If there was a question about who was the greatest video game developer of the 1990s, a clear leading answer would be Bullfrog. From 1989's Populous through 1999's Dungeon Keeper II, Bullfrog delivered a seemingly never-ending string of hits, built around strong mechanics, universal themes and stripped-back interfaces. Syndicate, Magic Carpet, Theme Hospital, Powermonger, Dungeon Keeper and Theme Park were all genre-redefining classics.
With such a body of work behind them, it's surprising that neither Bullfrog themselves nor their successor company, Lionhead, made much of an attempt to keep their legacy going. Lionhead instead got bogged down making MOR action-RPGs (the Fable series) and indulging founder Peter Molyneux's increasingly bizarre ego trips, and their great stable of games was left to rot...until recently, when other ex-Bullfrog staffers started resurrecting their old games as "spiritual sequels." First up was Satellite Reign, a highly enjoyable remake of Syndicate, and now Two Point Studios have joined forces with Sega to resurrect Theme Hospital.
Two Point Hospital is so close to being Theme Hospital 2018 that it's really just missing the official IP. You start off as the administrator of a fairly straightforward, basic hospital and it's up to you to get the place running properly by making sure you build the right treatment rooms and hire the right specialists to deal with the local common diseases. As the game continues, you move to new areas in Two Point County with different requirements, such as hospitals in freezing cold regions where the main struggle is keeping everything nice and warm, and ones on tropical islands which have the opposite problem. There's a hospital that's been built in a haunted old castle (yes, really) and others in run-down areas with (shudder) socialised healthcare where you can't fleece the hospital visitors for cash on the spot. Oddly, this ends up being one of the more straightforward scenarios.
Each hospital requires careful balancing between budgetary needs, answering patient requirements and keeping staff happy. Force your workers to stay on long shifts and provide poor facilities for them and their motivation and efficiency will drop. Keep your patients standing around for hours with no food or toilets and expect to see them storming out or - in extreme cases - dropping dead on the spot (and possibly returning as a ghost to haunt the corridors).
Fortunately the game avoids the potential downer of dealing with real medical issues by adopting a lighter tone. The diseases are all invented, comic creations. One disease turns patients into 8-bit masses of pixels and has to given "more resolution" to return to normal. Another turns patients into giant dogs. Another replaces patients' heads with lightbulbs. The increasingly surreal illnesses and the offbeat ways of treating them keeps the game feeling fresh as it progresses, all accompanied by amusing, detailed animations which reward zooming right into a room to see what's going on (most of the game is played zoomed way out as you rush around the hospital putting out fires, sometimes literally).
The game's comic tone belies the fiendishness of its difficulty curve. The game is relatively forgiving and you only need to achieve a couple of modest objectives per scenario to unlock the next one, but if you want to max out each mission it requires a lot of tactical thinking and understanding the game's systems thoroughly. It's a game which you can play relatively casually but also rewards those who want a much more gruelling challenge.
Since release, the game has also been constantly updated with new maps, scenarios, diseases and challenges, making for a decidedly massive game for this kind of management sim. I have 60 hours in the game and there's still more I need to do and see.
Two Point Hospital (*****) takes a game from the 1990s and updates it for modern audiences with better visuals and a streamlined interface, but loses absolutely none of the wit, humour, intelligence and challenge. A compelling and rich management game which constantly entertains, it is available now on Steam. Console versions are also available.