Two Point Hospital
Silly hospital management returns after two decades
“We wanted to feel like you’re not really throwing anything away”
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 bathroom noises. TwoPointHospital 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 ThemeHospital’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 organization.”
Management of this organization 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 organization. You’re not just leaving hospitals behind. They’re still there and they continue to contribute to the overall value of the organization.”
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 organization 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 ThemeHospital. “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 ThemeHospital 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.
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 humor 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 labor 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 favorite 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 behaviors. 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”