I don't know where the 5.5 comes from! This is one of my favourite games of all time, and i have been waiting for another installment of the "THEME" series from Bullfrog ever since. I have played it through to the end 4 or 5 times in the past 9 years. The blend of funny illnesses, quirky humour and freedom of the simulation are fantastic. You can control everythig from staff salary, research, staff training to the hospital temperature. The game is not all that dificult once you get the hang of it. I reccomend it to all, and at least play a few levels before passing any judgement. If Bullfrog released another game from this series i would buy it without hesitation!