Dáil debates

Tuesday, 3 April 2007

Adjournment Debate

Hospital Services.

10:00 pm

Photo of Charlie O'ConnorCharlie O'Connor (Dublin South West, Fianna Fail)
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I thank the Ceann Comhairle for the interest he has shown in this matter and for facilitating me and Deputy Crowe again. The reason we have raised the issue together, as neighbours in Tallaght, is because of our extreme concern regarding the manner in which this issue is now developing and the way it is being handled. Less than 50 days remain before the general election and a great deal of politics is in the offing. However, the people of Tallaght seek clarity in respect of the hospital's future. The HSE took the decision, approved by the Government, to locate the new major children's hospital — some call it a "super hospital" — at the Mater site. We had difficulty in accepting that but we have moved on. Now we want to know what the future plans are for Tallaght Hospital.

I was present some weeks ago when the Taoiseach visited the CDI project in Jobstown and members of the national media asked him if the children's hospital in Tallaght would close, as is claimed by some political posters in Tallaght and even in The Echo this morning. He said the children's services at Tallaght Hospital are not closing. That is the question we want answered. I raised the matter last week in the Dáil. The Ceann Comhairle is aware that I have raised it at every opportunity at the committee on health and in the Dáil in various Adjournment debates and through other procedures. Last week the Minister said that no decision has yet been taken as far as the future delivery of services in the region is concerned.

The Echo covers local issues well. It states in its editorial this morning:

'Medical politics' is a very interesting phenomenon that looks set to feature strongly in the election whenever it is called. The phrase is extremely apt in terms of our report this week on whether it is actually possible for Tallaght Hospital to co-operate with the planned new children's hospital at the Mater. It seems that the charter that rules what Tallaght Hospital can and cannot do dictates that it must develop and improve the facilities at the hospital. Obviously moving any part of the operation to the Mater ..... would conflict with this obligation.

Another report that has worried people in the Tallaght region suggests that the Department of Health and Children has sent a copy of the proposed statutory instruments to the hospital. A prominent member of the hospital board and the director of the Adelaide Hospital Society made reference to that at a political party meeting last week. It prompted a member of the Tallaght Hospital Action Group to say: "These statutory instruments will finally bring into law what we are all afraid of — Tallaght Hospital closing".

The Minister will understand my concern and emotions on this subject. Even if I did not live in and represent Tallaght, I would still believe that the Tallaght Hospital services must be maintained.

Photo of Joe CostelloJoe Costello (Dublin Central, Labour)
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The Deputy is not from Tallaght; he was not born there.

Photo of Charlie O'ConnorCharlie O'Connor (Dublin South West, Fianna Fail)
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Let me make my point. The Ceann Comhairle appointed me to the Tallaght Hospital board in 1988 and I have taken a strong interest in the project since then. I was a member of the board that opened the hospital in 1998. I live in the shadow of Tallaght Hospital and, like my neighbours in Tallaght, I want to know the position with regard to the future delivery of services. We cannot create a situation where children's hospital services will not continue to be delivered and, indeed, developed on the Tallaght Hospital site.

The Minister of State probably has a prepared script. I hope he listens to what I and my colleague, Deputy Crowe, say on this matter and tries to get answers for us. We simply want to know what the future holds for the children's hospital in Tallaght. That is what people in the area are asking. This is not just about the election, as I hope to be campaigning for Tallaght Hospital long after it, in whatever role I hold. What is the position with the hospital?

Photo of Seán CroweSeán Crowe (Dublin South West, Sinn Fein)
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I appreciate the fact that this matter has been selected for discussion. It is important for people living in the area. People are also concerned about what is happening with regard to Crumlin hospital, Temple Street Hospital and the Mater Hospital. The roll out of services affects children throughout the country and that is the reason we are focusing on it.

Major decisions are being made about children and their well-being. The difficulty for public representatives is that the people affected by the decisions are not being told what they are. They are not being given the full story. Last November, I raised a matter on the Adjournment in this regard. I spoke about the necessity for the Minister for Health and Children to respond on the proposed future development of hospital and community services in south Dublin and its hinterland. The Minister said that no decision had been made about services to be provided at the National Children's Hospital in Tallaght in the context of the national paediatric hospital and associated urgent care centres. Has any decision been made about the roll-out of those services? When will these important decisions be made? A statutory instrument has been sent to the board of Tallaght Hospital but people are still in the dark about what is proposed.

A total of 32,000 children attended Tallaght Hospital last year while 30,000 children visited Our Lady's Hospital in Crumlin. The local newspaper, The Echo, has suggested that the board of the hospital met to discuss proposals or requests to eventually move the service to the Mater site. According to the newspaper report, a prominent spokesperson said that the hospital will not be moving and that it is seeking to enhance the hospital's services, as its charter directs it to do. The hospital intends to adhere to the charter.

On 27 February 2007, the Taoiseach, when asked about the new paediatric hospital at the Mater, said that he did not envisage any changes in Tallaght Hospital, regardless of what happens. He made similar remarks at the opening of a centre in Kilnamanagh. However, this appears to contradict remarks attributed to the Minister for Health and Children, who spoke to representatives of a local action group on 16 January last. She said there would be no tertiary services at Tallaght Hospital. These services deal with serious illnesses such as heart problems, cancer and so forth. She also said there would be no secondary children's medical services at Tallaght, which cover illnesses such as tonsillitis, broken limbs, appendicitis and so forth. The Minister further stated there would be little day surgery, no children's accident and emergency service and no inpatient or overnight beds for children.

What children's services will be left in Tallaght Hospital? The area has one of the country's largest youth populations but there will be no local facility for children. As local representatives do not know and the Taoiseach and the Minister for Health and Children do not appear to know or at least are making contradictory statements on the subject, I hope the Minister will clarify the situation and erase some of the worries shared by parents and residents of the area. This issue affects not only them but people throughout the city. They are concerned about where this strategy is leading.

The people in Our Lady's Hospital in Crumlin have said publicly that they will not move to the new Mater site. A representative of the board of Tallaght Hospital, according to the report in the local newspaper, says it will not downgrade children's services at the hospital and suggests it is not moving. There is talk of a realignment and a merger of the hospital in Crumlin with the Coombe Hospital. What elements remain of the proposed roll-out of paediatric services in Dublin? The boards of the various hospitals appear to be taking a different direction from that put forward in the McKinsey report. I can quote other people on this issue. There are many contradictions in what is being said publicly and privately.

Regardless of the election, there is great concern about this issue. People have a stake in the hospital and they want to know what will happen to it. The hospital in Tallaght is an amalgamation of a number of hospitals, including the National Children's Hospital. The remarks being made by different individuals seem to suggest that thechildren's part of Tallaght Hospital will be removed.

Tim O'Malley (Limerick East, Progressive Democrats)
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I am replying on behalf of my colleague, Deputy Harney, the Minister for Health and Children. I thank Deputies Crowe and O'Connor for raising this matter on the Adjournment.

In late 2005, the Health Service Executive, at the Minister's request, undertook a review of tertiary paediatric services. McKinsey and Company were engaged by the HSE to advise on the future strategic organisation of tertiary paediatric services in line with best practice and in the best interests of children.

The resulting report, "Children's Health First — International best practice in tertiary paediatric services: implications for the strategic organisation of tertiary paediatric services in Ireland", included a number of key recommendations. It stated that the population and projected demands in this country can support only one world class tertiary paediatric hospital, and that this hospital should be in Dublin and should ideally be co-located with a leading adult academic hospital, that is, should be within walking distance of such a hospital. It should also provide all the secondary, namely, less complex, hospital needs of children in the greater Dublin area. It should be supported by a strategically located urgent care service.

A joint HSE-Department of Health and Children task group was established in February 2006 to advise on the optimum location of the proposed new hospital. The task group recommended that the new national paediatric hospital be developed on a site to be made available by the Mater Hospital. This recommendation was endorsed by the board of the HSE in June 2006. At its meeting on 8 June 2006, the Government strongly endorsed the recommendation of the board of the HSE, in line with the recommendation of the report of the task group, that the new national paediatric hospital be developed as an independent hospital on a site to be made available by the Mater Hospital. The Government subsequently reaffirmed this decision.

The Government also mandated the HSE to move forward with the development of the new hospital and its associated urgent care centres and to explore any philanthropic proposals in respect of its development. A joint HSE-Department of Health and Children transition group was subsequently established to advance the development of the national paediatric hospital.

The current stage of the process, which is being overseen by the transition group, involves the preparation of a high level framework brief for the new hospital. This brief is being developed for the transition group by Rawlinson Kelly & Whittlestone Limited, RKW, an established UK-based health care planning company. RKW will be advising on a range of issues which will help to inform the design of the new hospital. For example, it will advise on the preferred model of care, the core services to be delivered at the new hospital and the additional range of services to be provided outside the main hospital through the urgent ambulatory care service, taking account of international best practice in the planning of children's hospital services. Children attending an urgent care centre who need to be admitted to hospital will be transferred to the new hospital for secondary or tertiary care.

The report specifically stated that 85% to 90% of children presenting to accident and emergency units do not require to be admitted to hospital and, in the circumstances, it can be anticipated that children attending an urgent care centre associated with the new national paediatric hospital will continue to be treated at the centre and discharged home.

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 its associated urgent ambulatory care centres.

RKW has engaged in an extensive consultation process in the course of its work, including consultations with the National Children's Hospital in Tallaght and the other children's hospitals in Dublin, and its report is expected to be completed this month.

The Dáil adjourned at 10.55 p.m. until10.30 a.m. on Wednesday, 4 April 2007.