New Children's Hospital - A symbol of Ireland's scandalous and shady behavior

Geuze

I am under the impression that the new hosp replaces three older childrens hosps.

Crumlin

Temple Street

What is the third? Maybe I am wrong.

jmayo

https://www.boards.ie/discussion/comment/121775708#Comment_121775708

You obviously have never tried to get into James hospital by car then if you think it also hasn't bad congestion in the area.

It is laughable at this stage that you have posters on here, some I have noticed have been posting on this for years now, who will support this come what may.

As someone who has experience of Crumlin, it can be hard to get to, fook all parking, has an old buildings without some modern facilities, but shoehorning the new hospital into a smaller further into the city centre site was lunacy.

This is at a time when more people in the Dublin metropolitan area are now living outside the city centre.

Oh and this hospital is for the entire country not just people in central Dublin.

Oh but it's alright the professors in James/Trinity are happy.

Anita Blow

https://www.boards.ie/discussion/comment/121785398#Comment_121785398

It'll replace Crumlin, Temple Street and the NCH in Tallaght. All three will close.

Connolly & Tallaght UCC will remain as satellite centres for urgent care and outpatients.

Anita Blow

https://www.boards.ie/discussion/comment/121785406#Comment_121785406

I've posted on this thread before recognising difficulty of access as a legitimate concern. However there is multiple competing interests that trump routine access and consultants seemingly wanting an easier commute. This includes co-location with adult sub-specialities, future tri-location with a maternity hospital and proximity to the existing tertiary maternity hospitals which are all based in Dublin city centre. These are all factors which tangibly affect the quality and safety of care we provide, specifically:

• We rely on access to adult specialists for more niche areas. SJH as the largest hospital provides access to these- burns, plastics, cardiothoracics etc. These tend to be time-critical specialities in the event of an emergency presentation and so co-location provides more timely access. The opposite is also true as there are many specialities in paediatrics which are niche/unavailable on the adult side and so co-location allows for a transitional service for those who have outgrown paediatrics (metabolic, neurodisability for eg)
• Proximity to maternity services is probably the most essential aspect of the current paediatric hospitals and any new hospital has to at least match the current service provided. All high risk congenital anomalies are delivered in Dublin and these are the most time-critical transfers in paediatrics (in which risk of death is measured in minutes or hours). An unwell baby can be on the operating table in Crumlin within 20 minutes of delivery in Dublin at present. That would not be the case if the hospital was located further afield and would materially worsen the service provided. Additionally sometimes specialists from the paediatric hospitals need to be present to operate immediately at the delivery and these mother's can go into labour at any time requiring specialists attend at short notice.
• Consultants and medical staff don't necessarily want an easy commute (at least more than any other worker). But they are contractually obligated to be within 20 or so minutes of the hospital when on-call to attend in the event of an emergency. As with anybody else they've quite reasonably bought houses that allow them to be within 20 minutes of their work. To move a hospital quite a distance away would require consultants to stay on-site on frequent call rotas, the HSE likely having to pay on-site overtime rates and increase the cost to the hospital to build accommodation for these consultants to stay overnight. Seems a fat chance since the current hospital has gotten rid of all the call-rooms for junior doctors who will now have no rest facilities for their on-call shifts

jmayo

https://www.boards.ie/discussion/comment/121787872#Comment_121787872

Ah yes the old colocation.

All hospitals in future will have to be beside a pre-existing one will be the new rule.

Proximity to maternity services:

Ehh if the new childrens hospital has to be close to the maternity hospitals then why move NMH out to Vincents site?

Would it not have been a very good idea to move to new site with lots of room for new children's hospital and move new NMH out there as well ?

Instead we still have new NMH not near new NCH.

A bit of joined up thinking perhaps?

Ah yes has to be near on call consultants.

20 minutes in any type of Dublin city centre traffic will not get you far.

I am wondering how many consultants live in the close environs of Crumlin or James.

How easy is it to get from Blackrock, Foxrock, Dalkey, Howth, Malahide to James?

Anita Blow

https://www.boards.ie/discussion/comment/121788524#Comment_121788524

Well no I don't think anybody is suggesting that form of co-location. However you can't dismiss the very valid benefits of pairing services together, especially when one is so reliant on the other.

Regarding NMH there is two considerations- obstetrics and paediatrics. From an obstetric point of view co-locating maternity services with a general hospital is preferable because there are many mother's who have to be delivered in general hospitals for medical reasons and these hospitals lack obstetric anaesthetists, obstetricians and midwives. From a paediatric perspective, babies born in general hospitals in these situations have worse outcomes because they tend to be quite unwell (owing to mum's medical condition) and are being delivered in a setting with no paediatric service. this means a paediatric transport team have to attend the delivery (but are sometimes engaged in another transport and so may not be readily available) and transport of an unwell newborn itself confers poorer outcome. Having a maternity service co-located with a general hospital means immediate access to paediatrics in these cases and confers better outcomes.

For the minority which require surgical neonatal care (IE- those cases that require urgent transfer to Crumlin), SVUH is still within reasonable distance of the new hospital and could easily be transported in less than 20-25 minutes.

Moving NMH and children's hospital out to a greenfield site doesn't address the fact that they still require timely access to adult sub-specialities, on-call medical staff and the other two major maternity hospitals who will also be delivering congenital anomalies.

Anecdotally I've never had an issue with a consultant getting in urgently but again I wouldn't have known any that have lived as far out as Malahide, Dalkey or Howth. I do know some who live that far out/further out but use a hotel for call. In my own area these locations would be too far out.

Hotblack Desiato

Daft headline in today's Irish Times

https://www.irishtimes.com/world/asia-pacific/2024/04/26/building-a-chinese-childrens-hospital-more-than-twice-as-fast-and-six-times-cheaper-than-ireland/

How did China build a children’s hospital six times cheaper than Ireland in just three years?

Because they're a dictatorship and pay workers a pittance (or use forced prison labour)

cnocbui

https://www.boards.ie/discussion/comment/122066141#Comment_122066141

You are quite correct, however the NCH blowout to €2.24 billion does mean it will be 132% more expensive per m² than the near equivalent Perth Childrens Hospital, which rather ironically, is considered locally to be an exercise in shambolic cost blowout.

Unfortunately for Irish taxpayers, we only do Heineken class cost blowouts.

mvt

Great, realistic posts from Anita Blow, well put.

Also don't think the workers on that hospital would be paid a pittance-interestingly they don't pay income tax either.

The main cost difference would be no need for planning issues or health & safety helped by centralised planning which is non negotiable- whoever thought a dictatorship would have any positives :)

jmayo

So do Australia have no planning laws, no labour laws, no H&S as they could build a new hospital in Adelaide for nearly a half billion or so less than our one ?

Oh and they have

800 beds to our 380.

all single rooms with ensuite

40 operating theatres

Two helicopter pads

fleet of automated robotic vehicles to help move supplies, meals and equipment around the hospital

tailor-made patient electronic medical records.

rainwater harvesting systems

heat recovery systems

SuperBowserWorld

https://www.boards.ie/discussion/comment/122067258#Comment_122067258

Jesus, do you have to rub it in. 🤣

Ireland is a special case though. We like to do things our way to benefit the few.

Podge_irl

Which hospital is this?

Cause this is their new women and children's hospital

The project is estimated to cost $3.2 billion and is due to be complete by 2030-31. Early works are set to start in 2023 ahead of construction beginning in early 2024.

jmayo

https://www.boards.ie/discussion/comment/122067263#Comment_122067263

The only thing special about us is that the ones in positions of power would be classified as special needs in most sane countries.

Cluedo Monopoly

UHL needs 300 beds. We could have them if the NCH was built anywhere near the budget...and there was an ounce of political will.

cnocbui

https://www.boards.ie/discussion/comment/122067258#Comment_122067258

Ireland just doesn't do beds - second lowest count PHP in the EU.

Why have beds when there are perfectly good trolleys? UHL has had patients on trolleys continuously for over 20 years. Why spend on beds and appropriately sized hospitals when you clearly don't need to?

You don't get to have an annual surplus of €10 billion by over provisioning hospital beds - pffft. Just imagine if they had been as profligate with the NCH as those aussies, why the budget surplus would probably have only been €7.5 billion - unthinkable!

WA has a population of 2.6 million and PCH has 298 inpatient beds, so one bed per 8725 of population.

Ireland has a population of 5 million and the NCH has 380 inpatient beds, so one bed per 13,157 of poulation, that's 33% fewer.

Cluedo Monopoly

https://www.boards.ie/discussion/comment/122067455#Comment_122067455

Yep and many of our Irish healthcare workers cite a stressful work environment and better nurse:patient ratio and high bed utilisation as the reasons to go to Australia. The levels of healthcare worker emigration only makes the situation worse and worse.

SuperBowserWorld

The trolleys are handy when you die and they need to wheel you to the crematorium.

Cluedo Monopoly

https://www.boards.ie/discussion/comment/122067483#Comment_122067483

They are also handy when A&E patients need be hidden from view when a govt politician is walking through. That happens regularly.

Some UHL patients frustrate the process by falling off the trolley and dying on the floor, only to be noticed an hour later.

Roll on the elections...

SuperBowserWorld

Trolly is also handy if you need to do some shopping. You can be bleeding out, and pick up a nice bar b que or battery powered sander in Lidl at the same time.

Podge_irl

https://www.boards.ie/discussion/comment/122067455#Comment_122067455

Irish healthcare has many issues but you can at least debate honestly. There are many pediatric beds outside the NCH in Ireland, whereas pretty much the entirety in WA will be in the PCH. Your bed number comparison is ridiculously flawed.

cnocbui

https://www.boards.ie/discussion/comment/122067746#Comment_122067746

WA is a quarter the size of all of Europe. It takes over three hours to fly from Kununnura to Perth. In the Perth metropolitan area alone there are a further 102 paediatric beds in other hospitals on top of PCH's 298.

Health Minister Kim Hames said the expanded capacity at PCH was
part of the Government’s program to boost the total number of paediatric
beds across the metropolitan area to just over 400. 
“PCH will be supported by six other public hospitals - Fiona
Stanley Hospital, Midland Public Hospital, Joondalup Health Campus, Peel
Health Campus, Armadale-Kelmscott Memorial Hospital and Rockingham
General Hospital - all with dedicated paediatric beds,”

There are paediatric beds in regional hospitals, such as a 10 bed paediatric unit in Broome.

As for dishonesty…

Podge_irl

https://www.boards.ie/discussion/comment/122068182#Comment_122068182

Excellent, so you acknowledge your comparison above was completely worthless and you appear to have known it was completely worthless when you made it. So what was the point of it?

Ireland has broadly similar number of hospital beds as Netherlands and Spain, more than Finland or Sweden though it is indeed on the lower end of the scale in Europe. In terms of acute beds it is more than all those. There are, of course, huge issues in step-down care and freeing up the beds quick enough. Our occupancy rate is far higher than the Netherlands, yet we are not a sicker country, so obviously there are problems that need fixing.

There is nothing wrong with the size of the NCH or the number of beds in it though.

cnocbui

https://www.boards.ie/discussion/comment/122069383#Comment_122069383

Your attempt to deflect from your face-planting is amusing. The comparrison I made was perfectly legitimate and relevant, given it's a beds to population comparrison between top tier childrens hospitals for given populations.

Despite being 33% better provisioned relative to population, Perth Children's Hospital is already estimated to be inadequate in capacity in a year or two due to underestimating population growth. Apparently the peak medical body had early on argued it should have had another floor added.

I hope the NCH is adequate in size and capacity, but I suspect it won't be.

tom1ie

https://www.boards.ie/discussion/comment/122069383#Comment_122069383

podge, just to pick up on your last sentence, there is of course something wrong with the number of beds in it, as there should be more due to the money spent- going off international numbers no?
Other countries manage to build hospitals for a much lower cost per bed than we do- ergo there is definitely something wrong with the number of beds in it.

IMO I think the PM team should be shouldering the majority of the blame with the hospital costing so much- unless the PM team can point to political pressure which made the project Kick off before technical designs were in place.

Podge_irl

https://www.boards.ie/discussion/comment/122069669#Comment_122069669

Well I think the argument there is more that it should have cost less. The planning and execution certainly seem to have left a lot to be desired and late changes in the requirements added a lot of cost.

Had it been built on a greenfield site somewhere I doubt they would have built more beds. More beds means a lot more staffing and related ongoing costs obviously.

Podge_irl

It's a beds to population comparison that doesn't remotely count the correct number of beds or compare the correct populations. The NCH is not supposed to be the primary children's hospital for the entire population.

tom1ie

https://www.boards.ie/discussion/comment/122069694#Comment_122069694

Absolutely it would have cost less on a greenfield site but then you have the whole co location argument.
It would seem that the big issue with cost overruns is that they just weren’t ready to go to tender for a contractor as they didn’t know what they were tendering for.
Absolute gold dust for a contractor.

Podge_irl

https://www.boards.ie/discussion/comment/122069797#Comment_122069797

Yeah, I personally am not arguing against the location and I know that it will increase the costs to build it there. But, while I am by no means on expert on this, at first glance the issue you highlight does seem like some seriously bad project management. It's the same kind of mess of changing plans that plagued Berlin Brandenburg Airport for example.

cnocbui

https://www.boards.ie/discussion/comment/122069701#Comment_122069701

Better change the name to Dublin Children's Hopital, then, right? The people who termed it 'National' need to cop-on…

It will be the national hospital for the island of Ireland catering for children and young people in need of specialist and complex care. It will also be the local children’s hospital for Dublin, Wicklow, Kildare and parts of Meath.

https://www.childrenshealthireland.ie/about-us/new-childrens-hospital/

Podge_irl

https://www.boards.ie/discussion/comment/122069977#Comment_122069977

Jesus Christ, it is in the very thing you quoted

It will also be the local children’s hospital for Dublin, Wicklow, Kildare and parts of Meath.

It will only be the national hospital for tertiary referrals. The majority of kids treated nationally will not be treated in it.

London is full of "National" hospitals, and no one is counting the number of beds per 65Million of the population in them.