Mattie McGrath (Tipperary, Independent) | Oireachtas source

Deputy Joan Collins is on her way; she is at another meeting. I am happy to speak on this Bill, which seeks to provide for the enhancement of children's health services and to establish a body that will be known as Children's Health Ireland to plan and deliver paediatric services. Goodness knows that development is needed in that area and we know that the saga of the new children's hospital went on for decades and we still have no deadline for when it will be delivered. I must declare that my late brother was a paediatrician who worked in many hospitals in Ireland and abroad. He finished up working in South Tipperary General Hospital and he was a wonderful advocate for sick children and children with special needs such as dyspraxia, dyslexia and autism. The lack of support services for these conditions causes trauma, pain and anguish to families.

The Minister of State knows better than anyone about this seeing as he has met some parents with me and he has tried to sort out the child and adolescent mental health service, CAMHS, situation in our area and especially in Cork. I would like a progress report on that because the service is not there at the moment. The Minister of State is well aware of my thoughts on this issue of the children's hospital ever since we in the Rural Independent Group tabled a Private Members' motion on the national children’s hospital in late March 2017. As part of the motion, we called on the Government clarify the exact mandate and the statutory and legal standing of the Children’s hospital group board and the National Paediatric Hospital Development Board. That matter remained shrouded in vagueness.

I said at the time that it was a national disgrace that the interests and vanities of medical academics, certain third level institutions such our neighbours out the road, Trinity College Dublin, and the political inability to admit a mistake took precedence over the pleas of parents and sick children. Previous speakers talked about the lack of consultation with staff and I agree that there should be meaningful consultation at all levels. It should not be the case that the higher up the pecking order one is that he or she would get more consultation. There should be proper and meaningful consultation and the people who should have been consulted were the sick children's parents and the likes of the Jack and Jill Children's Foundation and other organisations that do so much to fill the gaps and provide some semblance of service for very sick children and babies. "Gaps" is the wrong word to use because it is not a gap; it is wide open. They do not have the services. As Jonathan Irwin so excellently recounts in his tale of when he took his little baby home from hospital, "You are on your own", and it has become much worse in the 20 years since that happened. There is no support for the care of special needs children.

None of the arguments put forward by the Minister of State, the Minister or his party has allayed the fears of the parents of all of these sick children because they are hollow. I saw it here myself when we had a briefing in the audiovisual room. We were being supported on all sides that it was the wrong site but then when the party Whips came in, everything changed and there were only a few of us left standing. However, a wrong decision is never right. The location is not right and will never be right. I do not like to think of sick children in ambulances trying to access that hospital. Deputy Gino Kenny says it is a wonderful development. I have not seen it lately but I know where it is. I have been there and access is just not viable. We had a saga about whether there would be a helipad there and then I found out that the Sikorsky rescue helicopters are unable to land there. They will have to attempt to land on the three or four-storey side of a building. Pure, sheer and utter contempt and madness are being used to justify bad decisions taken by successive Governments.

What is equally galling is that we know that Members in each of the main parties explicitly accepted that this was the wrong site but have somehow convinced themselves that getting the hospital built now is more important than getting it built in the right place. That is sad because it will never be the right place in an expanding and overgrown city. A silk purse cannot be made out of a sow's ear and that is what it is. The staff have to have security going out to their cars at night as well. I am not trying to demonise the people living in that area but that is the sad fact. Nurses have been attacked and threatened on the way to and from work and the car park is not safe.

I asked questions at the time about the tender for the site, the process and the price. I know this from my small amount of experience in construction that the price will double because of the costs of demolition. Nice buildings with heritage value are being demolished but the cost of disposing of them and taking them out along with the noise and the interruptions to a hospital with sick children will be high. The cost of asbestos disposal will also come into it, not to mention the problems with the neighbours who have to be respected. It is difficult to undertake any construction project in the inner city. It doubles the cost because of the lack of landfill space and the legislation that we rightly have around that. We had a greenfield site out the road where anything could have been designed with ample green spaces and therapeutic gardens for sick children. Instead they will be looking out on concrete all their lives and at the moment they are looking out at cranes, jackhammers, noise, dust barriers and God knows what for the duration of the construction. There will be no outdoor therapeutic space with flowers, fauna, water and everything else that we know is helpful to children with many difficulties.

That should have been thought of as well but the stubbornness and buy-in from some of the medical profession had to have this. When they came in to brief us after they got scared about our motion, I counted them the evening that I was here sitting in the audiovisual room. There were 24 officials of all levels here from the HSE. Why three or four could not come in and tell us what they were doing is beyond me and they did not answer any questions. We thought it was a mighty crowd when we went in but the room was half full if not two thirds full with officials from the HSE along with the consultants who were proposing this. Considering the zeal with which they promoted it, one would wonder what vested interests were there because, as I said, a silk purse cannot be made out of a sow's ear. It will never be the right site and it will never be a site where people can go in with their child or their family and take them out for a stroll in a pram and sit for a while in a nice garden with a nice atmosphere away from noise and the hustle and bustle of the city with their specially trained dogs and everything else with them. We cannot do any of that on this site.

It was totally reckless to carry on the project at all costs. After many years of delay and threats of court action the people from Connolly for Kids came together to try to expose the madness of this project but they were rubbished, vilified and not listened to. The power of the system and senior officials in the HSE was brought to bear against them. Ministers who are afraid to stand up and give proper scrutiny and evaluation of proposals that are brought about by others rather than their own system the HSE and that is why we have it. I was over at the Irish Nurses and Midwives Organisation, INMO, this morning and the people there said that they are never listened to. They go into meetings with the Department of Health and they think that they are getting engagement but the next thing is that the Department of Public Expenditure and Reform just rubbishes it and they do not get listened to. I am an employer myself and if an employer does not listen to its employees, it is on a shaky road because they often have valuable information to impart and it is nice to respect them for their thinking. Deputies mentioned engagement and consultation with them. They should be consulted. They work there and have to drive there. It is their career and their vocation in many cases and they should have been properly listened to but, like many other things in this country today, what is big is wonderful, powerful people get their way and to hell with all ordinary people and their views and ideas even though they make common sense.

The Minister of State was not in the role at the time but he is continuing with this. It is the wrong site and I cannot the imagine the disruption that is there at the moment. I have met nurses who cried in front of me and I am sure other Deputies have met them. They told me how long it takes for them to get in and out of work.

Some of them have to get up at 5 a.m. They arrive there at 6 a.m. to get ahead of the rush and then sleep in their cars for an hour or an hour and a half. They do it to avoid the rush. It was a crazy decision. I salute Jonathan Irwin and the Jack and Jill Children's Foundation and the other people who led the campaign. They have been crushed but they have not gone away. It will be proven in the fullness of time that they were 100% right. They had no vested interest. They were concerned with the interests of the sickest and weakest children in our State and future generations and nothing else. They did it selflessly. They were joined by some eminent professionals whose names elude me. They came in here and they were vilified and demonised as if they were crackpots. They had experience of building children's hospitals in other countries. They had experience of these kinds of very delicate developments. This will be one of the costliest in Europe according to the projected figures. I am sure it will be two - if not two and a half - times the price in the contract.

There were questions when BAM got the contract. It had issues straight away. Much negotiation had to take place before a sod was turned or any machinery went on site. I would love to know how it is going on with the quantity surveyors and risk assessors regarding the issues with the structures that had to be removed and the damage done to the structures left behind and the reinforcement which was required. It is a difficult job. We all know, for example, what a major reconstruction of a home can involve. We often ask why we did not just build a new one. Many people look at a greenfield site and they cannot get planning permission so they do up an old house on the farm. They have wide walls and structural problems with roofs and drains, for example. A greenfield site can be adapted by bright and intelligent architects and engineers.

We had the model put before us. We have the space to do what we want. We could have a helicopter pad. A helicopter will have to land elsewhere and the patient will have to be transported by ambulance through traffic on the final leg of the journey. It is daft to have a national children's hospital without a helipad. It would not happen in wartime, when one would be under pressure. The first thing to do is secure the airspace and have some place to get people in and out fast.

The craziness continued and all the assurances of the National Paediatric Hospital Development Board rang hollow for the parents. They still ring hollow and will be proved loud in the fullness of time. It is my great fear we will be back here in a few short years talking about completely avoidable deaths. I do not say it lightly. I am not scaremongering. I fear we will be back here in a few years talking about completely avoidable deaths that unfortunately will have taken place when vulnerable high-risk babies had to travel from rural Ireland or some parts of Dublin to gain access to the congested St. James's site. I met the ambulance drivers and the specialist nurses. The Minister of State met them too. Did he listen to them? In such situations, the nurses scream at the drivers asking how long more when they are clogged up in traffic despite the sirens and Garda escorts. No one listened. That was four and five years ago when traffic was low on account of the downturn in the economy. The nurses were screaming and trying to do their best, for example for a very sick baby transferred from Clonmel, Cork, Donegal or anywhere in the country by ambulance. There was no helipad. These were our children and loved ones and perhaps the family was following behind them in a car or perhaps the mother was with them while the nurse was shouting to the driver, "How long more?" and the driver was in a cold sweat, doing his best. Advanced paramedics do their best to drive in those conditions in no-go areas.

It was madness. It was disgraceful. I do not know how one would describe it. They bulldozed the project through and insisted it go ahead in spite of the parents, the nurses, paramedics and people such as Dr. Finn Breathnach, who had unquestionable expertise in building projects such as this in the UK and elsewhere. It has been brushed under the radar. No doubt there will be more Supplementary Estimates passed to build it. It is draining resources from all the other services. It is reckless spending. One would think there was an unending purse. CAMHS and many other children's services, including orthodontic treatment services, are starved. There are children with all kinds of different issues and there is no place for GPs to refer them onto. Other Deputies referred to the fact that people have to go private when they cannot afford to do so. They have to pay €125 or €150 for a consultation. The CAMHS waiting lists are shocking. There are young adolescent children with mental health issues in the paediatric ward. It is causing untold trauma to their parents who have to stay with them. We have to hire agency staff to come in and sit with them at night but no one is thinking of their massive trauma. I spoke to the Minister of State and he agreed to intervene for one or two of them but I should not have to speak to the Minister of State and he should not have to intervene. The wonderful paediatric ward in South Tipperary General Hospital won an award last Friday night. No cognisance is taken of the interference and disruption it is causing the other sick children that are in there with medical issues and not mental health issues. One has to ask oneself why 12, 13, 14, 15 and 16 year olds have those serious issues but they have them.

The Minister of State told me that half the beds covering our area in Cork are unopened because of the vagaries of consultants who will not agree and play ball or do their duty. They have a hippocratic oath and a duty. They should cut out the nonsense. The Minister of State told me he was powerless to do anything. I accept that but it should not be the situation in a modern democracy. The buck should stop with the Minister and the red tape should be cut out in this dispute with consultants when sick children with mental health issues are languishing in children's wards. They are adolescents and should not be there at all. It is a terrible situation. It causes trauma for the whole hospital. It causes trauma in the children's ward. Some decisions have been taken lately by the management that they will not take these sick or distressed children anymore. Where will they go? I understand they are not being admitted into the hospital in Tipperary. I do not have proof of that. Where will they go? Their parents are desperate and frightened and they need support. They need psychiatric help. The parents have been traumatised. We are wasting the money. I was told today by the Minister, Deputy Regina Doherty, that the budget will increase by €600 million this year. It increased last year and the year before and we keep increasing it. The result is worse outcomes and fewer outcomes. There are some great outcomes in the HSE but the most vulnerable children of all are being denied access. I do not know what the Minister of State thinks of it but I look forward to his reply.

I hope the day never comes - I fear it will because we have persisted in the madness of pursuing the present location of the national children's hospital - that lives will be lost as a result of the inaccessibility of the hospital and its lack of a helipad. There is some kind of a helipad on the third or fourth floor. I cannot understand why. It will cause noise and disruption to the other sick children in the hospital who should be treated in a tranquil, sanitised, peaceful and calm area. Children love quiet. They love fun and games too but they love the quiet. Sick children are very special to me as they were to my late brother.

I am just saying that the train left the station and nobody had the power or the gumption to stop it. It is almost a full-time job trying to counter the professional spin and aggressive tactics used by the National Paediatric Hospital Development Board to push the project over the line. I salute the foot soldiers, the volunteers, the people who cared and the ordinary people, daoine na hÉireann, the Jack and Jill Children's Foundation and others that came together to form that group. I spent lots of time with them. Nobody wanted to listen. This was a vanity project for some professionals. No doubt the name of the Minister, Deputy Harris, will be on the door but if people cannot get into see it, it is not much good to them.

I have many serious questions on the legality of the National Paediatric Hospital Development Board and I will frame those after I review what the Minister says on the matter. There are serious question marks over the way it was pushed through and the way they would not countenance any engagement. To hear from Deputy O'Reilly, who was a trade union official, certain elements of staff were consulted more than others. They can consult all they want but if they do not listen it is very sad. I believe Mahatma Gandhi said it is bad enough to make a mistake of doing the wrong thing but to persist in doing the wrong thing is appalling.

I hope the Minister of State will have some answers and some accountability, which is very scarce in the Government, the Department of Health and the HSE these days. I hope he will clarify some of those issues and that we will get an update.

Why are any of us who want to be brought out not brought out to get a site report, to see the mayhem, the bedlam and the progress? We will know for ourselves when we arrive on site how close to completion it is because dates have come and gone, announcements have come and gone but it does not matter because we should be representing sick children not big business and not consultants with big egos. We had that experience in the last debate on the Bill we are going to discuss next week: big egos and consultants. The truth did not matter, it got crushed. Today the Government has decided to bring the legislation forward without pre-legislative scrutiny, more bullying tactics and more irresponsibility on the part of the Minister for Health, Deputy Harris. He is quoted in the Irish Examinertoday saying that he wanted full scrutiny of that Bill but he has proposed to introduce it without pre-legislative scrutiny. That is totally arrogant, juvenile and childish on his part.

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