Questions remain over best place to site Dublin’s new children’s hospital

A year ago today, the Government announced that the new national children’s hospital would be built at St James’s Hospital in Dublin.

The news was greeted with a mixture of approval and relief; here was Ireland’s biggest and arguably best-run hospital landing the plum capital project to be built under the current Government.

It seemed that at last the vision of providing top-notch care for the nation’s children in a purpose-built facility was getting back on track after the debacle surrounding the Mater site, torpedoed on planning grounds. The new hospital won’t be ready as was promised in time for the anniversary of the 1916 Rising, whose principals vowed in the Proclamation to “cherish all the children of the nation equally”. But things would be heading the right way.

Scant progress
On the surface, not much has happened in the year. Minister for Health James Reilly sent in a team of his officials to warm seats on the old board overseeing the project and it took months to set up two new boards and fill them. It's taken a year to appoint a chief executive and there have been delays in putting out a tender.

This ground can be made up quickly if the structures work efficiently and the planning application is successful, but there is a far more fundamental question. It isn’t “when will the hospital be built?” but “is it being built in the right place?”

We’ve been here before. We built two Luas lines that didn’t join up and are spending hundreds of millions making up for that mistake.

Now it is planned to spend over €500 million building a state-of-the-art children’s hospital, without locating it beside a maternity hospital. It’s the equivalent of building two light rail lines that never meet. Here’s why. There are about 500 high-risk pregnancies in Ireland each year and, in many, the mothers involved are booked in advance into a maternity hospital.

Many of the babies born require urgent medical attention in a children's hospital. They might have life-threatening cardiac or respiratory conditions that require immediate paediatric intervention. As reports into the death of Savita Halappanavar reminded us, none of the Dublin maternity hospitals has an intensive-care unit or high-dependency unit.

Danger to babies
Currently, these newborns are transported in a hazardous fashion by ambulance to one of the children's hospitals in Dublin. After the new hospital is built, they will still have to be transported by ambulance, with all the risks that involves.

This is hardly “joined-up thinking”. There are two ways of dealing with the problem: build a new maternity hospital beside the children’s hospital at St James’s or move the children’s hospital to a site beside a maternity hospital.

There is no appetite to revisit the decision to award the children’s hospital to St James’s. There is, theoretically, space to build a maternity hospital beside the new children’s hospital there. However, the site is cramped and access is poor, the building cost would be high and it is doubtful whether the money can be found for many years.

But rather than changing the Government's decision, why not tweak it, as An Taisce has suggested, by moving the site down the road from St James's to land beside the nearby Coombe Maternity Hospital in Dublin 8?

The two hospitals are closely linked and are now in the same Dublin Midlands hospital group.The two hospitals will share bosses, budgets and facilities; in effect, they will be indivisible.

The Coombe site is controlled by State agencies (Nama and Dublin City Council), so it can be purchased without difficulty. Because it’s a greenfield site, planning permission presents fewer difficulties. An Taisce has claimed the hospital could be built there for €130 million less than at St James’s.

Switching to the Coombe would also free up the back end of St James’s for an upgrading of cancer facilities to world-class standards.

No location is ideal. For the sake of the children of Ireland and, following the Mater fiasco, for the sake of national pride, this project has to go ahead. But in the right place.