David Norris (Independent)

I welcome the Minister, although she is leaving the Chamber. I am sure the Minister of State at the Department of Health and Children, Deputy Moloney, will communicate my views to her. It is a pity a script was not supplied because, even though I was present to hear most of the Minister's contribution, I had a difficulty in catching her more technical comments. Furthermore, I missed part of her contribution because I had to leave to take an urgent telephone call. To assist in the proper running of the House, there should be a requirement on Ministers to circulate copies of their speeches, especially on important matters such as this. The Minister is extremely competent. She is very good at dealing with matters on her feet and throwing out general and vague ideas. It is not enough for her to believe she is supported by a majority of consultants. We need to know how many hold the different opinions on this issue. If we know how they are divided, as parliamentarians, we can make a decision on the evidence presented. The Minister is highly driven. However, I do not always happen to believe in the ideological forces driving her. It is important, therefore, that we receive this information.

For a number of reasons I wish to speak briefly about the timeline for this development. A number of years have passed since I placed a motion on the Seanad Order Paper asking the Government to establish an international peer review of the hospital, particularly its location. At the time - three, four or five years ago - I was advised by senior professionals in the paediatric field that such a review was necessary. It was suggested it could be conducted expeditiously, perhaps within six weeks. It is a matter of concern that the proposal was not accepted by the Government. I have highlighted this point because I do not want it to be said I am a Johnny come lately who is raising objections at the last minute. I am not one of those colourfully referred to by the Minister as "rocking with delight" when they hear bad news in the morning. I do not have an appetite for bad news. I consider it necessary for a good, modern, national facility to be established in the interests of our children's welfare. If we are to make a proper and balanced decision on the matter, we need access to all of the information. I am not a Johnny come lately. I made a rational request for the matter to be reviewed. It would not have significantly impeded or delayed the development of the hospital. It would have cleared the air and made it absolutely obvious that there were no vested interests involved. It would have made it clear that the process of deciding on the location and development of the national children's hospital was proper, fair and judicious.

This has re-emerged as a central issue principally because of the resignation of Mr. Philip Lynch in recent months. This was an astonishing development. His departure was subject to obscurity because he said he had resigned but the Minister said she had pushed him. It is not clear whether he resigned or was pushed. He went in any case. He outlined the reasons for his departure in a statement:

There were fundamental differences between the Minister and myself on the need for open and informed discussion at Board level at all times on a range of substantive issues relating to the NPHDB. Amongst the issues outlined were:

The substantial funding gap

The development of the AMNCH at Tallaght

Clarity or absence of governance proposals for the new Hospital

Effectiveness of stakeholder communications

Planning and design challenges for the Mater site

The Minister dealt, to a certain extent, with the "clarity or absence of governance proposals" in response to Senator Fitzgerald. On the evening Mr. Lynch's resignation was announced, I happened to be in the company of a member of the board of the group. When I asked the person in question about the matter, I was astonished to be told the €110 million funding gap could be met by philanthropy. This is not the kind of economic climate in which we can anticipate such significant philanthropy. The Minister has mentioned that in Canada $98 million was raised through philanthropy. I remind her that the economic climate in Canada is completely different because its banks operated judiciously and prudently. It is in a wonderful position - it is not at all threatened. People in Canada who have money to spare can engage in these philanthropic exercises. I was not particularly thrilled to hear Ronald McDonald would be involved in the project. It seems we are relying on the sale of hamburgers to provide our children's hospital. Reference was also made to the philanthropic interests of the pharmaceutical industry. That is a new one on me. We know philanthropic companies are very efficient at squeezing the Government. They have squeezed the public dry in terms of prescription drugs and all the rest of it. I would be interested in probing a little further the idea that they are about to become philanthropic. What will they get out of the taxpayer in these circumstances?

There is a series of contradictions in this context. I was interested to read a recent article in The Irish Times by its former environmental correspondent, Mr. Frank McDonald. I think I can say he fully supported the hospital. The article was accompanied by a nice picture showing abstract art in it. Although Mr. McDonald was lyrical in his praise of such aspects of the project, he did not mention that access was one of the critical elements of the development. This difficulty was addressed by the Minister and others when they referred to the development of the metro north project. I remind the House that Mr. McDonald has devoted almost all of his entire journalistic career to trying to prevent the metro north project. This is another of the contradictions to which I refer.

I took the liberty of interrupting the Minister to ask her about the matter of access which is particularly important. It was being discussed when I was listening to the wireless one day - I am not sure whether it was on the Joe Duffy programme. If somebody is talking sense, it does not matter to me whether it is on "A Prayer at Bedtime" or the Joe Duffy programme. While there is a great deal of hot air and a lot of rubbish is spoken on the Joe Duffy programme, there is also a certain amount of sense from time to time. The programme to which I refer covered the story of a woman who had tried to drive her seriously ill child who was moving towards having peritonitis to the Mater Hospital. She was prevented from going down one street because there was a match in Croke Park, a factor we need to take into account in this context. After she had managed to get into the car park and park her car, she went through what she thought was the main entrance, only to be told it was not the proper entrance and that she needed to walk to a different entrance. Her child developed peritonitis when his appendix burst before it could be operated on, but, luckily, his life was saved. Such things can happen. That is why access is important. It is dangerous to say excellence in treatment is more important than access. There must be a balance between the two. I do not doubt that the boy in this case received excellent treatment, but if he had not been able to access the hospital in time, it would have been of no use. One can have a world-class facility, but one will have a real difficulty if people cannot gain access to it in critical circumstances.

I am familiar with a document that criticised the work of the location task group because "no study of ambulance transport times or traffic impact on Emergency Access" from the proposed new "enlarged catchment area", the entire greater Dublin area, to Dublin hospitals was undertaken. The document continued:

It is essential that ambulance access times to the Mater ... from the outreaches of the catchment area should have been studied. Life-threatening emergencies do not respect gridlock from rush hour, All-Ireland finals, events at the O2 or the RDS, city centre marches etc. The absence of these two studies ... is a gaping and dangerous defect in the Task Group's report.

The task group's report was produced four years ago, probably around the time I proposed that a peer review be undertaken. Such issues should have been covered in the examination of the suitability of the site, but that did not happen. God knows, I am not against the location from a personal point of view. It is located right next door to me and I would like the infrastructure of the north inner city to be built up. As the principal proponent of the metro north project, I would be pleased to see it going ahead. However, I cannot blind myself to these questions.

I wish to give another example of the continuing series of contradictions in this regard. On 7 March 2006 the HSE website carried the following announcement on the children's hospital site:

The outcome process has not been predetermined ... It is open and objective to the point where the outcome may even be a decision to locate somewhere other than an existing hospital site ... Any suggestion that this group has prejudged anything is completely misplaced.

It appears the situation had altered by 29 March 2006, however, as a message on the same website announced:

This process is to recommend only where the hospital is to be sited ... The prime consideration in making this decision on site location will depend on co-location to an adult teaching academic hospital and adult national centres of treatment.

That decision had been made in principle, so there is a contradiction there. That is regrettable and could have been obviated.

In regard to the rigorous, robust and independent process about which the Minister spoke, in a press statement on 11 January she said the task force engaged in extensive consultation with the three existing paediatric hospitals, the three maternity hospitals and external experts in arriving at its recommendations. There were no hospital site visits. There was one meeting with each of the three children's hospitals and they were all held on the same day, 26 May.

As far as the external experts are concerned, one of them, who has been extensively quoted by the Minister and the Department, Sir Alan Craft, a past president of the Royal College of Paediatrics and Child Health in the United Kingdom, said in a letter to The Irish Times, because he was concerned by the impression being given by the officials, that the extensive consultation referred to consisted of a telephone conversation with a member of the task force to discuss the parameters against which a decision regarding location could be made and which other specialties should ideally be co-located. He said he did not see the report nor was he involved in making the decisions. There is a whole raft of contradictions and I would like to refer to one or two more.

The RKW report states:

This brief ... takes as given:

The McKinsey recommendation that all Dublin secondary inpatient beds should be co-located with the tertiary services.

The decision of the Task Group endorsed by the HSE that the hospital should be located at the Mater site.

RKW, the consultants, were not allowed to examine a situation as fundamental as the matter of the site. They referred to issues regarding environmental quality which relate to the density of building on the site but were not able to deal with it.

I mention car parking. As a matter of policy, car parking is limited by Dublin City Council in the city centre. We were told 800 spaces would be provided. Proportionately, that is fewer than the current number in Our Lady's Hospital for Sick Children. In an emergency, how many people are going to use the metro? I am a big fan of the metro but will people use it? Will it go ahead? It may well not go ahead.

It appears a certain amount of academic and inter-hospital politicking was going on. In the interests of the children of this country, we need to ensure the best possible thing is done. I do not want to impede the development of the national paediatric hospital. I am not a johnny-come-lately; I have raised these real questions consistently and they cannot be answered by bluster. I regret the Minister did not have a speech and that-----