Cancer in a Cold Climate Read online

  © 2010 ENID O’DOWD

  [email protected]

  [email protected]

  BIG BUSINESS: BEHIND THE PLAN TO CLOSE ST LUKE’S (pp.16-34)

  © 2010 MARIE O’CONNOR

  All rights reserved. No part of this publication may be reproduced in any form or by any means—graphic, electronic or mechanical, including photocopying, recording, taping or information storage and retrieval systems—without the prior written permission of the authors.

  978-1-908024-00-8

  A CIP catalogue for this book is available from the National Library.

  Published by ORIGINAL WRITING LTD., Dublin, 2010.

  Printed by CAHILL PRINTERS LIMITED, Dublin.

  SAVE ST LUKE’S HOSPITAL CAMPAIGN

  Mission Statement

  • To retain the proven centre of cancer care excellence that is St Luke’s Hospital at the Rathgar site as a satellite of the new cancer units at James’s and Beaumont Hospitals to complement their work, and to ensure that the needs of public cancer patients and their families throughout Ireland remain paramount.

  • To emphasise what makes St Luke’s special - the caring staff, the holistic care, the peace and tranquility of the unique environment, the feeling of spirituality and security - all of which contribute to the healing of cancer patients.

  Contact the Campaign:

  Email: [email protected] or [email protected]

  www.savestlukes.ie

  Write: Save St Luke’s Hospital Campaign

  Roncalli

  Luke Wadding Street

  Waterford

  Donate:

  Our account is with the Ulster Bank in Ranelagh, Dublin 6:

  Account Name: Save St Luke’s Hospital

  Account No: 00236712

  Sort code: 98-50-50

  ST LUKE’S

  The house I was born in on Highfield Road, Rathgar was only a few hundred yards from Oakland House. This was a beautiful mansion owned by Major Johnny O’Rorke, who had been a famous polo player.

  There it was, a country house and grounds within walking distance from the centre of the city. How many acres of green pastures it had you could judge by the fact that one side of the entrance was on Highfield Road while the rear gate was almost a mile away on Orwell Park. After it was acquired by the State it became a model for cancer care. The wonderful gardens and fields of St Luke’s Hospital were to have an effect on patients recuperation in an atmosphere, which could not be found in hospitals anywhere else. Patients in for extended treatment over a few months could stroll from their hospital rooms up to Rathgar (about four minutes away) and have a cup of coffee or use the very good shop facilities available there. Indeed some patients could be heard talking about their stay there as if they had had a Mediterranean holiday.

  Now inexplicably it is to be closed by the government. I was in the gallery of the Senate as the vote was taken. Amendments from Fine Gael and Labour to protect St Luke’s were lost. The air reeked with suspicion. The word Developer came into the mind. There is a huge area of green space apart from the fields attached to St Luke’s, which could be developed for housing. A walk down a partly hidden lane off Orwell Road will give an idea of the amount of space available for development. I notice this lane, by the way, has lately acquired a corporation plaque, which tells us in both languages that it is called Washerwoman’s Lane.

  I know this area well. Many years ago, as a schoolboy, I used to practice pole-vaulting there. I got permission from the butcher who owned the land and who used to graze his cattle next to St Luke’s. If this area and other land, which is now available, was for sale a developers dream could be realized. The Redemptorist Order nearby, sold a portion of its land recently.

  A combination of developers, government and civil servants have disgraced themselves in this country for the past fifty years playing developer games for profit. The Civic Offices (which was built over a Viking Village), the ESB buildings at Fitzwilliam Place and the five developers playing around with the Abbey theatre like a juggler tossing the balls in the air, are examples of how those in control of building space in this city have lost the sense of responsibility and replaced it with greed and deceit.

  It has got to stop somewhere, why not now?

  Ulick O’Connor

  24 September 2010

  ACKNOWLEDGMENTS

  I would like to thank -

  • those experts – the patients and their families – who revealed personal information about themselves and their loved ones to support the Campaign to save the national treasure that is St Luke’s

  • my colleagues on the Save St Luke’s committee for their support and advice in putting this book together and for their hard work over the years

  • health analyst and author Marie O’Connor for contributing the chapter Big Business: behind the plan to close St Luke’s and also for editing some of the chapters

  • Solicitors Terence Cosgrave and Herbert Kilcline for casting an expert eye over my draft

  • and of course my family who saw very little of me as I hid myself away with my PC in our attic office

  I BEHIND THE PLAN TO CLOSE ST LUKE’S

  ALMOST ARRESTED

  On 6 July 2010, five people were asked to leave the Dail Lobby. An usher warned one of them that the Gardai would be called to arrest her if she persisted.

  That person was me. I had shouted “Shame” twice or maybe three or four times at the six Green TDs who happened to come into the lobby as we were leaving to go home. My colleagues had also shouted “Shame” but only once, well, maybe twice.

  We had come from a Seanad debate in which Labour, Fine Gael, Sinn Fein and independent senators had spoken eloquently in favour of two amendments to the Health (Miscellaneous Provisions) Bill 2010. From its title you would wonder why our group had got so upset. It sounded rather boring; as if it were sorting out some minor administrative matters as such bills often do.

  Not so. This innocuous-sounding Bill contained a section dissolving the board of St Luke’s Cancer Hospital – a centre of specialist cancer therapy for well over half a century – and transferring the valuable 18-acre site and all the other assets to the Health Service Executive (HSE).

  One amendment put down by Labour Senator Phil Prendergast, would have restricted the use of the land and buildings on the Rathgar site to the treatment of cancer and might have saved St Luke’s. However, just one government senator attended the debate, Geraldine Feeney, the Fianna Fail Health Spokesperson in the Seanad.

  The Seanad debate showed just how successful our (email) lobbying campaign supporting St Luke’s had been. Senators spoke of the volume of emails received and the personal stories they had been told. When the bells tolled for the vote, the chamber filled up. Just as in the Dail the week before, the amendment was lost by four votes.

  Earlier in the day, news had broken in an interview on RTE’s Pat Kenny show of the appalling treatment and subsequent death of a cancer patient at University College Hospital Galway, an official ‘centre of excellence.’ Her sister spoke of her anger about what had happened and anyone listening had to be moved by her account.

  This had given us hope that senators might vote to save St Luke’s with its proven track record. But they voted on party lines. We were wrong.

  The Minister’s timing in introducing the Bill was immaculate; late May when public attention was turning to the World Cup and summer holidays. Early in June I had discovered that St Luke’s was under threat from a posting on the website politics. ie. I found that a debate on the second stage of the Bill had already taken place in the Dail the previous week when I was on holiday. I learnt that Ruairi Quinn, a Labour Party constituency TD had ‘outed’ himself as a former L
uke’s patient and had spoken eloquently of his experience there.

  The Campaign to Save St Luke’s had been established in 2006 by Waterford man Joe Guilfoyle. Campaigners had thought the threat to St Luke’s was over. We had to get our act together quickly and I took on the Press Officer role.

  Tired and emotional - with one person, a cancer patient – in tears, our group made its way out of the chamber. In the lobby, we encountered the six Green TDs. The week before in the Dail, the Greens’ votes were crucial in voting down the same amendment that had just been defeated in the Seanad. We did not understand why the Greens had done this as party leader John Gormley was on record as supporting the campaign to save St Luke’s. And he did not contribute in the Dail debates to explain his apparent change of mind. In fact, none of the Green TDs even attended the third and final stage of the debate: they merely came in to vote. Our group had hoped that the Green senators, given the lobbying and the breaking story of the Galway cancer patient, might support the amendment.

  It’s not a logical move to close St Luke’s when it is one of the few success stories of our public health system. According to patients past and present, Luke’s is an outstanding ‘centre of excellence’ to which patients are happy to travel. Patients and their families give their stories later in the book.

  Outside the Dail, I spoke briefly to Green TD Ciaran Cuffe who remained in the courtyard. He told me that they (the Greens) had met Professor Tom Keane and an HSE official and that they had convinced the Greens that Minister Harney’s decision to close St Luke’s was correct.

  Tired as I was, I didn’t think to point out that in briefing yourself on an issue you need to talk to all relevant stakeholders. And to tell him that, as in the original decision to close, the government in the Dail debate had completely ignored the wishes of patients and their families. And as Professor Keane and the HSE manager are employed to implement government policy they were hardly likely to advocate anything other that the closure of St Luke’s.

  It’s incredible to think that I came close to arrest, much closer than any of our bankers or others involved in financial scandals have come to date. I’m a community activist of many years standing with a passionate interest in our public health system. I have never been motivated by money though as a chartered accountant by profession I could easily have followed the money trail.

  The week after my near arrest, some Luke’s supporters including myself were interviewed on the Pat Kenny radio show from the grounds of St Luke’s. After the successful broadcast that received much support from listeners it was decided that I would write the story behind the decision to close St Luke’s; about the Hospital from the perspective of the most important stakeholders, the patients and their families, and about our efforts to stop the Bill from being passed.

  One month before I learnt about the introduction of the Bill my husband Tom (who tells his story on p.238) was diagnosed with prostate cancer. I now had a personal agenda to fight for St Luke’s.

  This is a book about that fight, about our struggle. It lays bare the deceptions, the deceits, the disappointments that campaigners have faced. It also reveals the hope, comfort and joy that so many have found in Luke’s, a centre not only of medical care but of spiritual sustenance.

  Health analyst, activist and author Marie O’Connor unmasks the real agenda behind the determination to close St Luke’s, a plan that is driven, not by patient welfare, but by business interests. In Sections II and IV cancer patients and their families explain why this hospital is so special to them, and in Section III, I describe how the St Luke’s Bill got through, who said what and who didn’t bother to attend debates except to vote for the death of the hospital.

  Finally, the book reveals what we learnt after the Bill, what campaigners are doing now to save this centre of excellence and how you can help. And at the end, when we hope you will feel as strongly as we do, we suggest some actions that you might like to take to continue the fight.

  Don’t let them close it.

  HOLLYWOOD, HARNEY AND THE REST

  The decision to close St Luke’s was actually taken back in 2005 and announced in July, on a day when the media was full of stories about the tube bombings in London and half the population was on holiday.

  In May 2000 the then Health Minister Michéal Martin established an expert working group on radiation oncology services to assess needs and advise how such services in Ireland should be developed. There were 23 members on the Committee. Four worked at St Luke’s; the Chairman, Professor Donal Hollywood who also worked at Trinity College, Dr John Armstrong, Consultant Radiation Oncologist, Eileen Maher, Director of Nursing and Dr Brendan McClean, Chief Physicist.

  The Group reported in 2003, recommending the ‘centre of excellence’ concept. This of course, dovetailed perfectly with the 2003 Hanly report. Not all the committee agreed. John Armstrong has gone on record saying that the committee did not adequately examine other models that are working well elsewhere, like the ‘hub and spoke’ model, a mix of large and small centres which combines medical excellence with patients’ concerns about access.

  It was expected that when the Minister of the day came to choose which hospital should be the southside centre of excellence, St Luke’s with its 50 plus years’ track record would get the vote. Social historian Tony Farmar in his 2007 book ‘A Haven in Rathgar’ tells the story of the hospital’s development from its birth in 1952 to its maturing as a high-tech hospital with an international reputation.

  However, Luke’s didn’t get that vote.

  On 24 June 2004, the Department of Health and Children sent out a request for proposals on the development of radiation oncology services in the Eastern Region. The deadline for submissions was 8 October 2004. By then, there had been a change of Minister, with Mary Harney taking over the health brief on 29 September 2004.

  A panel of experts - three internal experts employed by the Irish health service and three based outside Ireland - was set up to review the submissions.

  Four hospitals made submissions that they should become the centre of excellence for the Eastern Region South: St Luke’s, St Vincent’s Healthcare Group, St James’s Hospital and the Adelaide and Meath incorporating the National Children’s Hospital (AMNCH).

  There was no patient input.

  The experts examined the submissions and made a half-day visit to each hospital in the week commencing 13 December 2004. It was a pity they visited St Luke’s in mid December as it’s not the best time to see the hospital’s wonderful grounds.

  In January 2005 the experts recommended St James’s Hospital to the Minister. Much later, under Freedom of Information legislation (FOI), we obtained the marks given by the experts. They are included in the appendix in full.

  Overall St Luke’s received less than half the marks given to St James’s Hospital.

  St Luke’s has an 18 acre site with room to expand as well as ample free parking. The James’s site is already crowded and chaotic. With a new private co-located hospital to be built there, the site will become more congested. Yet under the category suitability of the site to accommodate radiation oncology and related services, St Luke’s was awarded a mere 46.75 out of 100, just over half the mark (85.5) awarded to James’s.

  Cynics might say ‘If you choose the right experts you get the right recommendation.’

  The truth is that experts - in good faith - can differ. And the terms of reference selected for a report, as well as the indicators used within those terms for any competition can greatly influence the outcome.

  On 25 July 2005 Minister Harney said that she had accepted the experts’ recommendation which meant St Luke’s would close. In the official four page press release announcing this, she made extensive references to St Luke’s and said the new facility at James’s would incorporate the St Luke’s name (later referred to as a ‘brand’). The implementation date set for the new cancer network envisaged by the Hollywood Report was 2011. This has now been put back to 2014.

&nbs
p; In the next chapter we quote six more experts. Their views are different. As we said, in good faith experts can differ.

  EXPERTS DIFFER

  In the last chapter we heard how the Minister accepted the advice of six experts. In this chapter we give the views of six different experts.

  Two are consultant radiation oncologists at St Luke’s who also work at other Dublin hospitals; we quote from interviews they have given to the media. Another is an experienced consultant who wrote a wide ranging report on St Luke’s, ‘More than a Leafy Suburb’ - which is featured in Section V. And we print extracts from three patients or family member’s stories featured in Sections II and IV.

  Professor John Armstrong, member of the Hollywood committee, and current Chairman of the Irish Cancer Society

  ‘I don’t think the expert group looked closely enough at the type of models that could have worked well in Ireland.’

  Speaking of the hub and spoke model whereby a central unit is linked to a number of peripheral units -

  ‘This model has yielded a dramatic improvement in the number of people using radiation oncology services in Norway and other countries underlying the importance of access, contrary to the findings of the Hollywood Report. The argument against satellite units is not as cut and dried as saying the population is not large enough.’

  Irish Examiner 17 FeBrú ary 2006

  ‘To me the biggest issues are access and waiting lists. Problems with the quality of care are not on the same scale as the fact that patients wait for cancer treatment on a constant basis… the current cancer plan is not the most efficient way of securing better cancer outcomes in Ireland. There are many other things I would prioritise, such as a screening programme for colon cancer which is a big problem in Ireland and the rolling out of Breast check and screening for cervical cancer. Will this plan detract from the rolling out of these screening programmes? Will it impact on the net increment of cancer care spend?’