Mattie McGrath (Tipperary, Independent)
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I thank the Ceann Comhairle for selecting this important topic today. I am disappointed the Minister, Deputy Harris, is not present but I say that with no disrespect to the Minister of State, Deputy Catherine Byrne.

This is a very serious issue given the serious impact the project is set to have on all of the sickest and most vulnerable children in society and their families. As the Minister is aware, the concerns around the national children's hospital, NCH, do not simply relate to the cost, although that is a massive issue. The Sunday Business Postreported recently that the cost of the project has exceeded €1 billion, and that excludes the fit-out of the hospital. The project appears to have already overrun by hundreds of millions of euro. I estimate the cost overrun to be approximately €600 million, a staggering figure.

The main concern, however, is the impact the NCH project will have if it continues to be located at St. James's Hospital. There is enormous fear that best practice with respect to the co-location of the new national paediatric hospital is not being followed. That is very serious. It is absolutely vital that co-location occurs simultaneously. One could ask whether that is going to happen and but answer is "No", it most definitely is not. As a matter of record, the project director of the national paediatric hospital, Mr. Fitzpatrick, said in a recent talk at the Institute of Technology, Bolton Street, that it will be ten to 15 years before a maternity hospital is co-located with the NCH at St. James's.

In the meantime, we must examine what are the risks and outcomes for sick children. Those certain to be affected are babies born with congenital diaphragmatic conditions whose chance of survival will rapidly diminish. I beg the Minister of State to listen to those concerned. A total of 15 consultants from Crumlin have written a letter stating that if the maternity and paediatric services are not co-located, it will result in "avoidable deaths and disabilities for newborn babies".

I also wish to raise the point that for the NCH to be built, the St. James's outpatient department will have to be demolished and relocated as it currently occupies the space. Is anyone aware of that and the potential consequences? It will also mean, at the very least, that St. James's adult accident and emergency unit will have to be demolished and relocated as well as the intensive care unit, at enormous expense.

We can also mention the impact on the facility management hub at St. James's Hospital. All this is expected to add between €100 million to €200 million to the cost.

Where is the accountability? Is anybody listening? Organisations like Connolly for Kids and the Jack and Jill Foundation are ignored and locked out of committee hearings. This is disgraceful. What consultations have been held with ambulance drivers and paramedics? This issue has all the signs of becoming the new NAMA in a few years' time but this time children will have died or become disabled and families will have been ruined. A RED C poll in June 2016 showed that 73% of the public thought that St. James's Hospital was the wrong site. A total of 60,000 people signed a request to the Taoiseach in June 2016 to change the site to the Connolly and relocated Rotunda Maternity Hospital site in Blanchardstown at the M50-N3 interchange. The site location decision carries enormous adverse consequences for so many. It is still not too late to do what is right by sick children, their families and future generations. The public would respect the courage and integrity it would require to do that. We know the site at the M50-N3 interchange is accessible despite what I heard the Minister say earlier in reply to a parliamentary question. We all use that junction, which is accessible by road, rail and air.

Catherine Byrne (Dublin South Central, Fine Gael)
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I apologise for the fact the Minister cannot be here to take this Topical Issue but I am glad to take it because it is in my constituency and I have been involved for a long time in respect of the location of the project in St. James's Hospital. I thank the Deputy for raising this matter. I am pleased to take this opportunity to update the House about the new children's hospital. The project to develop the new children's hospital is an extraordinary opportunity to enhance paediatric services for children. The granting of planning permission in April 2016 for the hospital, satellite centres and related buildings was a huge and very welcome milestone for the project. Independent reviews since 2006 have reaffirmed the importance of co-location of the paediatric hospital with a major adult academic teaching hospital. The Government decision in 2012 to locate the hospital on the St. James's Hospital campus was made in the best interests of children from a clinical perspective. St. James's has the broadest range of national specialties of all our acute hospitals in addition to a strong and well-established research and education infrastructure making it the hospital that best meets the criteria to enable the children's hospital to achieve our vision of excellence in modern paediatric practice.

As announced in June 2015, the Coombe Women and Infants University Hospital will relocate to the campus, in time achieving the tri-location of adult, paediatric and maternity services. Tri-location has benefits for children, adolescents, newborns and mothers. In all cases, the benefits of tri-location are maximised where the adult hospital provides the broadest possible range of clinical sub-specialties and expertise, which are readily accessible for paediatric and maternity patients on the shared campus. Also, tri-location that delivers the most significant breadth and depth of clinical and academic research on site will enhance the potential of research to drive best clinical outcomes.

Furthermore, excellence in modem paediatric practice cannot be achieved without an embedded culture of, and focus on, research, education and innovation. More than a hospital, the new children's hospital and satellite centres will be a research-intensive academic health care institution. To deliver this vision, the main facilities for research and innovation will be located at the Children's Research and Innovation Centre on the St. James's Hospital campus. This facility will be located adjacent to the Institute of Molecular Medicine, a cross-university facility which delivers both undergraduate and postgraduate education and which has a strong research platform in cancer, infection and immunity and neurosciences. This direct adjacency reflects one of the many and significant opportunities being leveraged by co-locating on the campus with St. James's Hospital with its rich history in clinical research. Clinical management and research staff at the new children's hospital will be able to study, evaluate and improve the health care services provided to children and young people in Ireland.

Objectors to the location raise concerns primarily about access to the site. I wish to reassure parents that the plans and design for the hospital recognise the need of most families to access the hospital by car while noting that the campus is better served by public transport than any other hospital in the country. While the Minister for Health is aware that not everyone agrees with the decision on the location of the hospital, he believes the priority is to make progress on the new hospital as soon as possible so that we can ensure children, young people and their families have the facilities they need and deserve.

Mattie McGrath (Tipperary, Independent)
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I thought the Minister of State would add something from her personal perspective.

Catherine Byrne (Dublin South Central, Fine Gael)
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I will.

Mattie McGrath (Tipperary, Independent)
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We have been there and seen that. What consultation did the Department have? Were the ambulance drivers ever consulted? In respect of problems with the St. James's campus, helicopter restrictions mean that the helipad, which is on a fourth floor roof at one end of the children's hospital, can receive only the lighter Air Corps AW helicopters and then only on flight paths not restricted by the adjacent upper hospital floors. The heavier coastguard and marine rescue Sikorsky helicopter is not licensed for roof landings and must land at the Royal Hospital Kilmainham. How are they going to get there then? Ambulance drivers and paramedics have contacted me to say they have listened to nurses and parents screaming at them about how much longer it will take to get to the hospital because they are stuck in traffic. The Minister of State knows it better than I do because she lives in the area. I would not dare to suggest something about access. The Minister of State knows the problems with traffic.

The parking limitations are appalling in respect of the proposed children's hospital. There is no space left on site for almost 600 surface spaces leaving them with a net gain of only 420 spaces. This gives one a final cost of over €138,000 for each of the 420 car parking spaces. We have been told they go down but one would think they were going down into soft sawdust. It is accepted that the children's hospital will have to cope with 10,000 arrivals and departures every day. An additional 3,500 staff will work at the children’s hospital. If the essential maternity hospital is ever built, St. James's Hospital has indicated that there will be no additional parking. I have met nurses who work there. I am not demeaning the area but they fear for their physical safety going to and leaving the hospital. The biggest issue is the distress caused to patients. A community group in Munster is trying to set up a community air ambulance. It has raised €3 million to buy and run it voluntarily. We have volunteers who are willing to work along with the Jack and Jill Foundation and other groups yet the Government is making it more difficult. A helicopter cannot even land there. This is reckless and dangerous and will cause trauma, stress and, in what are not my words but consultants' words, unnecessary deaths.

Catherine Byrne (Dublin South Central, Fine Gael)
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Hopefully, there will be no unnecessary deaths. The children this hospital will most the benefit are very sick children who must endure very cramped conditions in Our Lady's Children's Hospital, Crumlin. These conditions go back 30 or 40 years. For the first time in this country, there is a commitment by this Government and the previous one to build a national children's hospital.

I will contribute my own thoughts on this matter. I have long been involved in the lead up to the decision to locate the national children's hospital on the St. James's Hospital site. I do not think that some of the Deputy's accusations that certain buildings will need to be knocked down are true. An extra 670 car spaces will be provided for families. Some of the staff live less than 20 minutes away while some who arrive by car live less than ten minutes away so saying that this will present a problem for staff is an overstatement.

Mattie McGrath (Tipperary, Independent)
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It is not.

Catherine Byrne (Dublin South Central, Fine Gael)
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I will finish because I do not want to end up arguing with anybody in the Chamber because that is not my way of doing politics but I assure the Deputy that there has been wide consultation during the past two years with every community group, every family with a sick child, every neighbourhood and all the staff and different services on the campus. I attended the oral hearing, which lasted more than two weeks, and sat through many presentations by people for and against locating the hospital there. The new national children's hospital on the site of St. James's Hospital will give us an excellent hospital that will facilitate and care for the very many sick children in this country, particularly those coming up from the country.

Mattie McGrath (Tipperary, Independent)
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A pipe dream.