Editor

NPH Governance debate

Click here for NCHA’s letter to the Minister for Health, copied to members of cabinet, on 10th December 2012 seeking clarification as to why the Government decided to favour St. James’s adult site over the Coombe site. Other serious concerns regarding the site, including that regarding  governance of the new hospital, are listed in the letter. NCHA has to date not received any clarification from the Minister.

See article in IrishTimes, 25.01.2013 – Minister may scrap board developing national children’s hospital.

Editor

The site decision-NCHA’s position

NCHA accepts that a decision regarding the location of the National Children’s Hospital has been made by government. NCHA considers the choice of St. James  to be a very poor one. In particular, it is unacceptable that the need of our sick youngest citizens, our newborn babies, for optimal care is being long fingered. Only ‘ultimately’  (press release http://health.gov.ie/blog/press-release/government-decides-the-location-for-the-new-childrens-hospital/ )  is it planned to build a Maternity Hospital at St.James.

NCHA  considers the 150 acres at Connolly Hospital, immediately accessible off Dublin’s M50 ring road, to offer unrivalled potential to deliver best medical care for all  citizens of Ireland – both adults and children – for the long term future. The Connolly site must be mothballed and protected for such development.

Meanwhile, unless the government has a change of heart regarding the project, there should be no delay in commencing what can only be a short-term strategy – building the children’s hospital on the co-located* James – Coombe campus. As the country cannot afford to build both a new maternity as well as a new children’s hospital in the more expensive inner city, NCHA believes the  children’s must be built beside, and physically linked to, the existing Coombe  Maternity hospital.

*The McKinsey Report definition of Co-location (p27) is “within a practical walking distance”. The walk from St James to the Coombe we understand to be 7-8mins.
Adult hospitals don’t have children, Maternity and Children’s hospitals do. The few adult hospital staff who are needed in the children’s or maternity hospitals can walk, jog or cycle – sick babies can’t.

To read the Dolphin Report and allied documents, go to   http://www.dohc.ie/issues/childrens_hospital/

Editor

Co-location priorities not in St. James

The information below was received by NCHA under the Freedom of Information Acts.

FOI information:-  This  excerpt (in blue text below) is from a “Prioritisation exercise for the collocation of adult hospital specialities with a tertiary paediatric hospital in Dublin.. Proposed prioritisation of clinical service collocation” prepared by a  subgroup of the Task Group on NPH Location 2006 and presented to the Group at  a meeting March 2006. Location Report – Report of the Joint Health Service Executive / Department of Health and Children Task Group to advise on the optimum location of the new national paediatric hospital, was published  May 2006. The final report does not contain the list of priorities  identified by the Task Group subcommittee.

EXCERPT from Minutes of Meeting of Task Group on NPH Location, March 2006:-

“Priority 1a – Neurosurgery.  [NCHA Comment – is not in St. James’s]

Priority 1b     – no.1 – Transplant Surgery [NCHA comment – is not in St. James], no. 2 – Interventional Neuroradiology [NCHA comment – is not in St. James], no. 3 – Radiation Therapy [is in St. James], no.4 – Spinal Surgery [NCHA comment – is not in St. James]. no.5 – Cardiac Surgery. [NCHA comment -while an adult cardiac surgery department is in St. James’s that department has never been involved in paediatric cardiac surgery, which is carried out  in Crumlin with support technicians coming from the cardiac surgery department in the Mater.] 

Priority 1c    Those with a shared caseload, ease of consultant access –
ENT, Dermatology, Plastic surgery, Maxillo-facial surgery, Ophthalmic surgery, Orthopaedics, Urology.” END of Excerpt.

[ NCHA comment re Priority 1c specialities – all Urology in Crumlin hospital is performed by children’s specialists. With the exception of Maxillo-facial surgery the other specialities listed in Priority 1c are serviced in the main by consultants with a majority subspeciality commitment to paediatric practice. These consultants  have minor commitments to various adult hospitals – Mater, St Vincent’s(Elm Park), St. James’s, Beaumont, Tallaght. The amalgamation of the three children’s hospitals into the one National Children’s hospital will allow full time paediatric positions in these specialities. As currently obtains there are Temple St./Mater posts or Crumlin/ St.Vincent’s posts or Crumlin/Temple St./Mater posts etc. Gathering all the dispersed children’s work on one site will allow such historical geographic appointments to dissolve, to the benefit of children, as the National Children’s Hospital will have the volume of work to support full time paediatric specialists in these disciplines, joining the more than 25 specialities that already have full time paediatric specialists.

This FOI information is relevant given that we are now being told (Nov 2012) by a report leaked to RTE that the Dolphin Group favours St.James on medical [clinical] grounds. It appears to NCHA that the top priority services still required to be shared with an adult co-located hospital would over time more easily  transfer to the adult Connolly hospital (on 150 acre campus on the M50) from  Beaumont hospital (where they currently are) – adult neurosurgery, transplant surgery, spinal surgery, interventional neuroradiology – than for Beaumont to service the St.James’s site. Furthermore, one helipad only would be needed on the Connolly campus to serve the trilocated children’s, maternity and adult hospitals – unlike on the split James /Coombe site.

Editor

Connolly- a campus for the 21st century

The draft International Independent Review on the NPH Location, 2011, said: “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 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.”

We in NCHA say there is such a site.  The site is the marvellous 150 acre parkland around Connolly.The cabinet must choose it .

 

 

Editor

Letter from Crumlin consultants

“If [our emphasis] the National Children’s Hospital were to be located on the St James’/Coombe campus, we feel that it ought to be physically attached to the Coombe Hospital”.

Please note the above excerpt from a  letter by 40 Crumlin Hospital consultants  http://www.irishtimes.com/newspaper/letters/2012/1101/1224325979425.html.The letter was written to emphasis the priority that the children’s “must be physically linked to a maternity  hospital”. The letter does not suggest that the Cabinet should exclude considering a different adult hospital as the preferred site (though maternity co-location from ‘day one’ is a must, whatever site is chosen).

Editor

Dolphin Report is wrong

1 Comment

The Dolphin report leaked to RTE today shows the paternalism and self interest of adult hospitals is still rampant. Apparently, the report states that adult hospital co-location is  a must while maternity hospital is an optional extra. That is last century medicine.

When the 3 children’s hospitals are consolidated into one National Children’s Hospital, the new hospital will out perform any adult hospital in breadth and depth of service to its patients. It will not require interference by adult services and personnel untrained in paediatric care. Do  ‘they’  not know that, for example, Our Lady’s Children’s Hospital Crumlin has over 30 specialities (more than any adult hospital).

Adult hospitals do not have children in them. Maternity hospitals do. Clinical need demands that Maternity hospital co-location with the new children’s hospital  must take priority over adult hospital co-location. Dolphin is wrong.