Obsolescence and future of Paimio Sanatorium (1929–1933) by Alvar Aalto

Paimio Sanatorium was a result of major actions that a newly born independent Finland took in front of the fatal threat of tuberculosis. According to the law in 1929 the state covered the majority of the costs of building and running of a sanatorium. One of the many new sanatoria rose in Paimio, becoming world famous because of Aalto’s skills and activity. The history of the large municipal institutions is discussed; Paimio has many parallels in Finland.
By the late 1950s the daily procedure altered; the surgical operations and medical cure developed. The new wing of operation theatres was built and the balconies were converted into extensions of the wards. By 1970s many sanatoria became hospitals resulting extensive refurbishments. Still by 2010s the requirements of a contemporary hospital took over, and many sanatoria have been or will be re-converted for various uses. Also Paimio Hospital was gradually closed by June 2015.
How the radical interventions designed in Aalto’s architectural office until 1994 in Paimio are to be valued? Is the 1958 layout of the entrance hall to be kept? Ventilation machinery and the partial suspended ceilings altered the shapes of some of most valuable spaces. The protection order from 1993 do not specify the content of the definition "original interiors, structures and building parts". Is the “original” in some cases beyond the limit of realistic possibilities? Should we consider some later layer original, if the changes are extensive?
During the Conservation Management Plan process by the Alvar Aalto Foundation Paimio sanatorium was studied more carefully than ever before. The guidelines for the restorations were determined. It is balancing between an architectural presentation piece and an actively working building.