Theme Hospital: A Retrospective

I was just running through Theme Hospital again, and I think I got to... around level 9/12 or so. Theme Hospital is a fun game. It's a strategy game, so the fun stems from you, and the choices you get to make. You get to design the layout of your hospital and your rooms, hire whoever you want on your staff, place benches and drink machines accordingly, and then watch it all in action from above when you open your hospital. However, it is only when you reach the later stages of the game, do the many frustrations and problems of Theme Hospital become apparent.

I would postulate that Theme Hospital fails in the gameplay section for one main reason: gameplay maintenance. Gameplay maintenance--in strategy games--is when you must maintain everything you have created. In SimTower, this would be individually clicking on every apartment and lowering the rent to make your tenants happy. In Command & Conquer, this would be to repair your buildings or create new tiberium silos. Gameplay maintenance is an understandable feature in strategy games, as long as in comes in doses and is fair to the player. In Theme Hospital however, it is taken to a frustrating extent as you get deeper and deeper into the more complex levels of the game. This can pretty much be summed up by a scenario I was in that kind of went like this:
- The voice announcer lady says: "Doctor needed in psychiatry--2 Surgeons needed in--Doctor needed in GP office--Earthquake imminent!--Doctor required in Slack tongue clinic!--Epidemic warning--2 surgeons needed--nurse required in fracture clinic!"
If you've played the game in the later levels, you will find that this is barely, if at all exaggerating the situation. On top of that, you must keep an eye on:
- The condition of your machinery
- The happiness of your doctors
- The health of your patients
- The length of your queue lines
- The cleanliness of your hospital
- Any notifications on the bottom of your screen

In my opinion, the fun in strategy games does not lie in gameplay maintenance--it lies in the design choices you get to make. I believe that was one main thing Rollercoaster Tycoon tried to achieve, and did it well. It tried to remove many of the micromanagement gameplay features that you see in games like Theme Hospital, and let you concencrate on the fun aspects of strategy games, which in this case was building your park. You didn't have to worry so much about maintaining it.
I think if Theme Hospital focused more on the building aspect and less on the maintaining aspect, it would be a much better game. Several ways they could fix this are:
- Automatically have Doctors who are doing nothing return to the staff room. This removes their anger and keeps them happy, without letting them ask for another tedious raise.
- Have a button to automatically repair all of your machinery, instead of searching your whole hospital for rooms with machines.
- When the queue lines for your rooms get to long, pop up an alert, recommending the player to build another GP Office, or whatever office is required.
- Seriously improve the AI--I would have handymen walking around in circles in vacant areas of the hospital instead of cleaning up messes in the populated areas. I would have the most qualified doctors waiting in empty rooms, while my least qualified doctors would answer job calls when they were the furthest away from the office they were headed to.

Theme Hospital, as it stands, has too much micromanagement, in my opinion. You, as the player, are required to do to many things in a too narrow window of time, and because of that, too many things can go wrong and the game becomes increasingly tedious and frustrating. The only way to win then requires you to do everything right, and nothing wrong.

For an example of what would happen if you removed virtually all of the micromanagement, once again, just look at Rollercoaster Tycoon. All of the rides are equivalent to treatment rooms, except there is no need for employing individual doctors. All staff maintenance is removed by not giving handymen and mechanics 'happiness' bars. Lastly, any ride maintenance is kept to a minimum, and it is barely required to keep your park running. By comparing these two games, you can see what the effects of gameplay maintenance are on strategy games, and which style you may prefer as the player.