Ms Eilísh Hardiman:

I thank the joint committee for inviting Children’s Health Ireland to attend to update it on the new national children’s hospital. I am joined by Professor Jim Browne, chairman of the board of Children’s Health Ireland.

I welcome the opportunity to provide the committee with an update on the new national children’s hospital project as requested in its invitation. As Children’s Health Ireland is the client of the development board for the project, my update to the committee is in accordance with this remit.

Children’s Health Ireland commenced on 1 January 2019 as the entity that governs and delivers acute paediatric services at Crumlin, Temple Street and Tallaght hospitals and from July at Connolly Hospital in Blanchardstown. The commencement was facilitated with the support of the boards and management of Our Lady’s Children’s Hospital, Crumlin and Temple Street Children’s University Hospital, both of which dissolved this month. I take the opportunity to thank the two former boards and the existing board at Tallaght University Hospital, as well as the previous Children’s Hospital Group Board, for their stewardship of acute paediatric services for many decades and, in some cases, centuries. I also acknowledge the previous Children’s Hospital Group Board in helping to get Children’s Health Ireland commenced. I point out that all board member positions are voluntary and involve the greatest of dedication and effort.

In the delivery of the physical buildings Children’s Health Ireland continues to work closely with the development board on matters related to the build, design and equipping of the new facilities. A series of management and working groups engage on a monthly basis to progress all matters related to ensuring the paediatric outpatients and urgent care centres at Connolly and Tallaght hospital and the new national children’s hospitals meet the clinical and operational needs of children, their families and staff. I take the opportunity to recognise the commitment, work and support of Mr. John Pollock, the former project director of the development board. Within weeks, we will be delivering a service at the paediatric outpatients and urgent care centre at Children’s Health Ireland at Connolly Hospital. It will be followed next year by the paediatric outpatients and urgent care centre at Children’s Health Ireland at Tallaght Hospital. The new facilities, together with the opening of the new national children’s hospital in 2023, will transform how acute paediatric healthcare is delivered to the sickest children in Ireland and local secondary care services are delivered in the greater Dublin area in delivering better healthcare outcomes, as well as ensuring better experiences for children, their families and staff.

Children’s Health Ireland at Connolly Hospital in Blanchardstown was handed over by the development board to Children’s Health Ireland for clinical commissioning in May. Equipment installation is near completion and operational. We hope it will be done next week. Clinical commissioning is under way in time for opening on 31 July, initially on a phased basis.

I remind the committee that 25% of the population are children under 18 years of age. The majority are healthy, which is good, but one quarter of three year olds are obese, while 16% of children have a chronic disease, such as diabetes, allergies and asthma. This figure is increasing and 2% are acutely ill or have very complex care needs.

There is an over-reliance on hospital based inpatient care, with many services accommodated in facilities in Dublin that are no longer fit for purpose. The new children’s hospital will provide national paediatric tertiary services which account for about one quarter of what we do, as well as secondary paediatric care services for children in the greater Dublin area There are 442 beds and 3,388 whole-time staff equivalents delivering services annually to 25,000 inpatients, 28,700 day cases, more than 145,000 outpatients and 120,000 emergency department attendees at the three children’s hospitals.

All national paediatric services are within the remit of Children’s Health Ireland, some with an all-island remit, for example, the all-island congenital heart disease network. The plan for children’s healthcare is outlined in the integrated programme for child health which includes acute paediatrics, social, community, primary care and child and adolescent mental health services. This cross-divisional programme, rightly, reflects a population-focused, integrated and interdisciplinary approach to children’s healthcare and identifies the resources required to best support parents, guardians, families, children and young people in achieving healthier outcomes.

From the perspective of Children's Health Ireland, we have been focusing on our integration programme. The programme centres on valuing and aligning the different cultures of the three hospitals, integrating ICT systems, standardising clinical and operational protocols and staff recruitment and training. Significant work is under way across Children's Health Ireland and I will update the committee on some of these aspects. We have implemented a single patient administration system. Part of Children’s Health Ireland’s path to integrating ICT systems is a new patient administration system. It was implemented and went live in mid-April at Crumlin and Temple Street children's hospitals. It was done without any disruption to services. It will allow Children’s Health Ireland healthcare professionals working in both hospitals and Connolly Hospital, Blanchardstown, when it opens to view shared patient details, including inpatient and outpatient history, referrals and waiting list details, transfers and chart tracking. This means that patients will have a single Children’s Health Ireland unique identifier across Crumlin, Temple Street and Connolly hospitals. It is a tangible and valuable result of the early part of our integration work to support shared and common outpatient waiting lists, starting with general paediatrics.

Turning to staffing, the majority of recruitment for the paediatric outpatient and urgent care centre at Connolly Hospital is well advanced, with most doctors, nurses, health and social care professionals and administrative staff recruited and start dates in the forthcoming weeks and months. We will start to treat patients from 31 July. Children’s Health Ireland at Connolly Hospital will provide a range of services, including urgent care, with a short stay observation unit. Children will be observed and treated for up to eight hours before being discharged. A very small number will require admission to one of our hospitals. The facility will also have outpatient care services, including general paediatrics and orthopaedic fracture clinics. Other specialties will follow. At Connolly Hospital Children’s Health Ireland will create additional capacity for general paediatrics, which is a welcome development in addressing waiting lists. It will also contribute to significant reductions in waiting times and make the situation better for children and their families.

Children’s Health Ireland at Connolly Hospital represents a significant transformation of services for families and children. It will facilitate a new model of care in paediatric services in north County Dublin and its environs, something it does not have. It will deliver the right care, at the right time, in the right facility and as close to the child’s home as possible, as outlined in Sláintecare. I welcome the opportunity to invite and bring members of the committee to the centre ahead of its opening in order that they can see at first-hand this new state-of-the-art facility and the impact it will have in the delivery of care and services.

Children’s Health Ireland is in a period of transition, not just for our staff who transitioned to the new entity in 2019 but in how acute paediatric services are delivered in Ireland. We believe the changes we are making and the impact they will have can be used as an exemplar for the transformation of services across the system. The changes we are making will deliver better, safer and more sustainable healthcare for children, young people and their families.

I thank members of the committee for their attention. I am happy to take questions.