Tuesday 28 February 2012

Eilish O’Regan: Hospital rejection leaves sick children in limbo

POLITICS, planning and the lives of sick children: the potent mix of issues which fuelled the debate over the new national children's hospital was always going to be volatile.

But nobody could have predicted that the much-needed project to improve the health of the nation's children would be so prolonged -- or end up in such a sorry mess yesterday after An Bord Pleanala rejected the plans to build it on the Mater site.

The plan in 2005 was to close the three existing children's hospitals housed in outdated facilities in Dublin and bring them all under one roof in a state-of-the-art building which would open its doors in 2012.

The opening date was then pushed back to 2014 and again, more recently, to 2016. But now it's back to the drawing board and an uncertain future.

There were too many vested interests involved along the way as the project became embroiled in a heated dispute over the location.

Former health minister Mary Harney was not for turning and insisted she was convinced of the merits of locating at the Mater. By the time she left office, tens of millions had been spent and there seemed little point in pulling the plug.

In 2005, consultants McKinsey were asked to compile a report on the "strategic organisation of tertiary paediatric services for Ireland".

A task force was set up and it recommended the Mater site, a choice that was strongly influenced by the new hospital being co-located with the adult hospital.

The government decision in 2006 to accept the task force's recommendation sparked accusations of favouritism because it was located in then Taoiseach Bertie Ahern's constituency and in the hospital where he had worked as an accountant.

However, it was the medical politics which were even more fierce and turf wars erupted as many prominent doctors in each of the existing hospitals -- Temple Street, Our Lady's Hospital for Sick Children and Tallaght -- laid claim to the right to have the new building located either in their campus or nearby.

The board of Crumlin Hospital refused for a long time to join the group planning the new hospital and bitter opponents of the Mater site criticised the cramped campus, access problems and traffic gridlock which they claimed would surround it.

A development board was set up early on and a chief executive, Eilish Hardiman, was appointed as costs covering everything from hiring planning and other experts to staff salaries mounted into tens of millions.

By 2011, the bill had risen to between €550,000 and €650,000 a month, on top of the €29.3m that had already been spent.

It had also became even more complicated when developer Noel Smyth weighed in and offered to build the new hospital at cost on a greenfield site.

The question of financing the construction of the hospital constantly hung over it.The State would cough up €450m but around €200m was dependent largely on charity or philanthropic sources.

It was hit by another bombshell when the chairman of the development board, Philip Lynch, was forced to resign in October 2010 after Mary Harney was told that he no longer had faith in the Mater site.

HE was replaced by developer John Gallagher, who was due to power ahead with the Mater location. But in March of last year, he also delivered his resignation letter to the new Health Minister, James Reilly. Dr Reilly said he was going to ask a review group to look again at the Mater site.

But this spurred Mr Gallagher to step down, saying there was a "risk of incurring further material ongoing costs in the project without full government support".

He was replaced by enterpreneur Harry Crosbie and everything seemed to be back on track after Dr Reilly's review team, made up of experts from abroad, backed the Mater site.

The expectation was that so much debate and bloodletting -- as well as the pressing need to treat children in modern hospital facilities -- would make it a certainty for planning permission.

There was also a pledge that the 445-bed hospital would receive government funding, part of it coming from the National Lottery.

But An Bord Pleanala's reasons yesterday for rejecting the planning application -- referring to how the hospital high-rise would detract from the "vistas of O'Connell Street and North George's Street" -- looked on the face of it to be overly fussy when set against the needs of sick children.

It has created a new limbo and in the meantime the three existing children's hospitals continue to be at risk of lacking the level of necessary investment needed to deliver the kind of service that young patients deserve.

Eilish O'Regan

Read the article @ The Irish Independent


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