Hospitals of the future

The hospital has generally served as the site, rather than the focus, of sociological inquiry. The premise of this chapter is that there is something significant to be learned about the forces that shape healthcare practices, and by implication understandings of health and illness, if our focal point is the hospital itself. The chapter will illustrate how various aspects of ‘the hospital’ have been identified as sociologically significant in social science scholarship. The chapter briefly explores the historical evolution of hospitals, the relationship between hospitals and their wider ecosystem, hospitals as places of work, hospital architectures and infrastructures, and hospitals as financial assets. In reviewing this work, the chapter will emphasise the organisational complexity of modern hospitals, particularly in regard to the diversity of groups that now have a stake in their form and functioning. The chapter will then propose how we can conceptualise hospitals as distinct and coherent organisations in such a way that does not elide their internal complexity nor obfuscate their entwinement with their wider socio-political ecosystem. I will argue that contemporary hospitals reflect an emergent mode of governance that I will define as strategic multiplicity. Hospitals, conceptualised in this way, are the institutionalisation of the aspirations of multiple stakeholder groups, and the strategies for mitigating tensions between these aspirations. In light of this, the chapter will conclude by suggesting avenues for future sociological research on hospitals.