St Luke's cancer hospital is scheduled for relocation to a new centre of excellence, but supporters continue to fundraise and some resist the move. Are they wasting their time, asks Rosita Boland
ST LUKE'S HOSPITAL, in Rathgar, Co Dublin, is one of those medical institutions held in particular esteem by the public. With its 179 beds, it has been in operation as a cancer hospital since 1954, and its staff have long been praised for their thoughtful, sensitive and respectful dealings with patients at a particularly vulnerable time. Cancer treatment requires regular attendance over a period, and is not a process easily forgotten. The affection in which St Luke's is held is probably best demonstrated by the fact that former patients, and their family and friends, have raised €25 million for the hospital since 1980.
In 2005, Minister for Health Mary Harney announced the National Plan for Radiation Oncology Services. It included the transfer of St Luke's to St James's Hospital, to create an integrated centre of excellence for cancer treatment in line with best international practice. At present, for example, there are no surgery facilities at St Luke's. The Government's original date for delivery of this plan was 2011, but it has since changed to 2014.
Last year, writing in this newspaper, the Minister again defended the Government's plan to move St Luke's. "This is not about bricks and mortar; rather it is about the highest standards of treatment and care," she declared.
She is entirely correct in stating that patients deserve to have the best possible care available, which these planned centres of excellence will hopefully provide. However, she underestimates the unscientific attachment that people do have to bricks and mortar, to a specific place. St Luke's, which is located on 18.5 acres, has the rare luxury, for a public hospital in Dublin, of extensive mature gardens, which provide a tranquil background for patients undergoing stressful treatment.
Last October, a campaign called Save St Luke's was formally launched in Dublin, and since then there has been a series of public meetings and marches. The last such march was on Sunday, June 8th and was attended by 200 people.
The campaign's chairman is Rory Hearne, who is also chairman of the People Before Profit Alliance, the political group which ran several candidates in last year's general election and campaigned for a No vote in the recent referendum. Save St Luke's has a 12-person committee, composed of patients, patients' relatives and supporters, one of whom is Sinn Féin MEP Mary Lou McDonald.
"People Before Profit took up the campaign to save St Luke's because nobody else would take it on," Hearne says. "And the reason that many campaigns fail is that they are organised too late in the day - but we are still at a point where the date for the projected move is far enough away that we have a real possibility of changing it."
Save St Luke's does not accept the argument that cancer patients there would have better treatment elsewhere, should the planned centres of excellence be built.
"St Luke's has existed and functioned without surgery services to date, and it's a bit of a red herring, because cancer treatment is long term and Luke's is very close to existing surgery centres, such as Vincent's," Hearne insists.
"St Luke's Hospital is in an absolutely beautiful place, and if I were a cancer patient in Dublin and offered a choice, I'd go there, because environment does matter," states consultant radiation oncologist at St Luke's, Ian Fraser. He is virtually the only consultant at St Luke's who has been prepared to go on the record about the hospital's future since the news broke of its move. "Patients are not happy at all at the idea of Luke's moving. Not at all. But we can't deliver multidisciplinary care surgery here, and and that's the Achilles heel of Luke's. This is an enormous site, and at one point we could have explored the possibility of developing facilities on site. However, the decision has been made to move, and we now have to go with that decision."
Fraser believes it is now time to look forward, even though "we all know that infighting between the HSE and doctors in Ireland is ferocious. But meantime, why are we continuing to invest money in a site that is going to be closed? If we're going to move, don't faff around and waste money. They've got the plan, but like a lot of things in the Department of Health, it's sitting on a shelf."
Fraser doesn't think the campaign has any real chance of saving the hospital.
"Once the Hollywood Report , recommended that Luke's be on the site of a general hospital, and once the Government accepted that, the campaign was unfortunately doomed."
MEANTIME, THE Friends of St Luke's Hospital continue to raise funds for an institution which is due to move off-site. In May 2005, two months before Mary Harney announced the Government's National Plan for Radiation Oncology Services, she opened a 15-bed extension to Oakland Lodge in the grounds of St Luke's, a 49-bed facility where country patients can stay for the duration of their outpatient chemotherapy and radiation treatment. Each room has an extra bed, which can be used by visiting family or friends. The refurbishment and development of Oakland Lodge (originally nurses' housing) was funded by money raised through the Friends of St Luke's Hospital. Clearly, a building is no more mobile than a garden, so this significant financial investment has a limited life.
On average, the Friends of St Luke's Hospital raise €1 million a year, but in recent years that annual figure has risen to approximately €2 million. "Something that has become very popular is people putting buckets out at their 40th or 50th birthdays and asking people to donate to St Luke's rather than bringing presents. They nearly always have personal contact with the hospital through family or friends," explains appeals director Deirdre Hughes. The office has a staff of four, and Hughes is constantly on the road throughout Ireland, attending fundraising events. All monies raised go back into the hospital.
It would be true to say that since the establishment of the Friends of St Luke's Hospital in 1980, rightly or wrongly, the many members of the public who have jointly raised €25 million now have a sense of being included in the ownership of the hospital.
"Without a doubt, wherever I go, people ask me: 'What's happening to Luke's?' Our attitude has been from the beginning that it's business as usual. We are still continuing to fundraise. We have a lot of patients to be seen over the next seven years, when we are due to move, and there's no way we'll drop our standards here in the meantime," Hughes says.
Apart from knowing that the intention is to move off-site, the Friends know nothing else about St Luke's projected future. The planned radiation oncology service at St James's, in common with the other services around the country, is due to be funded through a public-private partnership (PPP). At present, St Luke's is run as a public hospital, so questions are being asked about the ethics of any future fundraising for a PPP initiative. It might also be argued that people should not have to fundraise for equipment and facilities which should be provided by the State.
"The Friends of St Luke's would prefer, naturally, if the hospital wasn't moved," Hughes says. "But we probably won't have a say in it."
QUESTIONS HAVE ALSO been asked about the future use of the valuable 18.5 acres in Rathgar, which is owned by the State. This month, St Luke's stated: "The July 2005 Government announcement very clearly states that the long-term use of the St Luke's campus in Rathgar is yet to be decided and that St Luke's will be directly involved in the identification of a use that is in the best interests of the health services in the long term."
Whether or not the Save St Luke's campaign is doomed, as Ian Fraser suggests, it seems that the hospital's management would prefer if it did not exist. When Rory Hearne and another campaign worker were handing out leaflets in the grounds of St Luke's the week before their march, one staff member took a leaflet, and was informed in their hearing by a colleague that management had instructed them that staff were not to get involved in the campaign. Twenty minutes later, the campaigners were approached by a security guard and asked to leave the premises. The security guard told them this request had come from management.
When The Irish Times sought an interview with St Luke's chief executive Ann Broekhoven, the request was turned down, although an invitation was issued to submit e-mailed questions to Broekhoven via the hospital's PR company. In response to a question about the above exchange in hospital grounds, Broekhoven replied: "We all have a shared objective that the patients' wellbeing should be uppermost and to preserve the 'peace and tranquillity' that is a hallmark of the St Luke's patient experience, we discourage all forms of canvassing on site.
"Regarding staff, the Board and executive management support the decision of the Minister announced in July 2005. As is normal practice in all institutions, the views of St Luke's Hospital will be articulated only through the chair of the board or chief executive, or others acting on their behalf.
"Members of staff are fully entitled to hold and articulate a different view in their private, individual capacity and we do not have any issue with this provided these views are not presented in such a way as to be confused with those of the hospital corporate body."
There is a large sign currently in situ at the entrance to St Luke's. It declares: "St Luke's Hospital - Expanding to meet your needs." But expanding where and when?
