Theme Hospital. Bullfrog Productions (1997) PC

Doctor, attend Psychiatry please. Two surgeons needed in Operating Theatre. Nurse required in Pharmacy…

And so on.


Ever dreamed of running your own hospital and showing those blasted lefties that profiteering in a hospital can only a good thing? Well now is your chance. Build your dream hospital through zoning rooms, hiring and firing staff, training your staff to become specialists, price gouging, and taking a chance with poorly researched drugs. That’s basically Theme Hospital. You see Theme Hospital is a management sim in the vein of Theme Park and Dungeon Keeper (the other great Bullfrog games of the era.  The default setting can hide some of the depth from you, but you can instruct Doctors to take chances with cures when you only 50% sure they have a certain illness, and your cure is only 67% effective. Adding some depth to the proceedings.

Rise of the janitors!

Theme Hospital follows a level structure, and is sadly lacking a sandbox mode. A game such as Theme Park is basically sandbox mode with levels, you have access to everything you research and you could choose to move to a new park for a different challenge. Here you just move on to the next level, and gain maybe one more room to diagnose or cure each level. As you progress the level you are on will task you with meeting a set requirement, this could be simply “earn x amount”, or it could be something more intangible such as increasing your reputation. For me these levels are easily the worse as sometimes, a death will just happen and screw your reputation. For example, when you have a 95% cure rate for an illness still means 5% will die, people dying dents your reputation and it can be deeply frustrating. This isn’t “XCOM 95% chance” where you seem to miss 50% of 95% chances, but it is frustrating when one or two people die out of the 10 people who have that illness that visited your hospital that level.

The tone in case you can’t tell, is humorous. You are not curing cancer, AIDS, and STIs, you are dealing with “Slack Tongue”, “Bloaty Heads”, “Baldness” and “King Complex” to cure these, you cut the tongue off, pop the head and re-inflate, fit hair, and stop a pillock dressing like Elvis respectively. There are more fun illnesses such as Hairyitis (Sprites look like Chewbacca/Cousin IT from Addams Family) too but you have to slog your way through to level 8 or 9 for them to start turning up.

Get used to this bastard showing up at inopportune times.


I encountered a couple of game breaking bugs both of which required restarting the level or reloading an earlier save file. The first is a bug I kept running into was rooms getting themselves corrupted. What this meant is the item in that room would duplicate periodically until the game freezes and crashes. I only noticed this when I spotted three nurses running around inside one pharmacy. I don’t know what triggers this, but unless you luckily have a back up save of that level then you will need to restart the level entirely.

The second is the mouse just decides to stop working. Your mouse will suddenly decide it is mapped to a side of the screen meaning the mouse is stuck on furthermost pixel in a direction. It leaves you screwed if you don’t frequently save your game as this will require a hard reboot to resolve.

And now what we all came here for… HARD CORE NUDITY!

It is pretty annoying, as this is a game released in 1997, and this sort of thing should have been patched out by Bullfrog or companies such as Good Old Games that packaged these older games.

These issues are especially prevalent the longer you go on in the game. As the later levels require more staff/rooms/floor space it makes completing the game deeply frustrating as you need to save every 5-10 minutes or reboot the game.

Pathfinding is also atrocious, fully expect to see your one Psychiatrist assigned to one room wandering about in an empty wing of your hospital, expect a horde of 17 janitors to be pottering around cleaning one square foot of your hospital and ignoring the vomit outbreak in reception (this is actually pretty realistic), expect emergency patients to take the longest possible route to get to the room they need. It is frustrating because no matter how good you think you’ve layed your hospital out the Gomers will find their way into a room with no entry.

Added on top if you are playing on the PS1 version, which is the version I played most growing up, as once you hit level 7 or 8 the game starts to chug making game days take minutes in real life.

This is what happens if you don’t constantly pay attention (borrowed from reddit)

Late Game

The main issue with Theme Hospital is the game becomes a serious chore. Playing for a couple of hours is great, but if you try to complete the game you’ll hit the inevitable wall of attrition around level 7. Before this point, levels are short and sweet. 10 to 45 minutes tops. But level 7 onwards it becomes 2+ hours per level. And it isn’t that the game throws new and exciting ideas at you, it is just the same but more. Instead of needing £40,000 cash to complete the level you need £200,000, cure 500 people, and have a reputation of 600. None of this is especially hard to do, but you need to keep playing keeping an eye on the screen managing disasters you enter a cycle of click click click, you can’t fail, but you have to wait two hours for that money to tick high enough. If you leave the PC unattended machines will blow up and doctors will fuck off, or patients die. So you sit there, grinding.

Oh balls…


And that folks is the primary issue that stops Theme Hospital remaining an awesome game. As it simply becomes boring. By Level 7 you have seen most things, bar a few illnesses. But the gameplay loop never changes. You go from a hospital with 1 of a handful of rooms, to a hospital with 4 of everything. You have to re-research everything each level, you have to go slow the first year or two of gameplay to get your finances on an even kilter depending on the level. So you’re doing the same 4 functions over and over, and if this doesn’t start to bore you then you’re a better, more patient person than I am. Compounding this is the atrocious AI leading to you search every square of your hospital for missing doctors/nurses.

Ultimately, Theme Hospital is a fun game for the first 5-6 hours of playing. But that’s it. After those 5-6 hours there is another 10-15 hours left to play and I really don’t see any reason  to play beyond the 7th level. This ultimately affects the overall score.

Play the game and you’ll have fun. But £5 bet you don’t complete the game from start to finish. I can’t find anyone who has.

Pros: Fun, interesting game design with humerous illness and personality quirks.

Cons: All of which get old really quickly. Frankly, a little boring, the freaking UI


Back in the Day:

Theme Hospital received above average to good reviews on the whole scoring 7s to 9s across the board. It was praised for it’s humorous tone, but was slated for poor AI.

Also available on: Playstation

I'm awesome. I write about videogames occasionally but spend most time painting and playing Warhammer in varying formats.

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Posted in PC
2 comments on “Theme Hospital. Bullfrog Productions (1997) PC
  1. Awesome review for Theme Hospital! Back in the days, I always found this game entertaining and have invested hours playing it. Now, I think it would make a nice sidetrack game for me. I tend to visit it for the nostalgia also. And yeah, I get your point. Our thirst for new game ideas and excitement to try them kinda make old games less exciting anymore. But still, Theme Hospital was a dear game to me. If anyone find this game’s humour and style likable, it has a spiritual successor called Two Point Hospital.

    Liked by 1 person

    • I do fancy Two Point Hospital, it seems as though it has that little bit more purpose to keep the game going.

      I’d give Theme Hospital in the high 80s if the gameplay loop was a little more interesting and levels different.


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