Costs and compromises lie at the heart of the Government’s decision to locate a new national children’s hospital at St James’s hospital in Dublin. Infighting between medical and political interests generated so much public confusion in recent months that the best interests of children and their parents appeared secondary considerations. Now that a decision has been taken, no time should be lost in providing this vitally needed facility.
The cost of the hospital has been put at €500 million and Minister for Health James Reilly does not expect it will be completed until 2017 or 2018. Whether that is because of anticipated planning delays or cash constraints is unclear. This lack of ambition in terms of a completion date is of concern because – six months ago – advocates for the St James’s project had undertaken to develop and fit out a children’s hospital by 2015. A new maternity hospital was expected to add a further €100 million. Dr Reilly described planning risks at St James’s as “moderate”, compared to “significant” at the Mater. Cost considerations, the need for early action and streamlined decision-making may have been deciding factors. Consequently, a risk of planning refusal remains.
This is likely to be the largest capital project undertaken in the lifetime of the Government. Six years ago, the cost of building a children’s hospital at the Mater site was put at €850 million. That was at the height of the building boom. The choice of location was regarded as “astounding” by healthcare experts while its location in the constituency of the then taoiseach was seen as significant. Rejection by An Bord Pleanála of development plans on grounds of height, bulk, scale and mass and the “profoundly negative impact” it would have on the Dublin skyline led to the establishment of the Dolphin commission. It reviewed the various applications and, while favouring St James’s, did not make a formal recommendation. Within weeks of the report being delivered to Government, politically inspired “leaks” suggested that Connolly hospital would be chosen as the site. Opposition to this development by medical specialists from the three existing children’s hospitals in Dublin caused a rethink.
Any decision on the location of the hospital was going to cause controversy. Medical interests can be as ruthless as politicians’ in promoting personal and corporate agendas. What is important in this instance is that staff from the existing three children’s hospitals should have appropriate input into the governance of the State-owned hospital. In the past, hospital services often appeared to be arranged for the convenience of medical staff, rather than patients. That imbalance is slowly changing. When the new children’s hospital is built, the interests of children and their parents should always take precedence.