Criticism of the new children's hospital is aimed at a building not yet designed, writes Frank McDonald, Environment Editor
Consultants appointed to draw up a development framework for the proposed national children's hospital had just arrived in Dublin to start work last week when the board of Our Lady's Hospital for Sick Children in Crumlin pulled out of the project.
Brian Gilroy, estates manager of the Health Service Executive, is baffled by much of the criticism levelled at plans to locate a "world class" tertiary hospital for children on the Mater hospital site, given that the building has yet to be designed.
How then, he says, can critics of the plan say with any certainty that the rooms would be too small, that children would be denied natural light, that there would be no outdoor play areas, or that a variety of facilities and services would be located off-site?
Mr Gilroy, an engineer who has spent much of his working life in the private sector, says these criticisms and others are all based on a misunderstanding of the size of the Mater site that is available for the development of a children's hospital.
Last September, the board of Our Lady's hospital based its detailed critique of the HSE plan on the assumption that a site of only 1.45 hectares (3.48 acres) would be available, whereas Mr Gilroy says it covers an area of 2.5 hectares (six acres). Part of this discrepancy arises from a provisional allocation of 0.5 hectares (1.2 acres) for a maternity hospital. But no decision has been made on whether such "co-location" will be provided at the Mater site - even though it would be desirable.
"This issue is only being looked at now," Mr Gilroy said. "The same exercise has to be embarked on to review what to do with the city's three maternity hospitals, in the light of best practice internationally to co-locate with an acute hospital."
It has been speculated that Holles Street would go to St Vincent's, the Coombe to St James's, and the Rotunda to the Mater. But there is no agreement on such a strategy, only that there should be a single national tertiary children's hospital.
According to Mr Gilroy, the development site available at the Mater would extend from Eccles Street to the North Circular Road, where the current accident and emergency unit is located.
He also emphatically denied that legal ownership of the new children's hospital site would be a "flying freehold", with the Mater still owning the ground. "Our discussions are on the basis that it will be transferred unencumbered to the HSE.
"If you add the current floor space of the three existing children's hospitals [ Crumlin, Temple Street and Tallaght], it comes to 53,000sq metres, and we've got close to double that based on a plot ratio [ floor area versus site area] of 3:1.
"In fact, it's even more, because shared services such as laboratories, kitchens and sterilisation areas, which both Crumlin and Temple Street have, can all be accommodated on the site of the new adult hospital being planned for the Mater.
"If you subtract these from Crumlin and Temple Street, the combined floor space comes down to 48,000sq metres", Mr Gilroy said, adding that the critics were also ignoring the likely provision of "ambulatory care" day clinics for less sick children.
If, as seems probable, Dublin City Council's planners were to permit higher plot ratios in the Mater area, the amount of floor space that could be provided would be even higher - though he conceded that this would involve some high-rise.
Here again, he maintained, the critics were "pre-empting the possibility that high-rise could be the way to go". Referring to the sprawling St James's Hospital complex, he said: "If you ask doctors there, they'd say it's better to go up rather than out."
As for outdoor play spaces for sick children, Mr Gilroy said these could be provided if required on the Mater site. But he noted that so few children at Our Lady's hospital actually used the playground there that it was eventually demolished.
Dealing with the issue of access to the Mater, he said the majority of hospital trips were made not by anguished parents driving a sick child through heavy traffic, but by staff and visitors - many of whom could easily use public transport.
Access to the Mater will also be dramatically improved by the proposed metro linking Swords with St Stephen's Green, and a concrete box for a metro station is to be installed at sub-basement level as part of the hospital's redevelopment.
"So it's a quite different scenario to what's there at present," Mr Gilroy said. In addition, more than 1,000 basement parking spaces were to be provided on the overall Mater site, and at least some of these would be for the parents of sick children.
Asked about fears that there won't be room to accommodate parents overnight, he said the existing Temple Street hospital could be used for this purpose after it is vacated "and it's only 236 metres walk away, less than the width of Crumlin hospital".
He also pointed out that all five of the children's hospitals abroad - in Chicago, Toronto, Melbourne, Manchester and Great Ormond Street in London - cited for comparison purposes by Crumlin in its critique are in inner city locations.
On November 7th, Our Lady's hospital wrote to the HSE saying that, before the Mater site was ceded, a framework plan for its development should be completed, with a consensus reached on design values, core services and expansion space.
"Nothing has happened since then to change this, except that we now have them saying they won't co-operate," Mr Gilroy said.
"We can't go back to the old days of spending 12 years arguing, because we won't have a hospital that children need."