The new children’s hospital: what’s taking so long?

It is 33 years since the idea of a new children’s hospital was first mooted, and it looks like it will take almost four decades for that plan to be realised.

In 1984, it was agreed that the Temple Street Children’s Hospital was ageing and unsuitable for modern medical use. An upgrade was approved back then, but in the subsequent years plans were either long-fingered or shelved.

As time progressed, paediatric medicine continued to be provided in Temple Street, Crumlin and Tallaght – each location with significant limitations in terms of space and facilities.

ExpandAutoplay

Image 1 of 5

Minister for Health Simon Harris with Grace Cawley from Donaghmede, Dublin, during the turning of the sod for phase one of construction of the new children’s hospital at St James’s Hospital. Photograph: Brenda Fitzsimons

In 1999 a plan was unveiled for a new children's hospital for the north side of Dublin, to be located on the site of the Mater hospital in Dublin. The plan was announced by taoiseach Bertie Ahern, whose Dublin Central constituency it was in, and then health minister Brian Cowen. It would replace Temple Street Children's Hospital. With funding of £230 million (€292m) the project was managed by Laura Magahy, who was also involved with the doomed National Stadium, aka "Bertie Bowl".

NMH board reaffirms commitment to St Vincent’s move

---

Cutting saturated fat does not reduce heart disease, experts say

---

Rhona Mahony: New hospital will revolutionise healthcare for women and children

---

Maternity move back on track as hospital boards soften stance

---

That plan was itself jettisoned in 2006 by then minister for health Mary Harney. Instead she formed a quango, the National Paediatric Hospital Development Board, with the aim of building a new national children's hospital to replace the three Dublin children's hospitals.

The rationale behind the strategy seemed sound. There was a clear need for national paediatric services with state-of-the-art facilities and equipment, which would provide specialist and general services for sick children. It would be trilocated with a teaching adult hospital and a maternity hospital (to come further down the line). The budget had now been raised to between €650 million and €700 million.

Controversial

The choice of the Mater site was controversial. Labour’s Jan O’Sullivan described it as another decision where Ahern could “bring home the bacon to Drumcondra”.

As usual there were overly-optimistic projections about the completion date – with some predicting it would open its doors in 2012.

The project proceeded apace for the next few years, even when the first chill winds of the recession began to bite. It was one of the first big projects to apply for planning permission under the Planning and Development (Amendment) Act 2010, which essentially allowed big projects to fast-track the process.

However, problems were beginning to emerge. The first was in early 2010 when a prominent doctor, heart specialist Maurice Neligan, announced that he no longer favoured the site, and claimed he had been "hoodwinked" by those in favour of the project.

Several months later, in October, the chairman of the development board for the new hospital, businessman Philip Lynch, also resigned.

Around that time several prominent consultants began to openly question the site, claiming the city centre location would increase traffic congestion and make it hard to access for families coming from outside Dublin.

New minister

The change of government in early 2011 saw a new minister, James Reilly, raising some questions about the site. At that stage some €30 million had been reportedly spent on this large-scale project.

In March that year he ordered a review, which was completed in July. The review, which was widely welcomed in political circles, backed the Mater.

With an opening scheduled for 2015, it seemed that the debate had been settled. However, in February 2012 An Bord Pleanála delivered a bombshell when it refused planning permission for the project.

Its ruling described the planned hospital as a “dominant visual incongruous structure which would have a profound negative impact on the appearance and visual amenity of the city skyline”.

Scrambling politically, the minister appointed an expert group chaired by Frank Dolphin to review the planning decision and to suggest different options. Mr Reilly said he was “not wedded” to the Mater site.

Number of sites

The group looked at a number of sites, including the Mater, St James’s Hospital, Connolly Hospital in Blanchardstown and a green-field site in Belcamp, north Dublin. The decision on which to choose was ultimately left to government.

There was some turbulence and disagreement between Fine Gael and Labour over this issue in the run-up to the final announcement, but in November 2012, St James's was chosen ahead of the other rivals. Among its main advantages were that it was already a teaching hospital with a large array of specialisms, and in close proximity to a maternity hospital (the Coombe).

The same criticisms that had been made of the Mater were now made of the St James's site. It was a city centre site. There would not be enough capacity for traffic. Public transport would be difficult. Why not opt for a green-field site near the M50, easily accessible by families from all over the country?

NUI Galway president Dr Jim Browne became chair of the board, with Eilish Hardiman appointed as chief executive (as she had been of the original plan). In April 2016, it received its final planning permission.

Asteroid

At that stage the budget was still being stated as €700 million. Acting minister for health Leo Varadkar was guilty of minor hubris when he confidently predicted it would be ready by 2020 "short of an asteroid hitting the planet".

This newspaper's health correspondent Paul Cullen reported in February that the cost would now be €1 billion, making it the second most expensive hospital in the world after the Royal in Adelaide (cost €2.2 billion). There will be 1,000 car parking spaces, and it will be the largest building project ever undertaken in Ireland.

Of course, an asteroid has also hit the planet. The latest completion projection is now late 2021 or early 2022, almost 40 years after the first modest proposal to upgrade Temple Street Children’s Hospital.