If governments didn't make mistakes, we wouldn't need elections. But if governments don't correct mistakes, they don't deserve to be re-elected. There is at the moment a perfect opportunity for the Government to show, however belatedly, that it is capable of acknowledging a mistake and doing something about it, writes Fintan O'Toole.
No irreversible decisions have yet been made on the location of the new national children's hospital. There is a chance to recognise the decision to site the hospital in a high-rise tower in the centre of Dublin city on the site of the Mater hospital for what it was: a prime example of everything that is wrong with public governance in Ireland.
The main argument for not looking again at this decision is that governments should not interfere with the decisions made by independent experts in the complex area of health strategy. This might be a rational objection if we did not know that governments interfere in such decisions all the time. In 1998, for example, Comhairle na nOspidéal carried out a review of the provision of paediatric surgery. It recommended unequivocally that the service should be provided at Crumlin children's hospital. Temple Street children's hospital was unhappy about this and lobbied the Taoiseach, Bertie Ahern, who represents the constituency in which Temple Street is sited.
Temple Street wrote on a number of occasions to the minister for health at the time, Micheál Martin, urging him to tear up the expert recommendations and "guarantee the equal distribution of paediatric surgeon posts between Temple Street and Crumlin hospitals". The pretence that the Government is bound by the flawed process which led to the choice of the Mater site for the children's hospital is, in other words, pure guff.
It would take a long time to go through the flaws in the process, but instead I will just highlight some of the extraordinary aspects which have emerged from my own trawl through the documents.
1. The task group which made the recommendation included no paediatrician, no child-health professional, no parent of a sick child and no one from Ireland's highly-developed child welfare organisations such as Barnardos or the ISPCC. Not surprisingly, its report says absolutely nothing about what is best for children.
2. The international experts supposedly consulted by the task group turned out to have had no more than brief telephone conversations with the group and to have had no involvement whatsoever in recommending the Mater site.
3. The total number of site visits to the major tertiary children's hospital in Ireland - Crumlin - made by the McKinsey team which set out the general principles for the project, the task group which made the decision, the international experts it supposedly consulted and the transition team which is now planning the development is, to date, precisely zero. No one has actually bothered to have a look at what a large hospital means in practice for children and their parents.
4. As recently as January 2005, a panel of international experts reported to Mary Harney on the location of radiation oncology services in Dublin and recommended against the Mater site, in part because of the absence of "adequate site area availability".
5. The Mater site allocated for the new children's hospital is less than a quarter of the size of the present Crumlin site, even though it will have to accommodate the specialist work not just of Crumlin but of all the other current paediatric hospitals as well. The potential for further development (a basic criterion in such developments worldwide) is extremely limited. If the children's hospital is to take up a larger area of the site, it would be at the expense of the maternity hospital which is also to be developed on the site, destroying the rationale of co-location on which the whole project is based.
6. The area of 90,000 square metres, which the McKinsey report regarded as necessary to accommodate a maximum of 585 beds in the new hospital, translates in all probability into a 10-storey or 11-storey building. No one has yet told us why a tower block is the best place for sick children to live.
7. It is not at all clear that the new hospital will actually own the ground on which it is built. This has serious long-term implications for the independence of the hospital.
8. The HSE only advertised for submissions on the model of care for the new hospital - in other words, the definition of what it is meant to do - this month. (The closing date for submissions was last Wednesday). Not only was the decision on location taken before there was a model of care, but the process of figuring out how the hospital should work is still in its infancy.
All of this adds up to a bad process. Mary Harney should establish a real international expert group, get all parties to agree in advance to accept its recommendations and tell it to answer a question which has not yet been asked: what is best for Irish children?