'New children's hospital moving ahead'

  • Niall Hunter, Editor

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.”

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