Ms Eilísh Hardiman:

I thank the Chairman and members for inviting the Children's Hospital Group to attend the committee to outline plans for children's health care. I am joined by Dr. Ciara Martin, one of our clinical directors. Our group clinical director is on leave this week.

The Children's Hospital Group consists of Our Lady's Children's Hospital, Crumlin, Temple Street Children's University Hospital and the National Children's Hospital at Tallaght Hospital. Academic arrangements exist with all universities providing paediatric education and research. Collectively, these three hospitals have 443 beds and 2,865 whole-time staff delivering services to 25,000 inpatients, 27,800 day cases, over 153,000 outpatients and 118,000 emergency department attendances annually with an expenditure of €300 million. All national paediatric specialties are in the group, some with an all-island remit. We have specific access and capacity challenges for some paediatric services but in general, the three children's hospitals and their staff are held in high regard for the services they deliver despite these challenges.

A total of 23% of our population are children less than 16 years of age. The majority are healthy, but one-quarter of three year olds are obese; 16% of our children have a chronic disease such as diabetes, allergies and asthma and this is increasing and 2% are acutely ill, some with very complex care needs. Currently, there is an over-reliance on hospital-based care, with many services accommodated in facilities that are not fit for purpose.

The plan for children's health care is the integrated programme for child health, involving acute paediatrics, social, community, primary care and mental health services. This cross divisional programme rightly reflects a population focused, integrated and multidisciplinary approach to children's health care and the resources required to support parents, families, children and young people in achieving healthier outcomes and will take ten years to implement.

The plan for the acute paediatric services element of this integrated programme is the national model of care for paediatrics and neonatology, developed over four years through extensive engagement with parents' representatives, general practitioners, GPs, community colleagues and hospital staff in all acute paediatric and neonatal services. This plan outlines where and how acute paediatric services are best provided across the health system, with the new children's hospital designated as the central component of an integrated clinical network for acute paediatrics. The primary principle of this network is to conveniently deliver most paediatric services locally, with regional units clearly identified and supported from the centre and all highly specialised and national services consolidated in one children's hospital. Multiple health policy reports exist to support this service configuration for contemporary and sustainable paediatric services, and reflect how acute hospital services are developing in other countries.

The 12 member Children's Hospital Group board, chaired by Dr. James Browne of National University of Ireland, Galway, NUIG, was established in August 2013 as an administrative board with specific remits to integrate the three children's hospitals, develop a single clinical and corporate governance for paediatric services and act as client for the new children's hospital capital project and information and communication technology, ICT, programme collectively referred to as the children's hospital programme. The three independently governed children’s hospitals in the group have voluntarily agreed to merge into a new single legal entity before moving to the new facilities. The Minister plans to bring primary legislation for enactment in 2017 to establish this single entity and the Children's Hospital Group board.

The children's hospital programme will successfully merge these three hospitals into a new single organisation. It needs to transform general paediatric and emergency care in the greater Dublin area with the opening of the new paediatric outpatient and urgent care centres at Tallaght and Connolly Hospitals in 2018, implement an integrated clinical network for paediatrics across the health system and move services into the new children's hospital by mid-2021, the largest capital investment in the public system. In line with the Government's digital first public service ICT strategy, the new hospital is planned as the first "digital hospital" in the system with the implementation of an electronic health care record, as well as other evidence-based standards, such as 100% single rooms.

A decade after the first health policy position on acute paediatric services, the McKinsey report in 2006, last April An Bord Pleanála granted planning permission for the new children's hospital to be built on a campus shared with St. James's Hospital as well as the new paediatric outpatient and urgent care centres at Tallaght and Connolly Hospitals. The new hospital will provide national paediatric tertiary services, 22% of activity and secondary paediatric care for children in the greater Dublin area, 78% of activity.

In summary, the Children's Hospital Group's ten year vision for acute children's health care is to establish a national children's health care organisation that puts children's health first and foremost in its decision making; an integrated care programme for child health, with the new children’s hospital central to a clinical network of acute paediatric services in regional and local units and by using technology, to reach out to GPs and into children's homes; to reconfigure paediatric services within the other hospital groups to reflect the paediatric population served, keeping appropriate services local and supported by outreach from the new children's hospital; a 24 hour national paediatric and neonatal retrieval transport service to ensure timely transfer of the sickest babies and children to the most appropriate hospital; successful integration of the three children's hospitals into a state-of-the-art digital hospital, providing both national specialist services and a local paediatric service to the greater Dublin area that our valued staff are proud to work in; and progress a paediatric academic health sciences network with academic partners and industry to enhance paediatric education, research and innovation. These developments, which will positively affect one quarter of our population need to be considered not just in terms of how they will enhance health care for children but also how this integrated plan for acute paediatrics can demonstrate that the Irish health system can be reformed to deliver better, safer and more sustainable health care.

I thank the members of the committee for their attention. Dr. Martin and I are happy to take any questions they might have.