Large institutions housed in large buildings are frequently regarded as the antithesis of personalized, small scale, domestic, home environments. However the attribute of ‘homeliness’ appears to be used more broadly to describe places where people feel a sense of attachment, control and identification. In a large multi-disciplinary study of a hospital re-building project in northern England a range of users were interviewed to ascertain their responses to the original older buildings and later the new purpose-built hospital. We found both staff and patients retained a strong sense of affection for the older buildings and frequently used the language of home to describe their responses. In contrast, the newer buildings were generally recognized as efficient but impersonal, lacking many of the positive qualities they were familiar with. In addition some respondents suggested that despite efforts to include art projects, the new architectural language was inappropriate for healthcare, believing that small scale, home-like environments were more conducive to health and well-being. The authors will draw on a range of anthropological and architectural frameworks to analyze the data which consists of extensive interview transcripts complemented by photographs. The paper aims to understand the conceptualizations which underpin the various user responses and to offer a critique of the design language of the current healthcare building program.