Our best chance of a world-class children's hospital


OPINION:OUR LADY’s Children’s Hospital, Crumlin, plays a unique role in Irish healthcare. On a daily basis, sick children from every corner of our island attend Our Lady’s with their families to receive expert care.

Every child who is diagnosed with cancer attends Our Lady’s, as does every child diagnosed with a congenital cardiac condition, every child diagnosed with haemophilia, every child with a major burn. And the list continues.

Our Lady’s provides over 80 per cent of the tertiary paediatric care nationally, including the national programmes for haematology, oncology, cardiothoracics, rheumatology and extracorporeal membrane oxygenation.

It also houses the National Burns Unit, National Cystic Fibrosis Referral Centre and one of the largest paediatric intensive care units on these islands.

The National Paediatric Bone Marrow Transplant Unit and the National Centre for Medical Genetics are additionally located at Our Lady’s.

The view of the hospital board is that given the importance of the role Our Lady’s plays in Irish paediatric healthcare, it is incumbent on it to ensure that it makes clear its very strongly held views regarding the development of the new children’s hospital.

In considering its position, the board placed at the forefront the opportunity for an integrated model of care in line with the Children’s Health First: McKinsey Report (2006) principles and the absolute requirement to develop the tri-location of acute paediatric, adult and maternity services to benefit children and adolescents.

The report identified 25-plus specialities an adult hospital should ideally have to provide the best clinical synergies benefit for a colocated children’s hospital.

The board strongly believes the St James’s Hospital campus offers exceptional opportunities to further develop clinical synergies which will directly benefit children and young people as it currently provides all bar three of these specialities.

The St James’s proposal for the new children’s hospital offers an outstanding opportunity to develop a single campus where expert care can be provided for acutely and chronically sick children from birth through to childhood and adolescence into adulthood.

In particular, the board of Our Lady’s is aware of the enormous challenge of providing care to adolescents as they transition from child to adult services.

In line with the McKinsey principles, the extensive range of clinical services within St James’s Hospital will allow for the establishment of a truly integrated model.

This will not only allow for organised transition of care from child to adult services, but allow for the first time in Ireland the subspeciality of adolescent medicine to be firmly established and developed across the widest possible range of services.

The quality of the care delivered to children is inextricably linked to ongoing acquisition of new knowledge and the skills of the professionals delivering care.

Consistent with this, the board of Our Lady’s has always supported the need for active research. It is proud of the research facilities (the National Children’s Research Centre) on the current Crumlin campus.

The wealth of research and core facilities available on the St James’s campus includes the Molecular Medicine Institute, the Clinical Cancer Trials Unit and the Welcome Clinical Trials building which is under construction.

Coalescing the facilities and programmes from both adults and paediatrics will encourage exciting synergy in state-of-the-art research methodologies and the greatest possible translation of novel therapies from the laboratory bench directly to children’s bedsides.

Our board also recognises the importance of the education of the next generation of healthcare professionals for all disciplines at the undergraduate and postgraduate levels.

We envisage a new children’s hospital that provides a research and educational environment which is truly a national resource available to all paediatric health professionals throughout the island.

Such a hospital can aspire to the achievement of world-class status.

The board recognises the challenge faced by the review group and Our Lady’s will, of course, support the ultimate decision the Government makes.

However, we are convinced the proposal to build the new children’s hospital on the St James’s campus, together with the future development of a maternity hospital, offers the best option for the care of children and the long-term interests of paediatrics.

This proposal will very significantly improve the services for the children, adolescents and families we serve.

We are convinced we have an exceptional opportunity to develop a world-class centre of integrated acute healthcare in Ireland, one which will serve children and their families for decades to come.

Critical to the delivery of high-class, evidence-based clinical care for children from a single national children’s hospital is an absolute acceptance of the fundamental importance of integrated (physical and operational elements) education and research, together with the range of clinical services within that hospital.

Exemplar sites internationally already operate such models of care.

We must now ensure Ireland will have the best model of care to deliver state-of-the-art paediatric care to our children.

John Hennessy is deputy chairman of the board of directors of Our Lady’s Children’s Hospital, Crumlin

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