Election outcome likely to derail the proposed plan for national children's hospital The location of a new national children's hospital has become a contentious election issue, writes Theresa Judge
A decision to locate a new €500 million national children's hospital solely on the site of the Mater hospital in north inner city Dublin is likely to be overturned if there is a change in government.
All Opposition parties say they will bring in independent experts to review the decision because of a suspicion of political interference given that the Mater is in the Taoiseach's constituency.
There has also been strong criticism of the Mater site from senior representatives of Our Lady's Hospital for Sick Children in Crumlin and the National Children's Hospital in Tallaght.
A senior doctor at Tallaght has this week described the Mater site as "inadequate" and "inaccessible".
Tallaght, which along with Crumlin and Temple Street hospitals would be merged into the new hospital at the Mater, is now stepping up its campaign to keep Tallaght open as a full children's hospital.
Both Fine Gael and Labour say they favour locating the new national children's hospital over two sites, one in north Dublin and one in south Dublin.
Meanwhile, Minister for Health Mary Harney has angered representatives of Tallaght and Crumlin children's hospitals by making an announcement last week on the location of an urgent care centre linked to the new national children's hospital - before consultants examining the issue have completed their report.
Harney announced that one of three urgent care centres would be located in Tallaght, in her constituency, in an obvious attempt to minimise political damage from her decision to take the children's hospital from Tallaght.
Prof Ian Graham, a senior doctor at Tallaght hospital and vice-chairman of the board, is now accusing Harney of "trying to confuse people concerning her plans to close down the National Children's Hospital at Tallaght and transfer its services to the Mater hospital site".
He points out that her announcement was "made without any consultation or agreement with Tallaght hospital seven days before a general election takes place".
An internal memo to staff within Tallaght hospital also stressed that there had been no discussions with the HSE before Harney's surprise announcement.
Saying that Tallaght children's hospital has been "neglected" over the past 10 years, Graham, in a strongly-worded letter to The Irish Times, says people are being asked to accept the closure of their hospital and to await "a new type of day clinic which will have no inpatient beds or specialist children's hospital care available round the clock".
Graham also points out that the number of children being treated at Tallaght has been growing steadily - 72,581 in 2006 - and that Harney's plan would "leave the whole of the southern and western part of greater Dublin without proper hospital care for such vast numbers of children".
Crumlin hospital is also unhappy with the Minister's announcement. The board of the hospital made a submission to consultants RKW, who were given the task of drawing up a design brief for the national children's hospital and a plan for how satellite centres should be organised.
The HSE said last week the RKW report would be published later in the summer.
Dr Pat Doherty, chairman of the medical board and a member of the board of management at Crumlin hospital, reacted to Harney's announcement by saying that Crumlin was "surprised" given that the RKW report had not been completed or considered by the HSE "that an element of the proposed development would have been announced at this particular time".
Crumlin is seeking an international peer review of the decision and would therefore welcome pledges from Opposition political parties to review the decision.
A submission from the board of directors of Crumlin hospital to RKW consultants details a range of concerns they have over the Mater site, relating mainly to the size of the site and the difficulties patients and emergency vehicles would have in accessing it.
The board of Crumlin says there are "inherent shortcomings" in the Mater site and that the lack of expansion space could mean that within a few years "other children's facilities are required leading to further duplication and fragmentation of services".
The board feels there has been "insufficient scrutiny and provision of information" to discuss the proposals properly.
Crumlin says that it expects RKW "to highlight the urgent necessity for completing a thorough traffic impact study", as RKW had pointed out that the issue of traffic and accessibility was not included in its terms of reference.
Since the Mater site was first selected, there has been confusion over exactly how much land will be available for the children's hospital, how much will be allocated for a proposed maternity hospital and for the development of services of the existing adult hospital.
The HSE has, in the past, said Crumlin was underestimating the area of land available for the hospital and that whatever land was needed would be made available.
The Crumlin submission to RKW is now calling for "absolute clarity" on a number of issues including "the exact limits of the site".
It says it has "grave concerns" over the "very modest building floor plate" which could limit future development.
It also says that co-location of the children's hospital with a maternity hospital is "essential" to eliminate the need to transfer very ill newborns. It also notes that details of the maternity hospital do not form part of the RKW framework brief.
Crumlin also raises concerns that the initial plan for the satellite centres - one of which Harney says is to be located in a new facility in Tallaght - has been changed with more services being provided than originally planned.
It says this could lead to fragmentation and stretch scarce consultant and specialist nursing resources.
While Crumlin favours a single-site hospital, senior sources there said the Fine Gael-Labour preference for a single hospital to be located over two sites might be preferable to the current plan of "effectively creating four sites around the city".
It is pointed out that Dublin is much more spread out than most cities and has poorer transport infrastructure.
Fine Gael health spokesman Liam Twomey says his party is committed to an independent review "from outside the HSE" of the decision to locate the children's hospital at the Mater. He believes the review could be conducted within six weeks. "All the information is already there, so it could be a quick review."
Liz McManus of the Labour Party says she believes the Mater site is "simply not feasible" and the preferred option would be for one hospital over two sites, with tertiary services provided at just one of these. She says this has been agreed with Fine Gael and that both parties are committed to a review.
As it is "the biggest and most important health project in 20 years", it is vital to get the decision right, she adds, and the concerns of experts in Crumlin hospital should be listened to.