Dáil Éireann Debate, Tuesday - 21 June 2016
376. Deputy Louise O'Reilly asked the Minister for Health the rationale for the location of the new children's hospital; the criteria his Department used in the decision process; the evidence and criteria it used to specifically demonstrate that adult co-location was necessary and optimal; the evidence of improved clinical outcomes in respect of adult co-location it used; and if he will make a statement on the matter. [16868/16]
View answerPlanning permission was granted on 28 April last by An Bord Pleanala for the new children's hospital development at the St James's campus, for satellite centres of the hospital to provide urgent and outpatient care on the campuses of Tallaght and Connolly hospitals, and for a Children's Research and Innovation Centre at the St James's campus and a family accommodation unit adjacent to the children's hospital. It is intended that the first phase of building works will commence in the coming weeks.
The Government decision that the new children's hospital should be co-located with St James's on its campus in Dublin 8 was clinically led. In 2006, the McKinsey report, Children’s Health First, recommended that the population of Ireland and projected demand could support only one world-class tertiary paediatric centre, that this should be in Dublin and that it should ideally be co-located with a leading adult academic hospital, to ensure relevant sub-specialty and academic linkages. The McKinsey report recognised the importance for quality of healthcare of having a critical mass of sub-specialist skills in a tertiary centre and stated this could be achieved firstly, by serving a large enough population to support a full complement of sub-specialists and secondly, by co-locating with an adult teaching hospital thus enabling access to specialties that encompass both adult and paediatric patients, facilitating clinical and academic “cross fertilisation”, and attracting the top staff.
Reviews since 2006 have reaffirmed the importance of co-location with a major adult academic teaching hospital. In 2011, Minister Reilly established an Independent Review Group to examine the project at the Mater. The clinical aspect of this review was carried out by a team of four Chief Executive Officers drawn from the National Association of Children’s Hospitals (NACHRI) and the Children’s Hospitals International Executive Forum (CHIEF). Their report stated that “co-locating with tertiary adult and maternity hospitals is essential to the development of an excellent paediatric service. This has become best practice internationally and was recognised in the McKinsey report.”
In 2012, following the refusal of planning permission for the project at the Mater campus, Minister Reilly established the Dolphin Review Group to advise on next steps. Their report stated that “Having reviewed the reports already prepared and considered their analysis and opinions, and having also consulted with a wide range of professionals in the field, we are also of the view that co-location is essential and tri-location optimal. We recommend that the Minister remains on this path." It identified St James’s as the most suitable adult partner for the new children’s hospital, from a clinical and research perspective.
The Government decision to co-locate the hospital with St James's was announced on 6 November 2012. In identifying the location, the Government carefully considered the report of the Dolphin Group, established earlier that year to advise on next steps following refusal of planning permission for the hospital at its previous location. The Government also considered detailed supplementary information on cost, time and planning which was subsequently sought from those members of the Group with the relevant technical expertise. The decision was clinically led, and was made in the best interests of children, with clinical considerations paramount in the decision. As announced in June 2015, the Coombe Women and Infants University Hospital will relocate to the campus in time, achieving tri-location of adult, paediatric and maternity services. Tri-location has benefits for children, adolescents, newborns and mothers. In all cases, the benefits of tri-location are maximised where the adult hospital provides the broadest possible range of clinical sub-specialties and expertise, which are readily accessible for paediatric and maternity patients on the shared campus. Also, tri-location that delivers the most significant breadth and depth of clinical and academic research on site will enhance the potential of research to drive best clinical outcomes. St James’s Hospital has the broadest range of national specialties of all acute hospitals, as well as strong and well established research and education infrastructure, making it the hospital that best meets the criteria to be the adult co-location partner.
