I was wrong about the children's hospital site


HEART BEAT:This project should be about sick children and nothing else, writes MAURICE NELIGAN

I SPENT my consultant cardiac surgical career between the Mater Hospital in Eccles St and Our Lady’s Hospital for Sick Children , Crumlin (OLHC). The round trip from my home was about 16 miles and the journey became more onerous as the city and its population grew. When the Mater was selected as the site for the National Paediatric Hospital in 2006, I welcomed the decision and wrote about it in this column. I also mentioned that the reasons for the selection and the process employed should be open to scrutiny. I could have saved the ink.

The Mater also was my mother hospital and was and is a very fine institution. The HA and three of our children worked there. Sara had all her working life there before she left long before her time. I was happy that it had secured this prestigious development. It would have been very convenient for us cardiac surgeons and the paramedical perfusion personnel who then worked from both locations.

I was asked recently to review my stance on the project. I did so, and in all honesty I think my original position was wrong. I had unwittingly passed over many little problems. This wasn’t about me, or the convenience of my colleagues or prestigious and academic considerations. It was about the “little problems”, the sick children and what was best for them. I feel that neither the Mater nor the joint children’s hospitals may be best served by this proposed development on a geographically constrained site.

Staffs from the various hospitals to be amalgamated were gathered together recently to be briefed on the current status of the project and to be told the planning schedule for enabling works and final planning permission. They were shown an impressive site model including the iconic tower of the children’s hospital, which would dominate the area. They were told that 1,000 parking spaces would be provided underground. It was to be the paediatric Promised Land.

Given our present economic circumstances, this project is not about totemic architecture, however excellent. It is about sick children and their families.

The Minister for Health warns us that there are to be severe cuts in the health budget. Such cuts will further diminish services to those with no recourse other than to the dysfunctional public system. At the same time we are given to understand that the National Paediatric Hospital with its ring-fenced monies of at least €500 million is to move forward at speed. OLHC has endured ward and theatre closures and lengthening waiting lists for years past. In what way would relocation improve this situation, since many of its problems have their origins in inadequate staffing levels? A much more modest investment on its current site and agreed staffing levels would hold the fort until the sun shines again.

I am surrounded by reams of documents and I am analysing dubious claims such as that hoary old chestnut “best practice”, which can be made to fit a variety of conflicting views. One of the dubious claims here is that the National Children’s Hospital should be in association with an adult teaching hospital. It is not specified why this should be the case.

Indeed, one of the experts consulted by the Task Force told us that he was not consulted on location and added that Dublin’s three children’s hospitals together are large enough to stand alone. Prof Alan Craft, past president of the Royal College of Paediatrics, said his “extensive consultation” had been a telephone conversation with a member of the Task Force. He had not seen its report nor was he involved in making the decision about the site.

It all sounds wearyingly familiar. Crucial decisions were made on limited and selective criteria and without honest debate among those most qualified at home to give advice, and driven by concerns far beyond the welfare of the children.

John Betjeman wrote in First and Last Loves: “Oh prams on concrete balconies, what will your children see.” We can do better, and in view of the fact this National Children’s Hospital is about all the sick children of Ireland, not just Dublin, let’s look for a greenfield site, spacious and easy of access. In these days of Nama and sequestered land banks, such may be available.

A radical thought suggests itself. How about making the nation’s children the template for universal health insurance and devolve to interested parties the building and running of the facility subject to stringent safeguards?