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When the Royal Liverpool Hospital eventually opened in October 1978 it was over five years late costing more than twice its original budget. Its attendant design flaws and compromises made it very much the hospital that jack built. Indeed, such was the scale of its failings that the experience led to capital planning procedures in the National Health Service (NHS) being overhauled. These failings, combined with its looming, grey brutalist facade, means that for many the Royal epitomises the very worst aspects of services run by the state. It is a monument to faceless, technocratic planning erected during the final throes of the ‘classic’ welfare state from 1945 to 1979. However, such a comfortingly familiar narrative obscures more than it reveals. Drawing on extensive archival records from both local NHS and predecessor organisations in Liverpool, as well as the Department of Health, this paper shows that a more intimate exploration of the hospital’s construction exposes a moving frontier reflecting more a war of manoeuvre rather than one of attrition. Ultimately, by providing a focus on place, people, and planning rather than established national or sectoral approaches, this paper shows that the hospital is a testament to voluntary ambition rather than social democratic state bureaucracy.

Michael Lambert is a Postdoctoral Fellow in Social Inequalities at Lancaster University.

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