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Interview: Why Two Point Hospital Is Worth Making An Appointment For

Finding the funny bone.

Two Point Hospital’s revolution in the healthcare sector is set for release on 30th August, as the latest game in the management sim revival and a spiritual successor to Theme Hospital.

We got to step into the shoes of a hospital administrator to go hands on with the game, before then sitting down to chat with Art Director Mark Smart and Technical Director Ben Hymers about its creation, inspirations and their favourite in-game ailments.


TSA: There’s this resurgence of management sims, and that’s obviously going to have been encouraging for you to see that there’s an audience, but have you taken any inspirations from them when reviving the hospital sim?

Ben Hymers: Well, it would be foolish not to, I think! Something we keep hearing actually, which is kind of weird, is that one of the games the success of which has inspired us a bit is Prison Architect, but we keep hearing that they’ve been inspired by some of our guys. So, it’s a bit weird that there’s this circle of inspiration going on!

Mark Smart: Yeah, I find in any creative medium you’re always going to glean things from other things. It’s like music, you know?

TSA: Although these days that gets you in trouble and you end up with Right Said Fred getting credits on Taylor Swift! [laughs] One of the first things I noticed when loading up the map is that you’ve got the three star system, and that’s a particular mobile game cliche, but I’m curious how that fits in your game, because it’s clearly not just a straight up high score measure.

Ben: Yeah, they’re just progression things, and that fell out of wanting to allow people to progress within the game, but then go back to earlier hospitals, maybe to improve them with stuff they’ve unlocked in later levels. Stars are just a natural mechanic to award you for doing that.

Once you get one star, you can move on, but there’s more to do. We definitely didn’t do that from wanting to ape mobile game mechanics, it’s just a really good way of allowing progression and allowing you to return to stuff.

TSA: I think it lends itself well to the scenarios and different environments you pass through.

Mark: When you first start off, you can stay with the first level and progress through to earn the second star and the third, but you might find it very difficult because you’ll subsequently get another cure in the next couple of hospitals, which you can bring back and use in this scenario. It’s just a way of bringing people through the levels, but being able to return as well.

TSA: Sticking with the scenarios, it’s something that feels like it fits some management sims better than others. Cities: Skylines, for example, is really all about the sandbox, but it seems to work well for Two Point. Why do you think that is?

Ben: Maybe it’s just the audience we’re targeting, I guess? I don’t know, that sounds all very marketing speak. I mean, we want it to be accessible and it’s good to prompt people with goals, but it’s also good to craft the experience a bit.

Mark: I think it’s all about the accessibility of it. […] When you’re comfortable with the game, you can guide your staff, train them up, it’s just a way of getting people through the game and making it so you’ve got a sense of urgency.

Ben: Yeah, it’s good to encourage people to do things. Something we have talked about is doing a sort of sandbox mode, which is more like what Cities: Skylines is. It’s just an environment, some stuff to build, have fun. At the same time, like you often say in the office, if you do that it’s almost like by giving you all this freedom everyone actually does things the same way. So by having these scenarios that encourage you to do different things, give you different goals or set up the scenario differently to change the game rules and what illnesses are available, it encourages people to do things differently to how they would on other levels.

Also as you go through the objectives, you start off working toward your one star, but maybe the second star has got different objectives that make you rearrange your rooms or delete them, or buy a new plot.

TSA: One of the things I appreciated was just how flexible it was with being able to move around rooms and not charging a fee, which I think does play well with having a fixed space and putting you under the pressure of a scenario.

Ben: Yeah, I know in a lot of these games you tend not to delete stuff, either because it costs you money in the game or it’s just a faff!

Mark: It gives you the ability to react to different situations. If you know you’ve got a lot of patients coming in that need a pharmacy, you can build a couple pharmacies and then, once that’s over, take it down and put in toilets or a restaurant! [laughs] It’s nice being able to move things in and move things out.

Ben: We worked hard to make the building system support that, because in a lot of previous games it’s very clunky.

TSA: You’ve got a very strong pun game… [laughs]

Mark: We’re very strong on the puns!

TSA: How big is the puns department at Two Point Studios?

Ben: Uh, it’s sixteen people. Our full studio size is also sixteen people!

Mark: [laughs] Well, you know some of the ailments and diseases we’ve got literally come out of puns first and then we work back. Others come out of visuals and then we try to think and…

Ben: And desperately crowbar a pun in there. We’re mostly dads at Two Point, so it’s a lot of dad jokes…

TSA: Well it’s also a games journalists dream, because of how often we shove puns into titles and straplines! What are your favourite diseases in the game? I guess you can have one each.

Ben: My favourite’s actually Mock Star, which hopefully you’ve seen. We had to change the name for legal reasons, so I’m not sure I’m allowed to say it, but it’s inspired by a certain character. It’s a simple one, where they just go to the psychiatry room to be cured, but the animations are just so flamboyant and ridiculous that I love it. We’ve got some great animators and that’s probably my favourite set of animations.

Ed – I think can say that it does look a bit like Freddie Mercury.

Mark: My one’s a little bit more difficult, because… I love them all!

TSA: It’s like being asked to pick your favourite child! [laughs]

Mark: I like the Mummy, and I like the way it’s cured as well, but I also like the Mimes. They just turn up and it’s more or less just about what our animators have done. Obviously mimes are trapped in a box, they’re climbing invisible ladders and prat-falling everywhere. I’m quite fond of them!

TSA: One of the things I noticed is that the waiting times seemed to be a bit extreme. I had the advisor pop up and say one was leaving after 176 days, because they hadn’t been treated and were getting bored.

Ben: Yeah, time works a bit strangely in this game, doesn’t it? It does in most games, when you think about it. It’s a tricky one trying to decide how to carve up time, and if you think about any of it, it’s kind of ridiculous.

I don’t know if you clicked on a staff member and saw their salary, but everything’s been fudged to work in a timeframe that seems fun. So a staff member’s yearly salary is something like $4,000. You can also adjust how long staff have breaks for, and by default I think it’s 15 days. That’s one hell of a break!

Mark: I think, when you say about waiting, there’s lots of ways you can improve that. You can have a better doctor in there, and if you’ve got big queues for the GP or something, you can build another room.

TSA: The reason I brought it up was partly if you’re trying to say something about the NHS? And actually, while there’s pretty hardcore management in there already, are you tempted to put in a realism mode, where it is a lot more like the NHS.

Ben: Well, like we were saying about different levels, there is the Duckworth-upon-Blige level. Everything else is run like a private hospital really – people come in and pay the money to get cured – but this one’s run much more like a public hospital, where you get given a budget, you don’t get any money from the cures, and are just tasked with improving the reputation. You’re given the budget, but you’re not getting anything else coming in until the next year. So that runs a little bit more like an NHS hospital.

TSA: I don’t know if you’ve got Steam Workshop support, but I’m sure there’d very quickly be a mod to turn it into the NHS.

Ben: I’m a big fan of modding in games, but Steam Workshop isn’t going to be in there for release – we may do it later – but that would be one of my goals to make a real life thing. We’re not going to do that in the actual game, because we don’t want real life things, we want silly illnesses.

TSA: Well, one thing you could do is have a politician visit, and maybe their name rhymes with Jeremy Hunt? Though probably not the one that they used on BBC Radio! [Note: this interview took place before the recent cabinet reshuffle]

Mark: [laughs]

Ben: [laughs] Oh yes, we can’t do that!

TSA: Sticking with reality, and I think there’s something that I haven’t made up, but I’m fairly certain someone was elected as mayor of a smallish town purely off the back of him saying he was really good at Cities: Skylines. Do you think Two Point Hospital players would make good real world hospital administrators and CEOs?

Ben: Amazing! They’d kill people, it’d be terrible. People getting lost in your hospital and not heating for 170 days!

Mark: I think as long as they suffer from 8-bit or they had people coming in with Cubism, they’d do fine!

TSA: I guess in the opposite direction, you do also get all those bus drivers and farmers who then go and play bus driving sims and farming sims.

Mark: I’ve never understood that…

Ben: Each to their own, I guess? We get a surprising number of people contacting us who are doctors or nurses and are really interested in playing our game. It’s quite popular with them!


Thanks to Ben and Mark for chatting with us about Two Point Hospital. The game is coming out on 30th August, and you can catch our hands on preview here.

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