Located in Causeway Bay, one of Hong Kong’s busiest urban districts, the redevelopment of St. Paul’s Hospital represents a 19-year transformation shaped by careful planning, long-term collaboration and the challenge of delivering a major hospital on a highly constrained site.

Originally a fragmented campus providing around 350 beds, the redevelopment expanded and upgraded St. Paul’s Hospital, a long-established private acute hospital, to support approximately 500 beds, consolidating services, modernising infrastructure and future-proofing healthcare delivery, all while remaining fully operational throughout.

This article looks at how the hospital was redeveloped in phases while continuing to serve patients and the people and decisions that shaped its delivery over nearly to decades.

The project was led by Vivien Mak, Architect and Director at P&T Group, who has been involved in the project since its inception in 2005.

 

Setting the scene: what was there before

When P&T was interviewed for the project, the hospital campus already carried layers of history and everyday life.

At the time, St. Paul’s Hospital consisted of two main buildings. One was an older structure originally built as a cotton factory, later converted into hospital use. The second was a seven- to eight-storey L-shaped hospital block housing the main clinical functions. Alongside these buildings sat a small vacant site next to the neighbouring school.

The hospital forms part of a wider campus owned by the St. Paul’s Convent, which also includes a kindergarten, a primary school, a secondary school and a historic Catholic chapel. From the outset, these elements were approached as one interconnected campus, rather than a collection of separate sites.

 

The original brief and early vision

The original brief was to redevelop the hospital on its existing site, without relocating services elsewhere. Early assumptions were that the main hospital block would remain in place, with new development attached to or built over it, while the older front building would eventually be demolished and rebuilt.

During the interview stage, the design team prepared a perspective sketch that became a turning point. The drawing proposed a new hospital building integrated into the campus, while opening up the forecourt of the chapel and introducing a garden at its entrance.

That early vision went beyond expansion alone. It proposed a clearer, more open campus that improved connections across the site and revealed the chapel, which had long been hidden behind older buildings. With this vision in place, the project was awarded and work began.

As the design progressed, it became clear that retaining the existing L-shaped hospital block would severely limit the hospital’s future flexibility. The decision was therefore made to remove it entirely, opening up the site and allowing for a cleaner, more functional masterplan.

 

Designing a hospital around its users

With the masterplan direction established, the design process progressed steadily, shaped by close collaboration with hospital users.

While the overall concept remained consistent, the internal planning of the hospital evolved significantly. Alongside working with the hospital planning group, the design team met individually with clinical departments over several rounds, refining layouts and functions step by step.

Early sessions focused on overall layouts and how different departments would sit next to and connect with each other. Later discussions moved into detailed room planning, gradually refining hundreds of layouts before finalising individual spaces.

“In hospitals, every room and every square meter has a specific purpose,” Vivien explains. “The hospital works like a machine, if one part doesn’t work, everything is affected.”

This careful, user-led process took time, but it was critical to ensuring the hospital would function properly once operational, a principle that guided every phase of the project.

 

Three phases, one continuously operating hospital

Delivering the redevelopment in phases required careful sequencing, trust and coordination across consultants, contractors and hospital users.

“The entire hospital was kept in operation throughout the whole process,” Vivien explains. “Everything just kept on operating.”

 

Phase One (completed 2009): enabling change on a 25x25 meter site

Phase One, completed in 2009, delivered a decanting tower on an extremely constrained site measuring approximately 25x25m (see Block A). Part of the site was still occupied by the edge of the old cotton factory building, while another portion was shared with the neighbouring school.

 

Given the limited footprint, the building had to be planned with exceptional efficiency. Once complete, hospital functions relocated into the Phase One tower, freeing up space for the main hospital works to begin. From the outset, this building was intended to become a permanent part of the hospital, later accommodating clinics, day centres and staff facilities.

 

Phase Two (completed 2017): delivering the main hospital block

Phase Two, completed in 2017, delivered the main hospital block and formed the clinical heart of the redevelopment (see Block B).

This phase involved deep basement excavation, extensive coordination with users and careful clinical planning to ensure departments, layouts and workflows functioned efficiently.

Excavation works were particularly sensitive due to the proximity of the chapel and required additional precautions and close monitoring to manage vibration.

 

Phase Three (completed 2024): completing the masterplan

At the start of the final phase, the area intended as a garden was still occupied by temporary infrastructure, including transformer and refuse rooms used during earlier construction stages.

Once Phase Two was complete, these elements could be removed. The old front block was demolished and two additional basement levels were excavated beneath it.

By the end of 2023, all three phases were fully connected at ground level and underground, with integrated basements allowing seamless circulation for patients, staff and services across the hospital.

The final step was the delivery of the garden in front of the chapel, the element first imagined in the project’s earliest sketch.

 

A hospital campus shared with the community

St. Paul’s Hospital sits alongside everyday community life in a way few hospital sites do.

The chapel remains an active place of worship, hosting regular Sunday services open to the wider Catholic community. The neighbouring kindergarten, primary school and secondary school also use the chapel for Mass.

During school drop-off and pick-up times, the streets around the campus fill with school buses and parents. With the opening up of the site and completion of the garden, children now cross the hospital grounds as part of their daily routine.

Previously, the chapel was largely hidden by the old cotton factory building. Today, it is clearly visible from the street and what was once concealed has become a recognised and shared part of the neighbourhood.

 

A focused team over a long period

Over nearly two decades, around 19 architectural staff from P&T contributed to the project at different stages. However, the core project team remained intentionally compact, typically made up of around 8 people at any one time.

This continuity supported efficient decision-making and a deep understanding of the project as it evolved. The redevelopment also benefited from long-term involvement within the practice, including early contributions from James Abbott, Architect and Group Director, P&T Dubai studio.

“It is wonderful to see that the original objectives of unlocking the full opportunity of this special project and site have finally been achieved after such long term dedicated effort from Vivien and the whole project team.” James Abbott.

Throughout the project, Vivien consistently credits the wider team, emphasising shared effort over individual achievement.

 

Recognition through different lenses

The redevelopment of St. Paul’s Hospital has received both international and local recognition, highlighting different aspects of the project.

Internationally, the project was recognised by the International Academy for Design and Health for healthcare projects over 40,000 sqm, acknowledging its contribution to health and wellbeing through design.

At the same time, the project received recognition from the The Hong Kong Institute of Architects under the Human and Social Inclusion category. In line with award criteria, this submission focused on the final phase, highlighting the garden, underground connections and the campus’s broader community role.

 

Most recently, the project was awarded a Silver Prize in the Architecture - Best Community category at the Perspective A&D Awards 2025, recognising the broader community value of the hospital campus and its role within the dense urban fabric of Causeway Bay.

Together, these awards reflect different readings of the same project, as a complex healthcare facility, a carefully phased urban intervention and a long-standing community institution within Causeway Bay.

 

A moment of reflection at completion

At the opening of the chapel garden, the hospital’s Medical Superintendent, Dr. William Ho, described St. Paul’s Hospital as “one of, if not the most beautiful hospitals in Hong Kong.”

For Vivien, the words carried particular meaning. After years of technical challenges, coordination and countless meetings, they reflected the shared effort behind the project.

“For us as architects, it really touches you when the client appreciates what has been created,” she says. “After all the challenges, they could see the result.”

 

A completed hospital for Hong Kong

Today, St. Paul’s Hospital operates as a long-established private acute hospital, now supporting around 500 beds and serving one of Hong Kong’s most densely populated districts.

Its transformation goes far beyond new buildings. Delivered in phases over nearly two decades while remaining fully operational, the project reflects a carefully balanced approach to healthcare delivery, one that respects heritage, supports community life and is grounded in long-term collaboration and trust.

Above all, it stands as a collective achievement, shaped by the dedication and commitment of the client, consultants, contractors and the wider project team over many years.

 

About Vivien Mak

Vivien is an Architect and Director based in Hong Kong at P&T Group.

She joined the practice in 1997 and has extensive experience delivering healthcare, institutional and community projects across Hong Kong. Vivien specialises in hospital and wellbeing-focused design and has led several award-winning healthcare developments in the region.

Alongside her professional work, she is an active speaker at local and international conferences and has contributed to research on elderly-friendly and health-responsive architecture., described St. Paul’s Hospital as “one of, if not the most beautiful hospitals in Hong Kong.”

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