Ms Eilísh Hardiman:

I thank the Chairman, Deputies and Senators for inviting representatives from CHI to attend this meeting of the committee. I am joined today by my colleague Dr. Ciara Martin, clinical director and consultant paediatric emergency medicine in CHI.

I welcome the opportunity to provide the committee with an update from the organisation's perspective on the new children’s hospital project as requested in its invitation. CHI is client to the NPHDB for this capital project and my update to the committee is in accordance with this remit.

To give some background, CHI was established as a statutory entity in January 2019 to govern and manage acute paediatric services for the greater Dublin area as well as all national paediatric services, some of which are on an all-island basis. This resulted in the children's hospitals at Temple Street, Tallaght and Crumlin merging into CHI to deliver healthcare to Ireland's children in preparation for the move into new children’s hospital. In July 2019, we also opened the first of our two paediatric outpatient and urgent care centres at Connolly Hospital, Blanchardstown.

Regarding our services in CHI, 334,500 children and adolescents were treated by our 3,614 staff in 2019. Despite this volume of activity, more timely and greater access to paediatric services remains our single greatest challenge as a health service provider. CHI has several infrastructure and workforce constraints contributing to our waiting list and access challenges, especially relating to theatres, radiology, critical care, laboratory and outpatients, and these are all addressed in the new children’s hospital.

Covid-19 has hampered our ability to deliver the same or an increased level of activity in 2020. CHI has returned its activity levels to, on average, 90% of the 2019 month-on-month activity after an initial Covid-19 period of reduced activity earlier this year. This was achieved through putting up some prefabricated spaces and from repurposing spaces such as playrooms, family lounges and other communal spaces in our children’s hospitals into clinical spaces to accommodate the beds displaced from our multiple occupancy rooms - those are rooms that have two to six beds - to meet infection prevention and control guidance of 2 m distancing between beds. We have seen a decrease in our emergency department presentations but an increase in our mental health presentations.

This pandemic has demonstrated more than ever the need for the children’s hospital. CHI is currently assessing the impact on services for children and adolescents of any extension to the build programme.

The NPHDB have advised that they expect building of the second paediatric outpatient and urgent care centre based at Tallaght to be completed by September 2021. CHI is planning an eight-week operational commissioning period before opening services in this new building by the end of 2021.

Regarding Connolly and Tallaght hospitals, our experience of opening services in a brand new spacious and child-friendly building in CHI at Connolly has given us a taste of what is to come at Tallaght and the new children's hospital. It has also demonstrated how a new building can facilitate services compliant with Covid-19 guidance. Our new facility at Connolly has allowed CHI to accelerate some of our plans to integrate and reform services during Covid-19 such as an integrated orthopaedic fracture clinic serving all patients in CHI.

The overwhelmingly positive feedback from children, adolescents and families that have availed of services in our new facility at Connolly is testament to the need for this investment and the benefits of implementing contemporary models in healthcare. We are already reaping the positive benefits of more efficient provision of care and an effective patient experience with 97% of our patients attending urgent care there being seen within 15 minutes. Since January 2020, we have treated 5,792 patients at our urgent care centre and have seen 9,217 patients at the outpatients department.

As client for the project, the crisis and challenges in healthcare created by the Covid-19 pandemic has only magnified the difficulties our patients, their families and our staff experience daily in delivering acute paediatric services to Ireland’s sickest children in outdated facilities in our existing hospitals with their poor digital infrastructure and old equipment. I emphasise the criticality of these two new buildings, their digital infrastructure, modern equipment and enhanced workforce, which are at the very core of our plans to enhance clinical outcomes and develop services provided to Ireland sickest children and adolescents.

The new children’s hospital will expand the physical capacity and type of facilities needed to increase activity and reduce waiting times in all paediatric services to help tackle current and future challenges in child health.

I wish to express my sincere appreciation to our staff for their continued dedication and support over the past number of months. We look forward to walking through the doors of the new hospital and delivering care there. In the meantime, we remain committed to reforming our services and prioritising investment to support improvements in the delivery of services and to addressing the challenges that exist within paediatric services. My colleague, Dr. Ciara Martin, and I are happy to take any questions the members may have.