Madam, - As a paediatrician, I have been greatly saddened by the ongoing row over the site of the proposed new national children's hospital and I congratulate you on the tone and content of your Editorial of January 16th. Children are at the heart of this matter and sectional or political interests should not prevail. Amid all the emotion, angst and concerns of deeply committed professionals, to my mind a number of certainties emerge.
Firstly, the children of Ireland are best served by a single tertiary children's centre to allow for comprehensive multidisciplinary treatment. Spreading this over two or three sites is not in the best interests of children.
Secondary or hospital-based care, currently delivered by a national network of paediatric departments with a policy of stabilising and transferring critically ill children should, of course, continue. The Mater site was chosen by an expert group which undertook the task without any political interference. Its integrity and commitment to getting it right are beyond reproach.
The problem is, in truth, that none of the three proposed sites is ideal: all have access and space limitations. Any hospital reached via the M50 has an access problem as the M50 is seriously congested most of the time. My last trip from Drogheda to Tallaght Hospital took over three hours.
Disengagement rarely works and I believe that the boards of Crumlin and Tallaght hospitals should re-engage with the process and air in committee their real concerns. - Yours, etc,
Dr ALF NICHOLSON, Baltray, Drogheda, Co Louth.
Madam, - There are many compelling reasons why the proposed new children's hospital should not be located at the Mater site. Accessibility is a huge problem, even for ambulances. To bring a sick child to hospital by metro is out of the question.
Parents need to be with their child in hospital. Where can they park? What accommodation is there for them? If they live outside Dublin (and this is to be a national hospital for children from all over the country), it is even more difficult. Looking forward 10 years, there may be restrictions on inner city traffic which will make the Mater site even more inaccessible.
The limited number of beds planned will be inadequate to cater for a population predicted to grow by 40 per cent in the next 10 years - and this hospital is to last for the next 50 years.
Medical diagnosis depends increasingly on technological developments so future developments and the space required can only just be imagined now. But one thing is clear: these will be totally beyond the capacity of peripheral units to provide, so the numbers attending the new children's hospital will continue to escalate.
Adolescent care is an area that seems to have been completely ignored and there is a pressing need to address it. It is now accepted that the healthcare of young people up to 18 years is best accommodated within the paediatric setting. As this principle is enacted, the demand for additional space to provide appropriate adolescent areas will further increasing the pressure on the new hospital.
Availability for specialist care from an adult hospital has been stressed by planners. However, it seems that, with all due respect, the range of desirable services that the Mater Hospital can supply is limited. No single adult hospital in Dublin has the necessary range of services, which include not only cardiac surgery but also neurosurgery, kidney transplantation, burns care and cochlear implantation. Of these, only cardiac surgery is located in the Mater Hospital.
Paediatric medicine requires delivery of services within a paediatric context - it requires paediatric equipment, paediatric-trained staff and adequate space in a suitable environment that is easily accessible. There is increasing evidence showing the importance of environment including space, housing (single rooms), natural light and open vistas on recovery times and rates of hospital infections such as MRSA.
This is a golden opportunity. We should not settle for anything less than what is ideal. Why should we not have the best for our children? A second-rate decision taken for expediency's sake will be something which, unfortunately, we will have all too much time to regret.
There is a large green field site available. Let us grasp this chance to plan a hospital that will provide all that is needed both now and for the future care of our young people and which will meet the needs of their parents and carers.
I hope and pray that our Minister and her advisers will take a fresh look at the plans for the proposed children's hospital and open up other possible solutions. - Yours, etc,
PAULINE A. O'CONNELL, Consultant paediatrician (retired), Mount Merrion, Co Dublin.