Mary Harney (Dublin Mid West, Progressive Democrats)

I propose to take Questions Nos. 46 and 47 together.

The objective of the Government is to ensure the provision of a world-class hospital to serve the children of this country. It was for this reason, and no other, that the Government strongly endorsed the recommendation of the joint task force group and the decision of the board of the Health Service Executive to locate the new national paediatric hospital on a site to be made available by the Mater Hospital. The decision was taken in the best interests of children.

The McKinsey report, commissioned by the HSE at my request, provided the original basis for the decision to co-locate adult and paediatric hospital services. The report is very clear. It demonstrates that best outcomes for children are achieved by having the necessary breadth and depth of services on a single site. Co-location of paediatric services with adult services and, in due course, with maternity services is in line with best international practice and this was widely accepted by stakeholders when the McKinsey report was published.

The collaboration of adult and paediatric specialists is of critical importance. It creates the necessary platform for sub-specialisation and improved outcomes. The optimum delivery of complex paediatric surgical services can best be achieved by creating teams of specialists covering both adult and paediatric patients. Co-location also offers the benefits of providing transitional care for children with complex illnesses who are now surviving well into adult life.

I am fully satisfied that the task group undertook a rigorous and robust examination of the key issues in making its recommendation. It is true that the site chosen for the new national paediatric hospital is in the Taoiseach's constituency. It is being suggested that the Mater Hospital, an internationally renowned adult teaching hospital, should have been disregarded as a possible site for the new paediatric hospital simply because of its location. Comments by the chairperson of the Mater and Children's University Hospital Limited at a public function a number of months ago were reported out of context. They related to the Taoiseach's long-standing support for the redevelopment of the Children's University Hospital, Temple Street, on the Mater site, which at the time was at an advanced stage of planning. This has now been overtaken by the Government decision to develop a national paediatric hospital.

It is perhaps understandable, in circumstances where services provided at three hospitals are to move, that the decision has not met with universal approval. However, some of the public comment has been misinformed. Not all paediatric services are moving to the new hospital. As is the case internationally, the new national paediatric hospital will be supported by a strategically-located urgent care service. The transition group will be advising early in the new year on the recommended scope and location of this service. The group is working to ensure that the widest possible range of services will be provided through the urgent care service.

The report commissioned by Our Lady's Hospital for Sick Children in Crumlin was submitted to the joint HSE-departmental transition group some weeks ago and has already been the subject of discussions with the hospital. I also received the report and met with hospital representatives to discuss their concerns. The transition group is overseeing the preparation of a high level framework brief to inform decisions in respect of the range of services to be provided at the new hospital and the specific site to be ceded by the Mater Hospital. I understand that the transition group is satisfied that the new hospital can be fully accommodated on the Mater site. The transition group has assured the Crumlin Hospital authorities that their report will be taken into consideration in the preparation of the framework brief.

To date, no decision has been taken in respect of the range of services to be provided at the National Children's Hospital in Tallaght in the context of the development of the national paediatric hospital and the associated urgent care service. The Taoiseach has given an assurance to Tallaght Hospital that the Government wishes to see it thrive on a sustainable basis as a particular focal point for the involvement of the minority tradition in the health care system and as a key health provider to an expanding local population.

I am satisfied that the development, as planned, is consistent with international best practice. For example, I recently had the opportunity to visit the Children's Memorial Hospital in Chicago, which is an established secondary and tertiary paediatric centre. The hospital, which operates as a stand-alone facility, will transfer to a city centre site where it will be tri-located with an existing adult teaching hospital and a new maternity hospital. The hospital authorities considered other options, including a move to a greenfield site, but ultimately decided the clinical and other benefits of the tri-location model far outweighed any other considerations and would allow for the provision of an enhanced level and quality of care for children.

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