Canossa Hospital (Caritas) Extension

Design Concept

The members of the Canossian order are best known for their education works throughout Asia, but in Hong Kong they are also involved in healthcare. The order’s first hospital here – with just 16 beds – opened in 1929, but was destroyed during the Second World War. It remained closed for 15 years, but in 1960 the hospital was granted a new site at the bottom Old Peak Road, overlooking Robinson Road and close to the Cathedral of the Immaculate Conception – the heart of Hong Kong’s de facto Roman Catholic district. It has been in operation at this location since 1964.

Over time, changing needs and ever increasing functional demands required various modifications and additions – including a major annexe – but by the year 2000 the whole structure was clearly due for a major overhaul. Not least, advanced medical practices and technology required a significant expansion in space and volume.

Though site constraints were an issue, the hospital board was adamant that the hospital had to remain in its original location and continue to operate throughout every stage of the construction. During its 40-plus years on the site, the hospital had established itself as a much loved neighbourhood-clinic, with many patients returning throughout every stage of their lives, and the thought of moving  – even temporarily – was out of the question. 

By the time CKL was appointed in 2007 – after a lengthy interview process – it was clear that the project would not only require a major new building, almost doubling the size of the existing hospital, but would also require a significant amount of work to the existing facilities – in particular the services – if a seamless connection between new and old was to be achieved. The original building’s floor-to-floor height was only 10 feet, nowhere near enough for modern air-conditioning systems – to say nothing of meeting the needs of modern operating theatres. New emergency systems such as fire sensors and sprinklers would also have to be installed to meet the latest standards.

Of immediate concern, however, was how best to build a major new extension on this difficult site, without disturbing the normal operation of the existing hospital. As a consequence, CKL’s first major design decision was to identify the best location for this new building – one large enough to accommodate at least four new operating theatres of decent size and volume, a central sterilizing unit, clinical and diagnostic laboratories, and new maternity and surgical wards. Space for future expansion would also be required. Moreover, the new building should not obstruct views from the existing wards, nor impede their natural ventilation. Finally, the construction site also required independent access so as not to affect regular hospital traffic.

Combined with the site’s challenging topography, all these consideration led inexorably to siting the new building on the steep concrete slope leading down to Robinson Road at the north-western end of the existing hospital. This had the benefit of independent access from Robinson Road for site traffic during the construction process – as well as improved access for fire services at a later date – while also offering the new extension excellent views out towards the Cathedral and beyond to the harbour.

To unify the old and new structures, and to allow an uninterrupted flow for hospital functions, the end of the old annexe block had to be demolished, while floor levels between new and old had to be carefully aligned to avoid the need for steps or ramps between different parts of the finished building. Unfortunately, the increased height of the extension created a situation where the hospital Chapel – which used to be at the highest point of the old hospital – would now be surrounded by taller structures on two sides, depriving it of light and views. This has been rectified in the final design, however, by creating a new ‘cloister’ to one side of the Chapel, allowing light in and views out over a new courtyard garden. Meanwhile, links to a smaller prayer room in the new building maintains the Chapel’s position as the highest point in the finished complex. 

The design was approved and, with the support of the Mother Superior, permission came from Rome to allow the building and renovation works to proceed. This required careful planning, with the work proceeding in phases to allow sufficient time at every stage to demolish and strengthen parts of the existing building, re-route existing services, temporarily weather-proof newly exposed internal walls and, when necessary,  link through to spaces in the existing building. Similarly, the relocation of many departments in the existing building was also carried out in stages, to minimise disruption to the running of the hospital as a whole. It was a delicate operation at every stage.

To complicate matters, the difficult site conditions also required clever engineering solutions. For example, special foundation piles were required: due in part to the depth of the bedrock, but also to minimise noise and vibration in the existing hospital during their installation. Due to an unexpected concentration of utility services along the nearside carriageway of Robinson Road, a further unexpected delay arose when the new building’s main drainage had to be diverted – via a specially built tunnel – to an alternative sewer line on the far side of the road.

In hindsight, the tightness and complexity of the project has prompted comparisons to watch-making: a lot of work was required to resolve technical issues that will never be seen. For the most part, the façade is made up of cladding and self-cleansing tiles for easy maintenance, the only exception being the floor-to-ceiling glass wall of the cafeteria. In contrast to the new building’s many enclosed and windowless rooms – the operating theatres and so forth – this is one space that called for spectacular views. 

The new extension was complete in the autumn of 2015, since when the main focus of the work has switched to the total renovation of the existing hospital – in some ways an even more complex task. New air-conditioning ducts have been installed on the external facade feeding improved outlets in the rooms within, while the relocation of clinical departments within the building – together with all their necessary services – has required careful planning and a delicate touch to avoid disrupting the running of the rest of the hospital. Among the major changes has been the complete opening up of the existing building’s ground floor to create a new out-patient consultation zone, complete with comfortable waiting areas, quite separate from the entrance for in-patient admissions. Similarly, the entire first floor has been repurposed for specialist out-patient services, including an orthopaedic centre, a physiotherapy department, specialist eye and dental clinics, and a new child health centre. The renovation work is due to be completed during the autumn of 2016.