New children's hospital

An as-yet unnamed children's hospital is currently under construction on the campus of St. James's Hospital in Dublin, Ireland, as a regional secondary and national tertiary centre. Referred to in planning documents simply as the new children's hospital, it will combine the services currently provided at Dublin's three tertiary children's hospitals: Children's Health Ireland at Crumlin (formerly Our Lady's Children's Hospital); Children's Health Ireland at Temple Street (formerly Temple Street Children's University Hospital); and Children's Health Ireland at Tallaght (formerly the National Children's Hospital at Tallaght University Hospital).

"National Paediatric Hospital" redirects here. For the existing hospital that is now located in Tallaght, see National Children's Hospital.

Unnamed children's hospital
Children's Health Ireland
Geography
LocationDublin, Ireland
Organisation
TypeTeaching
NetworkChildren's Health Ireland
Services
SpecialityChildren's hospital
Links
Websitewww.newchildrenshospital.ie
ListsHospitals in the Republic of Ireland

The hospital will be the lead centre in the Children's Health Ireland network, which will eventually encompass all acute paediatric services in Ireland. In addition to the main hospital at St James's, satellite centres will operate attached to Tallaght Hospital and Connolly Hospital providing local urgent care and outpatient services.

History

Background

The consolidation of Ireland's three tertiary paediatric hospitals (Our Lady's Children's Hospital, Temple Street Children's University Hospital, the National Children's Hospital) into a single hospital was first proposed in 1993 by the Faculty of Paediatrics at the Royal College of Physicians of Ireland.[1] The proposal was not acted on and plans were put in place to develop the three hospitals separately.[2] In 2005 the Health Service Executive was established, as a new agency to manage the health service. Brendan Drumm, Professor of Paediatrics at University College Dublin and Our Lady's Children's Hospital, was appointed as its first CEO. Professor Drumm was one of the authors of the 1993 Faculty of Paediatrics proposal. In 2005 the HSE commissioned McKinsey & Company to undertake a review of the strategic organisation of tertiary paediatric services for Ireland that would be in the best interests of children.[3] Pending the outcome of this review the HSE stopped the redevelopment of Temple St, Children's University Hospital on a site close by the Mater Misericordiae University Hospital; Professor Drumm, the HSE CEO, said the development of one world-class hospital was the way forward [4] rather than three separate hospitals, and he would not sign off on this expenditure. This decision was severely criticised by many paediatricians [5] who described it as "sabotage" and as being "a major lost opportunity for children".[6]

The McKinsey & Company report on the findings of its review, Children's Health First, was published in 2006. It recommended that, in view of Ireland's size and expected demand, there should be a single tertiary paediatric hospital based in Dublin, with good transport and access links, room for future expansion, ideally co-located with a leading tertiary adult centre, and "at the nexus of an integrated paediatric service" with urgent care centres around Dublin and with regional children's hospitals around the country.[7] It calculated the total bed requirements to be 380 (285 inpatient, 54 ICU beds and 41 day beds). McKinsey was not asked to identify a site but proposed nine assessment criteria for making a decision on the best location and model.[7] One of the paediatricians who contributed to the McKinsey report confirmed that their remit was not to select a site.[8] This recommendation was initially welcomed by almost all the stakeholders, including the three tertiary hospitals.[5] It was also quickly accepted by Government and it agreed to proceed with the single tertiary hospital model with satellite urgent care centres. Because the location for the new hospital had yet to be selected, the Irish Times Health correspondent at the time Eithne Donnellan suggested that "the real battle may only be starting".[9] Her concern was based on the long history of rivalry between the three children's hospitals [4] described by one paediatrician as "continuous internecine trench warfare" [10]

2006–2012: the Mater site

Later in 2006, a task force [11] composed of representatives from the Department of Health, the Health Service Executive and the Office of Public Works selected a site on the Mater Misericordiae University Hospital campus in north central Dublin as the location of the future tertiary hospital. The selection process was criticised by both the National Children's Hospital and by Our Lady's Children's Hospital. A patient interest group said it was gravely concerned at the decision of these hospitals to oppose the Mater site.[12] Another parents group which had been campaigning for a new hospital for many years said: "It would seem to us to be immoral and wrong for the development of this hospital to be delayed by even one day due to further debates and disputes over its location." [13] Our Lady's Children's Hospital decided to withdraw from the process and announced that it was instead considering the rebuilding of its hospital.[14] The National Children's Hospital called for the new hospital to be based across two sites; at its hospital in Tallaght and the Mater Misericordiae University Hospital campus [15]

The Government accepted the recommendation and in 2007 the Minister for Health, Mary Harney, established a National Paediatric Hospital Development Board (NPHDB) to oversee the project.[1] The chairman of the board, Philip Lynch, resigned unexpectedly in October 2010 citing "significant and fundamental differences" with Harney over the chosen location of the hospital, as well as over funding arrangements and governance.[16] Lynch had met with the property developer Noel Smyth and with staff from Our Lady's Children's Hospital and had come to favour an alternative plan, whereby the hospital would be built on greenfield land owned by Smyth in Newlands Cross outside central Dublin.[17] Harney announced that she had requested Lynch's resignation, stating that "it is not in the remit of the Development Board to revisit the Government decision taken on the location of the new hospital".[16] Lynch was replaced as chairman of the NPHDB by the businessman John Gallagher, who himself resigned only months later in March 2011, saying that he "no longer feels that he has the mandate to continue with his original remit to build the hospital at the Mater site", since the new Minister for Health, James Reilly, had publicly considered reviewing the decision to locate the new hospital there.[18]

Reilly went on to assemble an independent group of international experts from children's hospitals in Boston, Sydney and London as well as internationally recognised architects to review the process. In July 2011 this group "made a unanimous and unequivocal recommendation" [11] that the Mater site remained the best of the available options,[19] and the NPHDB formally applied for planning permission on 20 July, naming the project as the "Children's Hospital of Ireland".[20] The application was contested and went through an appeals process. In February 2012, An Bord Pleanála announced that it had refused permission for the project, stating in its decision that "by reason of its height, scale, form and mass, located on this elevated site, [the hospital] would result in a dominant, visually incongruous structure and would have a profound negative impact on the appearance and visual amenity of the city skyline," as well as constituting over development of the Mater campus and detracting from the historic character of the surrounding area.[20]

2012 onwards: the St James's site

In the wake of the refusal of planning permission, Reilly tasked another review group (led by the businessman Frank Dolphin) to determine other options for the new hospital.[21] The report proposed nine assessment criteria for making a decision on the best location and model.[7] Prioritising colocation with an existing adult teaching hospital – and, ideally, "trilocation" with a maternity hospital as well – the group sought submissions from six adult hospitals within Dublin.[21] It received proposals from the Mater (revised from the previous project that had been rejected), Beaumont Hospital, St James's Hospital, Tallaght Hospital, and Connolly Hospital, as well as a proposal from the Coombe Women & Infants University Hospital that was backed by St James's.[21] St Vincent's University Hospital declined to participate.[21] The group also received, but chose to exclude, a number of unsolicited site offers that were not linked to a Dublin teaching hospital.[21] The government chose the St James's site in November 2012.[22]

Construction on the first phase of the project, by BAM Contractors, began in 2016.[23]

The name "Phoenix Children's Hospital Ireland" was selected for the hospital in 2017 (based on the mythological symbolism of the phoenix), but was abandoned in 2018 due to legal threats from the Phoenix Children's Hospital in Arizona, United States.[24][25]

On 1 August 2018, a sub-committee of the responsible board raised concerns over cost overruns for the project and its affordability.[26] By December 2018, this had become a more public issue.[27] By February 2019, the estimated project cost had increased from €650 million to at least €1.7 billion.[28] In January 2019, the Oireachtas began to speak of hearings into the cost overruns.[29] Later in the month, the Public Accounts Committee was informed that the final cost could be over €2 billion.[30] On 19 February 2019, Minister for Health Simon Harris claimed that the only scandal in relation to the project would have been to cancel it. As of February 2019, an independent review of the procurement process was being carried out by auditors PriceWaterhouseCoopers.[31]

Construction was halted on March 31, 2020 due to COVID-19 pandemic restrictions.[32] While restrictions on construction were lifted in May, as of July 2020 work had not yet restarted due to disputes between the prime contractor and hospital board about the costs of the work stoppage.[32]

Design

The new hospital will be seven storeys high. Including the underground car park with 1,000 spaces there are about 160,000 m2 of accommodation with 6,150 rooms. There are 380 individual inpatient rooms, about the same number as Great Ormond Street Hospital, each with en-suite facilities and a bed for a parent or carer to sleep on. There are also 20 child and adolescent mental health beds for patients with eating disorders and acute mental health problems, 93 day beds and 22 operating theatres, some with specialised facilities and a hospital school. Ronald McDonald House Charities are funding a separate building for families with 50 bedrooms.[33]

References
  1. Flaherty, Rachel; D'Arcy, Ciarán. "The national children's hospital: A timeline". The Irish Times. Retrieved 17 January 2019.
  2. "Children's hospital beset by medical rivalries". The Irish Times. Retrieved 15 December 2018.
  3. "Introduction" (PDF). Thenewchildrenshospital.ie. Retrieved 28 February 2019.
  4. "Children's hospital beset by medical rivalries". The Irish Times. Retrieved 17 January 2019.
  5. Drumm, Brendan (2011). The Challenge of Change: Putting Patients Before Providers. Orpen Press. ISBN 9781871305357.
  6. "Impasse over children's hospital". The Irish Times. Retrieved 17 January 2019.
  7. McKinsey & Company (2006). Children's Health First (Report). McKinsey & Company. Retrieved 12 June 2016.
  8. "Experts never suggested Mater as site for hospital". Irish Independent. 17 January 2007. Retrieved 12 June 2016.
  9. "Hospital's location will be keenly fought". The Irish Times. Retrieved 15 December 2018.
  10. "Row over children's hospital site". The Irish Times. Retrieved 17 January 2019.
  11. "Review Group on the National Children's Hospital" (PDF). Health.gov.ie.
  12. "Experts never suggested Mater as site for hospital". Independent.ie. Retrieved 17 January 2019.
  13. Donnellan, Eithne. "Parents call for prompt review of specialist child unit". The Irish Times. Retrieved 17 January 2019.
  14. Donnellan, Eithne; Wall, Stephen Collins Martin. "Crumlin children's hospital examines options". The Irish Times. Retrieved 17 January 2019.
  15. Donnellan, Eithne. "Call for children's hospital to be based at two sites". The Irish Times. Retrieved 17 January 2019.
  16. Connors, Aoife (22 October 2010). "Controversy lingers over hospital project". Irish Medical Times. Dublin. Retrieved 12 June 2016.
  17. McCarthy, Justine (17 October 2010). "Children's hospital chief 'split board' over consortium talks". The Sunday Times. Retrieved 12 June 2016.
  18. Donnellan, Eithne (30 March 2011). "Second chairman resigns from board of children's hospital". Irish Times. Dublin. Retrieved 12 June 2016.
  19. "National Children's Hospital to go to planning on Mater site following Independent Review". Department of Health. 6 July 2011. Retrieved 12 June 2016.
  20. "An Bord Pleanála Reference Number 29N.PA0024 - Planning Decision" (PDF). An Bord Pleanála. 23 February 2012. Retrieved 12 June 2016.
  21. Review Group on the National Children’s Hospital (7 June 2012). Report of the Review Group on the National Children's Hospital (PDF) (Report). Department of Health. Retrieved 12 June 2016.
  22. O'Connell, Hugh (6 November 2012). "Children's Hospital to be built on St James's site by end of 2017, early 2018". TheJournal.ie. Retrieved 10 July 2020.
  23. "Minister for Health, Simon Harris marks the commencement of construction of the new children's hospital". newchildrenshospital.ie (Press release). National Paediatric Hospital Development Board. 20 July 2016. Retrieved 10 July 2020.
  24. Brennan, Cianan. "US hospital tried to speak to the Children's Hospital Group before launch of abandoned Phoenix name". TheJournal.ie. Retrieved 10 July 2020.
  25. "Children's hospital will choose new name amid legal threat". Irish Independent. Retrieved 10 July 2020.
  26. "Files show children's hospital cost overrun would have happened with other bidders". Breaking News. 19 February 2019. Retrieved 22 February 2019.
  27. Cullen, Paul; Wall, Martin. "Rising cost of national children's hospital a scandal in the making". The Irish Times. Retrieved 22 February 2019.
  28. "► VIDEO: New Children's Hospital set to become the most expensive in the world". Irishtimes.com. Retrieved 22 February 2019.
  29. "Oireachtas to begin hearings into soaring cost of National Children's Hospital". The Irish Times. Retrieved 22 February 2019.
  30. McMorrow, Conor (31 January 2019). "Claims cost of children's hospital could be over €2bn". Cite journal requires |journal= (help)
  31. Tuesday; February 19; Am, 2019-11:43 (19 February 2019). "Simon Harris: National Children's Hospital overspend not a scandal". Irishexaminer.com. Retrieved 22 February 2019.CS1 maint: numeric names: authors list (link)
  32. McGreevy, Ronan (10 July 2020). "Work on children's hospital halted over Covid-19 costs stand-off". Irish Times. Archived from the original on 10 July 2020. Retrieved 10 July 2020.
  33. "Dublin's new children's hospital: a world-class gamble?". Building Better Healthcare. 4 March 2019. Retrieved 16 April 2019.
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