Paragraph dropped from review on hospital location


THE FINAL report of a review of controversial plans for the Children’s Hospital of Ireland – commissioned last May by Minister for Health Dr James Reilly – dropped a paragraph saying a greenfield site would be “the ideal location” for the project.

The review endorsed plans to provide the 585-bed facility on the Mater hospital site in Dublin. A 14-day oral hearing by An Bord Pleanála on the scheme concluded last week, and it is expected the appeals board will issue its decision early next year.

The review panel’s chairman, Jonathan Erskine, told fellow members he had removed the relevant paragraph because of his concern that, if it was included, “the response will simply be that there is such an ideal site, and the issue will open up again”.

In an e-mail marked “Confidential: not for public circulation”, Mr Erskine, executive director of the European Health Property Network, a research and management organisation – told the panel members he had removed another reference to St James’s Hospital as an alternative site.

The draft had said: “The ideal location would be located on green space, provide for unfettered access, accommodate research and educational activity, provide sufficient space to ensure the aggregation of all patient care services meeting current and future requirements, and be tri-located with an adult tertiary care and a maternity facility.

“We agree that if there was a site and funding for such an aspirational location, it would be a magnificent campus. Unfortunately, given the current challenge of funding the one children’s hospital, the perfect location is not possible. Consequently, the team considered those options that were viable.”

In relation to St James’s Hospital, which occupies a site nearly four times larger than the Mater, the draft said: “The only other site that met the co-location criteria was St James’s. Unfortunately this location offers no advantage over the Mater site and in fact presents similar if not more constraints to those identified at the Mater.”

Mr Erskine’s e-mail, to four fellow panel members – all chief executive officers of children’s hospitals in London, Boston, Colorado and Queensland – and copied to department officials, said he was “not sure if the St James’s question should be introduced in the conclusions”.

In both cases of text being omitted, he asked whether the others agreed.

He also added the following paragraph: “Furthermore, the first part of the independent review – financial analysis and cost comparison – has concluded that there is no significant difference in the cost of constructing the national paediatric hospital on the Mater site, compared with a number of notional alternative sites.”

The final report, delivered to the Minister last July, noted “it is sometimes said that ‘the enemy of excellence is perfection’. Of all those who were critical of this site, none offered concrete alternatives. Rather, there was comment about the specific attributes of an ideal location that were absent from the Mater site.

“The reality is that no perfect site is available, and consequently the review team considered those options that are viable and achievable,” the report concluded. “Accordingly, we recommend the Mater site as previously proposed.”

The e-mail from Mr Erskine to his colleagues, dated June 24th last, was discovered from the department under the Freedom of Information Act by the New Children’s Hospital Alliance, which has opposed building the facility on the Mater site for a variety of reasons – including patient care, access and physical layout.

Dr Roisín Healy, retired consultant in paediatric emergency medicine and a member of the alliance, told An Bord Pleanála last week that the independent review “was never presented with a list of alternative sites or options, nor was its function to assess such. Therefore, it is not valid for it to state that no ideal site exists.”

I removed ‘The ideal location would be located on green space . . . We agree that if there was a site and funding for such an aspirational location it would be a magnificent campus . . .’

My concern here is that if the above text is included, the response will simply be that there is such an ideal site, and the issue will open up again. Do the CEOs agree?

Jonathan Erskine, chairman of review panel