Lets be real here: The Children's Hospital is a scam

Podge_irl

Why do you disagree with the Dolphin report? Why do you disagree with their finding that co-location with a tertiary hospital was best for clinical outcomes? Bar nebulous "vested interests" of which you claim. I have yet to ever see anyone actually give a reason why the proposed clinical benefits of co-location are incorrect? Please explain in detail why co-location is, in fact, not clinically preferred?

70% of the patients will be from the GDA, a large percentage of whom don't even own cars. What about people with free travel passes but no car? What about those who just can't afford a car. Public transport access it vital. Sick children, obviously for the most part, will not be arriving by public transport. Those visiting them and many of those working at the hospital can and will though. There remains enough parking for every single patient to be brought by car.

As regards emergency transport, the hospital is a 14 min drive from the M50 with a bus lane the entire way for an ambulance to use. I fail to see the problem. Why is a 2 min ambulance ride from the helipad such a big deal? The group deciding the location were aware of these factors but simply decided other factors were more important.

The entire point of the co-location was for best care for the kids. No one has ever tried to actually explain why this is not true. Why is there no benefit from having an adult tertiary hospital co-located? They selected first the Mater and then James' for incredibly transparent reasons. No one has ever explained why those reasons are wrong.

The fiasco with the religious ownership of the new maternity hospital is indeed a political mess and an example of something you should actually blame the govt for. Because it was easily possible to locate there without promising them any control. But the actual location is not the problem.

https://www.boards.ie/discussion/comment/117704870#Comment_117704870

So...

Tallaght.

LUAS, hospitals, M7 and M50, in GDA but outside Dublin city centre, Co-located, Current Children's Hospital, plenty of room behind current hospital

Or Blanch. No Luas but plenty of bus connections, plenty of room, hotels, outside M50, on motorway network, within GDA, Co-located...

James's nightmare for parents not in Dublin, small, horiffic build site, in city centre traffic, no expansion opption. Newlands cross to James's, for non emergency appointments, can take up to 40 minutes.

Podge_irl

Blanch is not a tertiary hospital.

Tallaght has far fewer specialities than the other Dublin hospitals. James' has the most, this was part of the consideration. They don't go into sufficient detail about why they didn't pick Tallaght for my liking, though its hardly devoid of congestion issues itself. Worth noting that the proposal for Tallaght had the exact same number of parking spaces. Also the site was actually incredibly constrained because there is an apartment complex on it...

Podge_irl

Also, worth mentioning once more - what people are asking for here is the very political interference they so often decry. The site selected as the one recommended by the expert working group and is supported by the boards of the 3 main adult hospitals in Dublin

Moaning about the cost escalation and any delays seems perfectly reasonable to me.

Moaning that it is "obviously" in the wrong location and is a scam is stupid. The logic for selecting the location is well documented yet somehow it is not those reasons that ever come up.

Flinty997

Its worth pointing out that co-location was originally meant to be a preferred option and not meant over rule all other considerations. Indeed many other other similar hospitals have not gone down the route of being co-located. Of course making it the overriding criteria, handily deflects any focus on the major negatives of the James locations, and also removes most of the other sites for consideration.

So it make the criteria carboard cut out for one location, its hardly a surprise when its selected. Of course they picked the Mater twice using similar methods, so James is third choice. Which is ironic since it has all the same issues (arguably worse) that stopped the Mater from going ahead.

Flinty997

https://www.boards.ie/discussion/comment/117704924#Comment_117704924

You are thinking about it wrong.

If you pick one of the least popular ways of getting to hospital as the most desirable in your criteria, ,and the most popular method the least desirable. Then its eliminates all these places from consideration.

Podge_irl

The only thing that stopped the Mater going ahead was ABP which quite clearly has not stopped James'. Clearly the downsides of the location of James' have not been deflected as it is all anyone ever talks about.

There are satellites for secondary care being built at Tallaght and Connolly. Tertiary care will be handled at the tertiary hospital. James has the most specialities of any hospital in Ireland - this is a positive thing for patient care.

The only thing people seem to point out as a negative is that it is hard to drive to at rush hour. This is not ideal but nowhere ideal exists.

This is not a million miles away from the same arguments that were had about centralisation of specialist care. But that has improved patient outcomes considerably.

Flinty997

More correctly, the LAST thing that stopped the Mater going ahead was the ABP. Basically an overdevelopment of the existing site. James is arguably worse in this regard.

"....The only thing people seem to point out as a negative is that it is hard to drive to at rush hour. This is not ideal but nowhere ideal exists...."

Actually thats false. Lots of things have been mentioned, expansion, cost, time, no new capacity, etc..

Flinty997

I'd love to know how much making it an Oval cost, and what problems that causes over a regular shape.

Even apple only went as far a Circle.

https://manofmany.com/living/architecture/inside-apples-insane-5-billion-apple-park-headquarters

Podge_irl

The Tallaght site wasn't exactly a barrel of laughs shape-wise either

jmayo

https://www.boards.ie/discussion/comment/117704870#Comment_117704870

So does every new childrens hospital have to be colocated with an adult or trilocated with a teaching hospital ?

Yes we know the Dolphin report came to that conclusion which the McKinsey report had also found in 2006.

But who set the guidelines for those reports ?

The Dophin report and Dophin working grouip onyl came into being because the previous best site in the country was thrown out because of planning.

Were you also telling everyone and anyone that the only proper site for the new childrens hospital was the Mater before it got kicked to touch?

Podge_irl

No, I think James' is a better site all round. But all of the teaching hospitals in Dublin come with some restrictions to one degree or another.

You are welcome to read some extra background not in the Dolphin report on the benefits of co/tri-location here but yes, it is the norm where possible to build children's hospitals co-located with tertiary adult teaching hospitals.

https://www.nchplanning.ie/wp-content/uploads/2015/07/3-Clinical-Case-for-New-Childrens-Hospital.pdf

And some background on one of the reasons they considered co-location to be so important

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1120824/

But the failings were not those of the surgeons alone. An expert review of 80 cases carried out for the inquiry showed inadequacies at every point, from referral to diagnosis, surgery, and intensive care.

The physical setup was “dangerous,” with surgeons on one site—at the Royal Infirmary—and paediatric cardiologists several hundred metres away at the children's hospital. The operating theatre and intensive care unit were on different floors, and children had to be transported by a lift that could be called at any time by others.

And of course the McKinsey report itself which goes into quite a lot of details

http://thenewchildrenshospital.ie/wp-content/uploads/2011/08/Childrens_Health_First_McKinsey_Report_2006.pdf

jmayo

https://www.boards.ie/discussion/comment/117706011#Comment_117706011

The reason they are having to build care centres in Tallaght and connolly is precisely because the James site is unsuitable, both from space and emergency access.

Space is a huge concern with James.

As Jack and Jull foundation pointed out there are other things like the setting, you could develop outdoor spaces, gardens, etc in Connolly rather than have your sick kids look out at a mucky Dublin skyline.

Then there is fact that they have to yet move the Coombe to James site.

It doesn't matter if the new NCH cost 20 billion the fookers behind it, running the project , the ones that will be running new hospital will defend it to the end.

https://www.boards.ie/discussion/comment/117705048#Comment_117705048

So will every new hospital not have to be shoehorned into the James site, since after all it has the most specialities in the country. 🙄

BTW I think you referenced centralisation when on about specialities.

The reason people around the country fought vehemently against some of the ideas of centralisation was that they were told what wonderful centralised services there would be and how there would be better care all the while they would have fook all access to it.

Oh yeah the great Trauma unit in a big city is great when you are 2 hours by road away and there are shag all ambulances to sometimes cover the area or a great oncology unit in a big city is great so long as you don't have to spend 4 hours commutting to and from it because they never thought of building overnight accommodation for patients to stay when getting treatment.

This is what people that don't live in our cities and beside our few public transport rail or tram links deal with.

FFS can anyone not plan for the future.

Build new NCH at Connolly, build new maternity that will cover north side of greater Dublin, turn it into teaching hospital linked to say Beaumont and Mater.

You can even add in plan to have Laus link to Airport with spur to Blanch with stop at hospital.

Nah fook that lets make sure the lads in Crunlin don't have too far to move to their new job, sure some of them are based in James already.

Besides we have to think of Trinity and UCD.

So fooking limited thinking in this country.

Podge_irl

Build new NCH at Connolly, build new maternity that will cover north side of greater Dublin, turn it into teaching hospital linked to say Beaumont and Mater.

You can even add in plan to have Laus link to Airport with spur to Blanch with stop at hospital.

All of that is certainly not going to make it cheaper or quicker than the current plan so we can remove cost and time as problems with the James' site

Of course every new hospital doesn't have to be on the same site. The primary tertiary paediatric hospital was somewhat specific criteria and, particularly in a country of our size, the more specialities available the better.

Flinty997

https://www.boards.ie/discussion/comment/117706395#Comment_117706395

Its pretty much a given that James was going to be the most expensive site to build on and the most restricted and take the longest.

No need to speculate any more. All of that has come true, and far worse than the most pessimistic estimates.

Job done. Well done lads.

Flinty997

https://www.boards.ie/discussion/comment/117706383#Comment_117706383

This ship has largely sailed.

Centralization was partly about cost cutting. Ok centers of excellence is one thing and economies of scale. Great. But in general this has resulted in less beds, longer wait times, and massive inconvenience and stress to those now having to travel long distances, and all the time and stress that involves.

If the counter to that is better outcomes. Fair enough. Has that really been demonstrated? I'm open to be convinced.

tails_naf

https://www.boards.ie/discussion/comment/117704870#Comment_117704870

It could have been co-located on a greenfield site for cheaper, build 2 new hospitals, loads of parking, expansion possibilities and M50 access. Moving out of the city centre would also help the staff who work there.

My Sister in law is a pediatrician, and she's spoken about doctors needing escorts to walk between buildings in thst area as its a bit rough. The feeling of getting mugged is just what you want when you are carting your sick kid off the luas as you can't get parking. It's a pure joke it was not built elsewhere.

Podge_irl

https://www.boards.ie/discussion/comment/117718449#Comment_117718449

Building 2 new hospitals would not be cheaper and would obviously take far, far longer. You think it would be in any way easy or straightforward to move the specialisms out of James and into this new hospital?

How would moving it out of the city centre help the staff who use public transport? The Connolly site did not offer any more parking and frankly its unlikely anywhere that did offer significantly more would get planning permission.

tails_naf

https://www.boards.ie/discussion/comment/117720015#Comment_117720015

The budget for a state of the art hospital was 600m. 2 is 1.2 billion. I've seen numbers from 1.5b to 2.4b quoted for this mess in the end. And still no parking. Green field sites were offered, and bringing planning into the equation is is laughable. The current location should not have been granted planning to begin with, so if they can get it there, they can get it anywhere.

Having it on/near the m50, with ample parking, would allow staff to drive, as we both know the nurses are mostly not living in the expensive city center, and are most likely commuting in.

Podge_irl

James' is a significantly larger hospital than the NCH. Also, assuming the costs would not have increased if placed on a greenfield site is quite the assumption.

Building a new Mode 4/tertiary hospital with the level of specialisation available in James/Mater would be more expensive and take significantly longer than building it where it is now. We would be talking decades before it is properly up and running.

Also, again, the Connolly site was planning to have the exact same number of parking spaces (with significantly worse public transport provision) as the James site.

Amirani

https://www.boards.ie/discussion/comment/117718449#Comment_117718449

Far more staff in James's use public transport than drive, so no, moving it miles out of the city would not have helped them.

Why is your sister in law working in James's if she's a pediatrician? There's no pediatrics there?

My girlfriend worked in James's as a doctor for 3 years until recently and many of her friends still do. They don't get escorts around the campus.

salonfire

https://www.boards.ie/discussion/comment/117722349#Comment_117722349

And what do you suggest those nurses who don't drive do? Those nurses who live in appartments and house-shares without cars? What about the nurses from other countries who can't drive here even if they had a car?

You have been told multiple times by people much better educated and experienced than us here than outside the M50 is a stupid idea.

mariab21

https://www.irishexaminer.com/news/arid-40355279.html

Ireland never fails to shock

salonfire

https://www.boards.ie/discussion/comment/117727708#Comment_117727708

I think Ireland has come on leaps and bounds if you ask me. From mass graves and paupers to a world class, fully equipped and modern Children's hospital close to the country's best Universities, other teaching hospitals, integrated transport and close to the most prestigious addresses where consultants and professors are mostly likely to be attracted to for living in.

mariab21

https://www.boards.ie/discussion/comment/117730229#Comment_117730229

Did you miss the whole mother and babies report scandal?

Shebean

https://www.boards.ie/discussion/comment/117730229#Comment_117730229

We certainly have not.

The veil was lifted and they can no longer so easily operate in secrecy (the state and church), however the state is very happy to put up roadblocks and deny survivors some respite or truly hold the culprit organisations to account.

The state and church were dragged kicking and screaming to were we are today by private individuals and organisations.

No Catholic organisation should be let near a child, hospital or any other authority.

My issue with the NCH is the blank cheque and complete lack of oversight and accountability.

salonfire

Where is the lack of oversight and accountability? As far as I know, various claims are due to be heard in the High Court.

Public spending is a big issue for you is it? Are you just as outraged and the various public sector pay increases which will equal the cost overrun of the hospital in three years? Can we expect you to be posting the outrageous cost of the salary increases three years from now?

How about the massive spending because of covid? That must give you real sleepless nights.

Or, is it more likely you don't give a fiddlers about spending usually and just churn out that nugget as something to hang on to to criticise the Hospital and by extention FG?

https://www.boards.ie/discussion/comment/117724666#Comment_117724666

there is nothing to stop people learning to drive on opposite side of road....by this logic the irish drivers of trucks on continent are miracle workers.

Looks to me,it should been built on greenfield site outside M50 (never forget majority pop are outside the m50),saying consultants wont work there,is kind of silly as ultimately,they work in hospiteals and will go there,go end up signing on,.....we are sunk into the 3billon territory now into what is,ultimately going to end up as a tribunal to find out exactly,what went on

salonfire

https://www.boards.ie/discussion/comment/117730990#Comment_117730990

And you think that the professors who work between the hospital and the universities as part of their work day are going to yo-yo between central Dublin and some field outside the M50 multiple times a day?

https://www.boards.ie/discussion/comment/117731052#Comment_117731052

For the money,they getting,yeah (afaik the head of hse gets paid more than american prez,our payscale higher up in the health service is genourous as fcuk)

Its simple as this,it shouldnt be built where it is....if your more concerned with the consultants/professors conditions and not access/whats best for patients,yous have your prioirties very badly wrong as regards healthcare