Children’s hospital debate to generate more heat than light

Previous iterations of the planning process suggest we should expect unexpected

Four years after An Bord Pleanála first held an oral hearing into plans to build a new national children's hospital in Dublin, the proposal is again being debated in a public forum.

The project has crossed the Liffey in the interim, and the design is different, but many of the same issues – and faces – are here again for the “Mark II” hearing.

The last time the result of the planners' deliberations was a shock rejection of the plans made to build the hospital at the Mater. The question this time around is whether the oral hearing that started Monday on plans to build the hospital at St James's will produce a similar result.

If this happens, about €70 million ploughed into the Mater and St James’s project will have been wasted. The political implications for the Government, which is likely to be in the throes of an election campaign when the decision is announced, would also be catastrophic.

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On the face of the evidence presented by the design team on Monday, many of the issues that caused the Mater project to fall foul of the planners have been addressed in the intervening years. The design planned for St James’s is more compact than the leviathan that was envisaged for the Mater, the site available is bigger and the consensus in the medical community behind the project is stronger.

Some of this is down to a “just get on with” sentiment among people who are, understandably, frustrated at the delays that have beset a development which was supposed to be ready by next spring but will not materialise until 2020 at the earliest.

With every year, the need for a new hospital increases in urgency as facilities in the existing children’s hospitals get more dilapidated and waiting lists lengthen. The new hospital will have more beds (473 as opposed to 432 in the three Dublin children’s hospitals at present), more operating theatres (18 against 12 at present), and more MRI machines (seven against 2.5).

Traffic congestion

It will also save lives, by providing more specialised care to a higher standard.

But while there is universal agreement on the need for a new hospital, St James’s is being opposed for many of the same reasons put forward against the Mater. These arguments variously relate to access, traffic and parking but essentially stem from a view that the development should be designed around the needs of car drivers over other users. In this view, St James’s, like the Mater, is faulted for being an inner-city location with limited space and traffic congestion issues.

Shifting the project once again to a greenfield site by Connolly hospital in Blanchardstown is seen as the answer to these problems, even if Connolly is a relatively modest facility by the standards of St James's or the Mater. This is basically an "urban vs rural" argument, one that has led opponents such as Jonathan Irwin of the Jack & Jill children's charity to claim that children and their families will have to fear for their safety in the urban depths of St James's.

Mr Irwin has engaged a professional planner to represent Jack & Jill's view at the oral hearing, and the New Children's Hospital Alliance, which includes a number of retired paediatricians who were instrumental in downing the Mater proposal, will also provide vocal opposition to the project.

The cost of funding the biggest capital project in the history of the State won’t figure much in the hearing, but it remains a concern. The Government has spent the €200 million windfall from the sale of the National Lottery that was supposed to have been ringfenced for the project, and the €650 million overall costing doesn’t include the building of a promised children’s research centre at St James’s.

At this stage, it looks likely that the project will get the nod, given the political and medical consensus behind it and the lessons learned since the Mater debacle. And yet previous iterations of the planning process suggest we should expect the unexpected.