You are in Sallins, your child is 5, the nearest A & E is Naas (if it hasn't been closed by then) but they won't see any one under 15, you put your child into the car and start moving, where to go Tallaght doesn't have an A & E it now has a "Ambulatory and Urgent care centre" that shuts at 10 pm, the nearest children's A & E is in Dublin far side of O'Connell Street.

You leave the husband with the rest of the kids or you get a neighbour to come in you tear up the dual carriageway, paying the tolls at the toll gates, that went in after Cowen sold the country, you get to Newlands, oh the traffic, the traffic, she is looking worse and worse, why is the traffic moving so slow, every traffic light seams to take and age, the mobile is ringing, he reminds you there is a concert on in Croke park that night, he's ringing ahead to see if the guards will escort you in you but you still have to get there. Do you take the Luas, Friday night, sick child even if you did you would still have to run up O'Connell street and transfer to the northern line (if its finished by then) before you get there, you press on. You get there but its an hour or so later than it would have been if you had of had a children's hospital closer to you. Closer to where most people live.

Because it took so long to get there your child is sicker than she would have been if you had of burst through the doors of a children's hospital in closer, it is too late, the illness has taken hold, yes they start to treat but it will be a long long road to recovery, Viral melingitis may mean that your beautiful child may never fully recover and you will have to care for her for the rest of your life.

Over the following weeks that she is in hospital you face the daily grind of the travel across the city, you and your husband meet in the street and pass over the watch, some times he finds a spot to park within a ½ mile or so of the hospital, 1000 spaces hope sly inadequate for a hospital with over 1000 staff, thousands of OPD visits and many many parents like you not wanting to saty away from their child while in the hospital.

Over the days the costs mount, the parking, the traffic fines the costs of eating in the franchised restaurants in the hospital. Loos of earnings, You have other kids also to care for, 2 hr comute, you see your husband in the car park as you cross over the batton of care for her. You go home grab some sleep and hope you wake in time to collect her brothers from school. They are suffering to cos you just ain't around for them. All because Mary stuck to her guns and a engineered report.

This is the future of children's care in Ireland

There is a little plaque in the South Dublin inner city, where I used to be, in 1825, two mothers, pregnant set out to reach the only maternity hospital, in the rotunda. They were pregnant and needed help. It was snowing. The next day their bodies and those of their new born infants was found in the snow. Such was the public emotion around same that a new lying in hospital was founded in 1826 on the south site of the city by a committee lead by Margeret Boyd.

Are we regressing to an 1825 care level. How many wil have to die or suffer unnecessarily on their way to the Ahern site before sense is seen.

We need two accessiable secondary care hospitals in Dublin one can be teritary care also.

The NPH as currently planned fails to meet some relevent National Standards.These National Standards were recently proclaimed by the Health Information and Quality Authority.

The very first standard is about putting healthcare service users at the centre of service design, planning and delivery. It includes requirements that the needs and preferences of service users be demonstrably be taken into account and that care is provided at a time and place that is accessible and convenient to service users, where this can be achieved safely,effectively and efficiently.

The standard is described as important as it ensures that the needs,values and preferences of people who use the service and their carers are respected and taken into account when designing, planning and delivering services.

The designing and planning of the NPH to date does not meet these requirements for a patient centred service. Further it is not the most efficient option available for delivering on the specification for a NPH

Active improvement measures are needed to close the quality gap and bring the substandard development up to the National Standards for Better Safer Healthcare. These need to be attained as they will in due course form the basis of a licensing system. The first time is the time for getting quality right.

A Statutary Development Board for a service is not at liberty to ignore the National Standards. If standards are not met HIQA is required to act and as is currently the case of one new hospital delay the opening of services until corrective measures have been undertaken.

It is now opportune to provide "a stitch in time" for the plans for the NPH.Just do it and get on with continously improving the project in an accountable manner.

Regrettably, it is NOT the right location to service the nation agenda.The location may well be suitable for different level of service to children in its more immediate catchment area.

Defenceless children suffered abuse by certain self-serving persons in positions of power. Likewise, we do not wish our children's wellbeing held to ransom by self-serving politicians in power.

STOP this irresponsible 'victory' of short term local self-serving political and vested interests over strategic national needs. Having to rectify the investment mistake in later years will make it even more uneconomic and unpalatable. The EU/IMF may have to safe us soon -and there'll be no anaesthetic in that operation!START and FINISH with the national children's interests as no.1 - they deserve a world class facility.

The remaining Development Board Members consider their position -and be held accountable for their actions and fiduciary responsibilities by the ODCE!

The Minister should simply RESIGN! We know she's inflexible -so she's nothing left to prove.

Frontline healthcare will be severely hit if Health Minister Mary Harney oversees up to 1bn in cuts as if it's not already in jeopardy.

MOVE THE NEW CHILDRENS HOSPITAL TO A GREENFIELD SITE as proposed by developer Noel Smyth. Noel has stated that he is waiting for the go-ahead to give a presentation to the board of the new national children's hospital on how the hospital could be BUILT FOR LESS on a site close to the M50 - 150 MILLION LESS than planned.

WAKE UP MINISTER & the rest of this so called Government - there is your first saving already.

AND as per yesterdays Liveline Poll on RTE Radio, 9 out of 10 callers were opposed to locating the hospital on the Mater Site.

I beg once again, can we please stand up now before it's too late and lives are lost - we have to organise a march sooner rather than later.

It seems to me that if you don't agree with the government, you will be cast aside, ignored & they will do what THEY want - not us the paying public.

Mary Harney has said she requested the resignation of the former chairman of the Children's Hospital Development Board, Philip Lynch - could this be because Mr. Lynch pinpointed funding issues and planning challenges at the site as the reasons for his resignation???

It's high time we stood up to these bullies, PLEASE, PLEASE arrange a march as soon as possible.

Auld yins like myself would stand with them if we were up from Culchieville.

My wife wants to break their car windows - start an era of civil disobedience.

well can they please tell me (the Government) why so many educated people are against having the new hospital located at this site? Have they not lerned yet how to stop throwing our money away. The children of Ireland in the future will need to be able to get to the hospital as quickly as possible and not spend precious time stuck in traffic in the middle of our capital, it would make sense to have the hospital in a location that has relative easy access to it and connon sense would prevail

Is the decision of the proposed site about the children of Ireland or about something else? If it does go ahead I hope I will never have to travel to Dublin with a critically ill child. because it could be fatal by the time we arrive there! I am sure most parents who live far away from Dublin, will agree with my last sentiment.

This proposal is completely unsuitable for the needs of the parents. This decision must be reversed. The Mater area is congested and difficult to get in and out of in an emergency. When building, there will have to be major undertaking with regard to underground parking and local infrastructure connected to the hospital. How many millions will that cost?? There are plenty of sites outside the Dublin area. I would suggest a complete rethink at the earliest opporunity. What is important are the needs of the children and their parents. Every other consideration should come second with regards to building a Children's hospital

I commend this website for it's continued good work and hopeful the truth will out. The sooner the better.

If Metro North is announced as "delayed" during the budget then the Mater site should be dropped immediately in favour of an M50 site.

NAMA has vast tracts of M50 accessible lands under its control along the North Fringe, Naas Road, Sandyford etc....all more suitable locations for this much needed facility.

In the ever expanding list of why Bertie Ahern is an embarassment to this country, the pressure he exerted to locate the Childrens Hospital in his constituency, still ranks as the most shocking example of his ineptitude and griminess....never mind the cupboard advert or the horseracing 'winnings', he will go down in history as the man who set back childrens health by decades with his interference.

There is a trend on this web site to medicalise understanding of the needlessly wasteful plans being processed for the new childrens hospital at Eccles Street and Temple Street, as for example by Andreas and Joan on 28/09/2010.

From a management perspective the phenomenon can be captured by the description of a form of group think known in management studies as the Abilene Paradox. Google for info on the paradox. It is a less excusable explaination than a medical one for not persuing other cost efficient effective options. There is no acceptable excuse on medical grounds.

Highlighting the massively wasteful proposal and the inability of those involved to breakout of a course of action and comeback to earth should help. I hope some responsible higher authority takes action.

Ireland does not need to add unnecessarily to its debt. The group making the proposals are behaving no differently to the developers who created the current national financial crisis. The group needs to be redirected or suspended. Plainly its members are locked in and cannot change by themselves.

More than five of the ten traits listed for a narcissistic personality disorder (NPD) in the Diagnostic and Statistical Manual of Mental Disorders IV are being displayed in the approach to the choice of site for the NPH.

" Narcissisists gravitate towards professions where they can control people and elicit adulation. They are more likely to work in politics,finance or medicine than shoemaking" (Sam Vaknin). If not admired they settle for inspiring fear or hatred. They enjoy the power of intimidating people. Our culture that celebrates image and spin affords opportunity for expression of narcissistic traits.

As people expressing NPD are unable to emphatise they are indifferent to the consequences of hurting people. In finance in particular they are able to make quick bold decisions without thought for the consequences these have for other people.

So while it may be vanity,as per Napoleon, it may also be group NPD (previously known as megalomania) that is preventing cost efficient decision making. There is no self cure. The guardians of the public purse need to act.

For the article that triggered this bit of (pop) psychology http://www.ft.com/cms/s/2/5ff67be2-b636-11df-a784-00144feabdc0.html

Aspiring to reach upwards and onwards without limits to the stars has resulted in the skyscraper design. Expensive rocket science for reaching the stars is not required to deliver high class patient centered hospital health care.

Thinking patients and children first leads to a different set of aspirations that may result in a much more cost effective design facilitated by an open mind to identifying the optimum site for delivering an efficient and effective answer to the primary needs.

M McGill identified the waste of taxpayers money intrinsic in current proposals.Normally public expenditure is regulated by applying Value for Money methodologies when making decisions on available options This exercise does not appear to have occurred. This now needs to be urgently provided.

The Controller and Auditor General who last week reported on waste in public expenditure should be immediately asked to assess the comparative VFM provided by the options and justify the expenditure involved in the combined TempleStreet and Eccles Street site option.

Quality at the right price is a well known Irish phenemon. Lets apply it to the information provided on the web site about the proposed childern's hospital.

It seems that the hosiptal is to be located in the city centre and is to spread over two locations. That the DoHC estimate that inner city building costs twice the price to achieve the same structure. That when the costs are added up the project will consume more than one billion euros.

At half the cost the same structure could be delivered on a greenfield site. Such sites are available and seem to have additional desirable features for patients. That on other sites a more efficient design is possible as the space constraints of the two small inner city sites do not restrict options, thus further reducing the building costs.

Changing location and achieving the right price would free up approximately half a billion euros. Just think of the additional features and care the would be possible. Think "quality at the right price" and reap the benefits for the care of children's health services.

The new children's hospital at a minimum needs to reflect these considerations. Common sence suggests a comparable approach to desigh to that taken at Crumlin is one viable solution to this infection control aspect of safety.

I can only welcome the provision of single rooms for patients. I presume the justification is the miminisation of hospital cross infections.However the whole effort seems to be very much set at naught by the highrise design. It would necessitate very special ventilation systems to eliminate the transfer of organisms from floor to floor. External wind air pressures can ealsly cause backdraft spread unless the desigh provides self contained air management for each floor,both above and below ground level.

The other design feature that is an infection control hasard is the many lifts, almost thirty it is believed. Safegarding against this consequence of the design is expensive requiring air tight lobbies with air exrtaction around lifts at each level. It seems impossible for patients to circulate from their relatively safe room to other areas for diagnosis or care without sharing the circulation channels, i.e. the lifts, with the micro organisms of other patients. Staff too have to use the same channels of circulation. The hasards created by the vast number of lifts could be avoided by use of a lower structure. Some facts to assure that the desigh has addressed the infection safety issue would be timely. I would wish to be assured that the lessons of the SARS epidemic have been learned.

Guess what the aggregated additional cost to the project will be. I would venture a guess of not less than 30M euros. Add that to your sums of additional capital expenditure that contribute to the uncertainty about the real cost of the capital project.

This decision can be retracted, the economic mess cannot. It's not too late. remember, the ONLY thing policians respond to it the possibility of losing their Dáil, Co. Council or Senate seats.

I sincerely urge that this decision be reviewed.

Before I could consider supporting the locationof the new hospital on the Mater site, or indeed on any site, all matters concerning the mix of public and private children patients needs to be agreed and made explicit. I agree with Bibi.

The silence on how the new hos[pital is to function in our two tier system is deafening. Nonetheless the information must be there in the business case and in the projected revenue budgets which contain figures for income from private parients. Let these figures be known. They are part of the justification for locating with the Mater.

A little story to share!
The CEO of the NPH and a member of the design team went out to the NCH at Tallaght to meet with children's staff there. The meeting started late as the Design team member was having difficultly parking her car! How ironic! One of the reasons repeatedly given for choosing the mater site was the "public transport links". However they came by car from their city center offices even though Tallaght and the city center are linked by the state of the art Luas line! This is true check it out!

Its ok for parents of sick children with their sick child to travel by public transport ( and the many staff who will be travelling to work before 7am and leave after 8pm at night, shift work is part of hospital life), but not the these people who are making decisions!

I think this sums it all up! Who maters? not the children!

To add a little to transparency it should be noted that no money will become available from a sale of Temple Street Hospital. It seems that the design team have found that the constraints of site available on the Mater campus are such that the Temple Street site is now also needed to help provide many of the functions originally specified for a National Children's Hospital.

Thus apart from not gaining approx 100M Euro's from disposal of the Temple Street site, further money will be needed to upgrade or replace the old Temple Street so as to provide modern facilities (say an additional 120M Euro) . Money will also be needed for integrating circulation corridors for shuttle arrangements be they underground, street level or aerial in nature. ( say 15M Euro).

A further change from the original plan for a single hospital is flagged in a letter in the Irish Times of 1/9/2010 from the Chairperson of the Tallagh Hospital Action Group. A 30M Euro back up satellite paediaric EM Department is now found to be required at Tallaght.

Thus it should be recognised that at least a further 150M euro that is not in the present stated ballpark cost should in a transparency setting be added to get near to the real cost.

It is time to consider what would be best for children and their parents rather than political and medicopolitical issues.

Mary Harney, the Minister for Health and Ciildren should show real leadership and move the National Paediatric Hospital on to a greenfield site. Co-location should take place with an acute Maternity Hospital.

Keep up the good work

"The Department's Hospital Planning Office(HPO) previously developed cost per bed estimates which were said to assume that the developments were on "green-field" sites with normal ground conditions, ample space for normal development and surface level car parking, reasonable access to nearby services and unhindered site access. The HPO concluded that acute hospitals also vary significantly in cost per bed depending on the mix of specialities and teaching requirements and pointed out that inner city locations can also add dramatically to the construction costs."

Page 23. Appendix 2, Worksheet 4:
Capital Costs : Major Teaching Hospitals

AverageTotal Cost per Bed (2007) 1,000,000
Building on average per bed (2007) 700,000 ( 70% of total cost)
Equipping (2007) 300,000 (30% of total cost)

AverageTotal Cost per Bed (2009) 828,456
Building on average per bed (2009) 557,340 (70% of total cost)
Equipping cost per bed (2009) 271,116 (30% of total cost)

The children's hospital will, we are told, have 392 beds. At an average cost of 828,456 per bed ( Major teaching Hospitals, 2009 prices!,DoHC figs.) this would be 324,754,752. Rounded up to 325million it is precisely half of the 650 million we are told the hospital will cost .

"Inner city centre locations can add dramatically to the construction costs" or so the DoHC Hospital Panning Office tells us in the above excerpt.. This 100% addition to average cost is stunningly dramatic. Could the Taoiseach and Government please take control of this madness. We are in the middle of a recession.We have vulnerable children on the streets whom we can't seem to provide for. Greenfield sites are available near the M50-cheaper to develop and much better for our children and families from all over Ireland.
A General Election anyone?

Over the past few years, every time the New Children's Hospital comes up in conversations i've had, the first thing everyone asks is "Why ever did they choose the Mater site?" I have yet to hear anyone who agrees that the Mater site is the right place for our new Children's hospital. In fact, they not only disagree with it, but do so vehemently. Of course, I am only talking to ordinary people from Dublin and around the country - parents, grandparents, teachers, nurses, office workers, shop keepers, plumbers, electricians, gardeners, etc. The reasons against (poor access, lack of expansion space, lack of green space, lack of sufficient parking etc) have been aired on this website and in the media, but the politicians and those on the development board do not want to listen to reason. Their main argument at the moment is that they have already put a lot of time, effort, planning and money into the Mater Site, so it has to go ahead. What kind of an argument is that? The site can still be used for a secondary children's hospital, but not for the main tertiary children's hospital. Our country's children deserve better.

At a conference in Dublin Castle, June 18th 2010 entitled "The New Children's Hospital" organised by Children in Hospital Ireland, Minister Mary Harney said that she wanted the new hospital to work from "day one". But, will it work on day 3650, ten years on? Will patients and their parents be able to access it easily and stress-free? Will there be room for all the patients and the research which is such a necessary part of a "gold standard" hospital? Or, as is the worry of many, will some of the patients and the research be sited elsewhere in a few years? As for parking, we all know there is never enough parking and how could there be in such a confined space? Has the Mater site been "future proofed"?

At the same conference, Professor Drumm stated that we owe a "huge debt of thanks to the tax payers" Too bad the tax payers were not consulted! Emma Curtis said they had had "lots of meetings about what the new hospital should have in it." There was no mention about the meetings to discuss the suitability or otherwise of the Mater Site. From that, I only assume there was none as it was a fore-gone conclusion. When it came to green space, there was great praise for the lovely views of the Dublin mountains from the upper stories of the proposed hospital. There are two problems with that scenario. Firstly, the views could very easily be blocked by another building in a few years time. Secondly and more importantly, children do not appreciate views. They live in the here and now. They want to see, touch, taste, smell, hear what is immediately around them. When we took our children, aged 3 to 6 up the Sugar Loaf many years ago, I was trying to point out the views to them, but they were not interested. They were playing house on the top of the mountain and I am sure many parents have had similar experiences with their children, espcially when on holidays. We were told at this same conference that there will be a roof garden on the 6th floor, but that can hardly be sufficient for all the children in the hospital who would like to play outside? The need for sufficient, accessible green space cannot be over-stressed. It is so therapeutic for all of us, whether healthy or not, but especially when we are ill.

I come back to my first question, "Why ever did they choose the Mater site"?

As it is a general hospital, containing all the necessary facilities, there can be no logical reason why it shouldn't be stand-alone, as are many of the great Children's Hospitals worldwide, for example - Gt. Ormond St. (London), Alder Hey Children (Liverpool), Melbourne Children's, Sick Children's Toronto, Children's Hospital of Philadelphia.

The views of real experts and professionals in the field of paediatrics such as the staff and parents of Our Lady's Children's Hospital, Crumlin, from whence this group emerged in early 2002, spurred on by none other than current HSE CEO, Prof. Brendan Drumm, have been largely ignored by NCHG in the current debate about the provision of a World Class Tertiary Children's Hospital for Ireland.

A survey undertaken by the Board in Crumlin in 2008 shows that far from supporting the Mater site as the new location for the NPH, health care professionals and parents there have very real concerns about the site chosen and the manner in which it was chosen i.e. 89% of Crumlin parents surveyed disagreed with the site chosen, 75% of Medical Board members did not support the establishment of the new NPH on the Mater Hospital campus and the vast majority of Crumlin nurses, allied health care professionals and administration staff did not support the chosen site as evidenced from signed petitions to the hospital Board. How are these views represented by Louis Roden and NCHG?

The former CEO of both OLCHC and the ERHA, Michael Lyons was damming in his criticism in an article in the Sunday Business Post in November 2007 when quoted as follows-"I can say now, having thought about it, that the process of planning for the new hospital has been the most flawed one I have ever encountered in my career in the public service. It lacked transparency and was not inclusive. As far as I can establish, little or no cost benefit analysis or options appraisal were conducted either in relation to the Mater site itself or in relation to comparing alternatives."

NCHG together with Minister Mary Harney and Prof. Drumm have failed to heed the collective critical voice of OLCHC and many others, now including Maurice Neligan, in their desire to have a new hospital (any hospital will do!) built and opened without further delay on the Mater site. They are ignoring the well founded, genuinely felt and reasonably expressed doubts about the model of care, access, quality of care environment, expansion capacity and fragmentation of services that will emerge on the Mater site. These concerns have not been addressed by any one of the numerous assembled groups of HSE/DOHC officials and private firms who have in sequence been handed temporary custody of this project, the latest of which is the NPHD Board. If this project goes ahead what will emerge will be a fragmented, inappropriate model of care, unworkable and detrimental to the needs of our sickest children from all over Ireland, their parents and the medical professionals who will care for them.

Interestingly, two former Chairs of NCHG have been appointed to the HSE and the National Paediatric Hospital Development Board respectivly. It's good to have friends in high places!

At the very least this grouping should have the decency to remove the word "Crumlin" from its name as it no longer has committed support from that quarter and misrepresents their constituency.

Louis Roden is unfair to the 22 medical experts who have written in support of Maurice Neligan's position paper, implying that they are an obstructive group intent on preventing the building of a high-quality specialist Children's Hospital. Apart from their professional national and international eminence they have been to the fore in giving backup to national parent support groups involving leukaemia and malignant disease, cardiac death in children, kidney reflux, AIDS, hydrocephalus, sudden infant death and many other forms of voluntary work. The highly productive Children's Research Centre was the brainchild of two medical staff members who led the way in the first fundraising drive, donating 50% of their annual hospital income to the Centre. Maurice Neligan, whose intervention has reopened a discussion on the siting of the proposed National Children's Hospital received no payment from the hospital for his life-saving work.

His supporters have earned the right to be heard. There need be no loss to the public purse. The Mater site can be used for the rebuilding of a local paediatric acute facility to replace Temple Street Hospital. It is in the public interest that the cost of building a National Children's Hospital on a freestanding site should be ascertained, bearing in mind current pressing problems with the national finances.