Monday 10 December 2018

Time to take another look at children's hospital plan


Jonathan Irwin

Like many others, I'm jaded and angered by our political leaders' propensity to spend millions on consultants, without actually listening to reason. Instead, politicians, policymakers and project planners who should know better, seem to sleepwalk the country, with the taxpayers' wallet wide open, from one disaster to another.


Expecting someone else to call a halt.

Then the story breaks. All hell breaks loose. We ask 'how did this happen?' Cue the Public Accounts Committee and Big Brother steps up in Leinster House and the nation has a collective jaw-drop.

Most recent examples include the Poolbeg incinerator – that massive phantom project that has only managed to burn up a staggering €100m so far. The list is strangely impressive – Irish Water, pylons and, what annoys me most, the National Children's Hospital are all heavy on consultancy and ultra-light on transparency.

The children's hospital? Some 20 years in the planning, €40m spent and not a brick in the ground!

With 300 very fragile children under the wing of Jack and Jill's home nursing programme and 1,700 families supported to care for their child at home since 1997, I am very sensitive to the needs of the families of a child with special needs. The location of the children's hospital is a vital part of the care programme for the child as they are frequent flyers to the hospital.

Our nurses were asked by the Dolphin Committee for their opinion on the location.

"This time, remember the patients, where sadly, once again, they were forgotten. They are so much more important than medical politics, academic politics or politics politics."

From the outset, I was gravely concerned at the Mater project and was relieved when An Bord Pleanala did its job and exposed the problems with the site. After this major planning collision with An Bord Pleanala on the Mater Site, one might expect the decision-maker to make an airtight Plan B that ticked all the right boxes. Alas no. St James's was the chosen one.

Was this another bad dream? I desperately needed to understand how it was possible that St James's Hospital was selected by the Cabinet.

Rather than relying on soundbites, I felt compelled to read the Dolphin Report commissioned by the Government to help in the selection of the ideal site for the proposed Children's Hospital from cover to cover. It was torture, but I did it. You should try it.

On concluding the Report, I was even more baffled at the decision to go with the St James's site, over the James Connolly Hospital in Blanchardstown which is a much better option. With the exception of access to Public Transport, St James's fails every requirement as demanded by Dolphin; parking, traffic, road networks, access, attractive surroundings, and future expansion. Before the building can even begin, a church has to be demolished, a graveyard removed, trees cut down and ancient light denied to local residents – and that's before one of Dublin's main sewers is diverted to allow subterranean parking floors to be dug. The site is also to contain a maternity hospital and an area to allow the hospital to become the Cancer Centre of Ireland.

Can this extraordinary choice have been made because of the Government's mania to take the three existing children's hospitals and then try to squeeze them into the car park of any existing inner-city hospital?

The thinking behind this project is skewed in the misconception that it has to be co-located with an adult hospital. McKinsey (one of the earlier consultants) did not demand this as an absolute requirement. There are a lot of babies in a children's hospital and in maternity hospitals but not one in an adult hospital. St James's lacks both a neurosurgery department and a transplant unit.

My major concern is Dolphin's vital recommendation that there is available a minimum area of 5/6 hectares for the children's hospital with additional space to expand over the years – St James's comes in at 2.4 hectares (increasing to 3.70h if including a maternity hospital) with little chance to expand. This alone should have eliminated St James's from consideration. I am hugely concerned that we are about to consign our sick children down yet another cul-de-sac. They deserve better.

The Connolly option is rich in space and expansion room (46 hectares), just what our sick children need and deserve. The reality at Connolly, which is beside the M50, is that it offers a "health campus" that can include a modern maternity hospital, a children's hospital and eventually an adult hospital upgraded to a tertiary capability with unlimited car parking and expansion in sylvan settings. And do you know who owns this site? The State!

Now I don't want to get into a head-to-head with the Minister of Health on the location of the National Children's Hospital, but I do have a solution for him.

Re-look at Connolly.

That's what we've been doing. It's got the space. It's a workable solution and I've been quietly working in the background with a number of like-minded people, who won't just say "we told you so" but will be ready to pick up the baton the day St James's is failed by the planning office.

Our children deserve the best hospital possible.

Of course, as well as the bricks and mortar of the National Children's Hospital, I am looking forward to a new hospital culture with Connolly at its centre. A culture where going to the hospital is not a terrifying experience. The entire hospital will be themed around 'Treasure Island' and popular nursery rhymes where hospital care and community care for the sick children are joined up.

The money follows the patient, whether that patient needs to be at home or in the hospital. When we get this element right we will save millions and hospital bed blocking will be a thing of the past. I know from personal experience with my son Jack, who was cared for at home until he passed away (also at home) aged 22 months in 1997. It was in his name that we set up the Jack and Jill Foundation and it was his home care rota that became the blueprint for Jack and Jill. Since 1997, we have supported 1,700 families to bring their children home.

They baffle the doctors, doing much better and deriving some inner strength from being at home. Others are brought home to die but truly leave their mark. Pioneers like Jack. These children have no voice and we owe it to them to ask the right questions at every stage of the development of something as important as the National Children's Hospital.

I do believe that Mr Reilly wants the best hospital and homecare for our children. While there are a lot of budget dots to be joined up with the HSE (maybe when we have many of those dots) where there is a will there's a way.

Let's just do it.

Irish Independent

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