Expansion needs – lessons for Ireland.
“We must emphasise that on-site … ‘corridor distance’ ..maternity tertiary service provision is of the utmost importance in any co-location model if we are to put children first”
Excerpt taken from letter from Consultant Neonatologists and signed:-
Dr. Eugene Dempsey,
Dr Pamela O’Connor,
Dr. Margaret Sherican-Pereira,
Dr. Martin White,
Letter, dated 31st March 2006 to the Chairman of the JointHSE/Department of Health and Children Task Group [on the optimal location of the National Paediatric Hospital] – received by NCHA under Freedom of Information Act.
NCHA notes the decision of An Bord Pleanála, 28th April 2016,to grant permission for the NPH at the site at St. James’s hospital in Dublin’s city centre.
Choosing between sites is not the function of ABP. We believe the government was wrong to have presented the St. James’s site for consideration by ABP and that it is the responsibility of the new government ,not of ABP, to the children of Ireland of this and future generations to change the site.
NCHA calls on the incoming Taoiseach and the Minister for Health to change the site to the Connolly campus off the M50 in Blanchardstown.
Mr Robert Morton, head of the National Ambulance Service met the Dolphin group 2nd May 2012. In minutes ,obtained by NCHA under the Freedom of information Act , he informs the Group ” Exemptions provided to ambulances do not increase speed in high-traffic areas. An important factor for the National Ambulance Service in relation to location [of the NPH ] is good access to a major thoroughfare eg M50 or other”.
it’ a no-brainer -Connolly hospital on a slip road off the M50 with its hard shoulder emergency lane, wins hands down over St. James’s.
Problems with St James’s Site – Dr Fin Breatnach
Air Pollution at the site (of a hospital for the sickest children in the country) will exceed EU statutory limits and even more so the stringent, non statutory but obviously more significant, guidelines of the World Health Organisation.
Material contravention of the Dublin City Council Development Plan
The hospital building is in material contravention of the Dublin City Council (DCC) Development plan i.e. the hospital will be 40 metres longer than and just as high as Croke Park. Its height will exceed 35 metres – the upper limit for the area in the DCC plan is only 28 metres.
The helipad, on a fourth floor roof at one end of the children’s hospital, can receive only the lighter Air Corps AW helicopters and then only on flight paths not restricted by the adjacent upper hospital floors. The heavier Coastguard and Marine Rescue Sikorsky helicopter is not licensed for roof landings and must land at The Royal Hospital Kilmainham resulting in additional unnecessary handling of seriously ill or injured patients which will inevitably compromise outcomes.
Due to the recognised poor surrounding road infrastructure, Dublin City Council have placed a car parking limit of 2,000 for the entire site i.e. for the existing adult hospital, The Mercer’s Institute for Successful Ageing, the planned relocated St.Luke’s Hospital, the National Children’s Hospital, The Children’s Innovation and Research Centre, the Ronald McDonald Family accommodation building, the National Blood Transfusion service and the full service Maternity hospital along with any future expansion of any or all of these facilities. The long, narrow St. James’s site is 19.4ha (47.93acres)in size, (10 acres leased to Trinity College, 38 acres leased to St James’s Hospital) with only one entrance at each end, will continue to have just one through road with a single lane in either direction to carry all cars, ambulances, buses and cyclists. There will be no cycle lane. In relation to the proposed children’s hospital, there is no space left on site for a surface car park. They plan on digging three floors underground at an estimated cost in the region of €40M. Unfortunately, the Main Drimnagh sewer runs through the proposed location of the underground car park and this will have to be relocated along with other services before excavation for the car park can commence. The cost of that work will add an additional €18M to the cost of the car park. They are planning on putting approximately 984 parking spaces in the underground car park. However, as they plan on building the Children’s hospital on an existing surface car park, they will lose almost 600 surface spaces leaving them with a net gain of only 420 spaces. This gives you a final cost of over €138,000 for each of the 420 car parking spaces! It is accepted that the children’s hospital will have to cope with 10,000 arrivals and departures every day. An additional 3,500 staff will work at the children’s hospital. If the essential maternity hospital is ever built, St James’s have indicated that, in keeping with Dublin city council regulations, there cannot and will not be any additional parking provided for those attending or working in that facility.
The critical co-location for the children’s hospital is a maternity hospital so that seriously ill newborns can have direct access to the appropriate paediatric experts without the need for hazardous ambulance transfer. If a full service (per KPMG study recommendations) co-located or integrated maternity hospital cannot be provided on site, then it is accepted that inevitably, babies will die each year as a result. No Maternity Hospital planning application has been made. The National Paediatric Hospital Development Board in its 2015 application to An Bord Pleanála indicated, in a “Draft Site Capacity Study” of the St James’s site that if you wished to build the maternity hospital after you had completed the children’s hospital, then the first thing you would have to do is to demolish the existing, quite new, adult out patient department and to relocate it somewhere else. You would then also have to build a new adult Accident and Emergency Department, a new adult Intensive Care Unit and a new Adult Hospital Facility Management Hub! Only then could you begin to build your maternity hospital – if you got planning permission!
Demolish and rebuild
St James’s In their submission to An Bord Pleanála St. James’s indicated that they wished to demolish and rebuild 65% of the existing adult hospital. Much of the remaining 35% would be listed buildings.
More site constraints-the FAU
The site is so constrained that the developers are not able to provide sufficient space to allow for the required number of Family Accommodation Units at the Ronald McDonald House.
Site too small for Future Expansion
Space was the number 1 priority according to the McKinsey report. There is insufficient space for future expansion and almost all of the small amount of planned green space will be quickly used up. Toronto Children’s Hospital doubled in size every ten years since the 1950’s. Texas Children’s Hospital was rebuilt twice in twenty years. The Clinical Space at Our Lady’s Children’s Hospital in Crumlin has increased by 75% in just the last 15 years. Although Our Lady’s in Crumlin was the last of the three children’s hospitals to be built in Dublin, it has become by far the largest provider of paediatric tertiary care because, unlike Temple Street and Harcourt Street Hospitals which were on constrained, city centre sites, Our Lady’s had lots of space to expand and develop. The new Lady Cilento Children’s Hospital in Brisbane, serving Queensland, opened in November 2014 beside a maternity and adult hospital. A wonderful design internally, it is now experiencing the problems that parents here in Ireland keep trying to warn the Government about – the city centre location is terrible for parents travelling with sick children – they don’t have enough parking and they don’t have enough parents’ accommodation.
More site constraints – the CRIC
The planned new Children’s Research and Innovation Centre building on the Trinity College end of the St. James’s campus is much smaller than was initially requested by National Children’s Research Centre at Our Lady’s Children’s Hospital Crumlin – another result of the constrained nature of the site.
Even more site constraints
Clinicians and Allied Health care professionals will not have their own office and will have to rely on “hot desking”. It doesn’t work – for either families or staff!
And yet more site constraints
The requested clinical adjacencies for a single “unconscious floor” i.e. Theatre, Intensive Care Unit, Radiology, Recovery could not be provided because of the constrained site and “vertical” adjacencies requiring elevator transfer was all that was offered. Vertical adjacency is considered to be “safe”, but it is not safest or optimal – why compromise with a new building?
Far too expensive at St James’s
The Children’s Hospital at the St. James’s site was initially costed at €480M. The latest estimate has increased to €750M, and that doesn’t even cover the fit out of the building – it is likely that there will be very little change out of €1 billion! Both the Children’s Hospital along with an integrated maternity hospital could be built on the publicly owned 145 acre Connolly site for less than the cost of building the Children’s hospital alone on the St. James’s site and built more quickly as there would be no need for extensive decanting or enabling works.
As regards access, a photograph , taken at 4pm, and indicating the proposed new entrance to the underground car park and service yard opposite the cottages on Mount Brown,presented at the oral hearing by a local resident,and showing an ambulance stuck in traffic, said it all. Access, at rush hour in particular, will be an absolute nightmare with 10,000 arrivals and departures every single day on top of the already crowded streets.
So, why at St James’s?
All of the problems above are the result of a myth – the government has indicated that the reason they chose the St. James’s site was because “senior medical people” had informed them that the clinical outcomes for the children would be improved if the children’s hospital was built next to the adult hospital. There is not a scintilla of scientific evidence to support this claim and the most recently built Children’s Hospitals in the UK, Australia and the USA are stand alone in a parkland setting. Surely all three countries couldn’t have got it wrong? END.
The following is a submission read at the Oral Hearing re the NPHDB application to build the National Paediatric Hospital at St. James, Dec 2015
We are the parents of a child who has a life limiting condition of Mitochondrial disease. He is aged 9 and has chronic renal failure, profoundly deaf, poor muscle tone so does not walk, an intellectual disability, a problem with his heart and many other organs are and will be affected by his disorder. We attended Crumlin first and now are attending Temple street.
To hear that the people behind the new Childrens hospital appear to be ignoring the parents of sick children is just unbelieveable. We are your clients and in any other industry, if the clients don’t like the product it wont be bought.
We suffered horrible stress going to Crumlin first, parking was a nightmare. I once had to park down the road in a housing estate and ended up falling trying to get my son into his buggy. I was shaken for a number of days after that. Then going to Temple Street wasn’t much better. Parking at metered parking when you could be 4-5 hours at an appointment creates more stress for parents. We finally got a disabled pass but there are only 5 disabled parking spots in the immediate vicinity of the hospital and normally never free when we attend for appointments. We have a van now with a ramp and need the extra space to put that ramp down. Now this new hospital is to be located in another city centre location again with no adequate parking and this will put more stress on already stressed parents of a child with a life limiting illness. What is wrong with the people behind this project??? They obviously do not live my and other parents lives with sick children.
Crumlin, Temple St and now James st are located in areas that are not safe. I will not venture out of Temple Street at night. There were alterations one night at A&E and the people could be heard all through the hospital and James st is no better. A city centre location is not a safe option for parents.The nursing staff in Temple street are consistently having their cars broken into. We are told not to take our mobile phone out and use it walking around the vicinity of the hospital because phones are constantly being snatched off parents and staff.
I have to laugh when I hear the people behind this hospital saying we should take public transport. We travel with a wheelchair, an NG feeding machine, a huge nappy bag than has one to two changes of clothes as my son vomits consistently, a huge changing mat as most disabled changing facilities in these hospitals are not big enough and we have to change my son on the floor. We would be carrying extra feeds in a cooler bag, medicines and water. He has a life limiting illness and you want me to take a bus into town at rush hour (& we mightn’t get on the bus) and then take another bus or Luas out to the hospital. That would take us the guts of 2-3 hours ONE WAY with a child with a life limiting illness. Seriously, who is this person that is suggesting that we travel on public transport. And we are lucky, we live in Dublin. A hospital located off the M50 would be a far better option for anyone travelling up from the country. Going into a city centre location is a nightmare for those parents who don’t know the way, don’t know where parking is located added on top of the fact that they are travelling with a sick child.
We recently had to attend the Lady Cilento hospital in Brisbane while on holiday this year, a fantastic hospital and one that made me realised what the potential of a childrens hospital could be. However, they are now experiencing the problems that us as parents here in Dublin keep telling you – the city centre location is terrible for parents travelling with sick children, they don’t have enough parking and they don’t have enough parents accommodation. The parents of sick children need to be listened too. We are your clients and customers of the hospital – if this was any other industry you would be out of business for not listening to your clients.
Parents of sick children are constantly fighting for their child, for services, for better care, for everything connected with their child and you are not listening to us. Every program where you see a debate on this, there are no parents of sick children represented. Why? Why is our opinion being disregarded?
Listen to a compelling interview with Shane Coleman on the Pat Kenny show on Newstalk on Thursday 11th Feb 2016. Then go to www.connollyfor kidshospital.com and click the Petition button .
Tell Enda Kenny the new Children’s Hospital is better on the M50 to serve the children of the country. We need YOUR signature.
Today , Friday, February 12th, “because of the number and complexity of issues involved in this case”, An Bord Pleanála has deferred its decision which had been due by Feb 15th.,2016. It now “intends to determine the application for permission [of the NPH at St. James’s] before the 12th May 2016″.
A letter to this effect has been sent to all those who made a submission to the board re the application.[ ABP Ref No.29N.PA0043]
Staff should note the excerpt below from the Submission to An Bord Pleanála by Dublin City Council regarding the application for planning permission for the Children’s Hospital. In Chapter 8, titled ‘Recommended Conditions’ ,section 8.6 ‘Roads and Traffic states-inter alia-
“5) Any proposals for off site temporary car park shall be subject to separate planning applications and shall be decommissioned on completion of the National Children’s Hospital development.[our emphasis}
6) Car parking for the entire St. James’s Hospital Campus shall be capped at 2000 car parking spaces. No additional car parking spaces above this number will be considered for any future developments within the St. James’s Hospital campus.”[our emphasis]
DCC -Main submission
National Petition opens with new website, facebook page and twitter feed. Visit www.connollyforkidshospital.com to Sign the Petition, Watch the 90sec. video, and spread the word -by email, hard-copy, facebook or twitter to SIGN, SIGN, SIGN
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