It is 30 years since the Consultative Council on General Hospital Services produced what was known as the Fitzgerald Report which recommended a radical re-structuring of the hospital services in this State. Among its recommendations was one which proposed a new hospital for Tallaght in which the resources of several old and highly-regarded south city centre hospitals would be re-grouped and concentrated to provide care for the rapidly growing population of what was then little more than a south-west Dublin village. Because of political resistance to such radical change, successive governments and Ministers for Health grappled fairly ineffectively with much of the Fitzgerald report, notwithstanding its evident good sense in trying to improve standards in fewer larger hospitals, with smaller less technically advanced hospitals providing basic care on a local basis. Finally, this week, the Adelaide, the Meath and the National Children's Hospital have moved to the fine, if still incomplete, modern hospital campus in Tallaght. Finally the citizens of one of the State's largest conurbations (as Tallaght now is) may begin to avail of the proximity and the excellence of a top-class modern hospital in their area. While the residents of the south inner city will feel understandably deprived of three institutions which they have trusted and utilised for generations they are not, in truth, very far away from the excellent services provided by St James's Hospital. And the Meath, the Adelaide and the NCH have the opportunity and the challenge to forge new traditions and new standards of excellence in Tallaght.
One element of the new hospital's "tradition" has already been forged in a careful and deliberate structuring of the governing board whereby the particular ethos of the Adelaide is bound to have recognition and influence in the policy-making of the new institution. That ethos is predominantly Protestant whereas the predominant ethos in the great majority of Irish teaching and training hospitals is Catholic. Like it or not, it cannot be denied that the ethical code which drives responsible Protestant doctors and nurses is slightly but significantly different (particularly in certain aspects of reproductive medicine) from the code which drives their Catholic colleagues. It is very important, therefore, that there should remain space within the Tallaght hospital for that different ethos to be conscientiously exercised - particularly as the new political relationships on these islands change in light of the Belfast Agreement.
The logistics of moving three hospitals (indeed, four, since St Loman's in Palmerstown will be bringing its psychiatric expertise to Tallaght) on to a new site, some parts of which are still being built and some still to be built, are immensely complex and daunting. Small wonder that, in recent times, there have been expressions of anxiety from sections of the professional staff about the readiness of the hospital to provide all the services promised. No transfer of resources on the scale of the moves to Tallaght could possibly be achieved without some difficulties. But the level of commitment of the people who will run the new institution is such that the patients need have little anxiety about their capacity to provide both care and cure. They deserve everyone's support and congratulation as they achieve this momentous development in Irish medical care.