Time is of the essence in finding a solution


With so much time already squandered, it is important to recall there are other options, writes DR MUIRIS HOUSTON

THE REJECTION by An Bord Pleanála of the Mater as the site for the much delayed national paediatric hospital is first and foremost a blow to the children of this country. And not just for those who currently avail of paediatric care here but for all children in the Republic, including those who may become ill before this saga finally closes with the building and opening of a new facility.

It would be very easy to focus on the aesthetics behind this decision; that would be a mistake. The key issue now is what is the quickest and most efficient way to build a new facility that meets the criteria set out in the three expert reports already commissioned during the project’s controversial gestation.

The last review group’s report, published in 2011, said “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. We understand that no one site has all of the requisite adult and current paediatric services that make that site a perfect choice.”

The independent expert review continued: “We unequivocally believe that co-locating with tertiary adult and maternity hospitals is essential to the development of an excellent paediatric service. This has become best practice internationally and was recognized in the McKinsey report.

“A good community-based children’s hospital could be developed on a green field alternative but it would not be able to offer the full range of tertiary and quaternary services that can be developed in concert with adult and maternity services.”

So, if we accept that no perfect site is available – including the Mater – then why not move on to agree an alternative? As long as it meets key criteria, including helicopter access, elements of the current NPH design, the inclusion of ambulatory and urgent care facilities and a well thought-out ICT infrastructure. And, crucially, once it includes a co-located maternity hospital, and, if possible, a tri-located solution that includes an adult facility.

The co-location of the NPH with an adult hospital was seen as advantageous by almost all of the stakeholder groups that presented to the clinical review team. And all groups stated that co-location with a tertiary maternity and neonatal service was an imperative.

One solution that must now be considered is Tallaght hospital. It has the space, and if the Coombe women’s hospital were to move there, the minimum criteria of a co-located maternity hospital is met, with the added bonus of adult healthcare on site.

There are other options. The late and lamented Maurice Neligan, in a 2010 Irish Times column headlined “I was wrong about the children’s hospital site”, questioned the need for co–location with an adult hospital at the Mater.

“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.”

With time already squandered, there is a compelling case to find a solution quickly for the future health of our children.