The decision to build a new, tertiary paediatric hospital on the grounds of the Mater University Hospital is welcome. It brings to an end a long period of uncertainty about the future of paediatric services in Dublin and means that the Republic will have a world-class facility to treat the most complex childhood illnesses.
Paediatric tertiary care is the provision of specialised medical services to patients under the age of 16. Typically it involves looking after children with cancers, blood disorders, major respiratory problems and cardiac conditions. Care for kidney, neurological and metabolic disorders must be available also, along with highly specialised paediatric surgery and intensive care facilities. A key aspect of such a facility is that it is driven by a minimum volume of complex cases, thus ensuring high quality care and the best outcomes for children.
A taskforce - formed in February after the publication of a consultants' report, Children's Health First - has made its decision in favour of the Mater site in a timely and transparent way. Its recommendation has been endorsed by the Health Service Executive. The taskforce was given clear criteria upon which to base its deliberations: the new hospital was to be co-located with a leading adult academic hospital in Dublin; it was to be easily accessible by public transport and by the road network; and it must have space for future expansion and the development of research and education facilities.
Significantly, the task group also recommended that a secondary and tertiary maternity hospital be located on the site of the new paediatric facility. This will allow high-risk deliveries to take place in a maternity unit equipped with an advanced neonatal intensive care unit offering the best chance of survival for premature and sick babies.
In the event, the taskforce concluded that the project could be delivered more quickly on the Mater hospital site. Timing is an important consideration, as existing facilities in both Temple Street and Crumlin hospitals are in a parlous state.
No decision has yet been made about the provision of urgent care for children at sites other than the proposed national paediatric hospital. There are likely to be two other urgent care centres in Dublin, possibly with facilities for daycare are surgery and out-patient clinics. Whatever model is finally chosen, it is imperative that children in the greater Dublin area have access to quality secondary paediatric care following the closure of inpatient facilities at Crumlin and Tallaght hospitals.
In choosing the Mater, the taskforce made it clear that St James's Hospital also satisfied the clinical and access criteria for the new facility. And while staff there and in other hospitals may be disappointed, it is imperative that any sectoral interests are now subjugated in the drive to develop a world class facility for the delivery of complex paediatric care in the State. It is vital too that the new hospital is run as an independent institution with an ethos that reflects the multicultural state we live in.