Draw Breath

Via Twenty Major, I see that St Luke's Cancer Hospital in Dublin is set to close, with services being moved to a radiotherapy centre in the enormous St. James's hospital closer to the city centre. It's a sad thing to see a hospital closed. In my experience it's a common phenomenon that cancer centres are regarded with a seemingly strange level of affection on the part of patients and their families. This, I guess, is largely down to the incredible people in oncology departments who not only administer the technologies of medicine but the massive emotional impact that cancer can have on patients' families (often, in fact, the impact is greater for families than for the patient themselves).

Still, all that said, I think that the move to centralise cancer services is probably the one bright element in the monumental, world-historical, fuck-up that is Irish cancer care (see here, also via Twenty Major, for one example of how bad things are).

Cancer services are best provided in a centralised manner for two reasons. First, oncology is very very expensive (and set to get more so), so it's simply easier and more effective to pool resources than it is to have a radiology machine here and another one there etc. And it's better to have lots of experts in one place than to have them either dotted around the country or (as also happens) driving from hospital to hospital. Second, and I don't think people consider this very often, people with cancer tend to end up needing all sorts of other services - CT scans, dermatologists, pain management, kidney stuff and so on. If you don't have the resident expert or technology at your own small hospital, you're going to have to bundled at great discomfort and expense into an ambulance to be ferried to the scan or whatever. That is just not a good thing.

Given all this, while the Irish health services is an almost criminal disaster from end to end, I just can't bring myself to feel regret at the concentration of cancer services in Ireland. It's sad that St. Lukes will close, but it will probably make the lives of cancer patients (those who have got in the door anyway) just a little bit easier and, perhaps, a little bit longer.