I have absolutely no doubt that Kaiser Permanente's new hospital in Oakland is a big step up from its predecessor in terms of the facilities offered to patients and their loved ones. But in terms of how it looks and feels outside - even by the dismal standard of recent American hospital design - the stocky compound that opened last week is enough to make you sick. It's an oversize, thin-skinned thud, massive in scale and anemic in tone. There's almost no effort to connect with anyone who doesn't arrive by ambulance or car.