. N. Exton-Smith, of An Investigation of 
Geriatric Nursing Problems in Hospital.^^ It was probably the Royal College 
of Nursing that recommended her for the project.^^ Apart from nursing 
officers from the Ministry of Health who were involved on a very intermittent 
basis, and the 'nurse juries' arranged at the beginning of the project (see 
Chapter Three), Norton was the principal source of information on nursing 
and ward practice generally. She left to take up a research position with the 
National Corporation for the Care of Old People in 1963, but had 
considerable input into the King's Fund Bed Project at decisive early 
stages. She was the spokesperson on 'user needs', and the concept of 
'user needs' was central to Archer's method of design. 

The result of the team's first year's work, however, from September 
1 961 to September 1 962, was not, it seems, what the sponsors expected. 
Instead of concrete suggestions or designs for hospital equipment, the 
NPHT were presented with a highly abstract and theoretical 43 page report 
entitled 'Studies in the function and design of non-surgical hospital 
equipment'. In the words of the Report, as the end product of the year's 
work, it consisted virtually entirely of information garnered from outside 
sources, the investigation having been organised 'as an information 
seeking and evaluating body'. In the design method which Archer was 
devising, a precise formulation of the design problem was essential, and 
this was what, in his view, the Report represented. A subsequent three 



52 

Doreen Norton, Rhoda McLaren and A.N. Exton-Smith, An Investigation of Geriatric Nursing 
Problems in Hospital, Edinburgh, Churchill Livingstone, 1962 (1975 reprint). 

53 

Interview, Doreen Norton, 22.4.99. An account of Norton's work appeared in the Daily 
Telegraph, 'The shy reformer working to brighten our hospitals', February 22, 1 968. 



52 



year programme for solving the problem of designing and specifying 'non- 
surgical' hospital equipment was proposed. It involved the formation of 

three groups: a pilot study sub-unit would 

become responsible for specifying and selecting fixed and movable 
equipment of the class defined, for a projected hospital 
development. This group will strive to satisfy all the commissioning 
authority's needs and in doing so will it will indicate to the workers in 
the other subunits what the problems are in the implementation of a 
specific project and where the gaps in knowledge lie. 

An 'inductive studies' sub-unit would 'provide analyzed catalogue 
information for the pilot study group'. The pilot study group would 'raise 
questions for a third sub-unit, the 'peripheral studies group', who would 
'provide tabulated information for the pilot studies group, and so on'. 
Archer, with Misha Black, had already had a meeting at the Ministry of 
Health in April 1962, as a result of an approach to the Chief Architect to 
request that they suggest a suitable hospital for the pilot study. The new 
West Middlesex, a district general hospital being built at Isleworth, just west 
of London, was nominated. 

The Nuffield Provincial Hospitals Trust, however, declined to 
continue with funding. Although Archer considered that the Nuffield 
governors, dominated as they were by eminent medical men, had resented 
any suggestion that lay professionals might be better at specifying hospital 
equipment, it seems likely that the highly abstract and theoretical nature of 
the document with which they were presented had come as a surprise. 
Large sections of the Report were devoted to laying down precise 
definitions, terms of reference and objectives. Llewelyn-Davies' book, by 
contrast, was an accessible and practical handbook widely used by 
architects involved in hospital building. With only £600 of the grant 
remaining. Archer decided to disband the team and use the money to allow 



53 



Agnew to develop at least one tangible example of how their methods 
could result in useful equipment. The chosen item was a lockable ward 
medicine trolley, which was duly produced and trialled.^"^ Although 
ultimately quite successful, this was not enough, it seems, to persuade the 
NPHT to renew their grant. The projected next phase of what was to have 
been a four year project was now in abeyance unless another sponsor 
could be found. 

In August 1962 Misha Black approached the King's Fund in the 
hope that they would take over financing the project.^^ A key player in the 
pre-NHS medical metropolis, the Fund had lost its original purpose with the 
coming of the Health Service. No longer involved primarily with financially 
supporting the running of London's prestigious voluntary hospitals, officials 
of the Fund had been re-defining its role since 1948.^^ They turned to such 
areas as hospital catering, equipment and, in particular, the training of 
hospital administrators and other non-medical staff. They also continued to 
run the Emergency Bed Service and the Nursing Recruitment Service on 
behalf of the MOH. In some ways the Fund was a more likely sponsor for 
the RCA project than the Nuffield Trust. Less dominated by the medical 
elite, less involved with sponsoring medical research, and with strong 
allegiances to the traditional concerns of lay hospital management for 
patient welfare, they had already made it their business to advise on 
hospital equipment, and had plans to open a centre where hospital staff 

^"^The method of design of the medicine trolley was described in Royal College of Art, Studies in 
the function and design of non-surgical hospital equipment, Supplement to preliminary 
report, November, 1962. 

Misha Black to Hall, 2.8.62, A/KE/PJ/1 7/1 . 

'Future of the King's Fund', British HospitalJournal and Social Service Review, August 23, 
1968., p.1537. 



54 



could familiarise themselves with what was available.^'' And as noted 
above, receipt of a number of enquiries regarding hospital beds had 
already led the Fund to consider setting up a working party on this subject 
before Black approached them about the hospital equipment project. ^^ 

The King's Fund Working Party on Hospital Beds, which first met in 
February 1963, was of a traditional composition for the Fund.^^ In the chair 
was the Honourable Mrs R. M. T. Campbell-Preston, chairman of 
Westminster Press Provincial Newspapers and a member of the South 
West London Group Hospital Management Committee. The members 
comprised a matron from a London teaching hospital, a ward sister from a 
non-teaching hospital, a consultant in physical medicine, an engineer 'well 
known to the Fund' who was chairman of a large engineering firm, together 
with the former Secretary of a London Hospital Management Committee 
who was now the Regional Staff Officer of the North West Thames 
Metropolitan Hospital Region. Slightly less usually, a senior representative 
from the Ministry of Health was also included. This arose because the 
Working Party was deputed to carry out for the MOH that part of Enoch 
Powell's five-fold survey of hospital equipment which related to hospital 

57 

Known as the Hospital Centre, this opened in large (20,000 sq ft) central London premises in 
1963, during the course of the bed project. It incorporated the Fund's Division of Hospital 
Facilities and the Hospital Catering Service and was intended to provide information on all 
aspects of hospital planning, organization and equipment. The centre included a lecture 
theatre and conference facilities. The entire first floor was made over to 'a changing display 
of hospital equipment'. 'The Hospital Centre's Unique Role', British Hospital and Social 
Service Journal, April 5, 1963, p. 393. 

The Secretary of the Northern Group HMC, in possession of a legacy to re-equip a private 
patient's wing, suggested in September 1961 that the Fund provide a grant for the study of 
the use of different bed positions. It was known that the Royal Marsden Hospital had just 
installed some electrically powered beds at a cost of £200 each. The Fund, although 
sympathetic to the idea, refused a grant on the basis that 'the Nuffield Trust was 'initiating 
similar work'. A/KE/PJ/1 7/1. 

59 

King Edward's Hospital Fund for London, Design of Hospital Bedsteads, p. 4. 



55 



bedsteads. The initial attendance of the Undersecretary, Gedling, was 
perhaps an indication that, notwithstanding Powell's concern with saving 
nursing time, the Ministry had never lost sight of the potential economic 
benefits of standardising hospital equipment. 

Standardisation of equipment had been discussed at high level at 
the MOH since at least 1958. Although the Ministry had accepted the 
Messer Committee's conclusions that year that joint (rather than central) 
contracting 'provided the only practical method of combining the 
advantages of large scale buying with the existing autonomy of hospital 
groups', Powell's concern with 'the mechanization of the nurses task' had 
again brought the matter to prominence.^" So, too, had unrelated events in 
the 1950's concerning other kinds of medical equipment. Between 1947 
and 1954 there had been thirty six explosions in operating theatres in the 
UK, apparently caused by sparks igniting anaesthetic gases, and 
prompting the MOH to convene a working party which produced 
recommendations in 1956.^^ But the increasingly rapid and largely 
uncontrolled introduction of electromedical equipment into hospitals 
continued, and was viewed as a potentially serious risk to patients and 
staff. The Ministry had employed a single Electrical Safety Officer since 
1950.^^ In theory this individual was responsible for the safety of all 
electrical devices (apart from x-ray equipment) in all NHS hospitals; an 



®°Report of the Messer Committee on Hospital Supplies, quoted in 'Hospital Supplies and the 
Hunt Report', British Hospital and Social Service Review, December 9, 1 966, pp. 2361 - 
2367 and 2361. 

Report of a Working Party on Anaesthetic Explosions including Safety Code for Equipment 



and Installations, HMSO, 1956. 

erview, Kenneth Dobbie, 6.6.00, i 
Hospital and Social Service Journal, March 3, 1 966. 



^^Interview, Kenneth Dobbie, 6.6.00, see also 'Hospital Engineers and Safety Officers', British 



56 



impossibly large task that was further compounded by the relative lack of 
electrical engineering skills then available on site. In the pre-war years 
hospitals had frequently employed marine engineers. Their prospects in 
shipping were dwindling and their expertise with steam was relevant to the 
major equipment then present in the hospital milieu: that for heating and 
autoclaving. By the mid 1960's, the superintending engineer at the MOH 

was led to conclude that: 

the present image of the hospital engineer is too closely allied to the boiler 
house ... in the past the boiler house was very important but you 
don't need to look into a crystal ball to see that the steam boiler will 
disappear from the hospital just as the steam engine has 
disappeared from the railways . . . '^^ 

He urged hospital engineers to take more interest in electrical, and 
particularly electronic, equipment. ^"^ A few of the most prestigious hospitals 
employed chartered engineers, but these were largely mechanical. 
Electrical engineering skills were not widespread in the Service, and the 
issue of electrical safety was unlikely to recede. Standardisation of 
equipment offered one way of reducing potential hazard. 

There were, therefore, not only financial reasons why equipment 
standardisation was of considerable interest to the MOH in the early 
1960's. But undoubtedly economics was to be the most enduring concern. 
Powell's time at the Ministry came to an end in October 1963. 



'The outlook in hospital engineering', British HospitalJournal and Social Service Review, 
June 25, 1965, p.1198. 

64 

The initial reluctance in several branches of engineering to adopt electronic devices had 
considerable implications for medical equipment design in the 1960's. For an example see 
G.M.Lawrence, 'Design Solutions for Medical Technology: Charles Drew's Profound 
Hypothermia Apparatus for Cardiac Surgery' in R.Bud, B.Finn and H.Trischler (eds). 
Manifesting Medicine: Bodies and Mactiines, Amsterdam, Harwood Academic Publishers, 
1999, pp.63-77. 



57 



'Mechanization of the nurses task' was not pursued to any extent as a 
solution to the nursing shortage. Electrical safety was tackled by the 
issuing of technical memoranda by the Ministry of Health. But 'supplies' 
(including consumables) continued to account for very substantial 
expenditure. In 1963 around twenty percent of hospital expenditure came 
under this head.^^ This figure represented an increase of between 25 and 
30 per cent on the previous year's. 'I am heartily sick, wrote the Deputy 
Secretary,' when visiting hospitals, of being shown new beds, or lockers, 
"built specially to our design", no doubt at considerable extra cost.'^^ 

The Hospital Services Division, instructed to look into the matter of 
standardising equipment in 1958, had produced a discussion document for 
the Regional Hospital Board Secretaries. Its author, Gedling, took the 
opportunity of getting the files out again, 'since the work linked up with the 
Minister's discussion on the mechanization of nursing'. As a start, he wrote, 
'I should like to see proposals for producing standard specifications for one 
or two common items of non-technical equipment, and I think that beds and 
bedside lockers are as good examples as any.'^^ 

Undersecretary Gedling's place on the working party was later 
deputed to the less senior but more useful Controller of Supplies at the 

MOH, J. F. Hunt, who was to become a significant player in the King's 
Fund Bed project. ^^ By 1962, the Public Accounts Committee was 

Office of Health Economics, Hospital Costs in Perspective, 1963, p. 5. 

^^'Deputy Secretary to Secretary', 1 7.8.62, MH1 36/1 1 . 

^'''Deputy Secretary to Secretary', 14.8.62, MH1 36/11. 

J.F. Hunt, Assistant Secretary, MOH Supplies Division replaced Gedling on 23.10.63., 
A/KE/PJ/17/1. 



58 



breathing down the necks of the MOH and their Report for the year 1962-3 
made plain that they regretted the delay in the preparation of standard 
specifications, since they had raised the matter the previous year.^^ They 
urged 'their introduction at the earliest possible date'. They were confident 
that 'future Committees would follow with interest the progress made in 
drawing up the specifications'/" Hunt was deputed to chair a committee of 
enquiry into hospital supplies in 1962. In the Hunt Committee's Report, 
published in 1966, the organization of supplies on an area rather than a 
hospital group basis would be advocated, as would increasing 
standardisation, as essential, if sensitive, courses of action. ^^ The King's 
Fund Bed was potentially a prominent example of what might be achieved. 
Furthermore, the project was the only one of its kind thought likely to come 
to fruition in time to appease the Public Accounts Committee. The working 
groups set up by Barber in response to the Public Accounts Committee's 
findings were not expected to report before the end of 1964 at the earliest. 
But centralisation remained a sensitive issue in the NHS. In an internal 
MOH paper Gedling warned 'We are here contemplating a serious 
reduction in the power of HMCs and Boards of Governors and must expect 
opposition'. ^^ Promotion of standardisation was considered more likely to 
succeed if it came from the 'neutral' voice of the King's Fund, rather than 
the Ministry. Some old-style hospital governors disliked central control as 
much as their medical colleagues, and the more flamboyant took special 



69 

Civil Appropriation Accounts (Classes l-V)1961-2, HMSO. 
''°Civil Appropriation Accounts, (Classes l-V) 1962-3, HMSO. 
Report of the Committee on Hospital Supplies Organisation, (Hunt Committee), HMSO, 1966. 
'The specification and purchase of hospital equipment', 18.4.63, MH1 36/11 



59 



delight in flaunting Ministry directives/^ The Ministry had a good 
relationship with the Fund, who were, in turn, respected by senior medical 
staff and hospital administrators. Perhaps because of lay dominance, the 
King's Fund traditionally managed to walk the tightrope between the MOH 
and hospital staffs. 

The secretary to the Working Party was a relatively new official of 
the Fund, Irfon Roberts. Roberts had hoped to go into the Colonial Service 
when he was decommissioned after the war ended. Thwarted by ill health 
he had opted for hospital, instead of colonial, administration.^'* Taken on to 
the King's Fund Bursary scheme, to train in hospital administration, his first 
task for the Fund had been to run a two year investigation into the 
organization of portering work in hospitals, which he completed in a single 
year. During the time that the Working Party on Hospital Beds was in 
operation Roberts was made an Assistant Director of the Hospital Centre. 
It is clear that he was the engine driving the Working Party and did most of 
the work generated by it. 

In the event, the Hospital Development Committee of the King's 
Fund did agree to sponsor completion of the RCA's hospital equipment 
study, from March 1963. From June, it was agreed that the RCA's studies 

73 

See for example the anecdote by 'Monitor' in tlie Britisli Hospital Journal and Social Service 
Review, May 28, 1965, p. 963. On his first day of a new job, the author had admired the 
new staff dining room. ' "Yes", said the House Governor, "it is rather pleasant and, funnily 
enough I received a letter from the Ministry today with approval to build it" '. 

^"^Interview, Irfon Roberts, 27.7.98. There are strong links between the armed forces and 

hospital administration in the NHS at this period, certainly in the former voluntary hospitals 
and at the King's Fund. A former Royal Naval Officer, Jack Langworthy, ran the 
Emergency Bed Service at the King's Fund from 1 951 , turning down a job in MI5 to do so. 
The Secretary of the Fund at the time, Roger Phalps, had commanded a naval 
minesweeper and was known to favour an ex-Navy man for the job. In the selection of the 
Emergency Bed Service telephone operators, former Wrens (Womens Royal Naval 
Service) were given precedence. Taped interview, Jack Langworthy, no date, A/KE/Box 
284, tapes 7-8. 



60 



would focus on the hospital bed, and that they would report to the Working 
Party on Hospital Bedsteads. This connection, fostered by informal 
discussions between Archer and Roberts in which the former outlined his 
ideas about rational design, and by difficulties and delays in the planned 
selection of equipment for the West Middlesex, brought about a conflation 
of interests which did much to ensure the existence of the artefact known 
as the King's Fund Bed. 

In December, the Working Party visited the Royal College of Art. 
Misha Black presented a report 'explaining the scope and purpose of the 
inquiry into the design of hospital equipment sponsored by the King's Fund 
and associated with the West Middlesex Hospital. It was noted that since 
June, particular attention had been directed within the enquiry to the 
question of hospital bedstead design'. A presentation by Archer followed, 
outlining what had been done so far and what was proposed ... the 
administration and clerical arrangements could not all be achieved from the 
team's own resources. '^^ From this point on, the project was integrated with 
the research of the Working Party. In the short term, it was agreed that the 
RCA team and the King's Fund Working Party would pursue their own 
separate lines of enquiry on bedsteads, pooling all information they 
obtained. To some extent this proved to be like trying to pool oil and water. 
The King's Fund Working Party was gradually compiling a list of 
characteristics which hospital bedsteads should possess. This they did 
largely by their traditional method of seeking informally the opinions of 
senior hospital staff with whom they had good working relationships. Their 
list of characteristics was produced in October 1963.^^ By that time, 

''^A/KE/PJ/17/19, KFWPHB Minutes, 4.12.63, Item 11. 
'Notes on characteristics of a liospital bedstead suitable for the majority of patients', 



61 



however, the impetus for the project lay firmly with the RCA team, who 
were following at least the early stages of the complex systematic design 
method which Bruce Archer had been devising over the past five years or 
so. 



23.10.63, revised 1.11.63. AAD/1 989/9.