Children's Health Bill 2018: Second Stage

Question proposed: "That the Bill be now read a Second Time."

I am pleased to introduce the Bill to the House. I thank the Joint Oireachtas Committee on Health for undertaking pre-legislative scrutiny of the Bill last October and for their broad support of the new children’s hospital project. I hope that with the positive contribution and co-operation of Members of both Houses it will be possible to have it enacted without undue delay before the end of the year.

The background to this Bill, pure and simple, is the well accepted need and long held ambition to significantly enhance paediatric services for children in Ireland. In 2006, the HSE published "Children's health first", which outlined that there was compelling evidence for one national specialist paediatric hospital based in Dublin that would also provide all the less complex hospital needs of children in the greater Dublin area. The report underlines the need for access to urgent care centres in Dublin in addition to the proposed hospital. In 2012, the Government decided that the new children's hospital should be located on the campus at St James’s Hospital and last year gave the green light to construction. The new hospital will be completed by the end of 2022.

The outpatient and urgent care centres will open next year at Connolly Hospital Blanchardstown and in 2020 at Tallaght Hospital. The national paediatric hospital development board, which is charged with this capital project, should be commended for its work on this complex project. Building the new facilities is but one aspect of the new children’s hospital project. This project cannot succeed without providing the right structure for the staff who provide the care for our children. Paediatric services in Dublin are currently provided by three separate hospitals, namely: Our Lady’s Children’s Hospital Crumlin, Temple Street Children’s University Hospital and the National Children's Hospital at Tallaght. All three have a proud tradition of caring for our children and families over many years. All three recognise the increasing demands on paediatric services and fully support the development of a single hospital as a world class national hospital playing a central role in serving an integrated clinical network for paediatrics in Ireland.

However, providing services under the same roof but not under the same governance structure is clearly not feasibIe. Currently, the three children’s hospitals have their own boards and the integration and oversight of services of the three hospitals is managed by the children’s hospital group board, an administrative board. The staff and services of the existing hospitals need to come together under one single governance structure, hence this legislation. Under the Bill, the board of the children’s hospital group, will include representatives of the three hospitals’ boards and will become the first board of the new entity, thereby providing continuity in the important integration work. Establishing the legal entity as soon as possible will further assist the ongoing operational and cultural integration of these three hospitals in advance of the opening of the new hospital and centres. I commend the three hospitals' boards and the children’s hospital group board for their tremendous work and dedication to this project.

In drafting this legislation, we were conscious of the need to achieve the integration of the three hospitals in a way which respects the values and cultures of each, while creating an entity with the effective governance and accountability required to ensure that the State’s investment in this project delivers the benefits required for children and young people. The approach has been to establish a distinct body with appropriate governance to take over the services currently provided by the three hospitals, and to have a leadership role nationally in the implementation of the national model of care for paediatrics and neurology. Like the existing children’s hospitals it will operate as a provider of services under section 38 of the Health Act 2004, that is, it will be funded by the Exchequer through the health Vote.

The functions of children’s health Ireland will include planning, delivering and developing acute paediatric services as part of an integrated clinical network of paediatric care. The entity will run the new children’s main hospital and centres at Connolly and Tallaght hospitals when they are built. Before that, it will run the services on the existing sites at Tallaght, Temple Street and Crumlin.

The new entity will need to work closely with paediatric service providers in other hospitals across the country, in the primary care system and in the community. Accordingly, it is given broadly-worded functions that provide clarity, authority and certainty in respect of its leadership role nationally relating to paediatric healthcare and the national model of care for paediatrics, as well as to deliver on its remit for education research, philanthropy and advocacy on behalf of children’s healthcare in this country.

The new entity will be led by a 12-member competency-based board appointed by the Minister for Health, the first of which, as I said before, will be the board of the children’s hospital group. The Bill gives the board sufficient autonomy to make and implement the decisions required to effectively carry out its remit as a State body, subject to the high standards of corporate governance and accountability required of State bodies.

The three hospitals coming together under this Bill have different legal forms and the provisions in the Bill relating to their transfers are, accordingly, slightly different. Our Lady’s Children’s Hospital, Crumlin and the Children’s University Hospital, Temple Street are established under the Companies Act; Temple Street as a subsidiary of the Mater Misericordiae and Children’s University Hospitals Limited. Tallaght Hospital is a body corporate under charter and ministerial order. As they are funded as section 38 bodies, the hospitals’ employees are classified as public servants, subject to standard salary scales for the health sector and with access, in the main, to a public service pension scheme. The Bill provides that employees will transfer on existing rights and entitlements. As stated above, the proposed new entity will also be a section 38 body.

The Bill recognises the historical voluntary ethos of the three hospitals. For example, in line with their current practice, board members of the new entity will not receive fees. The Bill provides that the board of the new entity will nominate eight out of the 12 board members and the chairman of the board will be elected by the board.

Members may recall that the Minister announced earlier this year that the new entity would not be called phoenix children’s health. The legal name, children’s health Ireland, reflects the object and functions of the new entity. However, it is considered that it may be useful for it to also have an operational name or brand name. The Department is engaging with the children’s hospital group on arrangements for a new process to agree an operational name, which would be endorsed by Government. While ensuring wider consultation, this new process will acknowledge the previous naming process and the valuable input of staff, patients, service users and the Youth Advisory Council. Members may have particular views on the operational name and I assure them there will be opportunities to contribute to the naming process.

A two-step commencement approach is planned. It is proposed to establish children’s health Ireland and its board before the end of 2018 and, on 1 January 2019, to proceed to transfer the three hospitals to the new entity. The transfer is best made at beginning of the year for a variety of technical and financial reasons. However, the transfer will be subject to the completion of the necessary preparations and confirmation by the new board that it is satisfied it has the necessary structures and processes in place for a safe transfer day.

I will now summarise the main provisions of the Bill, which consists of 67 sections contained in nine Parts. Part 1, preliminary and general, provides for the Short Title of the Bill, definitions and administration costs. Part 2, on establishment and functions of children’s health Ireland, provides for establishment day and sets out the object and functions of the new entity. These have been well described already. It will be able to form or acquire subsidiaries or other corporate vehicles for limited reasons and, only with the approval of the Minister for Public Expenditure and Reform, it may acquire and dispose of land, borrow and accept gifts.

Part 3, on the board of children’s health Ireland, relates to the composition, role and modus operandi of the board. It will be a competency-based board. Of particular note is the method of appointing members of the board. The first board will be the board of the children’s hospital group. Half of the board, that is, six members, will serve for three years and half will serve for five years, thereby ensuring continuity on the board. When the term of office of the six members appointed for three years expires, they will be reappointed or replaced on the basis of two chosen by the Minister and four nominated by the outgoing board, similarly with those appointed for five years and so on every two years thereafter.

While the Bill does not provide for nominations by professional bodies, this is not to say that members of those bodies may not be members of the board at any given time. However, employees of the new entity cannot be members of the board. Board and board committee members may be paid expenses but not fees. This is in line with the voluntary ethos of the three children’s hospitals.

Part 4, on the chief executive officer, CEO, and employees of children’s health Ireland, provides that the CEO will be appointed by the board with the consent of the Minister, and can be required to appear before the Committee of Public Accounts. The CEO of the Children’s hospital group immediately before establishment day will be the first CEO. The superannuation provisions provide continuity for staff of the three hospitals. Employees eligible for the single public service pension scheme will be members of that scheme and all other employees will remain or become members of the voluntary hospital superannuation scheme.

Parts 5, 6, 7 and 8, relating to transfers of the three hospitals and the HSE to the new entity, are quite similar and I will summarise them together while drawing attention to some particular issues. These parts contain standard provisions for the transfer of employees, property, rights and liabilities, contracts, agreements and records of Crumlin and Temple Street, and such as may be agreed or designated for transfer from Tallaght Hospital and the HSE to children’s health Ireland. Of note is that land and buildings are transferring to the new body only from Crumlin hospital. Temple Street Children's University Hospital does not own the land and buildings it occupies in Temple Street. It is owned by a holding company, the Mater Misericordiae and the Children’s University Hospitals Limited, and of course there is no land to transfer from Tallaght Hospital, which will continue in existence as an adult hospital. No decision has been taken yet as to what will happen to the sites when the services move out in 2022.

After the transfer to the new entity, the Crumlin and Temple Street companies will be wound up by their directors under the provisions of the Companies Act 2014. As directors will no longer have the indemnity they would have enjoyed had the company remained in existence, the Bill empowers the Minister to indemnify past directors of Crumlin and Temple Street hospitals post wind-up where a concerned director has discharged, in good faith, his or her duties in pursuance of the functions of the company. As for Tallaght Hospital, the Minister for Health will, in time, bring a motion before the House to approve an order to amend the Tallaght charter consequent on the transfer of Tallaght Hospital's paediatric services to the new entity.

Finally, Part 9, on the national paediatric hospital development board, provides for a number of amendments to the order under which the national paediatric hospital development board was established and for the dissolution of the board in due course. The statutory instrument will be updated consequent on the establishment of children’s health Ireland. For example, it substitutes "Children’s Health Ireland" for the three children's hospitals in articles providing for consultation on the development of the new facilities and amends the appointment process to the board to better effect its role of equipping and furnishing the new facilities.

Section 67 provides that the members of the board in office immediately before the section is commenced shall cease to hold office, thereby allowing for the appointment of a board under a new process. In addition, the Bill provides that the board may plan, equip and furnish the maternity hospital to be located on the St. James’s Hospital campus next to the new children’s hospital. However, this function will only be commenced if a future decision is taken that the board is the appropriate body to do so.

In conclusion, as Senators can see, progressing this Bill is a vital step in the new children’s hospital project. I believe the provisions in the Bill will allow the robust governance structure necessary to oversee the transition to, and provision of, a single national specialist hospital for the children of Ireland.

I look forward to hearing the views of Members on the Bill

I welcome the Minister of State. I am dealing with this Bill on behalf of my colleague, Senator Swanick.

We will be supporting this Bill, which will place the new national children's hospital on a statutory footing. The Bill is long overdue, having been on the Government's list of legislation for three years. It is also disappointing that the new children's hospital will not be operational until 2020, or so we are told. When the St. James's site was chosen in 2012, it was expected that the hospital would have been built by now and would be operational.

The Bill makes provision for the establishment of a single statutory entity, children's health Ireland, which will provide paediatric services and take over the services currently offered by the existing three Dublin children's hospitals, Our Lady's Children's Hospital Crumlin, Temple Street Children's University Hospital and the national children's hospital at Tallaght Hospital. In addition to providing secondary and tertiary paediatric healthcare services, the new entity will be the lead centre for paediatric education and training and research and innovation in Ireland. It will also be the centre of a clinical network for paediatric services. The new entity will initially oversee the complex work of integrating the staff and services of the three hospitals I have outlined, which it will run as a single service initially on the existing hospital sites and, in due course, in the new hospital and centres being developed. The primary purpose of the legislation is to establish a body corporate that will govern and manage the new children's hospital and provide services on behalf of the HSE as a section 38 body under the Health Act 2004.

The Bill consists of nine parts, as outlined by the Minister of State, and covers establishment, functions and powers, board matters, employment - including the role of the CEO - accountability and standards. Functions will include the delivery of health services, research, education and related functions. The Bill provides for the creation of children's health Ireland, a legal name which describes the new entity whose future services remit is broader than only running a hospital. Under the Bill, this new entity will have responsibility also for providing secondary and tertiary paediatric healthcare services and will be the lead centre for the paediatric education and training and research in Ireland. We want this hospital to be up and running as soon as possible. I am sure the Minister of State and our colleagues in the Oireachtas want the same. We were told initially that it would be ready, open and operational in 2019, then it became 2020, and later 2021. Now we are informed that it will be 2022. I certainly hope that it will be open and operational by 2022.

The main clients of the hospital will be our children. In that context, I wish to refer briefly to waiting lists. There have been some improvements regarding inpatient day-case lists since 2016 and this must be acknowledged. The overall total number waiting in the group of three hospitals is down from 4,637 to 4,224, which is a slight improvement but certainly not good enough. The numbers waiting more than 12 months for scheduled treatment rocketed from 640 to 1,117 between June 2016 and June 2017. It has fallen back again, thankfully, to 1,078, nonetheless this is far too high and it is far too long for young children to be waiting for much-needed treatment. Prior to the Taoiseach, Deputy Varadkar, becoming Minister for Health in July 2014, there was a 20-week target in place under his predecessor, Senator Reilly, for children to receive scheduled treatment. However, when our current Taoiseach was appointed Minister for Health in 2014, he increased that to 18 months and, unfortunately, it has not been reduced in the interim. Last month, 449 children had been waiting more than 18 months for schedule treatment. For outpatients, the deterioration has been truly shocking. Overall, the numbers waiting has increased by 38.5%, from 32,290 to 44,714, in the past two years. That is totally unacceptable. For those who are waiting a long time, the wait has been proportionally longer unfortunately. The number of children waiting over a year has increased from 5,010 to 17,137 and the number waiting over 18 months has risen from 770 to 10,427, a thirteenfold increase since June 2016. That is the stark reality of what young people are facing.

I welcome this legislation and what it contains. I implore the Minister of State to impress upon the Government the need to have the children's hospital up and running by the new target date of 2020. It is imperative that this happens.

I welcome the Minister of State. I thank her for her very comprehensive overview the Bill and the project to which it relates. I am not going to say that I welcome every aspect of the Bill, particularly as we are on Second Stage. The Bill has been initiated in the Seanad and I thank the Minister of State for that. It is a welcome development. The Seanad has a particular role and function and I would like to see more Bills being initiated here. When the Taoiseach, Deputy Varadkar, addressed the Seanad, he referred its important role in the context of scrutinising legislation. That is our primary function and our primary role is to enhance, scrutinise and to seek to amend and improve legislation. I thank the Minister of State for giving us the opportunity to do so first by initiating the Bill in this House. I genuinely acknowledge the latter and the role the Minister of State plays in that regard within the Department.

I acknowledge that the Joint Committee on Health undertook legislative scrutiny in respect of this Bill and was broadly supportive of it and of the new national children's hospital project. That is important. There has been substantial pre-legislative scrutiny of this Bill by Members on all sides. That is also important.

The Bill, initiated in the Seanad and not yet debated in the Dáil, is to establish a body corporate, children's health Ireland, to provide paediatric services and consolidate the paediatric services currently provided by three hospitals. This is important legislation. As we go through the various Stages, it is crucial that we tease out various aspects with the Minister of State and her officials. I look forward to the debate because I am aware that a number of Senators intend to bring forward constructive and meaningful amendments, which, I hope, can be accepted. Clearly, the Minister of State must consider those amendments when they are tabled.

I want to single out two or three issues to which the Minister of State referred. Part 4 provides that the CEO will be appointed by the board, with the consent of the Minister, and can be required to appear before the Committee of Public Accounts. This is right and proper. It is worth emphasising that the Committee of Public Accounts will have the power, function and jurisdiction to bring in the CEO and cross-examine him or her in respect of any matters. That is really positive and it is one of the things that jumps out at me. I welcome that intervention because it is right and proper. Far too often we have not seen the sort of accountability that the public expects, not only in terms of the use of our finances for our health services but also in the context of general corporate governance, medical governance and everything else relating to the care of citizens, be they children or adults. Governance is important, as is accountability to these Houses, which approve requests for funding. This is going to be a state-of-the-art children's hospital and we want it to be par excellence in terms of the services it will deliver.

This is very important.

The Minister of State said "As for Tallaght Hospital, the Minister for Health will, in time, bring a motion before the House to approve an order to amend the Tallaght charter consequent on the transfer of Tallaght Hospital's paediatric services to the new entity." Perhaps the Minister of State, Deputy Byrne, could elaborate on "in time", as much as she can, given the current date and time and how far back we are from that.

It is important to progress this Bill fast. I am glad that it was initiated in the Seanad. We have waited for too long for a state-of-the-art national children's hospital. I welcome the legislation. I give it a guarded and cautious welcome, and I look forward to hearing the various debates and amendments as it goes through the Stages for enacting legislation in this House. It is an important piece of legislation and I am glad we did not have a summer recess before we got it under way. I say "Well done" to the Minister of State.

I am dealing with this Bill today on behalf of our health spokesperson, Senator Colm Burke, who has been unavoidably detained in Cork. Senator Burke played a significant role during the pre-legislative stage of the Bill when it was before the Oireachtas Joint Committee on Health. On behalf of the Fine Gael group, I acknowledge the work Senator Burke has done on the Bill and the interest he has shown in it.

I am always delighted to welcome the Minister of State, Deputy Byrne, to Seanad Éireann. She is deeply committed to her work and is a person for whom I have huge admiration. I salute her and encourage her in the important work she continues to do.

I agree with Senator Boyhan that it is great the Bill was initiated in Seanad Éireann. We have a significant role to play in initiating legislation. I would like to see more legislation initiated in Seanad Éireann. The Seanad is a most important vehicle available to Ministers who must get important legislation through, and who cannot get it onto the Dáil schedule through the Business Committee or whatever other convoluted apparatuses they have. The Seanad is a lot more straightforward and streamlined in that regard. I encourage other Ministers to do exactly the same as our good friend, the Minister of State, has done here.

I agree with the substantial elements of the Bill. Where amendments are necessary and important to enhance the Bill then they should happen. While I broadly welcome the Bill I would include the caveat that if a good amendment is tabled then it should be entertained and included. We have seen this happen time and again in this House, and hopefully we will see a lot more of it.

It is extremely important that we drive on with this project. The children and families of Ireland deserve a centre of excellence for the care of children. The narrative and debate have taken place over years. Lots of different scenarios and controversies have engulfed the development of a state-of-the-art children's hospital. Had we advanced the project a few years ago it probably would have been built a lot cheaper when value for money was available. When it comes to children's health, however, and the provision of a state-of-the-art facility, value for money should not be an issue. It is value for money, whatever it costs.

I am aware that a significant portion of the Bill is technical in nature and provides for giving staff their necessary rights. The project pulls together three very proud, traditional institutions that have provided fantastic care over the years. This poses technical and logistical challenges. The Bill will, hopefully, deal with the vast bulk of those matters. Even when the Bill gets over the line and is signed into law, unforeseen circumstances may present themselves and we should not be afraid to amend the legislation if such unforeseen circumstances present themselves.

The facility needs to be accessible to all children, and I know it will be. We should be the best country in the world for looking after our children when they get sick. We should be the best country in the world for looking after our children anyway. When children get sick the apparatus of the State needs to be able to kick in straight away to provide the necessary interventions and healthcare to ensure all children, with minor or critical injuries, can return to the best possible health that medicine can provide.

I commend all of the staff in the various hospitals. When I was a child I benefitted enormously from the children's unit in the Mater Hospital, and especially the eye unit. But for their work, dedication, care and attention to me during the four years I attended the children's eye unit in the Mater Hospital - after I had eye surgery in London - I would not have the limited eyesight that I have today. I hope that future generations of young people will be able to look back with great pride on the supports they receive from this new children's hospital.

There is already a unit of the children's hospital up and running dealing with planning. Eilish Hardiman is doing an excellent job leading that team. I commend the work that Eilish and her team are doing. I agree with Senator Boyhan that it is important to get the Bill kick started before the recess. I sincerely hope that when we come back after the recess it will move on to Committee and Remaining Stages very quickly.

We genuinely welcome this Bill and well done to the Minister of State for the work thus far on the new children's hospital. Living in the shadow of its construction, however, has caused a lot of angst among our neighbours within a 1 km circle around the site, but sin scéal eile for another day. The project is going ahead and we wish it well. We are all aware that it is so desperately needed. I commend the Minister of State for the work on the project to date, including this legislation.

Having been involved with the project from the outset, once this site was announced we were all a bit nonplussed. The hearings at An Bord Pleanála for three weeks over the Christmas period in 2015 gave us a great insight into what lay ahead for residents, staff, children and their parents in order to get this right.

Given the recent, horrific scandals within our health services, it is welcome to see that the purpose of the Bill is to strengthen governance. I am aware that the Minister of State takes this very seriously and it is clear that the Bill has elements of strategic planning behind it.

We are looking to the future to ensure that we try to structure more accountability and public involvement. This is welcome. It is also essential in the overhaul of the existing pervading culture within the health service and in the delivery of health services.

I have several queries and suggestions for the Bill. As this is the first chance for Senators to speak during the long journey of the Bill, I hope the Minister of State will hear our concerns and take time over the summer to consider the suggestions, which come from wanting to further strengthen the Bill.

On community ownership and stakeholder involvement, the objectives and functions in Part 6 of the Bill are great but lack detail on how the objectives and functions will be met. How, for example, does the Minister of State envisage the views of children and young people will be managed regarding the development of delivery of services within the hospital? Will it be consistent throughout the development and opening of the national children's hospital? We need further information on that.

Where is mental health and disability dealt with in the legislation? Will the national children's hospital have provisions to assist children with mental illness or disability? I am aware that some 20 beds will be for children with mental health needs, but I also refer to crisis situations. Tallaght and Blanchardstown hospitals will open satellite centres, which will encourage people to go to those units, and the national children's hospital on the St. James's Hospital site will take the most sick and serious cases.

We need to figure out the 24 hour a day, seven days a week, services for mental health crises because children, like adults, present most often out of hours with these crises. How will they be factored into the centre for highly specialised paediatric care? This is a high level consideration that should be referred to within the objectives. Will the Minister of State please address these concerns today?

Sinn Féin has several practical and ideological concerns regarding finances. Sadly, it appears that the Fine Gael mantra of privatisation and relying on a charity model of health service will continue within our new health structures. This has proved disastrous for the HSE and it is a mistake to continue on this ideological path. If we want to overhaul children's health services we need to change. Hospitals should not have to continue focusing on profiteering, nor should they be balanced precariously by depending on people reaching into their pockets to donate. To depend on this for such a vital service is unsustainable. We all know of scandals that have had an impact on people's readiness to donate. What will the money generated through fundraising be used for? Will there be a specific guarantee that it will be used only for health reasons and not to top up the chief executive officer's, CEO, pay as happened in the past?

The Minister of State said the CEO can be required to appear before the Committee of Public Accounts. I will table an amendment to compel the CEO to appear before the Committee of Public Accounts and to ensure there is no wiggle room in that respect.

Part 3 deals with the formation of the board of children's health Ireland. We would like the board to have 13 members, including one active representative of Dublin City Council, as is the case with the board of Our Lady's Children's Hospital, Crumlin. We need a council voice and patients' voices. Section 14 disbars a person serving more than two consecutive terms. We would prefer if it was two terms and not just two consecutive terms. We would appreciate clarity on the reasoning behind this element.

Has the Department engaged with trade unions about the transfer of staff contracts and, if so, what was the outcome of such engagement? We would also like to see a reference to staff well-being, given the burnout rate of front-line staff in our chaotic health services. Including well-being as an objective for staff would be most helpful.

We want the three properties that will be vacated, especially the one in Crumlin, to be kept in use for health service purposes. Can we get a commitment on that? Has the Department considered turning the Crumlin site into an elective-only hospital or step-down facility or using it for some form of health use given our capacity problems? I am led to believe that the covenant of Our Lady's Children's Hospital contains a term to the effect that it should operate only in the service of children's health. Will the Minister of State comment on that?

I have been conducting an extensive consultation with the community on the future of the current children's hospital after it closes. I will reserve commenting on the results until the consultation is finished but I invite the Minister to work with me on this consultation and give the results serious consideration. The staff of Crumlin hospital and the people of Crumlin hold dear and are rightly proud of the service the hospital has given to all our nation’s children there since 1956. They are sad it will close and decamp to the St. James's Hospital site. Their concerns need to be taken into consideration.

The Minister of State mentions the maternity hospital and says the planning and equipment will be provided by the board. I am unaware of planning permission being either sought or granted for this up to yesterday. Will the Minister of State let me know what is happening because that is a further development on the campus in which locals in the surrounding neighbourhood would be very interested?

Sinn Féin supports the Bill and asks that the Minister consider our suggestions and Committee Stage amendments. The new children's hospital is a prime opportunity to make a radical change in children’s health services. We need to get it right and we can push this Bill to do that.

I thank the Senators who have spoken this afternoon. As one of the line Ministers under the Minister for Health, Deputy Harris, I may not be able to deal with all the questions. However, I assure Senators and those in the Public Gallery that everything will be done to adhere to safety and accountability in all aspects of the new children's hospital, particularly in respect of funding and monitoring. To answer one of Senator Devine's questions, the CEO will be compelled to attend the Committee of Public Accounts. That is stated clearly.

Regarding the services at the children's hospital in Crumlin, an area we both represent, a process has to take place before information can be relayed and I do not have that to give the Senator. However, I believe there have been talks.

I thank Senator Martin Conway, who has left the Chamber, for his contribution. There is always great support in the Seanad. I am glad the Bill has started here. There are great concerns and the raw views too and I welcome them because it is important when I am asked to step in on behalf of the main Minister to hear the views. I assure all the speakers this afternoon that I will relay all the information and the officials will do the same.

None of us wants to see our children or grandchildren having to wait on waiting lists. I believe that with the new children's hospital under one roof we will have a real opportunity to change forever the way children are treated, particularly as regards waiting lists. We all want to ensure that in the future children in Ireland will have a world class hospital that will cater for all their needs and that they will not have to be passed from one hospital to another when they need operations or other medical treatment. I agree with Senator Devine, however, that we need to take into account the number of young people, particularly very young people, who are suffering greatly from mental health problems. I believe that will have to be taken on board in the children's hospital.

In response to Senator Boyhan, the Tallaght charter motion will come before the House at the end of the year and before the legislation is commenced.

I thank the Members for their supportive and some less supportive comments on the legislation and the children’s hospital programme, all of which we will take on board. I am sure there will be plenty of time when we move to Committee Stage to consider amendments. As I set out earlier, the overarching objective of the Bill is to provide for the establishment of a new body whose key function will be to take over and run the services currently provided by the three children's hospitals in Dublin in state-of-the-art hospital facilities currently under construction. Concern for patients is the paramount reason for this investment by the State. The new hospital, outpatient and urgent care centres, along with the regional paediatric units in Limerick, Cork and Galway and local paediatric units, will work together to deliver a new model of care for paediatric services. This will see children receive the right care at the right time in the right location and, where possible, close to home. For those who need to access specialist services in Dublin, the co-location of the hospital with adult acute services and eventually the tri-location of the hospital with maternity services will result in patients, from infants to adolescents, being able to avail of the best clinical expertise on one campus.

The new development will mean that children and parents will no longer have to travel between several hospitals for different aspects of their treatment. Parents will no longer have to sleep on the floor when spending the night in hospital with their sick child. Staff working in buildings that date back to Victorian times will be providing services in a modern building, where health and safety are paramount.

As I also outlined earlier, the building element of this complex project is proceeding well. Construction works on the main site are continuing as planned. The construction of the paediatric outpatients and urgent care centre at Connolly is also progressing as scheduled. The entire concrete structure is now complete and the centre is expected to open in summer 2019. Works at Tallaght are also progressing with the decant and creche works scheduled to be completed in august 2018 and the main works on the paediatric outpatients and urgent care centre is expected to commence in September 2018. The Tallaght centre is expected to open in summer 2020.

We all wish that will happen. There is no doubt in my mind that these urgent care centres of excellence for Connolly and Tallaght hospitals will be very much part of the overall approach of the new national children's hospital and the work that can be done in communities and in our new hospital. I welcome the fact that both of these centres are on time for completion. I do concur with some of the Senators' feelings around the extension of the completion date of the new children's hospital to 2022. However, as somebody who lives and works in the area, I can tell Members that on a daily basis, the amount of work that is being done at ground level is something the likes of which I have never seen. Everything possible is being done by the project team and the construction firm to complete the project by 2022, if not before.

It is important that we recognise the significant role of these outpatient and urgent care centres. The availability of consultant-led urgent care, with four to six hour observation beds, rapid access to outpatient clinics and diagnostics will mean that families and GPs can access a range services locally.

While the buildings are important, equally essential are the staff and the services that are provided to the children and families for their care. The ongoing work on the operational integration of Ireland’s three children’s hospitals and preparation for the move to the new hospital, and the opening of the two outpatient and urgent care centres is a large and complex programme of work, with multiple stakeholders. This Bill provides the new entity with the effective governance authority and accountability to oversee that work. The approach to populating the first board of the new entity recognises the need to maintain continuity and organisational memory and to ensure that board members have the required competencies to undertake the leadership role required over the next few years. Accordingly, the children’s hospital group board will be the first board of children’s health Ireland. Its members appointed a year ago, were selected on foot of nominations and an open competitive Public Appointments Service process. The board includes a member from Northern Ireland and an international expert, representatives from the three children’s hospitals’ boards, and experts in patient safety, change management, law and corporate governance.

I wish again to commend and thank the staff and boards of the three hospitals coming together, as well as the board of the children’s hospital group for the vision and commitment they have shown to this project, and in getting it to the stage we are at here today. Anyone involved in the new children’s hospital project is embarked on a sea-change. This is particularly true of the staff of the three children's hospitals, some of whom have devoted decades of their lives to these institutions. Change can be challenging. I want to recognise today the commitment that staff, past and present, have given to the three hospitals and say that I understand that they may feel they are witnessing the end of an era, and a sense of loss. I want to assure them that the development of this Bill was mindful of the history of the three hospitals coming together and the Bill is reflective of their values of child-centred, compassionate and progressive care provided with respect, excellence and integrity.

The Bill provides that staff will transfer to the new entity on terms and conditions which are no less beneficial than those to which they were subject before the transfer. In addition, there will be new opportunities for staff. We must never forget the ultimate prize for children and families and for the staff who care for them. The establishment of the new children’s hospital is the start of a new era, a unique opportunity which will enable us to tackle current and future challenges in children's health, which many Senators have acknowledged today, and to deliver on the huge advances that are possible in children’s healthcare.

I am confident that this legislation will put the right structure and approach in place to integrate the existing services and be prepared for the development of the best possible paediatric healthcare in the new facilities. I am confident that the Bill as proposed will provide this new entity with the powers and functions it needs both now and into the future to manage the transition to the new children’s hospital and provide services for children’s healthcare. It is therefore our hope that this Bill will progress through the Houses by the end of the year, in time to allow the new entity to be established and operational by year end, before the opening next year of the first outpatient and urgent care centre in Connolly.

I thank all Members of the House for their contributions and I look forward to the Bill being considered further on Committee Stage. With the contribution and cooperation of the Members of the House, I am confident that it will be possible to have it enacted without undue delay. Can I also acknowledge the fact that behind me are women who have worked on this project long before I came to the position I am in, and to acknowledge the Department's work with the Minister, Deputy Harris, on this. As a person who represents the area locally, I know the concerns that were raised with residents and I have spoken to them and to many people over the last weeks and months when the construction had started. There is a sea-change and it is not only for the children and their families, it is for a community as well.

I want to acknowledge the huge input of residents in the area, the community and the support that has been given by the F2 Centre Fatima. I also acknowledge the work done on the ground in local schools and with youth groups by the project team with whom I had been in constant contact and worked with before I was given this job. I recently opened a flyover at the site with some of the students from Goldenbridge secondary school, and a drone went over the site and took some amazing pictures. One of these students said to me, and on the day it took me to a different place, she said:

I never thought I would be part of something like this. My options have opened now and I am considering that I would like to work in medicine or maybe in this hospital when it is opened, and many of my friends are as well.

That is an added bonus to the hospital being at this location, that people who are already living and working in the community will have jobs, will have careers in medicine, and all other aspects of serving children through our new paediatric hospital.

I thank again all the Senators who made a contribution. Unfortunately I am not able to answer some of their immediate questions. I will, however, refer them to the Minister for Health. I am sure there will be many amendments forwarded as well which may be considered on Committee Stage. I thank the Chair and all of the Senators.

Question put and agreed to.

When is it proposed to take Committee Stage?

Committee Stage ordered for Tuesday, 24 July 2018.