Still no resolution on James’ site for NPH

I’ve been reading the submission from Connolly for Kids to the Oireachtas Health Committee. The submission is here, and the covering letter is here. My own views on the location of the NPH have changed little over the last few years. I wrote about Colocation, colocation, colocation in 2012, and I think the analysis there is still sound. For me, (a former paediatrics trainee, before going to public health), the most important feature is a maternity hospital adjoining the children’s hospital. Adjoining means accessible by corridor without going outside. Colocation with an adult hospital is not useless, but is much less useful than the Department of Health have suggested.

Given this perspective, I always thought the Mater site was complete non-starter. It was never going to be possible to fit the maternity service, nor a reasonably sized children’s hospital onto that site. After this decision was reversed on planning grounds, there was a challenging site selection process. I was involved, working on the proposal to locate the NPH beside the Coombe hospital, however, in the end the St James’ site was chosen. This was a much better choice than the Mater. It is a bigger site, more open, with better public transport, and a bit less traffic.

Unfortunately, as time has gone by, the weaknesses of that site are becoming more obvious. There is no immediate plan to bring in a maternity service, and it looks as if the NPH will, quite effectively, prevent any future major site developments for the adult hospital. St James’ is one of the biggest, and most important acute hospitals in the country, but large parts of it need to be rebuilt to meet modern service needs. Losing this opportunity would be a very high price for the NPH.

The other big issue is parking. Acute paediatric hospitals require much more parking that adult hospitals of the same size, because most of their patients arrive by car. This will not change. There is no prospect of parents of sick children bringing them in on the Luas, not by rail to Heuston station. It is already hard to park on the James’ site, and indeed the NPH build has already significantly reduced the number of parking spaces there.

It is true that Connolly does not have anything like the range of specialist services on the St James’ site, but this is not of great practical importance. The old model, under which some very hard-working adult specialists also did a bit of paediatric work on the side, is gone – almost all care is provided by fully trained paediatric specialists. Connolly could very rapidly be developed to meet a wider range of clinical needs, and this is probably necessary whether or not the NPH goes there. For example, if we ever do decide to build a national trauma centre, Connolly would be a far better choice than either James’ or Beaumont.

All in all, I agree with Connolly for Kids that Connolly would be a better site than James’ and would provide for a better and more affordable NPH. I hope the Oireachtas Health Committee will consider reviewing this decision.