Sir, - We noted with interest your Editorial "Treating Child Cancer" (March 1st). For many years now this organisation has been lobbying for coherent strategic planning of health care services for children.
As you quite rightly say, provision of health services has hitherto often come in response to pressures which may have little relevance to best practice in health care. This has left the country with a piecemeal development of services, resulting in duplication in some areas and shortage in others.
Reports of the crises facing children's services in the State's flagship hospital in Tallaght do not surprise us. Our sympathies are with the patients - in particular the sick children and their families - and with the many staff in the hospital who find themselves in the unwelcome spotlight. The worry and anxiety caused to patients, parents, families and staff should not be happening.
Children have special and unique medical, physical and emotional needs, yet we have never had any major public debate on the subject. The sad consequence is that this new hospital appears to be facing the possible downgrading or relocation of established services. Decisions are apparently being made in isolation from the overall aspects of health care provision for children. As a result, we have hospital action groups taking to the streets, pleading to save the hospital and its services. Without criticising these actions, we feel it cannot be the best way forward if major decisions affecting the lives and health of many people are taken as a result.
Your Editorial refers to the Fitzgerald Report's sensible proposals. However, at the end of the century, surely a fresh look, taking into account current demographics, changes in transport patterns and advances in treatments and technology, is needed to determine whether Fitzgerald's proposals are still relevant.
Health care in Ireland is complicated by the fact that we have a small country whose population is thinly dispersed in rural areas or concentrated in relatively small conurbations. We have to develop our own unique models to serve us in the best way possible.
While we welcome the continuation of talks between the three children's hospitals in the form of a Joint Council for Children's Hospital Care, we are concerned that, as proposed, it is confined to the three Dublin children's hospitals, and that its make-up does not include representatives of the children and their parents - or the specialised nursing staff who provide such a central role in the care of sick children.
We are calling for political and sectorial allegiances to be set aside in the interests of comprehensive planning based on actual needs and best practice. Let us establish a national workshop group comprising representatives of all involved with the provision of health services to children - both the users and the providers - to develop a strategy to take us into the 21st century. - Yours, etc., Mary O'Connor,
Development Director, Children in Hospital Ireland, North Brunswick Street, Dublin 7.