Saturday 22 October 2016

After we dared to dream, children's hospital is about to become reality

St James's is the right location, writes Professor Owen Smith, to finally deliver world-class facilities our children deserve

Owen Smith

Published 19/06/2016 | 02:30

An artist's impression of the atrium in the new National Children's Hospital to be built beside St James's, Ireland's largest and leading adult teaching and research-intensive hospital, in Dublin
An artist's impression of the atrium in the new National Children's Hospital to be built beside St James's, Ireland's largest and leading adult teaching and research-intensive hospital, in Dublin

I have been working in paediatric healthcare for over 30 years, specialising in the provision of paediatric blood and cancer services.

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This means that I have worked with thousands of critically ill children with complex illnesses who are subjected to frightening and sometimes painful treatments which can involve long-term hospital stays and, inevitably, time away from home, siblings, friends and the life that they know. In paediatric and young adolescent cancer we care for infants from birth all the way up to 16 years of age.

Obviously, as is the case when a child is sick with any illness, we also work to support parents and families as much as possible as they seek to deal with some terrifying times while forcing themselves to put on a brave face for the benefit of their child.

We do all this with the benefit of the best possible clinical staff available. We drive forward with medical innovations and invest our time and all available resources to deliver new research in the context of clinical trials which ultimately leads to better clinical outcomes for infants, children and young adolescents with life-threatening blood disorders and cancer.

It has been well recognised and reported that we are doing all of this within the limitations of the physical infrastructure that is available to us. Staff focus on the children but are very aware that the conditions in which the children are required to stay are not ideal. Many of us have spent time abroad as part of our training and doing research. We know what a modern medical institution can look like and we have often visited hospitals like the Boston Children's Hospital and have left with a sense of longing on behalf of our patients.

We have dared to dream that we could deliver something better for children in Ireland.

Many clinicians and medical professionals from across all sections of paediatric medicine have worked tirelessly to help secure a new hospital for children in Ireland. We have been on this road for nearly 20 years and have suffered many disappointments - on our own behalf, on behalf of parents and most importantly, on behalf of Ireland's sickest children.

But now, finally, our dream is about to become a reality.

We have the right location. We have a world-class hospital design - a child-centric design developed around the needs of the patient but with the needs of parents and families also accounted for, we have a children's research institute and two Urgent Care Centres - one at Tallaght Hospital and one at Connolly Hospital.

What we are on the cusp of having is more than we could have hoped for at any stage since we started this long journey. With the vision and commitment of the staff of the three children's hospitals in Dublin, with the political support of successive governments and the loud voices of determined parents who would not settle for anything but the best, Ireland is finally about to get its new children's hospital.

The campus at St James's Hospital is the right location for this hospital. The co-location of the new children's hospital on the St James's site offers many advantages. For adolescents with chronic conditions, it offers a seamless transfer from paediatric to adult services. The many surgeons who treat both adults and children will now be able to work on the one campus. It offers the shared use of complex and rare radiological and laboratory investigations.

In my career, one of the things that I find most difficult is seeing a child having to travel to St Luke's Hospital from Crumlin twice a day for four consecutive days for total body irradiation in preparation for bone marrow transplantation. This is necessitated by the need for them to get access to treatment but it is not an ideal scenario. Once we are all located on the one campus, this issue will be removed - something that will inevitably positively impact the clinical outcomes for children.

St James's Hospital is Ireland's largest and leading adult teaching and research-intensive hospital. It has the greatest number of clinical specialities and national services in the acute adult hospital system. It also has the widest range of adult sub-specialities that can support paediatric services, ensuring patients with conditions whose prevalence does not warrant paediatric-only consultants, get the best support.

The new children's hospital and St James's Hospital have matching levels of service complexity delivered by highly specialist staff. There is a huge opportunity to collaborate on behalf of children.

In the new children's hospital, my patients who are severely immunocompromised as a result of their cancer and its treatment will be able to access, safe, immune appropriate areas that is critically important to their recovery. Our new hospital will have a number of gardens, some which will be dedicated for the use of children who are immunocompromised. There will also be quiet reflective night-time gardens for parents who need time to sit outdoors, close to where their child is sleeping. The needs of child and parent have been well considered.

From my many years of working with families, I understand that one of the major challenges that they face is about accessing parking upon arrival at the hospital. A family dealing with a critically ill child faces insurmountable barriers and challenges every day.

These are further compounded by what can sound like something small but the inability to find a parking space when you have a critically ill child, a nauseous child in the back of the car can be a challenge too far. That is why accessible parking for patients is something that is built into the design of this hospital. There will be 675 spaces allocated to families and visitors. To reduce the burden on parents further, these can be pre-booked so that you know exactly where you go once you reach the hospital grounds. There will also be a drop-off zone and a concierge parking system for those who need to bring their child straight in the door of this hospital.

Through hours and hours of consultation with families and with young people who are former and current users of the system, we have worked with the hospital planners and designers to map out access to the hospital and to create a route and ease of entry which will help parents and children when they need this support the most.

The proposed new children's hospital has strong support from the parents of sick children, from the healthcare professionals who care from them - not only within blood disorders and cancer but across all the disciplines. It is something that many of us have worked toward for the majority of our careers.

The dream is about to become a reality. Children in Ireland are about to get the facility that they much need, and much deserve.

Professor Owen Smith, CBE is Professor of Paediatric and Adolescent Medicine, University College Dublin and Consultant Paediatric Haematologist, Our Lady's Children's Hospital, Crumlin

Sunday Independent

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