Cost of children’s hospital rises as families rely on outdated facilities

For quarter of a century, the plan to create a single super-hospital in Dublin fit for the nation’s sick children has filled those involved in health with alternate bouts of excitement and despair.

Repeated efforts to get the project off the ground at various locations have raised hopes, only for these to be dashed by disagreements within the medical community and a failure to properly plan for big projects.

At one point, it was planned to knock down Our Lady’s Children’s Hospital in Crumlin and build a new hospital. Then came the idea of locating the hospital at the Mater hospital in then taoiseach Bertie Ahern’s stronghold north of the Liffey.

With space in this inner-city location in short supply, those designing the project reached skyward. The resulting behemoth of a building was firmly knocked on the head by An Bord Pleanála, and about €70 million of taxpayers' money was wasted.

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Best practice says a children’s hospital should be located alongside an adult hospital and a maternity hospital. But with no site in Dublin offering this tri-location (until the maternity hospitals are moved), the arguments raged between those who favoured co-locating the children’s hospital with a maternity hospital and those who favoured siting it beside an adult hospital.

In 2012, following a review, then minister for health James Reilly announced the project would be built beside the adult hospital at St James's Hospital. The building design, which has since been granted planning permission, has won plaudits, but the site has been subjected to the same criticisms the Mater faced.

Main objections

The main objections relate to parking provision and access, given the admittedly congested roads around St James’s. These issues were thoroughly thrashed out during the planning process, which included a two-week oral hearing process. Nonetheless, the campaign against St James’s, led by a brace of retired paediatricians and a number of children’s charities, has continued.

As a result, the public has a somewhat sceptical view of what should be a flagship project for the capital. This scepticism will only be increased by the rising cost of the development, up from €650 million during planning to close to €1 billion now. That doesn’t include the cost of providing IT and equipment, which is likely to exceed €100 million in each instance.

Some €200 million was supposedly ringfenced for the hospital from the sale of the National Lottery, but this money has long since been spent. The Cabinet must now decide whether to press go for the project, knowing that to do so will severely strain health budgets.

HSE director general Tony O’Brien said recently he needed €9 billion just to renew the existing health infrastructure: by replacing ageing ambulances, clapped-out equipment and modernising hospital blocks. But the size of the children’s hospital project will swallow nearly all the available capital funds for the coming years – and then some.

Equally, could Dublin – and Ireland – hold its head high if a decision were made that children were not actually a priority and that we cannot afford to replace the ramshackle buildings in Crumlin and on Temple Street?