Everybody wants to support cancer charities, don’t they? Take Maggie’s Trust, which ‘empowers people to live with, through and beyond cancer’. The Maggie’s approach is defined by their cleverly designed modern care centres, which welcome not just people battling against cancer but their families and those who care for them. Maggie’s now plans to build a new centre, only the second in London, at St Bartholomew’s Hospital in Smithfield.

We desperately want to stop them.

Before you start shouting at the screen, let us explain. We represent another group, one that was set up to protect the heritage of Barts, rather wordily calling ourselves ‘The Friends of The Great Hall and Archive of St Bartholomew’s Hospital’. We think we do a useful job: Barts has led the provision of healthcare in London for almost 900 years. It was founded in 1123 by the monk Rahere to give free medical care to the poor of the City of London. No hospital in the country can begin to match its record.

Barts is fascinating and important architecturally. At the entrance to the hospital is the Grade I listed gatehouse (1702), which leads to the grand square with its elegant fountain (1859), surrounded by the remaining three James Gibbs blocks forming the North, East and West Wings (1730 – 1769). The central jewel is the Great Hall, reached by a fine staircase in the North Wing. The walls are covered in life-size Hogarth canvases, depicting acts of charity and healing – it is one of London’s great hidden treasures. The basement also houses the archives, which contain thousands of precious and ancient medical records.

Unfortunately, in the 1960s some rather grim extensions were added. And in the 1980s and 1990s, Barts was threatened with closure, but it survived and has since prospered. Life breathed into the hospital again, and in the 2000s The NHS Trust formed a special group to protect the character of the older buildings.

This group got as far as commissioning Hopkins Architects to draw up a proposal of how a heritage site could be developed at Barts. But then the report was shelved without reason. The Friends, however, took up the cause, and quite recently employed the same architects to dust off, renew and improve their initial proposal including the redevelopment of the archives.

But obstacles began to appear from unlikely sources. Although the NHS Trust had previously set up a group to pursue the protection of the historically and culturally important buildings at the hospital, their sympathy for the project has waned. They currently prefer the idea of developing the Maggie’s centre — an ultramodern illuminated glass-clad building.

Notwithstanding the incongruence of such a building at Barts, inappropriate in scale and unsympathetic to the Gibbs building to which it will be attached, the real shock was the discovery that these plans would prevent the planned development to protect the North Wing.

We have tried to find room for compromise. Our architects have presented alternative plans for the Maggie’s centre, which honoured the scale of their original proposal, but at a different site at the hospital that would not damage the North Wing or impact on any of the historical buildings. This idea seemed of little interest to either the trust or Maggie’s.

Maggie’s initial application for planning permission was strongly opposed by the Friends and others and was unsuccessful. Maggie’s promptly developed new plans — but with only a few modifications and absolutely no compromise as to the site.

All the while, the future of clinical cancer services at the hospital is itself in question. Reports suggest that the NHS will move some of the cancer units to University College Hospital, which draws into question the appropriateness of a Maggie’s centre at Barts. The Friends now plan to submit the Hopkins plans simultaneously, including an option to build a Maggie’s centre at a site detached from the North Wing that will not put the Gibbs buildings or their contents at risk.

There’s no easy answer to the question, ‘Yeah, but why should it get in the way of helping cancer patients?’ But the North-Wing and the Great Hall of Barts are historical and socially vital places that have the potential to become a self-financing heritage site.  There are more suitable sites on which Maggie’s can build their centre. They can carry on their work perfectly well without wrecking an architectural treasure.

Mr Marcus Setchell is Surgeon-Gynaecologist to Her Majesty the Queen.

Dr Julius Bourke is a clinical lecturer in neurophysiology and clinical psychiatry & honorary consultant psychiatrist at Barts.

PS: The Barts NHS Trust has commented on this piece:

While the Trust fully supports the Maggie’s Centre Development, it is vital that we preserve the heritage of the North wing and the Barts site. We are therefore actively pursuing the creation of a heritage trust to do just that, ensuring that the precious heritage aspects of the site are maintained, enjoyed and utilised to best effect.

Barts Health has worked very closely with Maggie’s as we feel strongly that there is an achievable balance that can be delivered of protecting and enhancing the heritage of the site whilst providing an important facility for patients and families affected by cancer.

We do not agree that this important development will damage or impact the future use of the North wing. We continue to meet with the ‘The Friends of the Great Hall and Archive of St. Bartholomew’s Hospital’ to share the developing site  plans  and patient environment enhancements. The Trust is focussed on protecting the important heritage of the site whilst  using the site efficiently and delivering new and upgraded buildings to support the provision of effective and first class healthcare to our patients.’

Maggie’s were unavailable for comment.

Tags: architecture, building, Cancer, Health, Hospitals, NHS