Light touch: a new addition to St Thomas's Hospital, the Evelina Children's Hospital exploits space, light and colour

Megastructure or campus? This is a key question for architects engaged in hospital design in the UK, where a combination of technophilia and response to short-term clinical fashion has for decades resulted in too many hospitals resembling rambling horizontal oilrigs rather than places of peace and healing. Budget and programme requirements have too often led to confusing environments, where patient care and visitor comfort come a poor second to an obsession with initial capital cost.

It is a relief, therefore, to visit the Evelina Children's Hospital in London, designed by Hopkins Architects. Here, primacy has been given to the experience of the patients during their sometimes long-term stay; this is an environment flooded with natural light, and in which colour and materials play an important role. It is a large (16 000sqm), exuberant building, whose confident structural design is worthy of the Victorians who created the St Thomas' Hospital complex in which the Hopkins building now sits.

The story of the hospital is complicated; founded in the twelfth century on a different site several miles to the east, it moved to its Thames-side location opposite the Houses of Parliament in 1871. The design by Henry Currey was of heroic proportions: a long series of linked courtyard blocks addressed the Thames at the rear, while a series of separate entrances fronted Lambeth Palace Road (the nearby palace is the home of the Archbishop of Canterbury). Currey created a hospital which managed to be both megastructure in terms of its physical impact and range of activities accommodated, yet at the same time a campus by dint of the way that different medical activities were separated within a series of hospital buildings.

Florence Nightingale founded her pioneering school of nursing in the hospital, with its then novel attitude to neatness and cleanliness, attitudes now having to be relearned in the wake of MRSA and other cross-infections (additional hand-washing facilities are being installed). A medical school opened at the hospital in 1871, and its role as a teaching hospital has continued to this day. Most significantly, the design of the hospital acknowledged the civic and symbolic function of such a group of buildings, whose grandeur responded to their cross-river parliamentary neighbour; the hospital was very obviously a part of the city in which it stood, and part of an urban grain capable of absorbing this monument to Victorian reforming zeal. Moreover, the courtyard arrangements facing the river gave dormitories air, light, and views, attributes which the Hopkins building emulates.

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Sadly, much of the Victorian design proposition has been lost or diluted, particularly in the decades since the Second World War, when extensive bombing destroyed large chunks of the complex. The impressive additions by YRM, completed in the early 1970s, have themselves been modified, with a resulting loss of circulation clarity. Accretional construction, no doubt for good purposes, has left the public realm of the campus in a sorry state, littered with obscure entrances, and with exteriors which Nurse Nightingale would have condemned as unacceptably dirty. The old road onto which the Victorian buildings faced, is long gone, the new route a busy urban road with a bus lane rather than hospital drop-offs. Inside St Thomas's, the forest of signage is a sure sign of circulation confusion. You have to work there to know how to get around.

Equally historically chequered is the story of the Evelina Children's Hospital itself. It was founded in 1869 by Ferdinand de Rothschild as an independent institution, located in Bermondsey, south-east London, close to the old St Thomas's Hospital site. On the formation of the National Health Service, the institution was incorporated within the trust responsible for St Thomas's and Guy's Hospitals, and Evelina was eventually located within the Guy's Hospital tower next to London Bridge railway station. It will relocate to the Hopkins building later this year, its name and history having been part of the fund-raising campaign to make the Hopkins Evelina possible.

The complex histories of the institutions involved in providing healthcare in this part of London have been incidental to the architectural effort in creating the new building. In place of complexity they have provided clarity; in place of that signage forest, they have given a clear sense of direction; in place of darkened back-of-house circulation routes they have provided light and views. The Guy's and St Thomas's hospital trust project manager. Alastair Gourlay, recalls the programme requirement for a 'real children's hospital, not an adult hospital with cartoons on the walls'. It should be noted that 'children' includes anyone up to the age of 18. The client brief, in part derived from long discussion with children and parents, was for a hospital that doesn't feel like a hospital', devoid of 'long scary corridors', and reflecting high aspirations both for an architectural 'wow' factor, and for evidently high levels of construction quality.