Mary Ann O'Brien (Independent) | Oireachtas source

Well done to the Minister on his statement on “The Pat Kenny Show” recently that a maternity hospital is to be co-located with the national children’s hospital and the fact that he has asked the national children’s hospital board to consider applying for planning permission for it. It is very much welcomed by us all. After 20 years of wasted time, nobody knows better than the Minister that many of those who were children at the start of this project are now adults, and we still have no hospital. The Minister is entirely focused on getting the job done for us. I am here because we are heading into a site that is crippled with flaws. Most of my questions come from the medical community, particularly someone who has been very helpful to me and who wrote a long letter to the Minister in September, paediatric oncologist, Dr. Finn Breathnach, formerly of Crumlin hospital, who is extremely concerned about the site.
The national children’s hospital board will have a very difficult job regarding planning permission. With the advent of the fact that the maternity hospital will be co-located with the national children’s hospital, we are going from 108,000 sq. ft. to 165,000 sq. ft. Justine McCarthy’s excellent article in The Sunday Timeslast Sunday mentioned that An Bord Pleanála considered a planning permission application for a private hospital in St. James’s Hospital a few years ago and the neighbouring Rialto association vehemently objected to a 29,000 sq. ft. hospital. There are no prizes for guessing that the local residents will be up in arms about the prospect of a 165,000 sq. ft. children’s hospital.
By whom and how was it decided that 165,000 sq. ft. was the appropriate size for the national paediatric hospital, the maternity hospital and their expansion space? The new Colorado children’s hospital is 134,000 sq. m for only 284 beds compared with the proposed national children’s hospital, which will have only approximately 100,000 sq. ft. for 469 beds. What strategy is in place for future expansion? A Texas hospital has twice doubled in size in the ten years since it was built. A Toronto hospital has doubled in size every decade since it was built.
Can the Minister assure us that everything in the project is in compliance with the public spending code of the Department of Public Expenditure and Reform? As part of the assessment and decision making process into the alternative sites on offer, as required by An Bord Pleanála, in particular the site at the Coombe and the greenfield site contiguous with Connolly Hospital Blanchardstown, such an evaluation should have compared alternative site options in relation to acquisition, decanting, planning, building and future running costs.

Millions of euro of public money was wasted due to non-adherence to this evaluation process in the case of the Mater site. In 2012, we were talking in terms of spending €485 million and now the figure has increased to €650 million. Expenditure of €485 million to €650 million is in the realm of telephone numbers. The cost of siting the children's hospital at Connolly hospital was estimated to come in at €500 million because of it being a greenfield site and close to the M50. The Minister knows the details as they have been stated time and again.
My third question is how can the Minister stand over his assertion that St. James's Hospital will offer the best adult hospital co-location and clinical outcomes for children given that major priority adult specialties identified by both the task group on location and the McKinsey report are not in St. James's Hospital? The local task group in 2006 found there was no evidence in the medical literature to support a claim of improved outcomes associated with adult co-location - that was stated by Dr. Finn Breathnach.
Some 44 of the most senior paediatricians in Ireland wrote to the Minister's predecessor, Deputy Reilly, in October 2012 stating that if we wish to improve the clinical outcomes for sick children, the most critical adjacency for the national children's hospital is with a maternity hospital. The Minister's Department admits in its press release of 2014 that these infants are often delicate and corridor transfer minimises the risk of destabilisation during an external transfer. In view of the clinical importance of maternity co-location, I greatly welcome the Minister's decision, as I said earlier. However, sadly, I note in an article on page 8 of today's edition of The Irish Times that a baby died following transfer between hospitals. The baby was transferred from Limerick to Crumlin, then to the Coombe and back to Crumlin again, but, unfortunately, that baby did not make it because ambulances are incredibly stressful for little babies.
I will move on to my fourth question. Numerous concerns regarding the feasibility of building the national children's hospital on the St. James's Hospital site have been brought to the Minister's attention. He will be aware that the plans for this site include a major national cancer centre in addition to the national children's hospital and a new radiotherapy unit and co-located maternity hospital. I understand that neither the Minister nor his officials have seen an up-to-date master plan incorporating these facilities for the St. James's Hospital site. For the sake of financial governance, accountability, transparency and public confidence, will the Minister and his Department absolutely reassure us and the public that the St. James's Hospital campus has been shown on a master plan to adequately accommodate all of these major developments and capacity for their future expansion? I note advice in the public spending code of the Department of Public Expenditure and Reform which states that where necessary, Departments and public bodies should be prepared at any stage, despite costs having been occurred in appraising, planning and developing a project, to abandon it on balance that its continuation would not represent value for money. I know for a fact that the Minister is a brave man. I know he does not do minute management but for the sake of the children of this country it is not too late to turn around.
I need to ask the Minister about three Jack and Jill Foundation babies who have come of age. He knows that we let them go at four years of age to the care of the HSE. These babies, Freya Doyle, Cillian Fottrell and Tom O'Leary, need 24-hour care; they are tube-fed and are prone to having epileptic fits. He has heard about them before. It is impossible for their parents to cope. On reaching their fourth birthday, our nurses try to negotiate with the HSE and it is proving impossible to get a home care package for them. I will write to the Minister and set out the details for him. Those in the Jack and Jill Foundation get very attached, naturally, to the children they care for and they are very distressed about this and they will issue a press release on this later this week.