Bernard Durkan (Kildare North, Fine Gael)
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Question 9: To ask the Minister for Health if the expert group currently examining the issue of the location of the proposed new children's hospital will be asked to make a single recommendation for a particular site or if a recommendation for two or more sites is likely to emerge thus leaving the final decision to him; if he intends to carry out a thorough examination of the costs to date associated with the issue including site, consultancy or architectural costs; the extent to which the costs to date have arisen from payments to particular agencies or consultants associated in any way with the examination of the project; if influence can be brought to bear on the recipients of fees to date to carry out any further work required on a pro bono basis; and if he will make a statement on the matter. [16250/12]

Dara Calleary (Mayo, Fianna Fail)
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Question 23: To ask the Minister for Health when the first meeting of the Dolphin Group will be held; and if he will make a statement on the matter. [16462/12]

James Reilly (Dublin North, Fine Gael)
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I propose to take Questions Nos. 9 and 23 together.

I am committed to ensuring the delivery of a world class hospital for the children of Ireland providing the highest quality treatment they deserve, in other words, the best treatment in the best environment. This project is one of the main priorities for the Government and is a commitment under the programme for Government.

The decision to refuse planning for the new children's hospital was disappointing. Immediately following the decision, however, I announced my intention to establish a review group to consider the decision of An Bord Pleanála to refuse planning permission for the national paediatric hospital. The Government has agreed the terms of reference for the review group. The terms of reference are as follows:

To inform itself about the planning considerations and processes affecting this project.

To consider the different options which now exist for progressing the construction of a national children's hospital having regard to –

·Government policy on the delivery of health services, including accessibility and paediatric services in particular and best clinical practice considerations,

·the cost and value for money considerations of the different options,

·the likely timelines associated with the different options,

·the implementation risks associated with the different options.

To advise me, in the light of these considerations, on the appropriate next steps to take with a view to ensuring that a national paediatric hospital can be constructed with minimal delay.

To report to the Minister within 56 days of the first meeting of the group.

The aim of the review is to consider all the possible options for the earliest possible delivery of a new children's hospital. The review group will present its findings on each of the possible options for my consideration. The group will not be undertaking a site selection process as such.

I have appointed Dr. Frank Dolphin to chair the review group. There is a wealth of expertise on the group. The membership is composed of senior planners, an architect, the CEO of a major UK paediatric hospital and senior clinicians in the field of paediatrics. Dr. Dolphin is currently in contact with the other group members and expects to hold the first meeting of the group within days. I will await the completion of the work of the review group and do not wish to make any further comment on the matter at this time.

Billy Kelleher (Cork North Central, Fianna Fail)
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We welcome the fact the Minister appointed the Dolphin group which is to report 56 days after its first meeting. I do not know what its findings will be but it has been asked to look at the Mater site, a greenfield site, a brownfield site, co-location and whether a stand-alone national paediatric hospital can be established.

These are quite broad terms of reference, which are welcome in the sense that at least everything is on the table again.

There is no doubt the report of the Dolphin group and its recommendations will delay the building of a national children's hospital because wherever it will be located, a process will be required. Obviously we would like it to go ahead as quickly as possible. In the meantime our children's hospitals, including the one in Crumlin, suffer greatly from a lack of capital investment. I do not expect any Minister to fund huge capital investment programmes without knowing where the national children's hospital will be located, but in the meantime the existing children's hospitals are at crisis point. What will happen these facilities in the coming years while we wait for the national children's hospital? This is a key issue for the delivery of paediatric services and health care in the short to medium term because there will be a delay regardless of what decision or recommendations are made by the Dolphin group.

James Reilly (Dublin North, Fine Gael)
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I welcome the Deputy's assertion that we are all on the one side, as we all want to see the hospital progress as quickly as possible. Nonetheless, the refusal on the Mater site requires time for reflection. The two months to be taken to report, including the month that has passed, will stand to serve the children of the State for 100 to 200 years and must be viewed in this timescale. I doubt there is any one more in a hurry than me to have the hospital built.

The last thing I want to see is scarce capital reserves and resources ploughed into temporary accommodation that will prove to be no longer necessary in a few years. I want this expedited. I have made it very clear that all options are on the table and that the advice the Government and I want is on the pros and cons of each option and for us to make a decision quickly to get on with this and provide what is a right for our children. We have some of the best nursing, medical and paramedical practitioners and we need to provide them with the best setting to provide treatment.

Eoghan Murphy (Dublin South East, Fine Gael)
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Will the Minister comment on recent remarks by the chairman of NAMA, Mr. Frank Daly, that NAMA is actively considering a number of potential sites for the proposed children's hospital? How will this fit in with the work of the expert group? Will NAMA come before the group with a recommended site or sites or will these be considered only after the current site is rejected, if it is? Is the Minister aware of any potential sites in NAMA, for example, the Elm Park site by St. Vincent's hospital?

James Reilly (Dublin North, Fine Gael)
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I am aware of all of the issues raised by the Deputy. It is the role of the group not necessarily to interview NAMA on all of its sites, but to give an indication of the pros and cons on a new site, a brownfield site or a greenfield site. It is not my intention that it will inspect every site because if it did so months would turn into years very quickly. I am aware of the sites to which the Deputy referred and there are quite a number of them. NAMA has written to me and has identified 11 sites, some of which might have use for hospitals of a different nature and provide opportunities on another occasion. I am not here to prejudge what the review group will tell me; I await its advices and I will act accordingly.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I am also very concerned about the situation regarding our existing paediatric hospital sites in Crumlin, Temple Street and Tallaght. I am particularly concerned about the hospitals in Crumlin and Temple Street because front line service providers have spoken out and made the case very strongly that one cannot suspend the resourcing of these services while the construction of the new hospital gets under way, and we are not even at that starting point yet.

Reflecting on the earlier comments, I appeal to the Minister not to use the intention of moving to a new paediatric national hospital as a reason not to continue to properly resource the existing paediatric sites, because there is ample evidence of intolerable situations where children are left waiting in totally inappropriate circumstances in accident and emergency departments trying to access beds in a number of these sites. I appeal to the Minister to say something positive on this matter.

The Minister indicated the Dolphin group would not have the responsibility for site selection but would report to the Minister on the various proposals presented heretofore. Do these include the very recently circulated proposal from the Coombe hospital? As far as I am aware, it was presented in the past week. Will the Dolphin group have an opportunity to appraise all cases known during the course of its period of deliberation? Will it offer an opinion on all of these and others which may yet present before it concludes its business? How soon after it reports does the Minister intend, and with whom, to make the decision?

Billy Kelleher (Cork North Central, Fianna Fail)
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The previous expert group that examined the Mater site indicated it was the most suitable site for co-location between an adult teaching hospital and a paediatric hospital. Is this principle still firmly the internationally recognised best practice? I know clinicians, planners and broad spectrum of expertise is involved in examining the matter. I presume the idea of co-locating an adult teaching hospital with a paediatric hospital is weighted or encouraged as the most suitable in terms of best care and health service delivery for children and mothers given the complications that can arise.

James Reilly (Dublin North, Fine Gael)
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The issue of co-location with an adult hospital is a major requirement. The expert group comprising four chief executive officers of some of the biggest paediatric hospitals in the world, three of whom were clinicians themselves, were unanimous on the fact that it needed to be co-located with an adult hospital. The basis for this is our childhood population would not be able to sustain an expert in rare disorders as his or her skills would diminish due to the infrequency with which he or she would treat patients. Therefore, the group felt treating adults and children is the route forward for a country of our size. The CEO of Great Ormond Street Hospital for Children was involved. This is a stand-alone hospital but even she acknowledged co-location is the best way to go.

Great people work in our paediatric services but there are limitations on the buildings in which they work. Our Lady's Children's Hospital in Crumlin has been very successful in fundraising and treats 80% of our tertiary cases, with Temple Street hospital treating 20%. I have visited Temple Street hospital, which is staffed by wonderful people but they point out it is made up of Victorian buildings joined with little attics and steps. It is utterly inappropriate. We need a modern facility to provide the best care for our children. We will expedite this.

The Dolphin group will report later this month, 56 days after its first meeting, and only a few days remain this month. It will be made aware of all of the options available. Rather than giving us the choice of a single place, I have asked it to point out the pros and cons of each option so the Government can make a decision in the interests of the people.