Jan O'Sullivan (Limerick East, Labour)
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With no disrespect to the two Ministers of State opposite, I regret the Minister for Health and Children, Deputy Harney, is not in the Chamber to take this important matter. She did not even attend the Chamber earlier when the matter was raised on the Order of Business.

My only concern is for the best outcome for the country's children. The resignation of Philip Lynch as chairman of the national paediatric hospital development board has cast a cloud over the hospital's future, however. Several substantial issues raised by Mr. Lynch have not been adequately answered by the Government.

Has the €400 million funding for the project been ring-fenced? A gap in funding, already believed to be €200 million, will have to be made up in philanthropic donations. From inquiries I have learned no one believes such a gap can be filled by this means.

The site for the proposed hospital has been controversial since it was first announced. There have been constant questions about the level of consultation and transparency in this choice. It is also believed political pressure was brought to bear on the choice. It is now being asked whether a national children's hospital can be delivered. Clear answers need to be provided to these questions.

Mr. Lynch also raised questions as to whether funding has been secured for an ambulatory centre at Tallaght which was to be part of the national paediatric hospital.

The public has lost trust in believing the Government has the capacity or even intends to develop a national paediatric hospital. Questions have also been raised as to whether the preferred site is appropriate since access, in particular, seems to be a problem. I do not just raise the question of whether it should be built on a greenfield site. Other suggestions, such as locating it at St. James's Hospital, were put forward at the time.

The questions I ask must be answered in the immediate future. Somebody must examine these issues independently, preferably somebody with expertise from outside this country. He or she should provide the public with honest answers to all these questions. The biggest question now is whether the funding will be available at all, irrespective of the site on which the hospital is to be built. Is the funding secured or can it be secured?

These questions should have been answered tonight by the Minister for Health and Children, who is responsible. She went on the airwaves over the weekend and blustered on this. She basically said: "I am the Minister, I am telling you it is going to happen and that will have to be good enough." A Green Party Minister and Fianna Fáil Minister are present. It should not be good enough for either of their parties to simply have the Minister for Health and Children say that. This man was put in the position of chairing this group. He is a person in whom I presume the Government had faith at the time. He has now resigned and raised these substantial questions which were not answered in a transparent or effective way by the Minister for Health and Children over the weekend.

I look forward to the Minister of State's reply, but this is not an adequate way of dealing with the issue. The Minister for Health and Children has not been in the House to answer questions and there was no response from the Government today to provide for a proper question and answer session with the Minister to address this crucial issue for our children.

Barry Andrews (Dún Laoghaire, Fianna Fail)
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No discourtesy is meant by my response to this important issue. The Minister, Deputy Harney, has invested a huge amount of time, appropriately, in this very serious matter for sick children.

The Government's priority is to provide the best standard of complex hospital care for children here. To further that priority the Government is fully committed to the construction of the new national paediatric hospital at the Mater Hospital site and to provide the associated ambulatory and urgent care centre at Tallaght Hospital. This is an essential part of the overall development and it is expected to open at the end of 2013. In late 2005 McKinsey and Company were engaged by the HSE to advise on the future strategic organisation of tertiary paediatric services. The resulting report, "Children's Health First", recommended that the new paediatric hospital should be located alongside a leading academic teaching hospital in Dublin. The principle of location alongside a leading academic teaching hospital is in line with widespread international best practice and enjoys widespread support. A joint task group, representative of the Department of Health and Children, the Office of Public Works and the HSE, was established in February 2006. This task group had extensive consultations with various stakeholders, including the three existing paediatric hospitals, the three maternity hospitals and external experts.

The high level framework brief for the new hospital, prepared by Rawlinson Kelly & Whittlestone Ltd., RKW, was completed in October 2008. The RKW report was informed by clinical and architectural experts from major children's hospitals in Toronto, Philadelphia and Manchester. The report includes a detailed assessment of capacity and concludes that the site adjoining the Mater Hospital can accommodate all the requirements of the new hospital and still allow expansion capacity beyond the year 2021. The designs for the new children's hospital have demonstrated that the site at the Mater campus meets the requirements for children, young people and their families. The Government decision to locate the new hospital on the Mater Hospital site is therefore based on the best possible expert advice and on internationally established best practice. The decision has been widely welcomed and has recently been supported by the faculty of paediatrics of the Royal College of Physicians in Ireland.

In addition, Dr. Ronnie Pollock of MPA Healthcare, London, was asked by the parents' group, the New Crumlin Hospital Group, whether the new hospital on the proposed site could provide the international standard of excellence in tertiary health care for children. Dr. Pollock replied: "it most certainly can. The synergy created by assembling some of the best clinical and research skills in the country on a single site will create the environment for Ireland to progress further in international standing with measurable benefits for children and adults." While the debate around location has been re-opened in recent weeks, the case for locating the hospital alongside a major acute adult facility remains unchanged. Whereas it may be possible to build the hospital somewhere more cheaply on a greenfield site, this once-off saving would be offset by higher running costs every year. The Mater Hospital site offers economies of scale and scope for shared services that cannot be achieved in such an undeveloped location.

In this regard the HSE has estimated that the cost of building the hospital to the same specification on a greenfield site would be in the region of €549 million whereas the cost of construction on the Mater Hospital site is estimated at €600 million. Both amounts exclude the cost of the ambulatory and urgent care centre at Tallaght. However, it must be borne in mind that the projected amount of €51 million would be a once-off saving. The savings derived each year from efficiencies delivered by shared services and economies of scale which would be available at the Mater Hospital site would not be available on the stand-alone site. It is estimated that a decision to move to a greenfield site could further delay the development by up to two years. The Minister does not believe that such a delay is warranted or justified. It is clear, therefore, that there is no good reason for changing a decision that was very carefully reached. It would risk delaying the project considerably and there would be serious disadvantages if the hospital were built on a stand-alone site.

The Minister established the national paediatric hospital development board in May 2007. Mr. Philip Lynch was appointed as chairman to the board. Mr. Lynch accepted appointment as chairman in the full knowledge that the location had been decided upon and that the function of the development board was to plan, design, build, furnish and equip the new national children's hospital on the Mater Hospital site. The Minister reluctantly asked for Mr. Lynch's resignation when it became clear that he could not accept the Government's position on the location of the hospital. Mr. John Gallagher, the new chairman of the national paediatric hospital development board, has experience and expertise in the areas of project delivery and philanthropic funding.

The board will now press ahead with work on the development. It commenced the planning process for the hospital directly with An Bord Pleanála on 11 October 2010. The planning process is proceeding under the Planning and Development (Amendment) Act 2010. The Minister believes this new Act has helped to streamline the process, by a direct referral to An Bord Pleanála. The estimated completion date for construction of the hospital is the last quarter of 2014. The Minister has asked the HSE to ensure that the fit out and commissioning of the hospital takes place as soon as possible after this.

The current estimate of the construction cost for the entire project is €650 million. This is a significant reduction on earlier estimates. The hospital will be funded from a total of €400 million from the taxpayer; €50 million from the HSE for the ambulatory and urgent care centre in Tallaght Hospital; €90 million in respect of car park, research, education and other elements; and €110 million from philanthropic funding. While challenging, the philanthropic element is considered to be a realistic sum for a project of this size. It is a statutory function of the national paediatric hospital development board to develop sources of philanthropic funding, and it has been working on this issue for some time. The Minister is confident that we will meet our objective of providing a world class paediatric service for our children in the new national paediatric hospital.