” I have asked the NPHDB to look at the possibility of submitting a planning application  for a new co-located maternity hospital at  the same time as the application for the NPH.”- this is a précis of what Minister for Health,  Leo Varadkar says to Pat Kenny in an interview on Newstalk 106-108 on 30th Oct.2014 [ NPH discussion starts at 31min into interview].

NCHA says “At last, someone is listening. Well done, Minister” But, is the NPHDB the appropriate body to forward a Maternity Hospital planning application?

Appendices to the Dolphin Report, June 2012.
http://health.gov.ie/wp-content/uploads/2014/08/Dolphin_Full-Appendices-1-5.pdf
Appendix 5 : A Note on Planning context
Excerpt:-
“..While global figures for population within the M50 can be stated at approximately 800,000, the NPH site investigation should take into account the location of the children if the focus is to be on the best service for children. With the expansion of suburbs westwards and northwards beyond the M50, the M50 has become a central spine and not a perimeter corridor. The GDA population (Dublin City, Fingal, South Dublin, Dublin Laoghaire Rathdown, Kildare, Meath and Wicklow) was 1,804,156 in the 2011 census, meaning 1 million of the ‘secondary care’ catchment lives outside the M50.
Population expansion continues outside the M50……..”

NCHA Editor’s comment – And that only refers to the ‘secondary care’ children.  Over 80% of ‘tertiary care’ (the very sick) children now live outside the M50.

Read letter from Dr Fin Breatnach to Health Minister Varadkar.  18th Sept 2014  Letter to Leo Varadkar

Jonathan Irwin of the Jack and Jill Foundation has published a letter received from an anonymous  medical consultant in St. James’s hospital .Read the letter here.

Thank you to the SBP for publishing a letter from NCHA in response to Minister Varadkar’s article in last week’s SBP. Below is the full letter sent in – it was  published in somewhat shortened form.

“Dear Editor

The Minister for Health (SBP,14^th Sept.) tried and failed to justify the building of the National Children’s Hospital (NCH) at St. James’s. He says “the debate has got caught up on the perfect location”. There has never been a debate. The Dáil has never debated it, the public’s opinion has never been sought. Groups seeking a greenfield site, but dependent on Department of Health(DoH) money, had their opposition to the government’s choice of the Mater quickly silenced(2006). A request from us to have a debate at Dáil na nÓg was rejected as “too complex a topic for teenagers” to handle. To its shame, Crumlin hospital, ignored and stone-walled by the DoH in its advocacy for children, finally capitulated and joined the NCH’s Development Board in early 2010.

Adult hospital co-location, an ideal, is not an initial requirement. Space, however, is. To suggest that because St. James’s is two and a half times bigger than the tiny Mater site it is therefore brilliant, is a nonsense. Co-location with a Maternity hospital is the immediate and paramount requirement.

With the new offer, to the Dolphin Review  in May 2012, of 36 hectares of the National Sports Campus contiguous with the current Connolly Hospital site at the M50/N3 interchange, giving a total of 145 acres(59 hectares), we have a near-perfect location. Unlike the St. James’s site, it is cheap, of low planning risk and shovel-ready for both a children’s and a maternity hospital. Adult neursurgery, neuroradiology, and transplant surgery can gradually transfer from Beaumont. These are the priority adult specialities from which children would receive improved clinical outcomes.

No inertia, Minister, let’s just get building. The children of Ireland will be cheering.

Dr. Roisin Healy.”

The International Independent Review  (June 2011) was commissioned by the present government. The following is from an email, received under the Freedom of Information Acts in which the Reviewers are discussing the draft  ‘Conclusions’ section of their report. The text quoted below was omitted from the final report, not because the Reviewers did not believe what they had written but because it was considered unnecessary to comment on St. James just to dismiss it.

“Comment: Removed this text: ‘The only other site that met the co-location criteria was St. James. Unfortunately this location offers no advantage over the Mater site and in fact presents similar if not more constraints to those identified at the Mater.’ – not sure the St. James question should be introduced in the Conclusions.”

Minister Varadkar- take notice.

In an e-mail, obtained by the New Children’s Hospital Alliance under the Freedom of Information Acts, in which the reviewers are preparing the final version of the International Independent Review (2011), the reviewer comments –
“I removed  ‘The ideal location would be located on green space, provide for unfettered access, accommodate research and educational activity, provide sufficient space to ensure the aggregation of all patient care services meeting current and future care requirements, and be tri-located with an adult tertiary care and a maternity facility. We agree that if there was a site and funding for such an aspirational location it would be a magnificent campus. Unfortunately, given the current challenge of funding the one children’s hospital the perfect location is not possible. Consequently the team considered those options that were viable.’
My concern here is that if the above text is included, the response will simply be that there is such an ideal site, and the issue will open up again.”
NCHA says – CONNOLLY is that IDEAL LOCATION, that MAGNIFICENT CAMPUS.

The following is from our organisation’s submission to An Bord Pleanála in 2011. While it refers to the Mater site, it is equally true of the St. James’s site

“NCHA wishes to note that both employees and patient families require more parking spaces than appear to be compatible with centre city parking. This is a strong argument in favour of not locating such a major health facility in the city centre. Furthermore the arrival of the carbon-neutral car of the future should be anticipated and catered for. Skilled staff, already difficult to recruit, and often working twelve hour shifts, will choose more friendly locations in which to work. They will not appreciate being forced on to public transport – what is appreciated is choice .”

“An emergency condition may be perceived to exist by hugely stressed parents at any time of day or night until they can deliver their child or infant into the care of professionals and the safety of the Emergency Department . Very sick children are much more likely than adults to come to hospital by car…In our opinion, a city centre such as Dublin’s, with narrow streets and a innate danger of gridlock if stressed, is incompatible with the duty -of-care of the only Children’s Hospital in the Greater Dublin Area- responsible for the timely, safe and optimal care of a child with a life-threatening condition. Every child is precious, not a minor statistic caught in a traffic jam.”

Dublin City Council imposes severe restriction of parking at St. James’s because of the poor traffic capacity of its feeder roads.

The head of the Jack and Jill Foundation goes into orbit .

Read his letter to the Irish Times here

The St. James’s site cannot support two major construction projects simultaneously.  Read the Irish Times article by Paul Cullen here.

So will the Children’s Hospital open only to have to endure more years of construction on this constrained site?