An Bord Pleanala’s rejection of planning for the New Children’s Hospital has led to a frenzy of new submissions to the review group, James Fogarty reports
Representatives from the Mater, Temple Street, and the Rotunda recently invited the media to a briefing to showcase their revised plans for the New Children’s Hospital (NCH). The fact that they chose the newly-built €284 million adult Mater hospital as the venue for the meeting was not lost on the assembled journalists.
“The Mater has a track record of building on this site, on schedule and on budget,” explained Mr Donal Walshe, CEO of the Mater and the Children’s University Hospital, Temple Street. We have addressed the issues raised by An Bord Pleanála, the representatives explained, and are confident that this redesign will be successful. Speed was one of the key selling points of the new design, and Master of the Rotunda Dr Sam Coulter-Smith pulled no punches when he warned that further delays in the construction of a new national paediatric facility would be disastrous.
“The new national children’s hospital is absolutely urgently required. Temple Street is on its knees and Crumlin is grossly under-resourced. We need to bring them together into a world class national institution on a tri-located site.”
The representatives expressed frustration that so many other acute hospitals had re-tendered for the NCH project.
“We are, it has to be said, disappointed that we are back where we have been before. We believe a lot of international experts have looked at the issue and come to the conclusion that this national paediatric hospital should be tri-located on the Mater site,” replied Dr Stephanie Ryan, Chair of the Medical Board at Temple St.
And well they might feel aggrieved, as almost all the original bidders have reapplied for this lucrative and prestigious prize. The field is, in fact, crowded with runners. While the Department of Health has refused to confirm exactly how many sites are being considered by the NCH review group, it has been reported that the figure could be as high as 50, with NAMA contributing 11 of the possible locations. Despite the McKinsey report’s recommendations that the NCH be co-located with an adult hospital and ideally a maternity hospital, it is by no means certain that an existing hospital site will be selected. According to reports in the media, building the contentious hospital on a greenfield site is looking more and more attractive to a Government eager to deliver on an election promise.
Following An Bord Pleanála’s decision to reject the NCH’s original design on the grounds of height and over-development, six of the capital’s hospitals, including the Mater, have submitted plans to Dr Frank Dolphin’s review board.
The other five are:
St James’s Hospital
The Coombe Maternity Hospital
Despite submitting proposals to the review group, many of the hospitals were reluctant to talk to this publication in detail about their proposals. There are exceptions to this however. Recently, the Masters of the Coombe and Rotunda hospitals, and the Clinical Director of St James’s Hospital presented their cases on the Pat Kenny Show.
The Coombe was the first to break ranks and go public with its bid, producing detailed conceptualised drawings of what the NCH might look like located on the maternity hospital’s site. According to the proposal, the seven-storey facility could be built at the Coombe by 2016 for around €420 million. Despite, perhaps, being a surprise bidder, the location at the Coombe site has drawn support from paediatricians, Dr Chris Fitzpatrick, Master of the Coombe said.
He added that the hospital presented to the review group alongside a team drawn from
Crumlin, Tallaght and Temple Street hospitals. The Coombe also has the support of St James’s Hospital should its own bid be rejected.
“This is not a Coombe proposal. It is a proposal being coordinated by the Coombe in the interests of children and not in the strategic advantage of our hospital,” he said.
One of the most interesting things about the Coombe’s bid is its view of co-location. Rather than being on the same site as the adult hospital – in this case St James’s – the Coombe is proposing that the NCH and the maternity hospital will be located together, with a 600 metre link to James’s.
“Co-location can be defined differently. For a sick neonate, a new born child, co-location is defined as the width of a corridor. On our site, in our proposal, that will be immediately available,” said Dr Fitzpatrick. This is a sentiment shared by James’s Clinical Director, Dr Kennedy.
“For adults who require transitional care, a distance of 600 metres is a very reasonable distance to travel. They do not need to be within the same perimeter.”
However, the Coombe’s bid has been criticised by the Rotunda’s Master as not being truly tri-located. Dr Coulter Smith explained that in cases of obstetric haemorrhage “vascular specialities... need to be a (hospital) corridor away”.
For the Mater, despite “being ready to go”, its bid suffered another setback when Crumlin Hospital decided to back St James’s bid. While it is perhaps especially galling as Dublin Archbishop Dr Diarmuid Martin is on the board of both the Mater and Crumlin, the move may be unsurprising. In 2007, Crumlin pulled out of the project over concerns about the planning application, although it subsequently came back on board. In a letter to St James’s, the Crumlin board said: “This proposal will very significantly improve the services for the children, adolescents and families we serve. We are convinced that the development of the national paediatric hospital on the St James’s campus offers an exceptional opportunity to develop a world-class centre of integrated healthcare in Ireland.”
Later Dr Martin told Morning Ireland that “the best match, in the view of the board of Crumlin hospital, is in the combination that St James’s offers.”
“Crumlin is by some distance the largest paediatric hospital in the country. It does the majority of complex paediatric care,” Dr Kennedy told the Medical Independent (MI). “I think having the endorsement of the James’s site really should make it clear the extent of the services and resources available on the St James’s site.”
Connolly Hospital has also decided to join the fray. Dr Trevor Duffy, Clinical Director at the hospital said he has always believed that Connolly is the best site for the NCH.
“I believed since the first day I landed at Connolly, which was around the time of the first competition, it’s the only place in the country to be honest,” said Dr Duffy.
He pointed out that access to Connolly Hospital is unparalleled, given that it is close to both the M50 and N3.
“If you look at the James’s bid, they’re talking about building on the old John Player site in town, which is back into the same thing. It’s a confined site, not exactly co-located, and you have to go across town to access it,” he explained. “If you build it at Connolly, there’s no local disruption. You can put diggers on it and floodlights and build 24 hours a day, seven days a week, and nobody would even know you’re there.”
He explained that Connolly Hospital told the review group that the NCH could form part of a new academic health centre planned between it, Beaumont Hospital and the RCSI.
The National Sports Campus Development Authority has also gifted 40 acres to Connolly Hospital in an effort to secure the bid.
“It’s parkland and it’s not overlooked. You can build whatever suits children. It’s very interesting to look at the children’s hospital in Alderhey (Liverpool). They’ve opted for a greenfield site and Alderhey will be one of the world’s leading hospitals,” he explained.
He also suggested there is “no doubt that it would be done by 2016”, and require less financial investment than any other site.
“There’s no site clearance, you don’t have to create tunnels of access, and there will be no demolition. There’s no add-on costs or impact in terms of commercial disruption,” Dr Duffy. “This is about the future of the State and I think not only are we able to build a maternity hospital without any problems, there’s plenty of scope to develop further structures like health parks and anything you could imagine on-site.”
He also added that Beaumont and Fingal County Council are supporting Blanchardstown’s bid to become the NCH. However, Connolly’s bid has been criticised. In particular, critics have questioned whether the hospital has the depth of clinical services to be the site of the NCH.
Tallaght Hospital, whose CEO is Ms Eilish Hardiman, former chief executive of the National Paediatric Development Board, has also submitted a bid, with the support of South Dublin County Council.
According to a statement from the hospital, the NCH will be co-located on a publicly-owned site adjacent to Tallaght Hospital, generating, what it has called, a Tallaght medical quarter.
“Tallaght Hospital has worked jointly with South Dublin County Council on this submission to the review group established by the Minister. The proposal envisages the development of a Tallaght medical quarter with state-of-the-art, patient-friendly children’s, maternity and adult hospital facilities. An over-arching campus governance arrangement will facilitate separately governed hospitals to achieve maximum optimisation of the campus for patients and their families,” said Ms Hardiman.
Back in 2006 Tallaght competed for the NCH, only to lose out to the Mater. This time around the hospital is playing its cards very close to its chest, and has refused to give any detail, saying only that “Tallaght Hospital and SDCC believe the proposal offers real and substantial benefits”. A spokesperson for the hospital said that this latest bid is completely different from the proposal made six years ago.
There have been a number of high-profile greenfield sites linked to the NCH, with the Newland’s Cross site probably the best known. The site, which has been offered by the developer and solicitor Mr Noel Smyth, was previously ex-amined by then chair of the National Paediatric Development Board Mr Philip Lynch as a potential site for the NCH. Mr Lynch was then obliged to resign his post.
The site has been offered again and a submission to locate the paediatric hospital at Newland’s Cross has been made to the review group. When contacted by this paper, a spokesperson for Mr Smyth said no details on the bid were being released at this time.
Elsewhere, developers Flynn and O’Flaherty have also offered a greenfield site in the Phoenix Park, the old racecourse, for a proposed nine-storey hospital. A statement from the developers said that the eight-acre tract of land is the ideal site.
“It is situated beside the N3 leading to the M50 two minutes away, has a quality bus corridor, is served by eight bus routes, has its own railway station with 95 trains stopping daily,” the statement said. It added that there is also easy access to the Mater, Tallaght, Crumlin, Blanchardstown, St James’s, Beaumont and Cappagh Hospitals.
As well as having no planning impediments, substantial savings would be made if the NCH is located at the Phoenix Park site, a spokesperson for the bid said. He added that because the site does not require an underground car park, €100 million would be saved.
A proposal by the Broadmeadow Healthcare group offers a 50-acre greenfield site at Lissenhall, Swords, Dublin. The location, which sits close to the M1/M50, can be built for less than the Eccles Street site would cost and on time, the group believes.
“Why are we trying to shoehorn a 16-storey building into the city centre?” asked Broadmeadow CEO Mr Francis Whelan. A greenfield site offers the chance to create a world class facility, he said.
A further 200-acre site at Merryfalls/Silloge in North County Dublin, has been offered by farmers Fergus and Frank Connon.
However, Dr Kennedy from St James’s Hospital believes greenfield sites cannot compete with established adult hospitals.
“Building up of services is a 40- to 50-year project in this country. At the James’s site, the benefit can be felt in four years; at a greenfield site, 40 years,” he said.
But Dr Roisín Healy disagrees. The New Children’s Hospital Alliance wants “a greenfield site on the M50” followed by a maternity hospital, a university and an academic research presence.
“And if it’s beside Tallaght or Connolly, so be it,” she said.
NAMA has also reportedly offered 11 sites to the review board, which include the former Glass Bottle site and an 11-acre site on South Circular Road. Regarding these sites, Minister Reilly recently informed the Dáil that the Dophin Group, so as not to delay the process, would not be inspecting individual sites. Instead, he said, the review group would simply advise on the pros and cons of each option so that the Government can make a decision. MI contacted NAMA requesting a complete list of the sites it has submitted to the review group, but as of going to print no response had been received.
There has also been a further twist in the children’s hospital story in that it has recently been reported that the Government is increasingly attracted towards the benefits of a greenfield site. Minister for Social Protection Joan Burton told the Irish Independent that Health Minister James Reilly is “seriously considering” a new €1.2 billion medical hub with the children’s hospital and a relocated Beaumont Hospital at its core.
“The site, including a possible DART link, business park and education centre, would be situated near Dublin Airport and the junction of the M50 and M1 motorways,” the Irish Independent said.
The proposed development is believed to be similar to the university medical centres in the Netherlands, which aim to integrate patient care, biomedical research and medical education. It is also believed that the HSE recently sent a team to investigate the Dutch centres.
The review group is expected to make its recommendations to Minister Reilly within the next couple of days. It is difficult to speculate as to the scoring system being used by the review group, although according to a spokesperson for Minister Reilly, it will be based on the original McKinsey Report.
“It has become a war, a bidding war, between the adult hospitals, and the voice of children and their parents is nowhere,” said Dr Roisín Healy.
However, one thing is agreed – there is an urgent need to build the NCH and build it quickly.