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Theme Hospital is a business simulation game developed by Bullfrog Productions and published by Electronic Arts in 1997 for MS-DOS and Microsoft Windows compatible PCs in which players design and operate a privately owned hospital with the goal of curing patients of fictitious comical ailments. The game is the thematic successor to Theme Park, also produced by Bullfrog, and the second instalment in their Theme series, and part of their Designer Series. The game is noted for its humour, and contains numerous references to pop culture.

Peter Molyneux and James Leach came up with the idea of creating a Theme game based on a hospital, but Molyneux was not directly involved in development due to his work on Dungeon Keeper. Designers originally planned to include four distinct gameplay modes corresponding to historical time periods, but this was dropped due to time pressures on the team. Multiplayer support with up to four players was added in a patch. The game received a generally positive reception, with reviewers praising the graphics and humour in particular. Theme Hospital was a commercial success, selling over 4 million copies worldwide, and was ported to the PlayStation in 1998. A Sega Saturn version was in development, but cancelled. The game was re-released on GOG.com in 2012 and Origin in 2015, and the PlayStation version was released on the PlayStation Network in Europe in 2008, Japan in 2009, and North America in 2010. Revival attempts have been made with the development of open-source remakes such as CorsixTH.

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Diagnosis and treatment cost patients money, and the player can change hospital policy, including the amount of diagnosis patients require. This can be set to over 100 per cent to force patients to have further unnecessary diagnoses. Other policies include when staff can go on breaks and whether they can leave rooms,[18] and loans can be taken out.[19] From time to time, events such as emergencies (in which patients arrive and must be cured within a time limit or they will die), and epidemics (in which a disease spreads rapidly) occur. During the latter, the player can attempt to cover it up by curing all affected patients before a health inspector turns up. If the player fails, they are fined and must face a damaged reputation,[20] a statistic that shows how well the hospital is doing and affects the flow of patients.[21] VIPs may also occasionally ask to tour the hospital; if impressed, the player is granted a cash bonus, a reputation increase, or both.[22] There is an advisor who keeps the player informed about what is going on.[23] Rats may infest the hospital, and the player is able to shoot them with the cursor.[24]

Although the player has no direct control over the patients, they have some influence over whether to evict them from the hospital and in determining what to do with them when given a choice by the staff. The player can pick up any staff member in the building and move them (mainly to reassign them to another room or send them to get rest), or dismiss them if they argue about pay or are no longer required.[25] The player may force patients to take a chance at a cure for their suspected disease before diagnosis is complete (at the risk of killing the patient),[26] and rearrange queues.[27]

Each level has set goals in the fields of financial attainment, hospital reputation, patients cured, and hospital value.[4] Holding negative funds or allowing sufficient patients to die will bring about losing requirements. When the goals have been met the player has the option to move on to a new, more elaborate hospital with tougher winning conditions and more diseases present, or stick with their current one.[30] If enough rats have been shot, the player is taken to a special level whose goal is to shoot as many as possible.[24]

A patch was released that fixed bugs and added support for Serial Cable, Modem, and IPX/SPX network gaming (with up to four players[31]) in the Windows version, and a difficulty setting.[4][32][33] In multiplayer, each player has a colour, which patients will wear to distinguish from those of other players. "Litter Bombs" are featured, allowing players to spread litter around other players' hospitals, while staff members can be persuaded to work for other players, and there are "Mini Missions", with instructions for players to perform. Players are also able to chat with each other during a game.[32]

Theme Hospital took over two years to develop.[34] The idea came from Peter Molyneux and journalist James Leach, who explored the possibility of other Theme games while discussing Theme Park. Leach suggested a hospital, and Molyneux was enthusiastic about the idea. Development began when the designer Mark Webley selected Theme Hospital from a list of possible games put together by Molyneux, and Webley, along with the artist Gary Carr, visited the Royal Surrey County Hospital, Great Ormond Street Hospital, and Frimley Park Hospital for research and inspiration.[5][35] Carr was initially displeased at the prospect of working on Theme Hospital: he had previously left Bullfrog to work for The Bitmap Brothers because he did not have faith in Theme Park. He chose to return based on his belief that he would work on Dungeon Keeper, which he was eager to do. Initially, Theme Hospital was to feature real diseases, but these were replaced with fictional, comedic afflictions as it was decided that the game's maladies should not be too realistic:[5] the team were faced with the dilemma of having to make the hospital fun and interesting, as Webley stated that theme parks are "colourful" compared to hospitals, and Carr believed that hospital rooms looked very similar and that it was hard to tell what each machine does.[36]

It was during a hospital visit (after witnessing an operation that they were ordered out of because they were distracting the surgeon[5][37]) that they came up with the idea of using made-up illnesses and cures: Carr considered death "quite sad" and believed that illness was not a popular subject.[36] He stated that using made-up illnesses gave them "creative freedom", which he believed was essential.[36] Webley said that Carr was concerned that using real diseases might be considered distasteful.[37] According to Carr, the team were aiming for humour rather than gore.[38] During the initial stages of programming, Bullfrog hired James Leach, who wrote the game's text and came up with the diseases. Molyneux was not directly involved in the game's production as he was then working on Dungeon Keeper.[5]

The game deviates from the NHS model; Webley and Carr decided that players should think of the hospital as a business, with profit highly important. The team, who worked in offices near the Royal Surrey County Hospital, drew some inspirations from Theme Park and borrowed a great deal of code.[5] Webley explained that this was an "obvious starting point" as he had been a programmer on Theme Park, and that the systems had been rewritten by the time Theme Hospital was complete.[35] A program which facilitated animation was built upon by Webley, who dubbed it the Complex Engine. There were not many meetings, and Webley took the team to the pub weekly with a list of tasks to perform. Webley explained that the way the team worked meant that only they could perform their assigned duties otherwise they would not get done, effectively giving members ownership of their parts of the game.[5] It was during one such meeting that the team realised the game was complete.[37] The disease called King Complex was to be called Elvis Impersonator, but Elvis's estate owned the rights. Bloaty Head was based on an allergic reaction Molyneux had, when his face became an "alarming size".[5]

Theme Hospital was released on 28 March 1997 (although it was previously due for release in November 1996[44]),[5][41][1] and is part of Bullfrog's Designer Series.[45][46] The game attracted some controversy from NHS managers, the Houses of Parliament, and The Daily Telegraph, who published an article criticising the game as "sick" and said that the British Medical Association was using it to train management staff.[5][37] The NHS argued that the game mocked hospital management. Webley was invited to appear on a local radio station; he did not consider the game to make light of real-world health management because it featured fictional diseases rather than real ones. Theme Hospital was a commercial success, which surprised Bullfrog and Electronic Arts. It repeatedly appeared in the top five of budget charts and sold over 4 million copies. In 2014, Molyneux stated that he wanted the game to make a comeback, and described Theme Hospital as "a great game that I and many people remember".[5]

Another reviewer who liked the graphics was Dawn Jepsen of Computer Gaming World, who also praised the humour, especially the "wackiness" of the illnesses, and described the game as "delightful and absorbing".[4] The humour was also approved by a reviewer of Jeuxvideo.com, who, like other reviewers, lauded the graphics, by describing them as colourful.[73] Next Generation's reviewer echoed others' views about the humour, describing it as something they had come to expect from Bullfrog, but criticised the lack of multiplayer support.[76] The humour was again praised by a reviewer of PC Power, who said that the ailments enabled Bullfrog to have "hilarious" cures. The "thoroughly engrossing" gameplay, and the graphics were also complimented: it was stated that the bright colours gave hospitals a "cheerful look". Theme Hospital was described as a "fantastic title".[78] Other comments from critics included Edge's reviewer's compliments of the balance of patients and illnesses against the player's resources, and his belief that the game is a refinement of its genre,[70] and PC Zone's reviewers commendation of the detail: it was remarked that it gets players "helplessly immersed", and the game was awarded the PC Zone Classic accolade.[75] ric Ernaux of Gnration 4 said the quality is "remarkable for a game of its genre".[79] 006ab0faaa