Putting the children's hospital on the Mater site was wrong when the decision was taken in mid-2006, writes RÓISÍN HEALY
THE PROPOSED National Paediatric Hospital at the Mater is to replace Temple St, Crumlin and Tallaght children’s hospitals, which will all close in 2014.
It will be the only centre for all tertiary (complex) in-patient care for children from all over Ireland and also for all secondary (non-complex) in-patient care for children from the greater Dublin area.
It will have the only emergency department for children in the greater Dublin area, supplemented by an ambulatory/urgent care centre open from 8am to 10pm at the Tallaght adult hospital.
This creates big problems for the late Maurice Neligan's "little problems", the sick children of Ireland, as he put it in one of his Irish TimesHealthplus columns on July 27th
Think of a critically ill or injured child in the back of an ambulance during Dublin’s rush hour, or a frazzled parent hunting for parking with a sick toddler in the back seat, or a staff member driving to work because a child has to be left off at a creche en route?
Parking facilities are totally inadequate, with only 1,630 spaces between the paediatric, maternity and adult hospitals, which together have over 1,000 beds and around 4,000 staff.
Future-proofing the hospital for expansion has not been possible. With a footprint of less than four acres, the building has morphed upwards from an original nine storeys to 13 storeys, to 16 storeys.
The model-of-care which should have informed the choice of location has only been developed in the past year. It, in turn, has been compromised in the attempt to shoehorn departments into available space. Services which should be on-site are being decanted to the ambulatory facility in Tallaght.
Educational spaces and the one floor currently said to be for the research centre are already being eyed as future clinical space, a move that would tear at the heart of the concept of a National Centre of Excellence.
Should co-location with an adult hospital have been the determining factor in the siting of the children’s hospital? Had the adult hospital been on a university campus with excellent biomedical research and educational facilities with all sub-specialties – neurosurgery, craniofacial surgery, burns centre, cardiac surgery, transplant surgery, marrow transplantation etc – and had an adjacent maternity hospital, the answer would be yes, of course.
But given that the six adult hospitals around Dublin have shared speciality departments between them, there is no suitable match for the children’s hospital.
Better by far for children to build with one of the soon to be relocated maternity hospitals, with an adult hospital accessible in a timely manner should a mother require its facilities.
The Irish Association of Emergency Medicine has stated that for safe care of emergencies, a second 24-hour emergency department and acute inpatient facility is required.
This could fit on the Mater site, serving the local community safely as a satellite of the National Paediatric Hospital.
The National Paediatric Hospital, serving the whole country, should be on Dublin’s periphery on an extensive campus, where it will cost significantly less than the €650 million quoted for the city centre site.
Embracing long-term and short-term patients in family-centred care, with excellence in research and education facilities, it could expand to provide rehabilitation and hospice care, a mental health institute, child development, community and primary care co-ordination and resource centres.
It could, like the new Royal Children’s Hospital in Melbourne, Australia, due to open in late 2011, or the new Alder Hey Children’s Hospital in Liverpool, due to open in 2014, be “a hospital in a park” where the natural setting is part of its essential character and function.
Such a campus would be responsive to the future.
Dr Róisín Healy is a specialist in paediatric emergency medicine and a supporter of the New Children’s Hospital Alliance, which opposes the Mater project