New children's hospital plan puts pressure on creaky facilities

Temple Street children’s hospital was 140 years old last week and it looks every minute of it. A maze of narrow corridors and dark and dingy stairs, it looks like a cross from the worlds of Charles Dickens and Alice in Wonderland. Staff and parents alike daily toil up steps, past the “mind your head” signs and the cracked windows, and through a rabbit-warren of passages and rooms.

The lift doesn’t reach the top floors so children have to be carried up to the Top Flat ward for sick babies. Any youngster unable to climb the steep stairs likewise has to be carried up to the school and the playroom.

Top flat

Top Flat has just one adjacent toilet for 14 beds and no work area for staff. Patient notes are written up on a small ledge. Every available area of floor and wall space is used to store or hang equipment and parents staying with their children have to make do with armchairs or thin mattresses placed on the floor.

This is the reality of children’s medicine in Ireland today; a similar story could be told at Our Lady’s Hospital in Crumlin or Tallaght children’s hospital.

The Promised Land

While the new national children’s hospital is the Promised Land of child medicine in Ireland, for many of those working in the sector now it must seem like a mirage more than a tangible reality.

Last week’s announcement by the Government that the project will go ahead at St James’s finally got things back on track after An Bord Pleanála shot down the Mater’s application to build the hospital on its site last February. But there was bad news amid the generally positive message, with the admission by Minister for Health James Reilly that the project won’t be ready until 2018.

That’s six long years away for the sick children of today, and four years later than the original completion date for the Mater version of the project in 2014. It is clear that many of the potential clients of the planned facility will have grown up by the time it is ready.

The plans to build a new world-class hospital for children pose a number of challenges for the existing hospitals. Temple Street, Crumlin and Tallaght are all due to merge into the new hospital when it is completed.

That sets up its own organisational and political challenges, but there is also the question of what level of services can be provided in the interim.

Unsuitable and overcrowded

Six years is too long a period to allow for stasis in the existing hospitals and it could easily turn out to be longer if the project is delayed. Indeed, based on experience up to now, this is probable not possible.