Oireachtas Joint and Select Committees

Wednesday, 16 January 2019

Joint Oireachtas Committee on Health

National Children’s Hospital: National Paediatric Hospital Development Board

Ms Eilísh Hardiman:

I am happy to answer that question for Deputy O'Reilly. I agree with her that there are challenges in respect of the existing hospitals which are trying to accommodate and meet care needs. I want to clarify that children's emergency medicine is different from adult services. I know that, unfortunately, the reason all but one of the children who are waiting this morning are in the emergency department is isolation. We have beds in the hospital but they are multiple-use beds and because these children have influenza and other infectious diseases we cannot place them in the wards. There is an absolute crisis. We need to get the hospital built as fast as possible because of the additional need for isolation specific to paediatric healthcare.

To answer the Deputy's question on the number being added to the existing bed base within the three children's hospitals, as a total number there will be 68 more beds. It is important, however, to break down that figure in order that it is understood. It is not just about numbers, but about the types of beds we are trying to introduce. The most important figure relates to inpatient and day cases, for which there will be 44 beds. Within that there are new beds for mental health and for children with eating disorders, of which we currently have none. Most important, we will also have 60 critical care beds. This will be the largest critical care unit on the island of Ireland. It will provide paediatric critical care for all of the sickest children in Ireland. It will provide the cardiac critical care for the whole of Ireland's services, because we are now providing cardiac services on an all-island basis. It will also have neonatal intensive care and critical care beds. That is a fundamental change. The greatest challenge for us in paediatrics is dealing with critical care needs and getting really sick children transferred from the regions quickly when they need to be transferred.

There also are the isolation requirements.

As for what is new, another 24 beds are based within the paediatric outpatient urgent care centres and in the emergency department as short-stay beds. We have demonstrated and already put them into Tallaght Hospital and we started to do so at Temple Street this year. I can report that for the children waiting for emergency care, our access for admissions in 2017 and 2018 has consistently reduced throughout the TrolleyGAR system because of these new ways of working. This hospital will address the critical need for isolation facilities for paediatric care, which has a greater demand for such facilities than in adult services. This year, we will open up the services at Connolly Hospital Blanchardstown. By July, we will have opened an urgent care centre and outpatient unit at the hospital. It will be the first time that there will be paediatric services in north County Dublin that will meet the vast majority of the requirements for that population. We have major pressures in this area, particularly at the facility at Temple Street, because 124,000 children avail of our paediatric emergency care facilities and 48,000 of them make use of the smallest unit at Temple Street. We anticipate that from this year, the investment that has been made in paediatrics will bear fruit and reduce some of the pressures being experienced at Connolly hospital.

We are dealing with a different way of working on the part of GPs. As we have demonstrated, by having short-stay beds we do not need to admit as many patients as at present and consequently, the initiative should help to alleviate any bed capacity issues. The initiative will be rolled out in Tallaght Hospital next year and then it will be rolled out in the hospitals. We have a highly integrated phased approach to how we are going to transform services for children, particularly in the areas of general paediatrics, trauma orthopaedics, in which we have seen significant improvements due to the investment that has been made in paediatrics, and of course urgent and emergency care. In line with the rest of the system and the Sláintecare report, we are increasing the bed capacity but we are doing so in a very niche way. It is not the same old, same old. We are identifying and future-proofing where we anticipate the future healthcare requirements are.

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