Healthcare for everyone? The development, decline and heritage values of modern postwar hospitals in Slovakia

Abstract This study explores the development and current heritage issues of healthcare built infrastructure in Slovakia from 1948 to 1989, a key period in the formation of a modern, centralised hospital network. It highlights heritage concerns while situating architectural and historical values at the centre of renovation and preservation discussions. After World War II, Slovakia’s healthcare system underwent significant transformation, with state-led planning and the mass construction of healthcare facilities. Central to this process was the 1947 competition for a new general Type II hospital, which established the foundation for replacing the older pavilion system with centralised monoblock hospitals. The establishment of special design organisations culminates in the formation of the independent Zdravoprojekt [Health-project] Institute in 1966, centralised healthcare architecture and planning efforts. During this era, the first generation of Slovak architects specialising in healthcare design also emerged. They created functional, large-scale hospital complexes that reflected both international trends and local conditions, balancing operational logic with architectural quality. Postwar hospital complexes embody social, urban, and artistic values. They represent the modernisation of public health, urban development, and architectural experimentation. However, these facilities currently face pressure to renovate or demolish without adequate consideration of their heritage significance. Thus, this study highlights that modernist hospital heritage demands informed renovation strategies rather than piecemeal modernisation. It emphasizes the need for heritage-aware approaches in the face of climate considerations, changing medical practices, and private investment pressures. The deliberate registers of existing facilities and proactive modernisation plans are recommended to maintain functionality while safeguarding heritage.