Dr. Sharon Sheehan:

I thank the committee for giving us an opportunity to speak. I am here at the master of the Coombe Women and Infants University Hospital. I am also a consultant obstetrician and gynaecologist. Like Dr. Greally, I have worked the three Dublin maternity hospitals as well as in Limerick and in the UK. I bring a range of perspectives to this.

Tri-location is absolutely essential. It is really simple as to why we should tri-locate. It improves outcomes and efficiencies across our services. What is very important, and I would like to take this opportunity to dispel many of the myths circulating, is we are not talking about moving a high-risk maternity unit onto the campus. We are talking about bringing the full breadth and depth of women and infant services that operate in the Coombe Women and Infants University Hospital onto the St. James's Hospital campus site to tri-locate with St. James's Hospital and the new children's hospital. Any misconceptions about a high-risk maternity unit are ill-founded. It is very important that it is the full breadth and depth. For us, in our hospital, it is about looking after maternity services. It is also very important to remember how much gynaecology service we deliver in our hospital. It is essential this is catered for on the St. James's Hospital campus and this has been allowed for.

The full breadth and depth of women and infant services is very important and it has been raised previously regarding the national maternity strategy. I had the great pleasure and privilege of sitting on the national steering group for this strategy. It fully endorsed the tri-located model, which is very important. Yes, it endorsed co-location but it fully endorsed tri-location, which is entirely consistent with Ireland's first and only national maternity strategy. This is very important.

Another very important issue to take into account is that we are not just talking about moving to any hospital. We are talking about moving to the St. James's Hospital campus. It is important to remember that St. James's Hospital is the largest and leading adult acute service in the entire country. It has the greatest number of national specialties and the greatest number of acute specialties. This is not just moving to any adult service, it is moving to the leading service for clinical specialties and research and innovation on the St. James's Hospital campus.

When we look at tri-location, and it has been raised previously, we speak about the transition for mothers and their babies to paediatric services, but we must also think about the transition for mothers and women to adult services. It is not just about children moving from paediatrics to adult care, it is about mothers moving across in a seamless transition to adult services. We are not just talking about buildings, and this is very important. Ms Hardiman mentioned this in her statement. Much work has already taken place, so we are in a position where we can state we are virtually tri-locating. This is not just waiting for a new shiny building and expecting our services to transition patients seamlessly across them. This is all about the collaboration that happens long before any planning permission applications are sought or a sod is turned in the ground. This is going on.

If I can speak about what is going on in the Coombe hospital at present with regard to maternal medicine, we operate one of the largest maternal medicine and comprehensive services for women with complicated medical histories during their pregnancies. Consultation is provided across our experts in the Coombe hospital and experts in St. James's Hospital and Tallaght hospital. This is already happening. We offer mothers who come in with complex maternal medicine cases the absolute optimum of care.

With regard to location with the children's hospital, extensive collaboration is going on regarding our services and paediatric services. An example of this is the all-Ireland fetal cardiac clinic. This is being led by Dr. Orla Franklin, who is a consultant cardiologist in Our Lady's children's hospital in Crumlin and Dr. Caoimhe Lynch, consultant obstetrician and gynaecologist and fetal medicine specialist in the Coombe hospital. This clinic looks after women from all 32 counties in Ireland. No other fetal service in the country is doing this. Mothers diagnosed with congenital cardiac anomalies in their babies in the womb are transferred and referred the Coombe hospital. They meet experts in our hospital and in Crumlin hospital, where their care is mapped out as is a plan for their labour and delivery and for what happens to the baby once it is born. This is happening right now.

This is the type of collaboration we need to have well-established before we think a shiny building will better enable it. We already know the service we offer for those mothers whose babies have been diagnosed with this condition in utero means the outcomes for those babies has improved. We are able to say this right now. Tri-locating only enhances this in terms of the physical space. So much work is already going on. Understanding the importance of tri-location across maternity services for women, paediatrics and adult services is very important. It is essential we do not lose sight of why we are moving onto the St. James's Hospital campus. It is because of the benefits the hospital will be able to deliver for us and the benefits the new children's hospital will bring. The benefits of tri-location are really simple. It will improve outcomes for our women and their families and it will improve efficiencies across our services.