Theme Hospital Review

Have you ever wanted to manage a hospital?  Me neither, and yet there’s a strange charm in playing a game about it.  Theme Hospital is all about every aspect of running your very own health care institution, from hiring the professional employees that will work to cure your patients to laying down every plant and vending machine.  Developed by Bullfrog Games in 1997 and published by Electronic Arts, Theme Hospital is possibly the only game among the very few that have even tried to do hospital management right.

I’ve played this game the same way for years.  I can run a fairly competent hospital, churning out a healthy profit while getting in good graces with every VIP that visits and bolstering an impressive patient cure to death ratio.  Despite all this time playing, I’ve never run a terrible hospital.  As challenging as this game can be, it’s actually disappointingly hard to fail at when you’re trying not to.  So, this review will focus on my first ever deliberately bad hospital.  The goal?  To fail the tutorial level.

When thrust into the first level of the game, you’re presented with an empty building.  Nothing much to start with, but the tools and funds at your disposal to begin constructing rooms and hiring staff.  This is the first of many stages with its own challenges but being your earliest hospital the player is given it serves as an introduction stage to help you get to grips with the game’s mechanics.

Theme Hospital Screenshot 2
When a hospital is done right

Generally, you want to put everything like the general practitioner’s office and pharmacy at the front of the building so that patients don’t have to walk very far.  I proceed to place every room at the back of the building to insure they have to walk as far as possible to even visit the general practitioner to find out what care they need.  Of course, I don’t build a restroom to ensure maximum discomfort. I hire the least competent doctors and nurses that are available and I intentionally keep them from going to their duties long enough so that a nice miserable queue builds.  Ordinarily, I’d have given them benches and plants all about the place to make their waiting experience as tolerable as possible, but instead they get a surplus of radiators that i crank up to max to make things unbearably hot and soda machines aplenty to milk them of their money.  The first patients to arrive swiftly make frequent visits to the vending machines, then proceed to vomit and litter.  There are no handymen to clean up, and I intentionally understaffed this hospital.

My first patient death is quick to arrive.   With only a twenty percent chance of a cure the game informs me, normally it would be wise to send them away so that they don’t die in my hospital—a bit coldhearted, but a patient dying in your care negatively impacts your reputation meter, although the consequences of that aren’t generally something you ever really feel or notice if you’re trying.  It is unfortunate, but he must die in my quest to create the world’s worst hospital.  It’s a man with a case of invisibility who had to tread through litter and vomit to what he thought would save him, only to drop dead the moment he left the pharmacy after treatment.  A small lava pit opens up, the grim reaper arrives, and the man miraculously gets up only to trip into the pit which closes in after him.  The grim reaper departs and I can take at least some comfort in that the man probably deserved it.  Maybe.

One game year later, mouse holes have appeared all over indicating that we now have a vermin problem, and not a single patch of vomit, litter, or the results of unfortunate bowel movements from patients unable to find restrooms has been taken care of and I’ve been forcing some of the less healthy patients to the back of the queue for in-game months.  I feel kind of bad at this point, but I’m committed.

Theme Hospital Review screenshot

“Patients are asked to be patient”

Steadily and surely, I’m seeing my reputation go down the drain, even faster in the second year. Wait times drive some patients to leave on their own, and some actually die waiting for treatment.  I’m beginning to realize just how dark this is getting, but the game’s jaunty soundtrack keeps things just cheerful enough to not get depressing.  My terrible doctors and nurses are taking unbearably long breaks in between working, it may be the heat from the radiators which affects employees as well as patients, or the fact that they were the worst I could find.

The end of March rolls around and the game’s advisor, a fairly helpful entity that makes himself frequently well known in the bottom right of your screen, warns me that people are getting annoyed at how I run my hospital.  “Get it together or face the consequences!” his text bubble reads, which I take to mean that I’m doing pretty well at my own goal here.

Billy Savile OBE, a VIP, wishes to visit my hospital at this point, and I decide that it’s time to share the true horror that is the way I run this facility with someone important from the outside.  I’m sure he’ll love it here.  Billy shortly arrives as a portly man in a suit with graying hair, and a top hat, the way most important people look I would imagine.

Through the front doors, he’s met with the sight of much of what I’ve mentioned before.  I could only imagine the shock and disgust of just seeing the sorry state around the receptionist’s desk from very ill patients.  The receptionist, like a lot of the other staff, was the worst I could find.  However, while she’s important to bring patients in and direct them to the general practitioner, she doesn’t do much else other than provide colorful commentary and deliver silly jokes over the intercom every now and again.  “We apologize for the amount of litter.” Has to be the one I heard the most in this hospital.

Billy checks in with her, then makes his way along the horrendous hospital hallways, peering into the different rooms to see how we cure people here, and what luck, another patient needs curing with only a 13 percent chance of success.  That’s almost certain death and would undoubtedly make a good show to entertain the VIP, so I give the go ahead.  Unfortunately, the patient is actually cured.  What rotten luck.  Billy leaves, probably a changed man after this experience, and I eagerly await word of his thoughts about his visit here.  We get word that he says he enjoyed my “charming” hospital, but only awards a grant of 400 dollars.  Clearly, he was not impressed.

Many more months of appalling medical malpractice later, my reputation finally hits rock bottom at the end of the year. I’m treated to a short game over cutscene of scandal–of what kind I’m not sure–with a doctor I assume to be the player, and a nurse together in a sports car, someone snaps a picture of us and we make the front paper with no headline.  A bit mystifying to me, maybe I’m just missing something.  But hey, I failed!  Exactly as planned.

Overall, no matter how you play it, Theme Hospital is an enjoyable albeit potentially repetitive game.  It’s lighthearted approach to dark humor keeps it fun and entertaining, but it’ll have you doing a lot of the same tasks at the beginning of and throughout each level.  I highly recommend picking this game up regardless as it’s a genuinely enjoyable title.  If you think you’d enjoy running your own hospital, either to into the ground or to prestige, give Theme Hospital a try.

“Look out for other Bullfrog products”


Darrell Thody

Living and raised in Oregon, USA. Writing and video game enthusiast. New to freelance writing.

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