Pip talks to the ex-Bull­frog devs cre­at­ing the next evo­lu­tion of The­meHospi­tal.


Im­me­di­ately after fin­ish­ing the Two Point Hos­pi­tal de­vel­oper in­ter­view tran­scrip­tion I… well, I should have started writ­ing this pre­view, but what I ac­tu­ally ended up do­ing was boot­ing up Theme Hos­pi­tal and cur­ing a swarm of pa­tients with com­i­cally swollen heads against a sound­track of jaunty mu­sic and toi­let noises.

Two Point Hos­pi­tal is both a stan­dalone game in a new, broader set­ting and, in­escapably, a spir­i­tual suc­ces­sor to Bull­frog’s 1998 hos­pi­tal man­age­ment sim­u­la­tion. Partly that’s be­cause of the struc­ture and tone of the game – com­edy and med­i­cally-themed de­sign – and partly it’s be­cause the studio is be­ing led by Theme Hos­pi­tal’s lead de­vel­oper, Mark We­b­ley, and lead artist, Gary Carr.

In this in­ter­view they’re joined by Ben Huskins – a long-term col­league of the pair and the lead de­signer on Two Point Hos­pi­tal. He ex­plains what play­ers will be do­ing this time around:

“You’re tak­ing on the role of this hos­pi­tal ad­min­is­tra­tor and you’re ar­riv­ing at Two Point County,” he says. “You start off in one lit­tle cor­ner of the world with a tiny hos­pi­tal in a lit­tle vil­lage. By prov­ing your­self there you get the op­por­tu­nity to es­tab­lish a new hos­pi­tal some­where else in the county and grad­u­ally, over the course of the game, you’re build­ing up this health­care or­gan­i­sa­tion.”

Man­age­ment of this or­gan­i­sa­tion is one of the big changes from the ear­lier game. “It’s al­most like a busi­ness sim on top of a busi­ness sim,” says Huskins. “You’ve got each of your in­di­vid­ual hospi­tals that you’ve built up and you’ve also got the whole or­gan­i­sa­tion. You’re not just leav­ing hospi­tals be­hind. They’re still there and they con­tinue to con­trib­ute to the over­all value of the or­gan­i­sa­tion.”

What the team is try­ing to avoid is that sense of hav­ing laid out and staffed a hos­pi­tal full of treat­ment rooms, di­ag­no­sis fa­cil­i­ties and ad­min­is­tra­tive lay­ers only to cast it aside for the next chal­lenge. “That was a big thing early on,” says Huskins. “We wanted to feel like you’re not re­ally throw­ing any­thing away. You’re al­ways build­ing up and build­ing out.”

Be­ing able to choose what you want to fo­cus on within that or­gan­i­sa­tion is, Two Point hopes, go­ing to en­able the game to cater to dif­fer­ent styles of play. Those who want to see more of the county might be con­tent with reach­ing a one-star rat­ing and un­lock­ing the next thing, if you pre­fer to fo­cus on one project for a long pe­riod of time you’d be able to spend longer with one hos­pi­tal, lev­el­ling it up.

Carr con­trasts this with pro­gres­sion in Theme Hos­pi­tal. “It felt very lin­ear, the orig­i­nal games. How long can I play this un­til the game beats me? We wanted to not get peo­ple into that sit­u­a­tion.”

get­ting a check-up

Dif­fer­ent parts of Two Point County will of­fer dif­fer­ent chal­lenges, too. A moun­tain­ous area might have snow and thus heat­ing the space is a press­ing con­cern. Hot­ter ar­eas would need air con­di­tion­ing and might re­quire fa­cil­i­ties for treat­ing trop­i­cal dis­eases, while teach­ing hospi­tals would present their own set of chal­lenges.

The com­par­i­son with Theme Hos­pi­tal is in­escapable. The ‘spir­i­tual suc­ces­sor’ la­bel doesn’t feel right, though. It’s more that a team led by the same peo­ple is mak­ing the idea, but in 2018, with lessons learned from its work and from play­ing a va­ri­ety of sim games which were built on Bull­frog’s man­age­ment sims.

We­b­ley specif­i­cally men­tions Cities: Sky­lines and PrisonAr­chi­tect as inspirations, and it’s in­ter­est­ing to note that the PrisonAr­chi­tect al­pha trailer cites The­meHospi­tal and Dun­geonKeeper as its own in­flu­ences. “What goes around comes around,” he says.

“We wanted to feel like you’re not re­ally throw­ing any­thing away”

So TwoPoin­tHospi­tal is a feed­back loop crossed with a re­boot, per­haps?

“The game is in­spired by the work we did [20] years ago,” says Carr. “But it’s got lots of fresh ideas in there,” adds We­b­ley. Carr con­curs: “We wouldn’t want to make a re­make any­way. It’s got to feel dif­fer­ent. It’s got lots of new el­e­ments to it, other­wise what’s the point?”

An­other point of dif­fer­ence, in ad­di­tion to the lay­ered na­ture of the busi­ness and a flex­i­bil­ity when it comes to ob­jec­tives, is that TwoPoin­tHospi­tal is in­tended as the first block in a co­her­ent world – Two Point County – rather than an iso­lated game.

“We al­ways imag­ined we’d have a place that would be the place where all our games would ex­ist,” ex­plains We­b­ley. “We’re start­ing off with TwoPoin­tHospi­tal but we’ve got ideas we’d like to add into the county and make it a place where the sim­u­la­tions can maybe in­ter­act with each other as well. That would be quite cool.”

I re­mem­ber the po­ten­tial for con­nec­tion sug­gested by the use of ‘Theme’ in the orig­i­nal game’s ti­tle. I’d vaguely hoped that dis­as­ters wrought by my The­mePark man­age­ment style might turn into a The­meHospi­tal cash cow, the lat­ter pro­vid­ing a venue for treat­ment.

We­b­ley is more mea­sured with his ex­am­ples. He men­tions the pos­si­bil­ity of re­peated char­ac­ters; per­haps lo­cal celebri­ties or field-spe­cific big names like a health in­spec­tor.

It’ll be in­ter­est­ing to see how Two Point ap­proach this con­nected idea of its games in the fu­ture, but right now the fo­cus is on mak­ing TwoPoin­tHospi­tal a suc­cess.

When I ask about the re­search process we get to the hu­mour that’s at Two Point Hos­pi­tal’s core. “We did weeks and weeks of re­search back in the ’90s,” says Carr. “We were go­ing to do a se­ri­ous hos­pi­tal sim game. That was the plan orig­i­nally.

“We got so weary of see­ing ill­ness around us and this hor­ri­ble busi­ness of health­care – which it is – that we just changed it on its head. Which ob­vi­ously was a great idea but not in­ten­tional. We didn’t go, ‘We’ve got this bril­liant spin!’ We just did it.”

As a re­sult the games have never fo­cused on treat­ment of real af­flic­tions. Play­ers of the orig­i­nal might re­mem­ber the treat­ment for Bloaty Head – a doc­tor must pop the swollen bonce and re­in­flate it. Or the wait­ing rooms full of pa­tients who had turned in­vis­i­ble or de­vel­oped cor­ru­gated an­kles.

rude health

One of the first con­di­tions re­vealed to be in TwoPoin­tHospi­tal is Light Head­ed­ness, where a pa­tient’s head is re­placed with a light­bulb. Treat­ment of this con­di­tion in­volves a grab­ber hand un­screw­ing the bulb and screw­ing on a re­place­ment head.

“Mak­ing up the ill­nesses and machines is a labour of love in the studio,” says We­b­ley. The start­ing point is a bad pun the team em­braces and builds into a dis­ease and treat­ment. The in­ten­tion is to stay in the realms of sur­real, comedic fic­tion.

For ex­am­ple, the con­di­tion Grey Anatomy has a name which riffs on the text­book, Gray’s Anatomy, (the lat­ter is also re­spon­si­ble for the pun name of the med­i­cal drama, Grey’s Anatomy) and turns a pa­tient monochro­matic. On the other hand, Chrome’s dis­ease didn’t make it into the game – the team ditched it be­cause it was too close to the chronic in­flam­ma­tory con­di­tion, Crohn’s dis­ease.

With­out a playable build to hand I fin­ish by ask­ing the team for their own favourite mo­ments so far. For Huskins, it’s the lit­tle an­i­ma­tions which bring the char­ac­ters to life. “We’ve got such a rich set of an­i­ma­tions in the game and be­hav­iours. You can read lots into what peo­ple are do­ing,” he says. “Stuff like a doc­tor who’s just been on a re­ally long shift, worked re­ally, re­ally hard, pa­tient after pa­tient, and fi­nally it’s time for him to go on a break and he gets up, goes through the door and as soon as he’s in the cor­ri­dor he just sprints as fast as he can to the toi­lets.”

For Carr, it was Dick May­on­naise. “We have a ran­dom name gen­er­a­tor,” he be­gins. “Have you seen Toast of Lon­don?” asks Huskins. “We were watch­ing that in the early days of Two Point and we loved the names they have there. We thought, ‘I won­der if we can cre­ate a ran­dom gen­er­a­tor that pro­duces names like that?’” Toast of Lon­don, in case you were un­sure, fea­tures names such as Hamil­ton Meathouse and Cliff Bo­nanza.

Dur­ing a playtest some­one looked to see which doc­tor had per­formed an ac­tion and found Dick May­on­naise had made it into the game. He has now made it out of the game after an ad­just­ment to the name gen­er­a­tor re­moved Dick as a first name.

May­on­naise, how­ever, re­mains.

“We were go­ing to do a se­ri­ous hos­pi­tal sim. That was the plan orig­i­nally”

A bustling wait­ing area might need at­ten­tion.

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