The next step in a legal challenge against plans for a new cancer centre on meadows in Cardiff will be put before a judge next week. 

Cat Lewis, who has been treated for cancer, applied to proceed to judicial review in June. The claim is expected to be placed before a judge on Monday, who will then decide whether it can progress any further. 

Ms Lewis was diagnosed with breast cancer in 2018 and was treated at both Velindre and Llandough Hospital. She is challenging the Welsh Government over plans to develop the new Velindre Cancer Centre on what’s known locally as the ‘Northern Meadows’ in Whitchurch. 

Ms Lewis lives on the nearby Hollybush Estate. She says she has sought to launch the legal challenge not only due to concerns over the environmental impact of the development but also for clinical reasons. 

“When I was receiving my treatment for cancer, those meadows became a lifeline for me,” said Ms Lewis. “The area is teeming with wildlife and it’s where children play and people walk their dogs.

"It is such an important local amenity for us all. During the lockdowns it became a lifeline for the whole community and not just me. 

“But this goes beyond a simple environmental issue. 

The National Wales: Cat LewisCat Lewis

“I and the campaign group who are supporting me strongly believe that any new cancer hospital should be co-located next to the University Hospital of Wales (UHW) in the Heath. 

“That has to be the best option for a modern day cancer treatment centre because patients like me would have a range of other services available directly on site like accident and emergency, surgery and intensive care.

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“A new cancer centre was opened in Liverpool last year and it’s right next to the main hospital. Why should cancer patients in south Wales expect any less?”

In June, when Ms Lewis launched her legal challenge, the Welsh Government issued a statement: "We are committed to improving cancer services in Wales.

"It would be inappropriate to comment on any potential legal challenge to the plans for a new Velindre Cancer Centre."

Meanwhile, a spokesperson for Velindre said: "We are committed to delivering excellent non-surgical tertiary cancer services for the population of south east Wales.

"It would be inappropriate to comment on any potential legal challenge to the plans for a new Velindre Cancer Centre.”

The National Wales: The cancer centre will be situated on these Meadows in Whitchurch. Source: Alex SeabrookThe cancer centre will be situated on these Meadows in Whitchurch. Source: Alex Seabrook

The news of the development in the legal challenge comes days after a leaked letter from a top cancer expert warned the plans to build the new centre could harm research and staff recruitment.

Professor Neil Burnet, an expert in proton clinical oncology, sits on the external advisory board of the Wales Cancer Research Centre. The letter, from November 2020, and obtained by the campaign group Co-locate Velindre, fed into the landmark Nuffield Trust inquiry into the Velindre proposals.

In the letter, Prof. Burnet said: “The board was unanimous in our opinion: we feel this represents a huge potential missed opportunity.

“There is a clear trend for specialist cancer services to be moved to larger hospitals with a wide range of specialist services as they are redeveloped. Cancer units which have had general services withdrawn from their campuses have been badly disadvantaged, both for patient care and research.

“Velindre is very much out of step with the prevailing thinking about patient care, an issue which needs to be considered very carefully.”

One issue raised by the professor in the letter was a lack of an intensive care unit at the proposed cancer centre, which he claimed would prevent the hospital taking part in some trials for new experimental treatments. The nearest ICU would be located at UHW, more than three miles away. 

The National Wales: A map showing the access to the new Cancer Centre. Source: Velindre NHS TrustA map showing the access to the new Cancer Centre. Source: Velindre NHS Trust

Another potential issue raised in the letter was the impact upon staffing, which could affect the “prestige and brand” of Velindre and Cardiff in cancer research communities.

He said: “The decision to re-site Velindre separately will also have implications for staff recruitment at both junior and senior level. That in turn will have a knock-on effect on research.

“Physical separation of radiotherapy degrades the capability for successful collaboration between oncologists and other specialities.

“There will be loss of prestige and damage to the strong Velindre brand and to the standing of Cardiff and Wales in the wider cancer care and research communities. The next [five years] will be difficult should Velindre be rebuilt distantly, and that will restrict opportunities for patients to engage in, and benefit from, research.”

Prof. Burnet’s letter was subsequently considered last year in the inquiry on the Velindre proposals conducted by the Nuffield Trust, a health think tank. The Nuffield report explored concerns around building the new hospital on a stand-alone site, instead of next to an existing large general hospital such as UHW.

The report said patients at risk of major escalation should not be admitted to the new Velindre Cancer Centre, and a cancer research hub should be developed at UHW.

It added most patients at Velindre are outpatients, who arrive for treatment and leave on the same day, and many value the convenience of travelling to the hospital, just off junction 32 of the M4.

The National Wales: An artist's impression of the proposed centre. Source: John Cooper ArchitectsAn artist's impression of the proposed centre. Source: John Cooper Architects

A spokesperson for Velindre said the Trust had a “strong track record of delivering research of international impact, working in partnership with our colleagues across the health, university and commercial sectors”.

“Velindre Cancer Centre already delivers multi-disciplinary, cutting edge cancer research with patient safety at its heart. Since the Nuffield Trust’s advice was published, Velindre University NHS Trust has worked closely with all relevant partners to deliver the recommendations on research and development.

“Specifically, work is underway in partnership with Cardiff and Vale UHB and Cardiff University to develop a Cardiff Cancer Research Hub at UHW—as per the Nuffield Trust recommendation—that will enable us to further develop our shared ambitions, including the successful delivery of complex early phase studies and advanced therapies for patients across south-east Wales.

“Velindre has also produced a research and development ambitions document outlining a 10-year commitment, and it continues to play its role in the development of a regional and national cancer research strategy for Wales. This was also a key recommendation by the Nuffield Trust.”

But campaigners have claimed the letter was a “damning verdict” of the plans for the new cancer centre, and are calling for an “independent clinical review” of the stand-alone model.

The National Wales: The area is a popular amenity for local people. Source: Alex SeabrookThe area is a popular amenity for local people. Source: Alex Seabrook

A spokesman for Co-locate Velindre said: “This letter shows that a permanent stand-alone cancer centre in Cardiff will have serious consequences for patients and erode Wales’ reputation in the eyes of the world. Nuffield merely recommended a process towards co-location starting with the research hub at UHW.

“Velindre and the Welsh Government have defied the real intent of Nuffield’s advice and made a mere staging post the final destination. So the review board’s letter still roundly condemns what they’ve chosen and every word still applies to this approved stand-alone cancer centre.”

In an interview after the letter was leaked, Prof. Burnet said he still held concerns about the standalone model, but added challenges could be overcome. He also said he sympathised with the fact that many people believe there is an urgent need for Velindre to build a new hospital rather than wait for UHW to be rebuilt.

“My view, based largely on experience of myself and others, is that cancer centres work much better if they’re co-located with a big general hospital,” said Prof. Burnet.

The National Wales: The Hollybush estate will be impacted upon by the development. Source: Alex SeabrookThe Hollybush estate will be impacted upon by the development. Source: Alex Seabrook

The professor, who started his consultant career at Velindre, said the lack of intensive care or surgical facilities was a concern when conducting intensive chemotherapy treatments or managing surgical complications.

He said: “I used to do quite intensive chemotherapy there. Most patients who have chemotherapy are absolutely fine, but sometimes there are complications with it. You need to be able to provide support for blood pressure, for example. If a collapse happens you need some quite intensive medical and nursing input, you need the patient to be in an intensive care unit. But in the back of my mind that was always a worry.”

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Another concern was staffing, and how making contacts and attending meetings becomes harder when clinical services are split across multiple sites.

He said: “You have one group of doctors doing intensive treatments at UHW, and a different group of doctors doing intensive chemotherapy somewhere different. You start to get fragmentation. You can overcome those challenges. But you have to work much harder at it, and have higher levels of staffing to do it.”

A third issue was the lack of space at UHW to fit a potential co-located new Velindre hospital. The current site in the Heath has little available space, and while there are plans to replace the UHW with a new building, these are in the early design stages. Velindre already has planning permission for the Whitchurch site.

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Prof. Burnet added: “I understand there would be huge problems fitting Velindre in at UHW, and I gather that Velindre needs to be rebuilt much sooner than my understanding of the time frame for the rebuild at UHW. But if you have a limited footprint you can also build up and down: in the USA it’s normal to have skyscraper hospitals.

“Saying there’s no space at UHW is important, but there are ways around a space issue. There are merits to both proposals, for sure. But that’s part of the problem. People can be polarised and get very angry about the opposition.”

A Velindre spokesperson said: “As noted by the Nuffield Trust in its report, south-east Wales can only deliver its cancer research ambitions by working in partnership, and Velindre will continue to focus on this.”

Similar concerns had previously been raised in a letter signed by 163 unnamed clinicians, who claimed it would be “safer for patients” to build the new cancer centre next to UHW.

The National Wales: The plans have angered local residents. Source: Alex SeabrookThe plans have angered local residents. Source: Alex Seabrook

Construction work for the new Velindre Cancer Centre is due to start in March 2023, taking around two years, and is likely to open in summer 2025. Enabling works to prepare the site could begin within the next few weeks. 

The Welsh Government signed off the outline business case in March earlier this year, while planning permission was granted by Cardiff Council in 2017.

Additional reporting by Alex Seabrook, Local Democracy Reporter.

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