BACKGROUND:Tallaght hospital has been ranked the worst performing hospital in the Republic, writes PAUL CULLEN
WHEN, AS he did on air yesterday, RTÉ’s knowledgeable Cathal Mac Coille has to ask what AMNCH is, you know the institution in question has an identity problem.
The Adelaide and Meath Hospital Dublin Incorporating the National Children’s Hospital, as its full title goes, has been better known as Tallaght hospital since it opened in 1998.
The hospital was built on a greenfield site in the southwest Dublin suburb after 20 years of planning and is the amalgamation of the Adelaide and Meath hospitals, the former National Children’s Hospital on Harcourt Street, and psychiatric services which were transferred from St Loman’s Hospital.
The amalgamation brought together different traditions and religions under an amended Adelaide Hospital charter, which recognised that the new hospital should be “a focus for Protestant participation in the health services” and would have a multidenominational and pluralist character.
However, another result of the merging of so many different institutions was an unwieldy 22- member board which has struggled with the complexities of running a modern hospital.
Tallaght is a voluntary hospital run by its own board, unlike some other hospitals which are run by the HSE. However, the HSE is responsible for funding and staffing issues, while the Health Information Quality Authority monitors standards.
The board is chaired by prominent senior counsel Lyndon MacCann and includes equal numbers of representatives from its constituent hospitals.
The hospital was stymied from the start by bad planning and a lack of resources. During construction, operating theatres had to be demolished because they were smaller than specified and laboratory equipment which would not fit on to the benches provided had to be replaced.
Originally, it was intended to have more than 830 beds and a 50-bed maternity unit. By the time it opened, this had dropped to 500 beds and the maternity service had not materialised. The new hospital ended up with 60 fewer beds than its constituent hospitals had in the city centre.
The first chief executive resigned in 1999 after a huge row with then Minister for Health Brian Cowen over cost overruns. In 2006, the Church of Ireland Archbishop of Dublin, Dr John Neill, expressed concern over what he said was the erosion of services at the hospital.
Tallaght’s efforts to win the new national children’s hospital came to nothing and it will soon lose these services when the new institution is built by the Mater. Last year, GPs were told not to refer any new breast cancer patients to the hospital as part of a centralisation of services in this area. However, a new urgent care centre will open in Tallaght in 2013.
Last month, Tallaght had its budget cut by €2.64 million after it was ranked the worst-performing hospital in the country under the HSE’s case-mix system.
Currently, the hospital has 600 beds and employs 3,000 people. Each year, about 76,000 people are seen by its A&E department.