Retro Look: Theme Hospital


Theme Hospital is one of those management-simulation games that were all the fad back in the 90’s. Created in 1997 by one of my favourite developers Bullfrog Productions, who are now sadly defunct thanks to EA. The team were also behind management-style games: Theme Park, Populous and Dungeon Keeper.

It saw the player stepping in the shoes of a director of a hospital, the theme of which is specialising in comical illness. At the start all you have is a plain building and a sizable budget to get yourself started. You create the rooms, you hire the staff, you set the budgets, you choose whether to go ahead with risky procedures, you are the dictator of the medical world mwahahaha! Sadly you do have to answer to the board of directors who will set goals for the current level you’re in and who will fire you if you do a poor job.

As you progress through the game you’ll unlock more rooms, but to start with you’ll only have a couple of options. The basic groupings of the rooms are: diagnosis, treatment and facilities. Clearly you need to know what is wrong with a patient before you can begin any treatment, the more diagnostic tests you perform the better your understanding of the problem (and the higher the chance of a successful treatment) and the more money you can charge the suffering patient…did I do they evil laugh already? Oh what the hell, mwahahaha! But just because you know what the problem is doesn’t mean you know how to solve it; if a person comes in suffering from Elvis Impersonation Syndrome if may take years to figure out the proper cure is to get a trained psychiatrist to tell them just how stupid they look. Then that’s if you already have the equipment needed, sometimes you’ll have to build whole new rooms; like the tongue-slicer room for those with Slack Tongue, or the inflator room for those with Bloaty Head.

The final last selection of rooms is the amenities of the hospital; toilets for the patients (because trained medical personal are above such common things) and Staff-Rooms for the, well, staff. We also have the Research room which will require researchers to research new treatments, upgrade current machines, reduce the risk of death for treatments such as the common cold (hey, it happens!) and most importantly running tests on patients with illnesses you know nothing about… and quickly getting rid of the body. Seriously the people they go into the machine and they don’t come back out, but at least it’s free for them. There is also a Training room where consultants can educate young doctors on the fine art of doctoring.

On the staff side of things you have Doctors, Nurses, Handymen and Receptionists. By the way this game is sexist; Doctors & Handymen are always male, Nurses and Receptionists are always female. This is something I didn’t originally pick up on when I played this back in the day but it seems so blatant now. Nurses run things like pharmacies, wards and plaster-removal; leaving all the real work to the men, I mean Doctors. The Doctors are present for every single diagnostic test and for every treatment too complex for a mere woman to comprehend, I mean nurse, I mean unqualified specialist. Doctors can also have additional qualifications: Psychiatry, Researcher and Surgeon. As you would expect only those trained with those skills can perform related tasks. If your consultant has one of these qualifications they can pass on these skills to young doctors via the training room.

Handymen fix machines, water plants, pick up litter and mop up bodily fluids. It’s always a little funny to see a handyman walk in during an operation just to water the plants; “oh don’t me guv’ I showered yesterday”. Meanwhile the fully awake patient ponders “Who puts plants in an Operating Theatre?” as two surgeons worry themselves about removing partially digested golf-balls from the patient’s stomach. Handymen also repair the machines in interesting ways, sometimes it’s a little complex with a blowtorch being brought-out, but more often than not it’s just using a hammer to smack it; then it’s back to the staff room for a cup of coffee. While the receptionist stands around telling people where to go. Oddly enough it’s the receptionist who has the most power at the start of the game, if you reduce the queue time you’ll get fewer patients and if you thought you would be smart and build two reception desks at the start you’ll end up with twice as many patients; making your, soon to be short, tenure as Director a very hectic one. However if you have too few patients you won’t be getting the money in, so you’ve got to carefully balance it out.

If there is one thing you notice when watching over your staff and patients (other than the patients are all rather funny looking) is that they’re incredibility stupid. The AI of the game leaves a lot to be desired; doctors will happy stand around in rooms no longer being used while a massive queue of people is forming for the unmanned room next door. Doctors you physically pick up and drop into rooms will sometimes decide that you didn’t really want them to that job and go do something else. Patients will wonder aimlessly about and on more than one occasion I had to restart a level because they managed to get completely stuck in a doorway. Handymen have the most skewed priorities imaginable, deciding to go out of their way to water a $50 plant on the opposite site of the hospital rather than repair the $5000 machinery that’s smoking right next to them. You can have whole herds of Handymen roaming the corridors of your maze-like hospital but somehow every single one of them will walk past the litter rather than picking it up. In short the AI sucks so be ready to personally direct every member of staff unless you have enough to staff every single room in the building.

The game itself is rather hard and often it’s even harder to know where you’re going wrong. You have a set of goals hidden away in the Status menu. Generally it’s have a good reputation (don’t kill anybody, have a clean hospital, short queues, etc) have money and cure a set number of patients. There doesn’t seem to be any clear goals to failing a level however; reputation hitting zero seems to be one, as does racking up a massive amount of debt, but more often than not I’ve had a game-over cut-scene pop-up (which are funny so I’m not too mad) and I haven’t got a clue what I’ve done wrong. I had a look at GameFAQs and in one FAQ the author states proudly “I have been playing Theme Hospital for about two years” adding “I can create a successful hospital WITHOUT the use of cheat codes up until about level six.”  So that may give you an indicator of the difficulty of the game.

Other annoyances are the inability to rotate the camera. Instead we have a fixed camera giving an isometric view of our hospital. I know why this is, the game isn’t really in 3D, but it doesn’t make deleting whole rooms just so I can pick up a misplaced radiator any less tedious. Also if your Handymen do fail to spot a damaged machine quick enough (or an earthquake hits) it’ll explode destroying everything in the room. Not only does it make it unusable but it means you can’t replace the damaged equipment or demolish the destroyed room. Instead you’re stuck with a worthless hunk of metal permanently reminding you of your failure. In a game where space is at a premium, and the placement of rooms are paramount to a smooth running hospital, this is just kicking a man when he’s already down.

I should point out that I’m not running this original DOS version, I’m not even using a DOS emulator. I decided to be smart and picked up a copy published by Sold-Out Software, which in theory should allow you to play it normally without the usual compatibility issues of these old games. Sadly life, and playing old games, is rarely that simple. While the game will play normally three times out of ten, it’ll also crash two times out of ten and the remaining five leaving the game playable but with an odd colour palette consisting mainly of purple. The original DOS version has more bugs than this updated version too, and thanks to the closure of Bullfrog, getting the necessary patches can only be done thanks to fan-sites; such as Ian’s Clinic, thanks Ian! The version I’m playing does have a difficulty settings, the original DOS does not, and again you’ll need to get a patch to add it. Finally there is multiplayer in my version…I have no idea how that works as I’m not setting up a LAN party just to find out, and once again this wasn’t in original DOS version but there is a patch.

At its core Theme Hospital is a lot of fun. There is always something to do, rarely do you have time to sit around and watch things happen, so you won’t have the chance to get bored but that is also its biggest flaw. While you’re off building new rooms, hiring staff and dealing with emergencies you can’t rely on the AI to keep everything running smoothly. In turn this creates scenarios that are less challenging and more unfair and confusing. That said the game’s humour is sure to raise a few smirks; so if you’re into retro-management-style-games and you see this game cheap, definitely pick it up.

Looking around on Amazon there are multiple versions of physical copies for various prices available, or if you prefer you can download it from Good Old Games for just $5.99. The game is also available on the original Playstation but the price range indicates that it was a very limited run.


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