Mercy Hospital holds special place in patients' hearts.

By CARROLL DU CHATEAU

This weekend Auckland's Mercy Hospital celebrates 100 years of service to the Auckland community. Over the century the nuns who run and own the hospital have shown rare flexibility, transforming the original Mater Misericordiae hospital of 1900 into the Mercy, a major, incorporated, private, surgical hospital, specialist centre and hospice that answers the needs of modern Auckland.

It has been an interesting journey. Friends who gave birth at the Mater between 1962 and 1979 tell of how, when they were in advanced stages of pregnancy, the hospital's Dr Pat Dunn would kneel on the floor and help them off with their shoes. Examinations would take place on a fully made-up bed, with Dr Dunn, who had a genuine reverence for mothers, examining them under flowered sheets. When they gave birth, they would do so under the gaze of the Blessed Virgin Mary, whose portrait presided over the labour ward.

All this became far more significant after the Mercy maternity wards closed at the end of the 70s and all Auckland women were siphoned through the public system, principally to National Women's Hospital, where doctors Denis Bonham and Herbert Green ran a very different establishment. The ethos at National Women's, as shown by the unfortunate experiment scandal of the mid-80s, was that patients must be prepared to be used as teaching material.

Such a problem could never have happened at the Mercy, mainly because it was not a teaching hospital. Instead, the hospital was run by a Catholic order of nursing nuns who had cut their teeth in the back streets of Dublin. They were intensely ethical. Explains Sister Rita Marie, who ran the hospital between 1981 and 1993, this was an order of women who were fiercely independent. From all over the world, as Irish immigrants driven from the homeland by poverty began to put down roots, they would call for Mercy nuns to come out and solve their social problems. And it is unlikely they, along with doctors such as Pat Dunn, would have allowed ambitious gynaecologists to take over their patients.

Mercy founder Catherine McAuley saw her order's primary duty as providing one-to-one care for the dying. During the Crimean War the Sisters of Mercy joined Florence Nightingale in providing care for the troops. The first Mercy nuns to arrive in Auckland after a nine-month voyage started teaching the next day, from the little house set up for them next to St Patrick's Cathedral in Wyndham St. It was 1850. Because the nuns, under the guidance of Mother Cecilia Maher, had learned fluent Maori during the trip they were highly successful with Maori children.

Fifty years later, after Mercy schools had been established in goldmining towns such as Thames, and in fencible settlements such as Onehunga and Otahuhu, and Mercy nuns had stepped in to staff the struggling Coromandel Hospital, the nuns, headed by Maher and Mother Ignatius Prendergast, used a small endowment from grateful parishioners to put a down-payment on a house on Mountain Rd. The hospital they built on a hill, surrounded by farmland opposite Josiah Firth's mansion with its concrete tower that still stands nearby, was Mater Misericordiae (Mother of Mercy).

The values of the new hospital - of compassion, of justice, of service, of respect for one's dignity and care of the poor - were as solid as the volcanic rock it was built on. Patients were welcomed in and treated almost like family. Although it was a convent at heart, all faiths and denominations were welcome.

Throughout the century, as the Mater/Mercy has been obliged to fit in with successive Government health policies and a devastating drop in young women entering the convent that has destroyed most other religion-based hospitals, the Mercy has survived with its core values intact. One of its strengths is that it has managed to transmit its vision to its lay staff at a time when the order itself is examining its reason for being. Just as important, in the materialistic 21st century, the order still owns the hospital and land.

Precisely how Mercy made the changes from an establishment run entirely by nuns in white wimples and veils, to the modern surgical unit it is today, is chronicled in a new book, The Mater, A History of Auckland's Mercy Hospital, 1900-2000, by Massey University lecturer in social policy Michael Belgrave. As Belgrave points out, the Mercy nuns, with their independence and strong sense of self-worth, fitted well into the growing city.

"The Mater was run by women with very clear ideas of where to take the place. Throughout the century they were dealing not just with the commercial elite, but also with the medical elite - who are not the most humble of people. And their ability to monitor and manage bishops, politicians, doctors, the nursing hierarchy and even market gardeners who brought the produce to their kitchens, shone through."

Even for an order with a strong commitment to acknowledging change and the brains to keep ahead of trends, the century was not without pain. Back in 1973 its hard-won nursing school was forced to close when nursing training was moved out of hospitals and into technical institutions. When successive governments became increasingly reluctant to increase subsidies to private hospitals, the Mater hit crisis.

The maternity unit, whose subsidies were hardest hit, at a time when there was an over-supply of maternity beds in Auckland, was closed in 1979. The hospital itself clung on only through a one-off injection of Government funding.

Meanwhile, the numbers of novitiates, who had traditionally provided free labour for the hospital, were dwindling.

And so, by the early 80s writes Belgrave, the religious hospital, in the sense of being run and staffed by a religious community within a set of prescribed rules, was gone.

The Mater's strategy needed a rethink.

Writes Belgrave, "Trying to keep fees down to ensure that ordinary New Zealanders had access to the Mater confused the hospital's mission. There was little point in not charging wealthy or insurance-funded patients the full cost of their care. Setting prices too low left deficits that Government was unwilling to pick up, and left no surplus for providing for those who could not pay, or for other charities."

And so the Mater transformed itself. Under the guidance of the forward-thinking Sister Administrator Rita Marie Vessey, who had attended the Mercy's St Mary's convent in Ponsonby and was one of the country's first nurses to gain a university degree in nursing, policy - but never Mercy values - was revised.

Fuelled by several trips to the United States and aided by executive manager Theo Peters, a Netherlands-born, innovative, private-hospital expert, Sister Rita Marie embarked on a deliberate programme to bring the Mater into the age of user-pays. First came an alliance between doctors and the hospital. The well-to-do and insured could pay full price; the poor would be admitted free. And no one but the person who opened the bill would know the difference.

St Joseph's Hospice, with its incredible standard of care for the dying and its exhilarating view over the harbour and city, was opened in the old maternity ward.

By the time David Lange and Sir Roger Douglas came to power in 1984, the Mater was ready for them. By 1988 the name of the hospital was changed from Mater to plain Mercy because, says Sister Rita Marie, so few people understood Latin that many addressed their mail to the "Martyr." As she says, with a rare smile, that kind of martyr was not a particularly good image for a surgical hospital.

Nearly 20 years later, Mercy is a healthy, flexible hospital. The paintings of Mary in her blue robes are still there, the photos of Mercy nuns in white habits and wimples, through to the drab civvies of today, adorn the hallway. But up there in the surgical ward, where theatre manager Jan Smeath reigns over seven state-of-the-art operating theatres used by 50 city surgeons for everything from open-heart to brain surgery, it is all polished floors, huge batteries of sophisticated machines, and laughter.

"The nurses here build great rapport with the surgeons," Smeath says later over a cup of cappuccino in the surgical cafeteria with its views over the city and harbour. "We work it so that surgeons know at least two people working on every op."

High on another side of the hospital, the St Joseph's Mercy hospice is similarly relaxed; the Mercy Angiography centre, photographing and widening the arteries of Auckland's middle-aged and well fed; the Mercy Specialist centre, pumping out its $100-plus-a-visit patients; the Mercy Pharmacy, dispensing hospital-only drugs; Mercy Radiology, which includes CT and MRI scans, carrying out some of the modern diagnostic imaging available in the city; a training and development link with the University of Auckland.

And, across town, at Mercy Outreach Centres, the mission continues with free glasses for kids and orthopaedic outreach programmes which means that children over 6 receive free glasses and each year up to eight older people, who can't afford operations, receive free joint replacements. Says Smeath, "The surgeon does the operation free of charge and we provide free beds and nursing care."

There's another big change too. For the first time, the hospital is run by a man - chief executive Tony Duncan, who took over in 1998. Again the sisters have no problem. Duncan, who started his career as a religious brother of the Order of St John of God, sees Mercy's big challenge as "combining business principles with the traditions and legacy of Catholic healthcare," and maintaining key links both international and with Auckland.

"Mercy cannot survive up on this hill in splendid isolation."

* Mercy Hospital Centennial Celebrations run this weekend and Monday, 10 am to 4 pm, with an exhibition of the hospital past, present and into the future in Gonzaga Hall.

There are small, guided, group tours of the hospital and an exhibition of the theatres on Saturday, 12.30 pm to 2.30 pm.