Trip to an Exurban Hospital

Darent Valley Hospital, Dartford

Because I have to see a specific consultant, I don't go to the local hospitals. This is merciful in a sense, as my occasional experience of them - Woolwich and Lewisham respectively - is mildly terrifying, with the phlebotomy department in the latter particularly Romeroesque. So where I do go, every three weeks or so for check-ups and currently every six months for major surgery, is Darent Valley Hospital, on the outskirts of Dartford. Like most of North Kent, this hospital and its site is deeply strange, particularly through its seeming mundanity. This is Daily Mail-land, where South-East Londoners go when they retire or when they find the SE insufficiently racially homogeneous. So it certainly thinks of itself as normal. But when I take the train from Westcombe Park to Dartford the landscape gets progressively weirder with every successive station, travelling as it does through the Clockwork Orange set (literally - it goes through the 1960s sectors of Thamesmead), past the marshlands, sidings and vast Edwardian concrete silos of Erith, and finally arriving in what at first seems like an identifiable small town, with a shopping mall, a high street and a branch of Wimpy preserved in aspic.

Darent Valley was Britain's first PFI hospital, and accordingly it couldn't possibly be in the town centre. For reasons probably connected to land values on the part of the private companies that lease the hospitals to the NHS (leaving them tied into decades of debt), PFI hospitals are always on the outer reaches, in the 'no there, there' places, quarantined away; and this is given particular acuity by the fact that Darent Valley is on the same bus route as Bluewater, the ultimate out-of-town, out-of-this-world mall, bunkered down inside a chalk pit and impossible to reach on foot. So the bus takes you past the M25, through what is probably legally the 'green belt' - that is, a landscape of 1930s spec housing, miniscule farms where forlorn horses look upon power stations and business parks, eventually dropping you off at the top of a hill, from which you can survey this extraordinary non-place. The Queen Elizabeth II Bridge, its ungainly, steep curve reaching to the hangars and containers of Thurrock, an endless strip of sheds and cranes stretching out as far as the North Sea.

The hospital itself, designed by Paulley Architects, is in the PFI manner which is by now familiar from a thousand New Labour non-projects: a bit of stock brick, a plasticky wavy roof, some green glass, plus a few dashes of jolly colour in the carpets (something which becomes slightly Suprematist in the X-Ray department). Inside is a branch of Upper Crust, a WH Smith and a shop which sells a huge range of cuddly toys, amongst other concessions. The first time I went here I was rather alarmed that this '21st century hospital' was still using manual scales, but certainly one can purchase a wide variety of pastries. Screens show - always grainy - footage of local appeals, health recommendations and, in the waiting rooms, the bafflingly invariably badly tuned daytime TV. I'm always well-treated there, bearing in mind the hours of waiting around, as I do what I'm told, placing all reasonable and unreasonable trust in the physicians. Not everyone has the same trust. A massive, tattooed bloke in the bed opposite refuses to have his op because he's scared of general anaesthetic - 'but what if I don't wake up?' The elderly make up seemingly 90% of the patients. In the bed next to me in the ward was an 88-year old man. His muffled cries of 'give over!' and 'I'm a human being!' would always end with some attempt at fisticuffs, only to be told 'you can't punch the nurses, sweetheart - that's naughty'. Everyone else keeps themselves to themselves, as well they should, something aided in my case by large quantities of painkillers.

In the main Outpatients waiting room is a wall display on 'heritage'. Everything in Britain, especially in the home counties, must involve heritage somewhere. Obviously there isn't much to be found in a hospital which has only existed for 8 years, but conveniently, it turns out that there was once an 'asylum for imbeciles' nearby in the 19th century. Sepia-toned pictures of this take up the space on the heritage wall.

Originally published at SDMYABT on 25/1/09