NCHA had until recently delayed commenting on the NPH Review of July 2011 as we could not get information on documentation required. As a result we have on 19/07/2011 sought the following under Freedom of Information Acts:-
LIST of DOCUMENTATION requested from the Department of Health under Freedom of Information Act 1997, 19/07/2011.
All documentation associated with the Terms of Reference, including emails, between the DoH and members of the National Paediatric Hospital Independent Review.
All documentation associated with ‘notional’ alternative sites, including the HSE’s rationale for choosing Sites A, B and C; also the location and ownership of any other sites considered. The Department of Health/HSE’s understanding of the word ‘notional’.
Minutes of all meetings associated with the review process.
A list of persons /organisations who met with members of the Review Group.
All documentation from persons and organisations (including hospital boards, HSE, DoHC, DoH, NPHDB and members of its teams, Dublin City Council, Project Review Team: Financial Review – listed members) made available to the Review Group.
The minutes of the 3 meetings convened by the EuHPN team at which the review Panel and “the client and consultant NPHDB teams were fully represented” (Review, part 1, pg 3).
The OCSC Traffic study (Review, part 1, pg 7, said to be ‘appended’. Not so).
All documentation regarding the provision of Information and Communication Technology (ICT) including cost. We note ICT cost is not included in the NPH budget.(Review, part 1, pg 29).
Re the A/UCC :-
(i) Documentation on which the comment “the functional content and the split of services between the NPH and this centre [the A/UCC at Tallaght]..is outside the remit of this financial review” is based .( Review part 1, pg 23).
(ii) The basis for the allocation of € 50 million for the A/UCC at Tallaght from within the € 650 million for the NPH (FAQs No. 5, Funding for the hospital).
(iii) The projected annual operational cost of the A/UCC. We understand the A/UCC is scheduled to open ahead of the NPH. Is it considered as a new entity?. Does the operational budget of the current National Children’s Hospital at Tallaght transfer to the NPH at the Mater? We note that “Tallaght Hospital has not provided the financial budget associated with the paediatric unit. As such the estimate calculated by the Project Team of the NPHDB has been accepted” .( Review, part 1, footnote 1, pg 37).
(iv) Documentation supporting the statement “A/UCCs….not located at Tallaght..will serve larger patients populations than the current location (Review,part 1, pg 30).
(v) Documentation is requested on which the comment “the Eccles St site [for the A/UCC] has not been discussed in any great detail and may prove impracticable, since the site will revert to the Sisters of Mercy if the NPH is not developed on this site” is based. Why might it be impracticable? Have the Sisters of Mercy been asked about this possibility?.
Re Revenue savings –
(i) Please supply documentation as to the components of the €23 million annual savings.(Review, part1,Table 8.2, Note 7, pg 37).
(ii) If the A/UCC is an integral part of the NPH, what loss of revenue savings is anticipated from service delivery on two sites?.
Re “Roof gardens on all sites” (Review, part, pg 31):- What is the area provision for roof gardens on the Mater and on comparator sites? What is the area provision for ground level gardens on comparator sites?
Re “Green Technology “- is the omission of reference to its use on comparator sites due to the Review Group being constrained by having to use the same “specification” as for the NPH on the Mater site?. If not, had the Review Group any comment to make on Evidenced-based Design principles in the holistic care of children and on Leadership in Energy and Environmental Design (LEED) green building standards “in the wider context of Europe -wide carbon reduction targets” other than the comment on Mobility Management Planning for staff. (Review,part 2, pg10). Documentation of other comment, if any, is requested.
What “demolitions/diversions”(Review, part1, pg 31) are required on the Mater site? In particular, does the PET/CT currently on site have to be relocated? If so, what is the cost of such relocation?
“The Eccles St. site is connected to a wide range of teaching /research facilities”. (Review, part1, table 8.2,Note 6). ” The Mater site has access to a large cohort of current education, training and research facilities and resources within close proximity to the campus” (Review, part 1, pg 38). Documentation as to the names of such facilities, where the site is connected to such facilities, their size and availability for NPH use is requested.
Re Patient Transport imputed cost(Review, part 1, Table 8.2, Note 5):-
(i) Does Beaumont Hospital not have radiation therapy? Why the choice of St. James hospital over Beaumont Hospital for paediatric radiation therapy?.
(ii) What is the estimated number of transfer episodes and cost of transfer of patients from the A/UCC at Tallaght to the Mater for medical, for surgical and for orthopaedic inpatient admission?. Please supply documentation made available to the Review Group on this data.
Workforce planning documentation:- We wish to see calculation of staff time spent in commuting between the NPH and the A/UCC. For example:-
(i) for Orthopaedic Surgeons of whom there are only 7, all in shared adult/paediatric practice in Dublin. It is likely that such consultants may often be professionally required to visit patients in both centres within a given working day.
(ii) for Paediatric Anaesthetists required in the NPH, in Tallaght A/UCC, for transfers from Tallaght to the NPH and for patients sent to Beaumont and St James Hospitals.
Current facilities, repair / replacement (Review, part1, pg 38). What “monies” [in euro ] “need not be expended” unless there is a two and a half year delay in opening the NPH? We note Temple St. requires only “minor capital investment” while Our Lady’s Hospital, Crumlin identifies a need to upgrade inpatient accommodation. No need is identified for Tallaght. What monies need be expended on the current facilities, repair/replacement on each of these hospitals pending the opening, on schedule, of the NPH ?.
Colocation/Trilocation (Review, part 2, pgs 8,16):-
(i) We note that no ‘potential clinical benefits’ of locating the NPH at the adult Mater hospital are named in the Review. We request the documentation of the clinical benefits, if any, identified (as per the Terms of Reference).
(ii) “The distribution of tertiary adult services across Dublin is fragmented”- Documentation evidencing this statement is requested please.
(iii) We request the documentation presented to the Clinical Review group informing the following statements by them : (a) “If the NPH is built on the Mater site, this would provide a base for the further strategic planning of adult services” (pg8), (b) “given those services that are available and the plan to consolidate others at the Mater site, our recommendation [re NPH at the Mater] is reinforced”(pg 16).
(iv) The Mater site offers the best opportunity to place the National Paediatric Hospital in a health community…”(part 2,page 8).What comparator ‘communities’ were used ?.
Re Access:(review, part 2, pg 10), we request:-
(i) Documentation of all Traffic Impact Assessment data submitted to and negotiated with Dublin City Council by the NPHDB consultant team and available to the Review Team
(ii) Both the McKinsey report and the RKW report specifically state that Emergencies be brought directly to the NPH ( bypassing A/ UCCs). Please supply documentation of all Ambulance Transport studies of transport time to the Mater done taking into account the ‘worst case scenario’ – that of emergencies occurring during ‘the morning peak period’ at the outer reaches of the new enlarged catchment area – consisting of the whole of the Greater Dublin Area.
(iii) Please supply documentation from the three Children’s Hospital Emergency departments of numbers of patients seen annually – by Triage Acuity category, and Admission Rates per triage category.
(iv) Please supply documentation, if any, re the ‘Major Disaster Plan’ for children in Dublin were the NPH emergency department to be inaccessible.
Note:-We do not require the “Report of the Joint HSE/DoHC Taskforce to advise on the optimum location of the new National Paediatric Hospital”2006 .[ Review,part 1, pg3 states it is appended- not so] as it is already in the public domain.END.
This documentation will not be available in time to inform our submission to An Bord Pleanala (submission closing date is Sept.14th,17.30 hrs) as the DoH states that in view of the volume of data requested it requires eight weeks to process the request.