When reviewing games there is a tricky balancing act when using direct comparisons. On the one hand, other games that a reader may know are useful anchors to make points around gameplay, style, or themes. However, it can be seen as lazy or potentially misleading, resulting in the classic cliché of labeling anything even vaguely difficult as “the Dark Souls of X”, or anything with grass (apparently) as a “Breath of the Wild clone”.
That said, I have absolutely no qualms in drawing comparisons with Two Point Hospital and the 1997 eccentric hospital sim Theme Hospital. After all, it comes from a studio founded by Theme Hospital veterans, and in many ways could be considered a long-awaited sequel. From the sense of humor, the inane illnesses, and the bored PA, Two Point Hospital is indebted to the bastion of hospital sims. Attempting to write a review, to write anything, about this game without drawing comparisons would be folly and ultimately quite confusing. Theme Hospital was a hilarious, engrossing, and incredibly deep landmark of sim gaming, and fortunately Two Point Hospital is, for the most part, a faithful love letter.
At the core of Two Point Hospital you manage a series of hospitals, progressing from one to the next after certain objectives are reached. When I say “manage” the hospitals, I really mean it – from room layout, staff pay, and training through to bin placement, temperature, patient happiness, and medical research, you get your hands on everything. Snack machines and toilet numbers are just as important as GP Offices and adequate staffing. Most levels start off with a blank canvas, letting you build your hospital and focus on the strengths needed to complete the objective. These objectives provide the key variations to each level and can revolve around treating a certain number of patients, researching new diseases, training your staff, or increasing the value of your hospital. You often must juggle multiple targets, for example treating a specific number of patients while maintaining your reputation above a certain threshold. In turn, each level sees you unlock new rooms and diseases, helping to keep the game challenging and (along with the objectives) stops too much similarity between the levels.
This does work, but only to a certain degree. New diseases and avenues for focus, such as staff training or research, do mean that ultimately levels go in very different pathways to each other. However, most start in a very similar fashion as all hospitals need the same basics. Receptions, seating, utilities, staff rooms, GPs, pharmacies, and the like are the foundation for most missions, so often the first 15 minutes or so of each level can feel repetitive. You can copy-paste rooms for efficiency, but even so, I did sometimes get frustrated having to map out the same opening time and time again. This feeling doesn’t last too long thankfully, and after this opening, the shifting objectives and new diseases stop the rest of the experience from becoming too stale. The game really comes into its own in the latter half of each new level, as you swing between the satisfying routine of having a well-operating hospital and the panic of everything bursting into flames and janitors hunting down ghosts so they don’t scare your current patients. You can go from one to the other in what seems like seconds, and can never feel too comfortable no matter how in-control you seem. It’s this balance that provides both satisfaction and challenge and is what Two Point Hospital does so well.
The sheer number of options at your disposal can feel overwhelming at first, but in general, they are handed out quite slowly and are relatively simple to pick up. One of the key reasons for this is how surprisingly effectively the game’s interface and controls are. Clearly designed as a PC game, with lots of sub-menus and detail, the Switch handles it all with aplomb. For the majority of the time I played in handheld mode, and had little trouble with small writing or getting lost in menus and detail. My only slight gripe would be a lack of touch controls, which would have proven invaluable – especially when laying out rooms or moving fiddly small items such as radiators and drinks machines. The only real technical problems I had were with long loading times and some slow-down, but these were minor. I never had the game break on me, though loading it up after I had put the Switch to “sleep” for any period of time did take a while.
Bringing it all back to Theme Hospital, if I may, and what Two Point Hospital does so well is bring that sense of fun found in the 90s classic. Hospitals, generally, aren’t fun places so Two Point Hospital leans heavily into the silly side of humor to bring the sense of enjoyment and lightness to what is actually a pretty dark area. The diseases are ridiculous, and often pun-based, such as the “Jest Infection” which sees people think they’re clowns and requires the aptly named “Clown Clinic” to treat. Equally important is the dry humor of the letters from inspectors you receive (one told me that my hospital existed, and not much more, as a review – which I didn’t take as a good sign). The bored PA informing patients not to die in the corridors is back, along with jokey radio stations playing behind the action. Even death is treated with a light touch, as you need to train up janitors to successfully bust the ghosts out of your hospital to keep your living patients happy and your reputation in tack. This is the real heart of the game and it’s where the Theme Hospital genes are perhaps most obvious.
The good news for those who enjoy this mix of tense management and off-the-wall humor is there are dozens of hours of it here. The base game alone, released on PC in 2018 before coming to consoles last year, has 15 hospitals spread across multiple regions, and the missions can take some serious time to finish. Even when you have passed on one star, you can return to the hospital at a later date (or continue there and then) to achieve further stars by completing additional objectives. As if that wasn’t enough (and it really should be), the new Jumbo Edition comes with multiple extra regions including mountains, tropical islands, and even an alien invasion. Each new area comes with new diseases, rooms, and the odd mix-up of gameplay with extra objective types to accomplish. And, even if that isn’t enough (and this is getting silly now), the “Sandbox” option lets you free play, tweaking settings to your heart’s content as you aim to build the ultimate hospital. This is the kind of game I can imagine losing afternoons too, in the same way, the hours flew by with Theme Hospital twenty years ago.
It’s a tough act being a spiritual sequel to one of the most beloved sim games of all time. You don’t just have to live up to an undeniably first-rate game, you have to live up to the rose-tinted two-decade-old memories of an important cornerstone in PC gaming. Thankfully, partly I’m sure by having some of the original creators at the helm, Two Point Hospital does just that. Some slight performance issues and repetition do little to dampen what is a charming, tightly designed, and highly addictive hospital sim. Yes, the magic, humor, and feel of Theme Hospital are here but more importantly, so is the successful gameplay tightrope of management satisfaction combined with frantic problem-solving. Taken as a sequel to a classic, or a stand-alone game, Two Point Hospital Jumbo Edition is a worthy addition to the Switch’s expanding library.
