Seanad Éireann - Volume 158 - 18 February, 1999
Adjournment Matter. - Hospital Relocation.
Mr. Costello Mr. Costello
Mr. Costello: I welcome the Minister to the House. The issue I have raised is one of considerable importance, namely, the need for the Minister for Health and Children to relocate the Children's Hospital, Temple Street, on the Mater Hospital campus and to ensure a full range of paediatric specialist and non-specialist services are maintained in the interim. The reason I raise this matter today is that there is considerable concern abroad that the Government is about to renege on its commitment to relocate the hospital. It is approximately 20 years since a site was obtained on the campus of the present Mater Hospital. In the best medical practice, the children's hospital should be located close to an adult hospital because after the age of 15 a child should receive treatment in an adult hospital rather than in a children's hospital. Therefore, it is important to locate the two hospitals adjacent to each other.
The present hospital in Temple Street is at least 170 years old. It is located in a number of old semi-Georgian buildings and other ramshackle  buildings that were erected from time to time. The actual structure is very poor in terms of requirements given the hi-tech equipment in the hospital, but particularly in terms of the needs of children and parents. Service in the hospital is second to none. Patients, their parents and nurses are extremely happy with the quality of the services provided, but the location and accommodation are very poor. There is an urgent need to relocate the hospital. Temple Street Hospital serves the entire north side of Dublin as well as counties Meath, Louth, Monaghan, Cavan and areas down to the western seaboard. Since the closure of Harcourt Street Hospital, Temple Street has been serving quite a number of families from the south side of Dublin as well.
It is the second largest hospital in Europe in terms of attendances for accident and emergency cases, having dealt with over 50,000 such cases last year and a similar number of admissions for operations and other treatment. It is by far the largest of the three children's hospitals in the country and provides an enormous amount of services. Neither the parents of children attending the hospital nor the children themselves have a bad word to say about the hospital's quality of service. However, the hospital building is long past its sell-by date and the sooner it is relocated the better.
Such a decision needs to be taken soon because I understand the extension to the Mater Hospital is due to start this year and the design work on the new hospital has not yet taken place to any great extent. If the two projects do not start in tandem there is a danger that it will be difficult to begin work on relocating Temple Street Children's Hospital at a later stage.
According to a report from Comhairle na n-Ospidéal, the level of specialist paediatric services should be reduced at Temple Street and paediatric specialist services should be concentrated in Our Lady's Hospital, Crumlin, which is stand alone and not adjacent to an adult hospital. If the specialist services are reduced and not maintained, the danger is that Temple Street will become little more than a general medical hospital without any specific surgical elements. As a result, the hospital would be run down and there would be a risk of its never being transferred to the new location.
Those are my main concerns. Is the Government still firm in its intention to relocate Temple Street Hospital and to maintain the level of specialist and non-specialist paediatric services there? Is the Government prepared to make funding available for the relocation?
Dr. Moffatt Dr. Moffatt
Minister of State at the Department of Health and Children (Dr. Moffatt): I thank the Senator for raising this issue on the Adjournment.
The relocation of the Children's Hospital, Temple Street, to the Mater Hospital campus has been under consideration by the religious orders who own both hospitals. There is general consensus that the transfer would greatly enhance the  quality of the paediatric hospital accommodation and would prove beneficial to both hospitals in terms of shared infrastructure support and complementary clinical services.
My Department is strongly committed to the amalgamation of the two hospitals on a single site, particularly in the context of the urgent need to address the critical service issues in both hospitals of the overall development of paediatric services, and also the proposed establishment of area health councils within the context of the Eastern Regional Health Authority.
From discussions with the two orders in this regard, the Department stressed the importance of a shared understanding of the commitments involved in such an amalgamation. Among the issues which would need to be considered are the governance, structures and management arrangements which will apply on the new site, the allocation of capital assets and the scope of clinical and non-clinical integration envisaged.
In November 1997, the Minister for Health and Children, Deputy Cowen, was pleased to be in a position to convey approval for the development of phase I of the Mater Hospital project at a cost limit of £25 million. In April 1998, arising from discussions with the two orders, as outlined above, a memorandum of understanding was submitted by the orders which endorsed their commitment to the amalgamation and set out in broad terms the arrangements for managing the integration.
While further details were sought on a range of issues, principally the governance and management arrangements which would be put in place, this document enabled the Minister to give the go-ahead for the appointment of a design team in May 1998. Its initial task was the preparation of a development control plan for the entire Mater site, including the relocation of the Children's Hospital, Temple Street, followed by phase I of the development.
The Senator will appreciate that to date it has not been possible to give a firm commitment to the timing of phase II, incorporating the Children's Hospital, but there is a general acceptance that in the interest of ensuring that paediatric services for north Dublin are maintained to a high standard, phase II should proceed as quickly as possible after the completion of phase I.
My Department is currently in discussion with both agencies regarding the possibility of accelerating the relocation of the Children's Hospital to the Mater Hospital campus and I hope to announce a decision in this regard shortly.
An accelerated capital development could offer a number of potential benefits both at service and strategic levels. Principally, the proposals would facilitate the transition process and the integration of services within the new Mater/Temple Street development. They would also contribute greatly to the development of paediatric services in line with the recommendations of the paediatric review group, which I will discuss later.
I am conscious that pending the implemen tation of the above proposals, it is vital that existing services for children on the north side of the city are maintained to a high standard. For this reason, in June 1998, my Department approved funding of £1.6 million for the refurbishment of Temple Street Hospital's accident and emergency department. Work is well advanced on the planning of this development.
I will now turn to the Senator's question relating to the maintenance of a full range of specialist and non-specialist services at the hospital, pending the relocation. It must be said that advances in health care in recent years, and factors such as the increasing specialisation of consultants, have had significant implications for the organisation of the health services on a national basis. Acute paediatric services are no exception to this.
The expanding range of specialties and sub-specialties has emphasised the need for a review of our existing paediatric services and, for this reason, the chairmen of the three Dublin paediatric hospitals recently undertook, at my Department's request, an examination of the role of paediatric hospitals in the delivery and organisation of acute services in Dublin. The review group's report, submitted to the Department earlier this year, contained a number of welcome proposals, in particular the establishment of a joint council comprising members from the three hospitals that would “identify specific actions needed to facilitate necessary changes and development”. The intention is that they will work together on the policy and delivery of national and regional ser vices in order to avoid duplication and get added value from pooling their resources.
My Department has prepared a formal position paper on paediatric services which is aimed at setting out the future role of the three paediatric hospitals within the context of the Eastern Region Health Authority. The Minister, Deputy Cowen, is putting forward proposals for the development of national specialties and tertiary services. My Department formally affirms its commitment to its continuing support for the three hospitals. In return, the Department will require that each of the three hospitals co-operates to the fullest extent in the provision of tertiary paediatric services and works closely to meet the regional needs of the east.
I am confident that the development plans which have been drawn up for paediatric services, combined with the proposed capital development set out above, are evidence of this Government's commitment to the enhancement of paediatric services, both on the north side of Dublin and at national level.
Mr. Costello Mr. Costello
Mr. Costello: I cannot say that I am much the wiser following the Minister of State's ten pages of elucidation and elaboration. My main concern with both phase I and phase II is the approach, because it will take about five years to build the £25 million extension.
The best advice would be that the two should go in tandem and that the relocation of the children's hospital should take place at the same time as the extension to the Mater Hospital.
The Seanad adjourned at 3.30 p.m. until 2.30 p.m. on Wednesday, 24 February 1999.
Seanad Éireann 158 Adjournment Matter. Hospital Relocation.