Children's hospital set for site at the Coombe until final hour

The Government made a last-minute decision to switch the location for the new national children’s hospital from beside the Coombe women’s hospital in Dublin to the St James’s Hospital campus nearby, The Irish Times has established.

Days before the announcement was due to be made last month, senior ministers had resolved to award the project to St James’s but to instruct that the building be on vacant land beside the Coombe.

This was seen as the option closest to the ideal of “tri-location” with an adult hospital and a maternity hospital, as recommended by a review group chaired by Frank Dolphin. The Coombe and St James’s Hospital are only 600 metres apart.

However, this compromise option was changed in the final days before the announcement, three separate sources have told The Irish Times.

This decision was taken in response to significant resistance within St James’s to a joint proposal tabled by the Coombe.

One source said ministers were “agnostic” as to where in St James’s the project would be built, so long as it went ahead with as little “trouble” as possible.

Initial planning work has since begun on a site at the western end of St James’s, near the South Circular Road entrance. Both hospitals put in bids for the project, but at the end of October the Coombe proposed a combined proposal “under the leadership of St James’s”.

Hazardous risks

In a letter to the Taoiseach, Tánaiste and Minister for Health James Reilly, the hospital argued that locating the project by the Coombe would significantly reduce the hazardous risks associated with the transfer, by ambulance, of critically ill newborn babies to a children’s hospital.

About 530 newborns with serious cardiac problems and congenital abnormalities have to be transferred from a maternity hospital to a children’s hospital each year.

“These children have the highest mortality and serious morbidity rates in the State,” master of the Coombe Chris Fitzpatrick and chairman Aidan O’Hogan stated in a letter.

Seriously ill children will still have to be transferred by ambulance when the new hospital is built at St James’s, at least until a maternity hospital is built on the site at an unspecified time in the future.

Joint plan

The Dolphin report favoured St James’s in spite of the “high” planning risk involved, but said there would be merit in a “joint plan” from the two hospitals.

However, a separate planning report suggested that the planning risk at St James’s could be reduced by expanding the site area proposed at St James’s and lowering the building height.

While the proposal to build the hospital at St James’s has generally been well received, a significant number of medical specialists at the existing children’s hospital in Crumlin believe co-location with a maternity hospital is essential.

Cost savings

Mr Fitzpatrick and Mr O’Hogan also argued that their proposal would allow the building of the new project to be completed without interruption to existing services at either hospital and would result in significant cost savings.

In the week before the announcement was made, TV3 and The Irish Times reported that a compromise proposal to build the project at the Coombe under the direction of St James’s was finding favour with ministers.

However, no mention of this hybrid solution was made when Dr Reilly announced on November 6th that the building would be on the St James’s campus.