Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I welcome the opportunity to speak on this issue. This debate is important because much concern has been expressed not just in recent weeks but over a long time about the development of a children's hospital, on whatever site. I am here long enough to remember the debate even prior to the Mater Hospital being identified as the site. People with eminent views and experience of paediatric care said at that time that other sites should be considered. However, a decision was made to locate the hospital at the Mater Hospital site, and we know the results of that in context of the planning decision by An Bord Pleanála to reject it on foot of the mass of the site and of the proposed hospital. The issue of site selection was revisited and eventually in 2012 the Government decided to locate it at St. James's Hospital on foot of thorough investigations of various sites. The Dolphin report did not make a 100% recommendation of any one site. However, there is no doubt in the context of clinical expertise and clinical outcomes that taking account of the clinical provision in St. James's Hospital was a key determining factor in locating the children's hospital on that campus.

Of course, there have been concerns about accessibility, parking and accommodation for families. I am not an expert in choosing the location of, designing or assessing the best clinical expertise for a children's hospital. I have to defer to the experts. However, having questioned many involved in the process and reading much of the documentation I have come to the view that St. James's is as good a site as we can find. That is determined not just by me or anyone in this Chamber: it was determined by the fact that An Bord Pleanála granted planning permission for that site and took into account many of the concerns being expressed by others who held a contrary view, for example, parking. A total of 1,000 places is proposed for the St. James's children's hospital campus. Of those, 675 will be ringfenced for families and patients. Therefore, there is an acknowledgement that parking is a critical component in ensuring ease of accessibility and that there is no pressure on parents or siblings to find parking. Many people who contacted me had very difficult experiences finding parking in Temple Street or elsewhere when bringing their children to Dublin. Another issue regarding accessibility is traffic. The inspector's report is clear that the James Connolly Memorial Hospital site was not necessarily the best and most accessible when taking into account the numbers who would use the campus and the dependence on car transport only to access it, as opposed to the availability of proper public transport services to the St. James's Hospital site. All of these issues must be taken into account.

I do not question the bona fidesof anybody inside or outside this House who has expressed a contrary view and has campaigned passionately for the same outcomes as I speak for, namely that we develop a world class health care facility for the children of this country. No parents of children who have been to hospital question the commitment or expertise of the staff but everybody questions the physical environment in which that health care is provided. The Minister referred to the crumbling facade of Temple Street which is a nineteenth century building. Our Lady's Hospital in Crumlin was built in the 1950s. We have to be conscious of the need to develop a world class facility. We must also take into account not just the building but what is inside the building in terms of attracting the best clinicians and medical professionals in the world to practice in the children's hospital. Having read much of the documentation and having listened to people with clinical experience and managerial and administrative experience in children's hospitals I believe co-location broadens the ability to attract world class clinicians to the children's hospital because in sub-specialities there is often a crossover and the seamless transfer from paediatric to adolescent to adult care has also been mentioned in much of the documentation. People have also expressed the view that we have stand alone world class children's hospitals being developed and there is no doubt about that. Some do stand alone, but they do so very often in close proximity to adult teaching hospitals.

For those who have concerns we need to make our point through action, through foundations and through concrete and steel and thereafter clinicians and that we should start building it, mindful that it is a huge undertaking for the State which stretches the financial capacity of the State. This is a flagship development of a new era of an expanding economy and ability to fund infrastructural projects. We do not want to see runaway escalating costs. It is imperative to rein in construction costs and that there is a robust tendering process throughout from initial construction, through kit-out etc.

This is an exceptionally exciting time. That is evident from older documentation I have read, such as the Dolphin report. It was also evident from recent presentations in the AV room at which people explained the St. James's site and outlined what is going to happen there. There is a lot of excitement and optimism among the paediatric clinical community. They are optimistic about the environment in which they will be providing care to the children who need it most.

When one talks to parents, one hears that they have slept on chairs in crowded wards where children are in close proximity to each other, not taking into account what is required in a modern children's hospital with stand-alone individual suites. One hears that we have provided care which, but for the commitment of the clinicians, nursing staff and other health care professionals, would have led to the collapse of the system. We have lacked a world-class infrastructural development. We must welcome, therefore, the 375 individual suites where there will be bed capacity for a parent or a sibling to stay with a child for a number of nights. The Ronald McDonald development also allows families to stay for longer periods. We must ensure that there is a holistic approach to the health of the child, that there is a nice ambience and that it is a suitable environment for a family to stay in while a child is being treated.

The transfer of children to the hospital is an issue which needs clarity. Of the children currently attending Dublin children's hospitals, 70% are from Dublin, Wicklow, Kildare and Meath. We should not consider the possibility that large numbers of children will be transported late at night in the backs of cars to the children's hospital. That is not what happens. If it is happening, it is for the wrong reasons. If it is the case, we are failing in our care systems in the rest of the country. Commitments must be made. If we are to develop a world-class children's hospital in Dublin, we must remain conscious of the satellite requirements in Galway, Sligo, Cork and elsewhere. We cannot have a situation where children have to be transferred urgently to the children's hospital without being able to avail of any support or triaging in their home areas. It is critically important that we do not concentrate everything in the children's hospital to the detriment of services elsewhere in the country. The Minister stated that construction of the two satellite outpatient centres will soon begin in Tallaght and Connolly hospitals.

The Minister must accept that there is huge pressure on systems throughout the country. I said in November 2012 that I was concerned that a national children's hospital, regardless of its location, could take all the resources from elsewhere. I am still concerned about that. Regardless of whether it is located on the St. James's site or at Connolly Hospital, the fact that the new facility is being built in Dublin could lead to there not being capacity in the rest of the country. The 30% of children who currently travel to Dublin for treatment would still have to do so because the necessary capacity, clinical experience and supports would not be available across the rest of the country. Planning a flagship hospital must also take account of the many areas of the country that are a long way geographically from the its location.

A helipad has been proposed for the hospital. Sikorsky helicopters cannot currently land on elevated helipads. What is being done to ensure that the vast majority of helicopters which transfer patients in this country will be licensed to land on the helipad at St. James's? As the Minister knows, these are the helicopters capable of carrying patients for long distances and during the hours of darkness. However, they are not licensed to land on elevated helipads and will have to land at the Royal Hospital, Kilmainham. How many people are expected to transferred to the hospital by helicopter per year? If facilities in Cork, Limerick, Galway and elsewhere are downgraded, more patients may need to be transferred to the national children's hospital because the capacity of the regions to triage and cater for children in their own area will have been undermined. We have limited resources. Those resources must not all go to one place if that would mean downgrades elsewhere.

Reference has been made to the land available at St. James's. It is important to acknowledge that much of the 14 acres will be taken up by the children's hospital. There is a four-acre site which will be available for the maternity facility when it moves from the Coombe. We need to follow through on promises about tertiary hospitals, tertiary care and tri-location. If tri-location is the ultimate goal, we should also expedite the movement of the Coombe facility to the site. To do otherwise would undermine the reason for locating the children's hospital on the St. James's site.

A huge number of students will be coming to St. James's, not only to the children's hospital but also to the adult teaching hospital, which already has many students. We must be conscious of the implications for public transport of such a large number of people working and studying on the site, many of whom will be travelling there on a daily basis. Public transport is a critically important component in that area. For that reason, the St. James's site is important as well.

When we consider how to assess a nation, it is often on the basis of how it cares for its elderly and how it embraces its young that it is judged. It is now time to build this hospital. Issues have been raised about the location in terms of ensuring that parents and siblings have access to accommodation, that there are car-parking facilities, that long-term accommodation is available, that there is a holistic approach to the child's care and health, that it has a nice ambience, etc. While there are concerns about the cost of construction, when the St. James's facility is built, it will be world-class in nature and will benefit the children of this country for many years to come. I hope it will get speedy support from Government, all requisite funding, and that construction can commence so that it can begin its future as a world class health centre for children.

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