John Moloney (Laois-Offaly, Fianna Fail)

The Minister, Deputy Harney, wanted to be present to reply to the debate, but, unfortunately, she is obliged to be elsewhere. I have had the privilege to be present for the past 60 minutes and, notwithstanding the criticism outside the House, it is obvious that many Senators couched their contributions in the national interest and have indicated that they want to try to deal with the various issues that arise.

Senator Cannon posed an extremely pertinent question with regard to the €400 million required for the project. It is only right and proper that a definite commitment to provide this funding should be contained in the Budget Statement. The Minister has referred to this commitment on numerous occasions. Senator Donohoe indicated that he fully recognised the commitment and integrity of both the Minister and Deputy James Reilly in the matter.

For a long period the integrity of the process relating to the selection of the site for the new national paediatric hospital was challenged or questioned, particularly in view of the fact that the site eventually chosen was located in the former Taoiseach's constituency. This has led to the waters being muddied to a degree, despite the fact that all of the evidence indicates that the site was selected on an independent basis. As Senator Feeney indicated, where there is competition between sites, the debate often becomes sidetracked. This is because there is a clear understanding that, regardless of which site is selected, certain benefits will flow to the political process and also the medical regime. As previous speakers stated, however, the debate must focus on the patient who must come first at all times. I am not an expert, but I have some experience of site selection processes. In that context, I am concerned that if we decided to re-examine the position on the site for the new national paediatric hospital, we could eventually find ourselves in a position where we would not be able to make financial provision for the development of such a hospital. It is important, therefore, that we proceed along the current path.

I recall what occurred when another independent report on the issue of cancer services in the midlands was published. When it emerged, the then Minister for Health and Children, Deputy Cowen, now Taoiseach, happened to live in Tullamore. There were suggestions at the time that he had interfered with the site selection process and dictated that the hospital to serve the four counties of Laois, Offaly, Longford and Westmeath should be located in Tullamore. When all of this was happening, with a number of colleagues from the midlands, I travelled to Dublin to meet the then chairman of the National Cancer Forum, Professor James Fennelly, to argue the case for locating the new facility in County Laois. Having been presented with evidence relating to the independent decision made to provide the service from Tullamore, I returned home with a different attitude. The assessment outlined the position on the likely throughput of patients and indicated that there would be a need to upskill consultants and other medical staff at one location. I stress that the decision of the National Cancer Forum on the matter was made on an independent basis. For some four years after the decision was made, people continued to argue the Taoiseach had been involved in influencing the site selection process. The actual position was somewhat different. I have always given credit to the Taoiseach's predecessor as Minister for Health, Deputy Noonan, who established the independent review group which selected Tullamore as the location from which cancer services in the midlands should be provided. My net point is that we ended up with a fragmented service and Senators will be aware of the awful difficulties which arose in the provision of cancer services for women at Portlaoise Hospital afterwards. There is a lesson to be learned in this regard. When an independent decision is made, it should be respected. People should not automatically assume independent bodies are influenced or dictated to by the Government.

Reference was made to the number of car parking spaces to be provided at the new national paediatric hospital. Some 800 car parking spaces at the new facility will be reserved for parents and staff will not be permitted to use the parents' car park. The Mater Hospital has already won awards for encouraging staff to use other modes of transport in getting to work. It is important to keep repeating this information, particularly in view of the fact that people seem to believe the number of car parking spaces to be provided will not be adequate.

Senator Prendergast raised a number of issues relating to mental health. I gave a commitment to her in respect of these issues last week. I will respond to her concerns in the next week or so and clarify the position on services in Clonmel.

I reiterate what the Minister, Deputy Harney, stated, that the Government's priority is to provide the best standard of complex hospital care for children in Ireland. To further this priority, it is fully committed to the construction of the new national paediatric hospital on the Mater Hospital site and providing the associated ambulatory and urgent care centre at Tallaght hospital. It is well known that in late 2005 McKinsey and Company was engaged by the HSE to advise on the future strategic organisation of tertiary paediatric services.

It was good to hear Senators refer to what constituted a tertiary hospital. Often the argument goes out that persons in a emergency would have to traverse the city. That is not the issue, and that has been so properly pointed out by Senators Donohoe, Feeney and Cannon a while ago. They make that point not to confuse what a tertiary hospital is about, and the Minister, Deputy Harney, has often tried to explain that.

The resulting report on a children's hospital first recommended that a new paediatric unit should be located alongside a leading academic teaching hospital in Dublin. I still believe the principle of location alongside a leading academic teaching hospital, in line with widespread international best practice, enjoys widespread support.

The joint taskforce, representative of the Department of Health and Children, the Office of Public Works and the HSE, was established in February 2006. The taskforce carried out extensive consultation with various stakeholders, including the three existing paediatric hospitals, the three maternity hospitals and the external expert. I reiterate there were extensive consultations with the three existing paediatric hospitals. Following these consultations, the taskforce recommended that the new children's hospital should be located adjacent to the Mater university hospital on Eccles Street.

The high-level framework brief for the new hospital prepared by Rawlinson Kelly and Whittlestone Limited was completed in October 2008. The report was informed by clinical and architectural experts from major children's hospitals in Toronto, Philadelphia and Manchester. The report included the detailed assessment of capacity, and concludes that the site adjoining the Mater hospital can accommodate all the requirements of the new hospital and will still allow expansion of capacity beyond 2021. The designs for the new children's hospital 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 site is, therefore, based on very best possible expert advice and, indeed, on internationally established best practice. The decision has been widely welcomed and has been supported recently by the faculty of paediatrics at the Royal College of Physicians of Ireland.

The new children's hospital will play a central role in the integrated network of paediatric services across Ireland. The merging of the three Dublin paediatric hospitals in a single hospital structure will ensure a critical mass of specialised skills to provide highly complex treatment and care of sick children. It will also provide additional benefits for sub-specialisation and the development of campus-wide support services. Dr. Ronnie Pollack of MPA Healthcare London stated that a synergy created by assembling some of the best clinical and research skills in the country in a single site will create the environment for children to progress further in international standing with measurable benefits for children and adults.

While the debate on the location has been reopened in recent weeks, Senator Feeney wondered whether this would delay the delivery of a new hospital. I dare say it will not, certainly going on what I heard here today. Whereas it might be possible to build a new hospital somewhere more cheaply on a greenfield site, and this had been mentioned, it is important to state that 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. The HSE has estimated the cost of building a 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 site is in the region of €600 million. Both amounts exclude the cost of an ambulance and urgent care centre at Tallaght, however it must be borne in mind that the project amount of €51 million would be a once-off saving and the savings derived each year from the efficiencies delivered by shared services and economies of scale which would be available at the Mater site would not be available on a stand-alone site.

In addition, it is estimated that the decision to move to a greenfield site would further delay the development by up to two years. It is so important to make the point that parents continue to ask when the hospital will be ready. If anyone talked about a hospital on a greenfield site two years down the road there would be suspicions about the commitment to building a hospital. The point was made by Senator O'Malley. The Government and so many others are committed to this project, and there is no one trying to find an escape clause here given the economic downturn. The commitment is alive and well. It is real. I think further commitment will be given to that in the budget speech. There is also no good reason for changing a decision which has been carefully reached. It would risk delaying the project considerably. There would be serious disadvantages if the hospital was built on a stand-alone site.

The development board will now press ahead with work on the development. The board is making good progress in planning and developing the new hospital on the Mater site and has formally asked An Bord Pleanála for the project to be considered under the strategic infrastructural legislation. It had an initial meeting with An Bord Pleanála on 5 November.

Subject to planning permission being granted, construction of the new hospital is scheduled to commence in the fourth quarter of 2011. Completion of the construction phase is scheduled for the end 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 construction costs for the entire project is €650 million. This is a significant reduction on earlier estimates. Of the total costs, €400 million is committed by the Exchequer and is reflected in the HSE's capital plan this year. It is important to emphasise that time and again. This will be increased to €450 million in the HSE's capital plan for 2011. The balance, as said by the Minister, will be from initiatives estimated at €110 million and €90 million from commercial and other sources of some, including car park, commercial units, research funding, private donations etc.

The Minister is confident that we will meet our objective of providing a world-class paediatric service for our children in the new paediatric hospital. I thank the Cathaoirleach and Senators.