Changing times: Hospital Sant Pau

Nearly a year has passed since the inauguration of the new Santa Creu i Sant Pau Hospital, built next to the existing Modernista site. The latest hospital stands on the northern part of the site, consisting of a central block, in which all outpatient activity takes place, in addition to four interconnected hospital blocks. These four buildings have yet to be completed, but by June of this year all the hospital installations are scheduled to be transferred to the new complex. While patient services will be moved to the new complex, the old grounds will continue to serve as a center for research.

“The mission of the Santa Creu i Sant Pau Hospital is to be a hospital of reference, open to society and its own health environment, centered on the people,” according to the hospital’s mission statement. With 623 beds, the hospital admits about 32,000 patients annually, treats 150,000 emergencies and 300,000 outpatients, according to figures in La Vanguardia. The hospital certainly seems to be fulfilling its goal. Nor has its singular and beautiful design been overlooked—in 1997, it was awarded  World Heritage Status by UNESCO.

Unlike his contemporary, Antoni Gaudí, who worked mainly on private projects, Lluís Domènech i Montaner was more involved with buildings for public use, such as the Palau de la Música, the Hospital of Pere Mata in Reus and the Hospital of Santa Creu i Sant Pau. The hospital’s roots stretch back to 1401 and the old city, when six hospitals were joined to make the Hospital de la Santa Creu. As the city expanded into the Eixample in the late 1800s, a project began to take shape that would bring the hospital up-to-date. It was formally initiated in 1902, but not officially finished until 1930.

Domènech i Montaner’s architectural design followed a strict logic. Erected on one of Ildefons Cerdà’s grid-like blocks that formed the new Eixample area, the architect made a slight alteration to the complex by rotating the whole building 90 degrees, so that viewed from above it resembles a diamond shape instead of a square. This was done so that the building would face towards the sun and away from the general direction of the wind, important for promoting natural light and eradicating the smell of drains within the building. Natural light was, in fact, an essential part of the architect’s design and many of the exterior walls were constructed from glass so that, in theory, no electric lights would be needed in the administration buildings.

What really stands out about the hospital, however, is the building’s artistry. Domènech i Montaner prioritized artisan craftsmanship in his works, in the spirit of a Modernista revolution that opposed the mass manufacturing of the industrial revolution. The letters "P" and "G," painted on ceramic tiles, appear everywhere and are a constant reminder of the hospital’s main benefactor, Paul Gil, a bank merchant residing in Paris who left a monetary legacy to the hospital. UNESCO called the hospital: “A masterpiece of the imaginative and exuberant Art Nouveau that flowered in early 20th-century Barcelona.”

The fantastical and uplifting appearance of the building does seem to go hand in hand with a series of scientific developments that have been pioneered at the hospital. As early as 1882, even before the Modernista complex was started, the hospital made headline news with the opening of Catalunya’s and Spain’s first Neurology Department by Dr. Lluís Barraquer Roviralta. The department has consistently been at the forefront of modern research; it specializes in Alzheimer’s disease, which currently affects more than 800,000 people in Spain alone, a figure that is expected to increase by 40,000 people every 20 years, according to the Director of Neurology, Rafael Blesa. The Catalan hospital’s lead in researching cures for this disease could not have come at a more welcome moment following the diagnosis of the popular ex-president of the Generalitat, Pasqual Maragall, as a sufferer of Alzheimer’s.

The hospital also was the first in Spain to carry out bone marrow transplants using a less toxic method than normal, in 1976. Catering to a proportionally high number of people over the age of 65, this technique enabled patients to have the procedure up to age 70, even though the standard age limit is 50. Since then, more than 2,000 bone marrow operations have been performed, at an average rate of 120 per year. The transplant program at Santa Creu i Sant Pau was the first in Europe to meet the standards of excellence required to receive accreditation from the European Blood and Marrow Transplant Group.

Another important development at the hospital has been the creation of a Centre d’Investigació del Medicament (CIM) clinical testing area, opened in 1983. Clinical trials for new medications are carried out in three stages: firstly, members of the public volunteer to test medicines that have previously only been tested on animals; secondly, the medicines are tested on a reduced group of patients and, finally, in the third and final stage during which the medicines are administered to much larger groups of patients. The scheme has attracted the interest of six multinational pharmaceutical companies that have pledged support for the project. From the project’s start in 1982, more than 280 tests have taken place, involving some 4,000 volunteers. In April 2006 it became the first hospital in Catalunya to install a magnetic resonance unit, allowing greater diagnostic capacity than ever before, as well as better image precision.

Many of these programs have not come cheap and the hospital has debt totaling €282 million, owed both to social security and hospital suppliers, according to La Vanguardia. The Catalan government has promised to donate €488 million between now and 2038, in order to alleviate the debt accrued by the hospital, and cover the associated financial costs.

How the move to new premises will affect the debt, and how it is expected to affect patient care are two questions that will remain unanswered for the present moment. Despite numerous requests to the hospital’s press department for an interview about plans for the hospital’s future, Metropolitan was repeatedly told that the new hospital was in-between administrators and that no-one was available to respond to questions from any media at the present moment. Apparently, a new administration will be named in the near future, but no specific date is available.

Stay tuned.