Sunday 23 October 2016

St James's a bad location for a children's hospital

Dr Eamonn Faller works in St James's Hospital and sees first hand why locating the children's hospital there would be a serious mistake

Eamonn Faller

Published 12/06/2016 | 02:30

Minister for Health: Simon Harris Photo: Kyran O'Brien
Minister for Health: Simon Harris Photo: Kyran O'Brien

The location of the new children's hospital is something that I care deeply about. Today, I'm a doctor who works in St James's, but a decade ago, I was that sick child, travelling up from Galway to Crumlin for chemotherapy. I was diagnosed with non-Hodgkins Lymphoma when I was 14.

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During that awful time when I received excellent care in inadequate settings, the idea of a new, easily accessible hospital with ample parking genuinely delighted me.

More than a decade after being that seriously ill child, I'm now a doctor. Not only that, but I work in St James's. It's a great place to work and a fantastic hospital, but it is not a suitable place for the National Children's Hospital. The site is not just less than ideal, or only okay, it is catastrophically wrong.

I listen with dismay as the arguments about the importance of accessibility and adequate parking don't seem to be cutting through.

Those in favour of St James's say the children's hospital must be co-located with an adult hospital. They are vague about the reasons because it's not going to save any lives. They cite Luas stops when asked about access. These people clearly don't understand the reality of being a seriously ill child or the parent of a seriously ill child.

I'm willing to wager that neither the CEO of St James's, or our current Minister for Health Simon Harris, or our former ministers Leo Varadkar, James Reilly or Mary Harney, ever had to jump out of their mother's car to vomit at the side of the road while, close to tears, she drives desperately around Crumlin, searching for a parking space.

An extra hour in a car each way for the sickest children is heaping misery upon misery. Among the most visceral memories I have of the whole experience is being spread out across the back seat of my parent's car, nauseous and weak, crawling through Dublin traffic and wishing every second of that car journey away. Twice a week, every week, for six months.

And what about the very sickest children? The single worst hour of my life was when, after needing an emergency transfer by helicopter from Galway to Dublin, I needed an ambulance transfer from Baldonnel to Crumlin because the air ambulance couldn't land in the hospital.

You won't be able to land a large air ambulance on the St James's site and there are plenty of the worst hours in store for the desperately ill children who attend that hospital. The location of St James's will penalise the sickest of children. It's unconscionable.

Until the people in charge experience these things, as patients or parents, the actual wellbeing of sick children will remain an abstract concept to them. It's not their fault, it's just a fact. And as a result, it's looking like the Government, for political reasons, will place an institution's interest ahead of the welfare of the children in this country.

I often wonder do politicians and the various decision makers in this process even realise that is what they are doing? Do they realise how decisions are made in our health service?

With, first, the Mater site and now St James's, do they realise the torch was passed from the most powerful medical institution with the most effective lobbyists to the second most powerful medical institution with the second most effective lobbyists?

Do they realise the needs and desires of our sick children and their parents have been ignored by successive governments? Do they realise patient welfare and future planning are coming, as usual, a distant second to political convenience in terms of importance to our Government?

Every day as I work in St James's, I still can't believe this is the anointed place. I enter via the back gate every morning (the future front entrance of the children's hospital) and even before the 10,000 arrivals and departures per day, the road leading up to it has tailbacks hundreds of metres long.

I then pass the proposed site of the future maternity hospital, an impossibly cramped space that will require clearance of a recently built out-patient department.

I look around my workplace, nearly hoping to find a source of evil and greed that has made it place its own institution over the welfare of the children of this country. But I find well-meaning people - most of whom are against the idea of placing a National Children's Hospital at an already congested inner-city site with woefully inadequate parking - doing good things, not evil at all. And this makes me realise something. The powers that be in St James's are simply doing their job, trying to enhance what is a very good institution. Maybe they don't realise either?

Look closely at what's being said. The people who just want a hospital, regardless of location, tend to be based in Dublin and its surrounds. The people who disregard arguments about accessibility, parking and cost, cite the completely baseless co-location argument as an acceptable reason to place the hospital at an otherwise hopelessly inadequate location.

As a doctor, I would not be writing this if there was any evidence to suggest that a single child's life would be saved by co-location with St James's. As a staff member in St James's, I wouldn't be writing this if I thought the cramped, inner city site's suitability even approached that of the accessible and unencumbered Connolly site. I don't want to dredge up my past as a cancer patient, I don't want to have to be critical of what is an excellent hospital and workplace. I don't want to be writing this piece.

But honestly? I feel obliged to do it. I have a unique perspective and, frankly, my 14-year-old self, be it vomiting at the side of the road in Crumlin, or being loaded into an ambulance on an airstrip on a stormy night in Baldonnel, would never forgive me if I didn't speak up.

Eamonn Faller is a 26-year-old medical doctor currently working with the infectious diseases and HIV service in St James's Hospital. Originally from Galway, he trained in Trinity College, Dublin, graduating in 2012.

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