A new children’s ambulatory/urgent care centre will open at Tallaght Hospital in Dublin in 2013, a year before the opening of the new Children's Hospital of Ireland on the Mater Hospital site.
The existing three paediatric hospitals in Dublin will move to the Children’s Hospital of Ireland in 2014.
The National Children's Hospital (NCH) at Tallaght will not close until the new Mater centre is opened, however, and will for a time run in tandem with the ambulatory care centre until it moves, according to Eilish Hardiman, Chief Executive of the project tasked with building the hospital.
However, she said it had yet to be confimed whether two emergency centres, the existing Tallaght A&E and the new urgent care facility, would operate alongside each other between 2013 and 2014.
The new ambulatory care centre at Tallaght is being built at the same time as the Mater development to provide emergency, outpatient and day care on the southside of Dublin when Crumlin and Tallaght Hospitals close.
The Rotunda maternity hospital will also move to the new Mater development.
In an interview with irishhealth.com, Ms Hardiman said it was not known yet whether further ambulatory care centres will be built in Dublin “The policy is to start with Tallaght and then evaluate it."
The Tallaght ambulatory care centre will be under the governance and management of the Children’s Hospital of Ireland and will share its staff and IT system.
The McKinsey report which prompted the development of the Mater site recommended two to three children’s urgent care/emergency facilities in Dublin when the new single children’s hospital is built.
Ms Hardiman said building work on the Mater site will begin in 2011 and will take two-and-a-half years.
Building will be completed in 2013, followed by commissioning and fitting out, and the new children’s hospital will open in 2014.
Eilish Hardiman is confident that the hospital will open in time. ”It is a tightly controlled design and building process.”
While Our Lady’s Hospital, Crumlin had expressed major reservations about the Mater site proposal initially, she says Crumlin is now fully on board with the planning process.
The choice of location for the new children's hospital has attracted much controversy; however, the process of establishing the new 750-bed hospital in around five years time is now progressing.
“Crumlin’s board formally joined up with the process last October and the hospital had in fact joined our model of care committee the previous April. They have agreed to full engagement. They want to have a leadership role in this.”
Ms Hardiman is adamant that the Mater, despite concerns about the issue, will be readily accessible to public and private transport.
“We have underground car parking for those arriving by car and we will prioritise car parking for child patients. We are looking at running buses to get patients and their families from train stations.”
"As regards ambulance access, an ambulance trying to get to the Mater at the moment still gets there. The ambulance services do not have issues about access.”
“A study carried out at TCD showed the hospital will be accessible to public and private transport.”
Eilish Hardiman is also confident that the new children’s hospital at the Mater will have adequate capacity well into the future.
The current bed total in the three hospitals is around 395 inpatient plus 75 day beds. The current indicative figure for the new hospital is 399 plus 81 day beds.
However, she says the bed numbers are not set in stone and can be revised. ”It is an indicative figure. There is flexibility there and we should have a more definite picture later this year of what the actual capacity will be in terms of inpatient and day bed numbers."
She points out that the way care will be delivered in the new hospital will reflect evolving practice in this area, including a greater emphasis on ambulatory care and day care.
“A special feature of the children’s hospital will be short-stay beds in the emergency department. If you look at patients admitted from an ED a lot of them only stay for one day, so they need a bit of time but cannot stay in the ED. With short-stay beds, you are not admitted as an inpatient but you do get looked after. This new way of working will reduce the dependency on inpatient beds.”
There will also be an emphasis on having the hospital as a "one stop shop” for care with an emphasis on getting as much as possible carried out on one visit.
Physically, Eilish Hardiman says, the new hospital has more than adequate capacity to expand.
She says an expansion capacity is built into the plans for the hospital. "This hospital may be there for 100 years so we will go through different models of care and different ways of delivering care."
“If in 30 years time you need to convert some of the general wards into intensive care beds there is provision for that within the design. We will have "soft space" built in so that, for example, there may be some offices beside areas of the hospital we know will need to expand and we will design those offices so that they can become expansion areas.”
"We can also build upwards. The height parameters allow us to build higher at the back of the hospital on the North Circular Road. We can go up to 16 floors.”
The Children’s Hospital of Ireland is costing €750 million to build. Out of this, €400 million is coming from the Exchequer, with the remainder through private/philanthropic donations and revenue from other sources including car-parking and commercial and retail outlets in the hospital.
She said the Ronald McDonald Foundation is providing, on a purely philanthropic basis , “home from home” accommodation for families; but she stressed, there will be no McDonalds restaurant on the hospital site.
In addition, accommodation for family members is also being provided in hospital rooms. Each bed in the hospital will be in a single room.
Although two of the existing three hospitals have a strong Catholic ethos and governance structures, the new hospital is to be run as a State institution.
Asked if the Sisters of Mercy Order, which runs the main Mater Hospital, will be involved with the new children’s hospital in any way, Eilish Hardiman said that had not been confirmed.
However, she stressed that the governance of the hospital would be on a secular basis. “We would see this reflecting the pluralist society we have in Ireland.”
She says while the children’s hospital will work very closely with the main Mater Hospital, it will have a separate governance structure.
The new hospital will be a digital centre with an emphasis on electronic medical records, handheld technology and integrated automatic transfer of data.
Eilish Hardiman adds that there will also be an emphasis on having the hospital as a ’one stop shop” for care with an a emphasis on getting as much as possible carried out on one visit.”
After 45 years of debate and delay we are to have one major paediatric centre for Ireland in keeping with the population served.
Not sure about the Mater site but the decision is made lets get on with it.
The governance arrangements require to be PLURALISTIC without fear or favour to any interest group or faith community while facilitating many and all.
The relationship between The Children's Hospital, the Ambulatory Centre and Regional Paediatric Units requires elaboration - what will be dealt with at CH and what will be be dealt with at Ambs. and Regs? How minimise duplication?
Also what about Conditions or Complications which cannot be dealt with at CH - will there be identified International Partner Hospitals/Services in contractual relationship to address such needs in an efficient, effective and and child/family friendly/manner ?
If these points are addressed then a better future lies ahead for hospital treatment of pour children and that can only be welcomed.
I really don't think a site as clogged as the mater in area so constricted as regards transport, is a good idea at all.
I live in Tallaght myself with four children. I believe in theory that the new hospital is vital to coordinate a good system of care and once a&e centres/clinics in Tallaght hospital are not compromised it should work. People are afraid of change and until we do change, our health care system will never work to its full potential to the detriment of our children's health.
Let's plan a brand new hospital for sick children.
Since we are beginning from scratch, there are no restrictions regarding size, shape or location.
The hospital is to cater for the whole population of our Republic, so we should consider making it accessible to everyone, as best we can.
Therefore, to some "expert" advisors, it seems that the location should be deep in the restricted streets of northside Dublin. There happens to be a car park beside an existing hospital. Let's put it there, they decide. The car park is chronically incapable of serving the needs of existing patients. The nearest public parking facilities are inconveniently distant. We'll put in a few underground spaces - that will answer that objection, they declare!
What about ward, theatre space? Oh, well, we can go up as high as we like. So, no problem there.
How much were the "advisors" paid for this advice? For nothing, practically, what was it? Ten, fifteen, twenty million? A bargain, anyway.
Heaven help the sick children and their parents!
From all parts of the city and the country they will come. They will struggle through the traffic, frustratingly searching for a place to park. Or, they will attempt to use an increasingly inefficient public transport system. Unless you happen to live near the metro, - when it is built, if ever.
Now, let's build a hospital designed to suit the needs of its 'customers', the sick children. Let us remember that these will be children who are for the most part seriously ill.
Why not select a green space site. Keep the building low - single storey - two, at most. Use the upper for offices. Plan for plenty of space around the hospital, after alll, the cost of land, now that the speculation bubble has burst, will be minimal.
Pick a site outside the present M50.
In such a site, access will be much easier. Public transport from the city will be no problem to provide. City motorists will have plentiful space to park. Those arriving from the four corners of the land will reach their destination without the nightmare of city traffic.
Let the children be able to look out on green fields and, If they are able, let them breathe the fresh air outside.
I know where I would prefer to have my children treated.
The problem is that no matter WHERE the hospital is put, it will be far from a lot of people. Dublin has the highest population (carrying nearly 25% of the entire population in one county) so logistically (and no dub bashing politics please) it would benefit most people here. That said, ALL children have the right to access to good and proper healthcare so there should be more dedicated childrens hospitals around the country, or at the very least, a dedicated air system that allows for quick and efficient5 transport to a proper treatment centre. This would save valuable time and minimise stress for parents, patients etc. There is more than enough money to fund something like this if the government stopped squandering it on developers debts.
It looks as though we will have to live with this bad decision since Eilish Hardiman says its with us for the next 100 years. Room to expand upwards 16 floors she claims. Well lets hope she builds adequate car parking space underneath to facilitate this expansion instead of a repeat M50 10 years on. Its certain there is very limited support for this location but like all H.S.E. decisions its forge ahead and listen to nobody.