Enda Kenny says the debate is over, but the noisy campaign against the project is not going away...
“I was the only driver on my own in the ambulance – and they were in the back, the medical team - who would be highly qualified doctors and a nurse - and the new born baby. I'm coming back from the country and running into huge problems outside the city in Lucan, coming from the airport, or coming from the Naas road. They're screaming in the back of the ambulance at me, 'John, this baby’s stats are dropping rapidly - how far are we from the hospital, where are we? How long do you think it will take?” says John Smith.
He’s a retired ambulance driver who spent 30 years rushing people to hospital - the later part of his career was with a neonatal unit dealing with critically-ill babies.
Mr Smith has recently decided to go public with his opposition to the decision to locate the new National Children’s Hospital as St James's, in south inner-city Dublin.
“I know what I'm talking about” he continues, citing the time he spent based in St James's, “It is crazy and criminal to build a hospital in there.”
Traffic on Dublin's South Circular road approaching St James's / Posted on Facebook by Connolly for Kids
The decision to put the hospital in central Dublin was made in late 2012 by then-Health Minister James Reilly - he set up a review group after An Bord Pleanála rejected a proposed site at the Mater Hospital in Dublin, as it would have had a “dominant, visually, incongruous structure and would have a profound negative impact on the appearance and visual amenity of the city skyline.”
It was due to treat its first children in late 2016 - abandoning these plans meant a loss of €26m for the State.
The redeveloped of St Jame's had an original completion date of early 2018 - but serious construction work on the site is yet to begin.
At the time, Mr Reilly said that the project would cost at least €484m. Last week, Independent TD Mattie McGrath claimed in the Dail that the cost is now likely to me more than €1bn - and that's before fit-out and IT costs.
James Reilly with Taoiseach Enda Kenny / Rolling News
In a response to a query regarding the cost of the project, the Children’s Hospital Group who are tasked with managing the project said, “€650m has been made available in Exchequer funding for the new children's hospital project, demonstrating the commitment of both the previous Government and this Government to the project.”
Campaigners against the St James's project argue that even taking into account the money spent on St Jame's, it would still be cheaper and quicker to build the hospital on an alternative greenfield site.
Under the charge from Mr McGrath that we will “end up having inquiries” about this project in years to come Enda Kenny replied that the hospital’s cost would be addressed in a memo for the Cabinet and that the St Jame’s project is “in the interests of all the children of this island for the next two generations at least.”
He added that “the decision was made after years of discussion about the principle of building a national children’s hospital and the location where it should be built. That argument is finished and a decision has been made.”
But not everyone believes that the debate is over.
“It's never too late to reverse a bad decision” Dr. James Sheehan told Newstalk. He developed the Blackrock Clinic, Galway Clinic and The Hermitage Medical Clinic, three of the country’s leading private medical facilities.
“The whole thing is absolutely chaotic” he continued.
He’s become involved in the Connolly for Kids Hospital Campaign - a group who want the project to be moved to Connolly Hospital - located off of the M50 in Blanchardstown.
While the Taoiseach says the issue is closed, this group is holding out hope that the location of the hospital can still be changed. It delivered a petition with 60,000 signatures to Mr Kenny's office in June.
That was one week after a Red C poll commissioned by Newstalk found that 73% of a representative sample of over 1,000 adults believed that St James's is the wrong site for the hospital.
Red C / Newstalk
Connolly for Kids has been engaged in a war of words with Health Minister Simon Harris - he accused campaigners of using "offensive language," following their claims that “babies will die” because of the Government’s decision.
Members of the campaign picketed his constituency office in Bray - they argue that comments about babies dying are based on a report completed by medical consultants who found that children's lives will be lost if the hospital is not immediately co-located with a maternity hospital.
“We can have disagreements but let’s not get into the gutter and attack the bona fides of the people involved in the project,” the minister said.
A protest at Mr Harris's office / Connolly for Kids Facebook
The group took exception to these remarks: “He's a young guy who himself said he knew nothing about health – he thought that was an advantage coming into the office. He knows absolutely nothing about it and he's sort of belittling us who spent our entire lifetime in medicine” Mr Sheehan said.
Minister Harris had no further comment to offer on this issue when contacted by Newstalk.
While arguments about babies losing their lives are emotive - in this case they are literal according to the campaigners.
Opponents to the project are disappointed that the children’s hospital will not be initially co-located with a maternity hospital.
“Tri-location of the new children’s hospital on a shared campus with St James’s Hospital and, in time, with the relocated Coombe Women & Infants University Hospital, is the optimal configuration of services from a clinical perspective,” The Children’s Hospital Group told Newstalk.
While the long term plan is to have children, adult, and maternity hospitals on the same site - it is unclear when the maternity facility will be developed - the Goverment announced yesterday that it will build a new National maternity hospital at St Vincent's in south Dublin.
In response to a query from Newstalk seeking clarification as to when the maternal hospital will be built, a spokesperson for the Department of Health replied:
“As announced in June 2015, the Coombe Women and Infants University Hospital will relocate in time to the St James's campus, achieving tri-location of adult, paediatric and maternity services,” it is not clear when this will be.
“A site for the proposed maternity hospital is identified in the Site Master Plan for the St James's campus, and the new children's hospital design has incorporated the required operational links with both maternity and adult hospitals,” the statement continued.
The relocation of both the Coombe Women and Infants University Hospital to the campus at St. James’s Hospital are both included in the National Maternity Strategy - and yet to advance to planning.
“There is sufficient space on the St. James’s Hospital campus – 3 acres – for the maternity hospital,” the hospital group told Newstalk.
“Co-location with a maternity hospital is a critical part of the picture so that very sick children – who they can anticipate before they are born – will be born adjacent to the children's hospital and move straight in for corrective surgery – heart surgery – whatever is necessary,” Dr Sheenan commented.
He points out that the development of the St James's site could be difficult:
“They talk about sites, but there is no site,” he continues, pointing out that the 3 acres put aside are currently occupied by new buildings which are part of the existing adult hospital. These would have to be demolished to make space for the additional maternal facility.
“The whole thing is absolutely chaotic” he adds, “It's only later, in a few years time when the place is finished in five or six years that people will realise that it's an unmitigated disaster.”
“The whole thing is insane. It actually is. For those of us who have some knowledge of what will happen in the future, with planning, it's total insanity,” he concludes.
The entrance to the redeveloped St Jame's hospital
Campaigners refer to murky ‘political motives’ when asked why the project is going ahead. When this was put to Minister for Health, Simon Harris by Newstalk he replied:
"Clinical considerations were paramount in the decision by the Government in 2012 to co-locate the new children's hospital with St James's. This decision was made in the best interests of children and young people. Independent reviews since 2006 have reaffirmed the importance of co-location with a major adult academic teaching hospital.”
The Wicklow representative continued, “The construction of the Paediatric OPD and Urgent Care Satellite Centres is scheduled to be completed in 2018, and the new children’s hospital in 2020. I want to see this hospital built, our sick children and young people need it."
Despite the loud protests the St Jame's project has maintained the broad support of political parties and medical specialists.
A mock-up of a single room in the new hospital
“We are unequivocal in our certainty that the campus at St. James’s Hospital is the right location for Ireland’s much needed and much wanted new children’s hospital,” a statement from The Children’s Hospital Group; the National Paediatric Hospital Development Board; Our Lady’s Children’s Hospital, Crumlin; Temple Street Children’s University Hospital; the National Children’s Hospital, Tallaght and St. James’s Hospital begins.
The letter highlights the benefits of co-locating the children and adults facility.
This has been disputed by Kids for Connolly - when asked about the foundation of this claim the Children’s Hospital Group pointed Newstalk to three reports reviewing the Irish project, and two recommendations for co-located projects in the UK and one in Australia - these can be seen on its website.
Dr Sheehan says that there are no medical journal entries to supply evidence that children’s outcomes are better in facilities co-located with adult hospitals - and Connolly for kids has published a detailed document criticising the merits of the literature cited by the hospital group.
They argue that the crucial co-location is child and maternity services and John, the former ambulance driver, believes that the inner-city site is a threat to the most vulnerable children in Ireland - babies who cannot be treated anywhere else.
“People have the impression that when an ambulance has its siren on that they can fly through traffic, that's not right. That's a fallacy,” he told Newstalk.
He recounts his own experience getting into and around the city centre:
“It's just a disaster – you see you can do nothing with the roads in that area because they are old.”
Mr Smith highlights the south circular road and the canal as being particularly dangerous:
“On the canal – where can people drive? You can only drive into the canal.”
“The longer you are in an ambulance with a child or a patient – there's more damage being done to that patient, particularly if they are critically ill.”
He said that he had remained quiet on the issue until Mr Harris took office:
“I thought myself that it was possibly going to be knocked on the head, like the Matter was knocked on the head eventually.”
“He's young – maybe he'll grab it by the neck (I thought) and say 'look-it – let’s go an build this new bloody hospital (in Blanchardstown) and get it out of the way and it will be built.”
However, he isn’t hopeful that the decision will be reviewed: "Politicians don't go back on decisions no matter how wrong,” he concludes.
In August of this year the National Paediatric Hospital Development Board appointed a contractor for the first phase of construction on the new children’s hospital on a shared campus with St. James’s Hospital and site clearance works, including demolitions, are underway.
The new children’s hospital is set to be complete in 2020.