Heart Beat:"For secrets are edged tools And must be kept from children and from fools" - John Dryden
Possibly many of the problems regarding the concept, siting and development of the new children's hospital derive from the layers of secrecy with which the project has been shrouded. The children, of course, are seen not to count and the rest of us answer for the fools.
This is a very big project, very costly, and with long-term consequences for the wellbeing of the nation's children. We would all like to know that everything about it is above board, that the right location has been chosen and why.
We would like to know the basis for this choice and the opinions of those consulted. It may well be that the right choice has been made; so let's know everything. It is our entitlement.
I suppose it was a mixture of cowardice and the simple desire to lead a quiet life, which has largely kept me out of this controversy. Now I find that writing this column places me in a difficult position.
For over 25 years I was a consultant cardiac surgeon in the Mater hospital (the National Cardiac Surgical Unit) and also in Our Lady's Hospital for Sick Children in Crumlin. In both fine institutions I have very many great friends.
If, in my hopeless endeavour to sit on the fence, I find that like Horace, "Brevis esse laboro, obscurus fio" (I try to be clear, but am merely obscure), you will understand my predicament.
A couple of things bother me about the initial process. Firstly, why did we need McKinseys, worthy as they may be, to carry out this audit? Have we not got enough experience inhouse? Secondly, how much did it cost? It seemed to have been completed in a very short time. These are legitimate questions, no place for secrecy.
However derived, the conclusion that the needs of children would be best served by one centre of excellence was accepted by all interested parties. This was merely the calm before the storm as any prescient observer of the Irish medical shambles could have foretold.
It is my understanding that each contending site made a submission to the deciding body as to its suitability for the location of the new hospital. I believe that all intimated that they would accept wherever was chosen. It is not clear if the possibility of a standalone, state-of-the-art facility on a greenfield site was ever considered. If not, why not?
We were told that the new hospital should be co-located with an adult teaching hospital. We were not told why nor by whom. Many frontline children's hospitals are not so situated and manage very well indeed. Furthermore, it was suggested that there should be a maternity hospital also on site. Our children's hospitals have survived for very many years without this premise. What is the necessity for this now?
In the same way that the adult teaching hospitals made their submissions to the group, I presume the paediatric hospitals did likewise. If not, I simply cannot understand why they have waited until now, when the decision, for better or for worse, has been made and the process was moving forward.
The answer of course is the fact that some liked the chosen location and some did not. The result: threats and blusters and cries of "we're not playing any more".
The problem here is that they don't own the ball and there's no point in running to Mammy, because she has firmly indicated that she is not for turning. Less firm apparently was the Taoiseach who is said to have had misgivings about the chosen location. I am alive long enough to be extremely sceptical about these "misgivings". I would rather think that this is merely an effort to keep everybody onside until after the election.
"Ah, you never know what'll happen, sure nothing's decided finally yet," classically accompanied by a wink, but in this case not by a nod. The Cabinet, no less, is standing firm on this decision; "let yiz all shut up now". I ask myself, where in the world would the cabinet in a democracy become involved in an issue such as this?
But there are serious questions to be answered. It is alleged that the deciding body contained no working paediatricians and that the level of consultation with the involved children's hospitals was minimal.
It is alleged that overseas experts consulted on the format gave no preference for any particular site. We were subtly led to believe that they were somehow involved, and that this was not merely a home town decision. Sadly such dissembling would be par for the course.
Many other questions have been raised and not answered. Who is right about the access to the various sites, and in any case does this matter very much? No matter where you go, someone is going to feel aggrieved and boy, aren't we great ones for a sense of grievance?
We don't know about room sizes, parents' accommodations, play areas, light considerations, green areas, etc. Give us all an idea and commitment as soon as possible. Remember, no secrets, no silences, because rumour and misinformation fill the gaps.
In any case, this is going to be a long time coming, wherever, if ever it is. Let us give credit only when the doors open and the petty rivalries are left behind.
I must confess that I do not see agreement on any chosen adult site within the city. They must all be, as Dr Pat Doherty of Crumlin put it, "suboptimal".
Lastly, the provision of the soon- to-be-vacated (?) site of Mountjoy to the Mater site would seem to answer most questions.
Is this too obvious?
Maurice Neligan is a cardiac surgeon.