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

Pete_Cavan wrote: »

Do you honestly think that building the NCH + another hospital several times larger + replacing several national centres of excellence would be cheaper than just building the NCH and tying in with the existing centres of excellence? ....t.

...2 billion maybe more....

I think it's exceeded most people worst fears by some margin...

jmayo

AndrewJRenko wrote: »

Which party members were involved - the party in power at the time the decision to go ahead was made? Or the party in power at the time the site was chosen? Or the party in power at the time the contract was awarded? Or the party in power at the time the decision was made to take BAM to the High Court?

How do you reckon that the corrupt party members managed to get dozens of officials to go along with the scam? How did they make sure that no other builder submitted a slightly lower tender?

A few posts in and you are in straight away to defend the new childrens hospital once again.

Mind telling us what skin you have in the game because everytime there is a thread on this there you are defend defend.

political analyst wrote: »

Isn't it the location the hospital consultants wanted? The project wouldn't have started if they had not been kept on board.

By the way, ambulances go through busy junctions all the time. I'm sure the paramedics can keep the child's condition stable until they get to the hospital.

Niner leprauchan wrote: »

Its central for a reason. No person needs to travel the entire lenght of the county and the closer to the city, the higher the population density. Possible smaller centres dotted around the outskirts could have worked but that wasnt on the table.

Its 3km from the red cow junction. where exactly would you like it placed?

You know the real funny thing, the plan is to build emergency centres in Tallaght and Connolly that emergency cases can actually get to.

So really this hospital plan is starting off admitting it is not capable of meeting most children's hospital requirements for the greater Dublin area.

This hospital is not meant to really cater for some kid with broken arm from say Blessington, Tallaght, Bray, Cellbridge, Dunboyne, Swords, Malahide, etc, etc all areas within 20km to 30km or so of Dublin city centre.
And it is siting bears that out.

It is meant to be for long term specialist treatment plans for serious illness and for serious injuries.
So a child needs cancer treatment, a child needs treatment for missing a kidney, a child has a heart condition.

But what about a child has major accident, they can't be airlifted by coast guard (and maybe even the AW139 Air Corp transport) straight to hospital.
Sure they can find a car park down the road maybe. :rolleyes:
Major drawback right from the get go.

The long term illnesses and conditions are ones that will have to go to this place regularly.

And those kids have to come from around the country, not just city centre Dublin and most definitely those along the two luas lines.

Oh and those children are the very ones that most likely won't be traveling in ambulances and definitely not on public transport.

But most sane people know this and most sane people not pushing an angle or with a vested interest in the current location would also admit the above.

AndrewJRenko wrote: »

You do know that not everyone drives or has access to a car, right? We need a hospital with great public transport connectivity, as is standard in UK and around the world. The Luas literally runs beside this building.

You mean the UK that has a great public transport system ?

Wippee a single disconnected public transport link runs along the building.
Now please tell us all how to we get to this single public transport link in the first place?

political analyst

jmayo wrote: »

But what about a child has major accident, they can't be airlifted by coast guard (and maybe even the AW139 Air Corp transport) straight to hospital.
Sure they can find a car park down the road maybe. :rolleyes:
Major drawback right from the get go.

The Garda traffic unit would clear the way for the ambulance to get to the new hospital or to the nearest A&E as soon as possible.

political analyst wrote: »

The Garda traffic unit would clear the way for the ambulance to get to the new hospital or to the nearest A&E as soon as possible.

This works great here in Cork. Air ambulances and rescue choppers land in Bishopstown GAA pitch, the patient is brought the rest of the way by road through a housing estate and traffic...

Makes no sense to be able to land on the hospital when they can do that.

MikeOxsgreen wrote: »

This works great here in Cork. Air ambulances and rescue choppers land in Bishopstown GAA pitch, the patient is brought the rest of the way by road through a housing estate and traffic...

Makes no sense to be able to land on the hospital when they can do that.

You know I'm the same. If I have a choice avoiding traffic and going direct to somewhere or having to go through traffic and indirect route I'll always do the latter. ...

Why do I get the feeling there are a couple of posters with interests in the hospital defending this shambles in the thread.

It is literally defending the indefensible. As a Project Manager, I'm acutely aware costs spiral and budgets overrun. However,overruns on this scale, gaps in the contract and design shortcomings on what was initially agreed,it is just nothing short of criminal on the Government's part.

jmayo wrote: »

A few posts in and you are in straight away to defend the new childrens hospital once again.

Mind telling us what skin you have in the game because everytime there is a thread on this there you are defend defend.

The only skin that I have in this game is that I'm a public servant who gets mildly irked every time we get bar stool experts pretending that they know everything about everything.

What's your skin in this game?

jmayo wrote: »

You mean the UK that has a great public transport system ?

Wippee a single disconnected public transport link runs along the building.
Now please tell us all how to we get to this single public transport link in the first place?

It's on the red Luas line, which connects directly to Connolly, Hueston, so that's pretty much all incoming trains to Dublin and Canal Dock rail stations. The red Luas line connects indirectly with the green Luas line. The red Luas line connects with a large number of bus routes.

Northernlily wrote: »

Why do I get the feeling there are a couple of posters with interests in the hospital defending this shambles in the thread.

It is literally defending the indefensible. As a Project Manager, I'm acutely aware costs spiral and budgets overrun. However,overruns on this scale, gaps in the contract and design shortcomings on what was initially agreed,it is just nothing short of criminal on the Government's part.

What are the gaps in the contract and the design shortcomings please?

Pete_Cavan

Northernlily wrote: »

Why do I get the feeling there are a couple of posters with interests in the hospital defending this shambles in the thread.

It is literally defending the indefensible. As a Project Manager, I'm acutely aware costs spiral and budgets overrun. However,overruns on this scale, gaps in the contract and design shortcomings on what was initially agreed,it is just nothing short of criminal on the Government's part.

Nobody is defending the management of the project but the idea that building it somewhere else would have avoided these issues is not that simple. To build it somewhere else, you either have to accept lesser vital services on site which results in lower quality of care and you need to transport patients, or you have to move those services to the new location which multiplies the scale and complexity of the project which likely multiplies the cost and time overruns.

TheChizler

MikeOxsgreen wrote: »

This works great here in Cork. Air ambulances and rescue choppers land in Bishopstown GAA pitch, the patient is brought the rest of the way by road through a housing estate and traffic...

Makes no sense to be able to land on the hospital when they can do that.

Yes, so much traffic...

Pete_Cavan wrote: »

Nobody is defending the management of the project but the idea that building it somewhere else would have avoided these issues is not that simple. To build it somewhere else, you either have to accept lesser vital services on site which results in lower quality of care and you need to transport patients, or you have to move those services to the new location which multiplies the scale and complexity of the project which likely multiplies the cost and time overruns.

Your trying to suggest its impossible to build this cheaper or better somewhere else. Or that the problems on this site are exactly the same as any other site.

jmayo

AndrewJRenko wrote: »

The only skin that I have in this game is that I'm a public servant who gets mildly irked every time we get bar stool experts pretending that they know everything about everything.

No, am clever enough and dumb enough to know I know far from everything about anything.

But I do know when somethings can be done better and when planning in this country is never fit for purpose, doesn't even meet current requirements never mind future ones.
Wait a public servant, you wouldn't be in planning by any chance.
Nearly ever public project carried out in this country has been an expensive crock.
Oh yippe we eventually got two linked tram lines but how fooking long did it take and how more expensive than first planned did it work out.

And yes as per usual we will get the refrain about our motorways, bypasses and roads.
Then again I know some of those bypasses and new roads have some very unsual traits and sometimes not very forward thinking features that really makes you scratch your head.

BTW how many crock ups did we make before we started getting them somewhat right or should we forget about M50 and Toll bridge ?

AndrewJRenko wrote: »

What's your skin in this game?

Lets just say I know a fair bit about dealing with and supplying our hospital system.
Oh and other half works in medical system.
So I have been around the block and know how inept the whole system can be.

Also I know people that either have to sadly visit the likes of Crumlin, Temple and probably in future the James location.

Oh and I know quite amount of people that have to visit those places to carry out work.
And public transport doesn't work for them.
James site is a pain to have to visit.

Oh and I am a taxpayer and have kids who will be paying for this as well.

AndrewJRenko wrote: »

It's on the red Luas line, which connects directly to Connolly, Hueston, so that's pretty much all incoming trains to Dublin and Canal Dock rail stations. The red Luas line connects indirectly with the green Luas line. The red Luas line connects with a large number of bus routes.

Do you know how many people live along train lines in this country?
You don't work in Dept of Environment or indeed transport if you think must people travel to Dublin via train, never mind those with sick kids.

TheW1zard

AndrewJRenko wrote: »

What are the gaps in the contract and the design shortcomings please?

How about giving a company a contract to build something without telling them what to build!

Pete_Cavan

beauf wrote: »

Your trying to suggest its impossible to build this cheaper or better somewhere else. Or that the problems on this site are exactly the same as any other site.

From a healthcare perspective, to build a better hospital somewhere else, you need to relocate many one off specialist facilities from James's to this somewhere else. That will be more expensive than locating beside these existing facilities. You can choose to believe that you can build a hospital several times the size of NCH with many more complexities, logical issues and duplication of services in order to maintain treatment for less money, but that is not how it works in the real world.

Pete_Cavan wrote: »

.... You can choose to believe that you can build a hospital several times the size of NCH with many more complexities, logical issues and duplication of services in order to maintain treatment for less money, but that is not how it works in the real world.

Considering this will be the most expensive hospital ever built. Even if per bed is not an exact metric. This hospital is more expensive by something like a factor of 5. It suggests that's exactly how it works, in the real world.

This is the exact opposite of the phrase "cut your cloth to your means"

jmayo

Pete_Cavan wrote: »

From a healthcare perspective, to build a better hospital somewhere else, you need to relocate many one off specialist facilities from James's to this somewhere else. That will be more expensive than locating beside these existing facilities. You can choose to believe that you can build a hospital several times the size of NCH with many more complexities, logical issues and duplication of services in order to maintain treatment for less money, but that is not how it works in the real world.

So are we now saying that every hospital in future has to be built right beside an existing one ?

jmayo wrote: »

So are we now saying that every hospital in future has to be built right beside an existing one ?

It isn't just now being said. Co-location is the international standard, particularly for countries of Ireland's size. Co-location with a tertiary hospital was a requirement from the outset of developing a new NCH.

Fewer bigger hospitals is the standard across the developed world so essentially yes. Which is why the NMH will co-locate with SVUH, Coombe with SJH and Rotunda with Connolly.

It's a different debate altogether but Dublin has far too many hospitals for its size which leads to unnecessarily fractured services.
While access & cost are obvious drawbacks, co-location of the paeds hospitals with one of the major existing hospitals is a step in the right direction for delivering cohesive healthcare.

gctest50

AndrewJRenko wrote: »

What are the gaps in the contract and the design shortcomings please?

Here's an interesting design shortcoming, the scumbag responsible should be lynched :

"The top floor of this iconic building is 29.9m high, marginally below the threshold of 30m, which prescribes an automatic requirement for life safety sprinklers," the report said. "It appears that the building has been re-engineered to deliberately avoid an essential life safety system given the fact that the top floor is just 100mm below the threshold for sprinklers."

https://m.independent.ie/news/environment/childrens-hospital-deliberately-designed-to-avoid-installing-sprinklers-claims-fire-brigade-36259501.html

Anita Blow wrote: »

It isn't just now being said. Co-location is the international standard, particularly for countries of Ireland's size. Co-location with a tertiary hospital was a requirement from the outset of developing a new NCH.

Fewer bigger hospitals is the standard across the developed world so essentially yes. Which is why the NMH will co-locate with SVUH, Coombe with SJH and Rotunda with Connolly.

It's a different debate altogether but Dublin has far too many hospitals for its size which leads to unnecessarily fractured services.
While access & cost are obvious drawbacks, co-location of the paeds hospitals with one of the major existing hospitals is a step in the right direction for delivering cohesive healthcare.

If you set the rule every new hospital has to beside an existing one and hospital like James in a location similar to James. Then you can see why we are stripping the rest of the country of services and moving them all to congested locations in the city, difficult to build in and expand, even the layout is chaotic. Hence they are expensive and will drag even more traffic from all over the country to these already gridlocked locations.

But hey it's done now. Hopefully there won't be too many more delays.

beauf wrote: »

If you set the rule every new hospital has to beside an existing one and hospital like James in a location similar to James. Then you can see why we are stripping the rest of the country of services and moving them all to congested locations in the city, difficult to build in and expand, even the layout is chaotic. Hence they are expensive and will drag even more traffic from all over the country to these already gridlocked locations.

It's not an arbitrary rule, it's being done because it leads to more services, greater specialisation and better clinical outcomes. There is nothing unique about Ireland that we should reject co-location/centralisation of services when it is the standard in every developed country.

GOSH is in central London
CHOP is in central Philadelphia.
RCH is in central Melbourne.
Sick Kids is in downtown Toronto.

Access is an issue for all of these, but in all cases the need to be closer to the bulk of the population, medical research facilities and public transport trumps access by car because it leads to better quality of care.

GOSH 1852
CHOP 1855/1866
RCH 1870/1963
Sick Kids 1875

Seems like these locations are historical and without any reference to cars or modern public transport, or even any modern thinking around co-location.
Similarly none of those locations being chosen to serve the "bulk of the population" of an entire country. But once established there's not much point moving them.

To copy the pattern of these hospitals, we would not moved hospitals and services, but invested in expanding and developing an existing children's hospital.
I assume therefore the biggest one might have been chosen, Crumlin. It only 4k away only 30 mins walk from James. Since we've already established that these distances are fine, for staff, visitors and patients, and transfers using Garda to get through traffic and housing estates is no problem. As suggested a new hospital is more expensive then using an existing hospital, so it would have been cheaper aswell to expand Crumlin than build a new building at James.

Building on Crumlin would not involve co-location, would be plagued by the same if not worse access issues and would necessitate a new hospital being built anyway as they existing hospital would have to remain in-use during construction.
It would offer no clinical benefits over the SJH site.
This is why the Crumlin board nominated SJH back in 2012 as the NCH site.

From a clinical perspective any alternative to SJH would require co-location with an adult tertiary hospital so that limits your options to SJH, Tallaght, Beaumont, SVUH, Mater.

Anita Blow wrote: »

Building on Crumlin would not involve co-location, would be plagued by the same if not worse access issues ..

... this implies James has access issues...also they are very close to each other. It's unlikely to have worse issues as you can easily walk between them. Unless walking is no longer an option. ...

Anita Blow wrote: »

and necessitate a new hospital being built anyway as they existing hospital would have to remain in-use during construction.
It would offer no clinical benefits over the SJH site.
This is why the Crumlin board nominated SJH back in 2012 as the NCH site...

So building a new hospital on a Greenfield site and the expense isn't the showstopper some have suggested. Now a new build is preferred. They rebuilt the Mater and kept it open. I assume those examples you have in other countries also stayed open as they grew over the years in the same site.

Anita Blow wrote: »

From a clinical perspective any alternative to SJH would require co-location with an adult tertiary hospital so that limits your options to SJH, Tallaght, Beaumont, SVUH, Mater.

...even though your examples in other countries are near other hospitals but not on the same site. Ireland is obviously a special case.

Mater is pretty much a twin of James in many regards. But it's interesting two almost identical sites with the same advantages and disadvantages, arguably the Mater is even more central. There was nothing gained changing from the Mater to James.

Well other than political maybe.

It's all old history. Pointless going over it.

Now we just have to wait and see how much money this will consume before it is finished.

Ash.J.Williams

Northernlily wrote: »

Why do I get the feeling there are a couple of posters with interests in the hospital defending this shambles in the thread.

It is literally defending the indefensible. As a Project Manager, I'm acutely aware costs spiral and budgets overrun. However,overruns on this scale, gaps in the contract and design shortcomings on what was initially agreed,it is just nothing short of criminal on the Government's part.

I was actually looking for that post that claimed these overruns are a normal part of these projects and found yours saying what I wanted to say! Tell me this before this project what you say would be a typical budget overrun? Tens /hundreds of thousands?

Podge_irl

Muahahaha wrote: »

Connolly Hospital in Blanch was the other option where they have acres of green space for future expansions and where Coastguard helicopters could have landed which they cant do at the new Childrens Hospital in St James, there isnt the space and the helicopter pad to be installed there cannot hold the weight of them. Meaning children with severe and urgent brain injuries may not get to the hospital on time because the helicopter cannot land there. You would have thought this would be a key requirement on where to locate the hospital but no it wasnt.

At a guess, children with severe and urgent brain injuries might also go to Beaumont seeing as its the national centre for neurology and neurosurgery. The NCH is not the designated A&E for every child in the country

crazy 88 wrote: »

city/city centre...does it matter? The area is inaccessible.

It is the most accessible hospital site by public transport in the country by quite a wide margin. You can access it easily from Heuston meaning its open to public transport for a large part of the country. It has tram and bus lines literally running through it.

Yes, I am aware that not everyone going to the hospital can use public transport. GOSH has no problem advising that as many people as possible attending the hospital should use public transport and doesn't even have a car park. The expert report that decided the location came to the not unreasonable conclusion that clinical outcomes were more important than ease of parking. There is a large car park being built and if it is only used by those who actually need it then there will be sufficient space.

On top of all this, you have 70% of Dublin households which do not have a car. How are they supposed to get to this hospital off the M50?

BrianBoru00 wrote: »

- There were plenty of "distinguished people" who are/were against the location.
- Parking IS a big issue in Ireland for a national hospital given the poor transport options nationally in comparison to other countries. Best international practice should not be the be all and end all and decisions should be made with due regard for this country and our infrastructure / culture /situation
-Clinical excellence - I never got this logic. Is Great Ormonde Street Hospital co located with an adult hospital?
Surely the whole point of a children's hospital is to have excellence on a standalone basis.

St James has excellent public transport options.
GOSH is located beside the National Hospital for Neurology and Neurosurgery but its location ulimately pre-dates the research that suggests colocation is one of the most important factors in deciding location.

Deleted User wrote: »

Sure grand, we'll get the Luas up from Cork. No problem.

SJH is one 2 luas stops away from the Cork-Dublin line terminus...

Everyone realises that not everyone using the hospital even can drive right?

crazy 88 wrote: »

Is that you Mr. Donnelly?

The central area you reference is surrounded by soul crushing gridlock all day, not just rush hour. I know as I live near St James's hospital. There's no justification for locating it where it is. And no one will be bringing a sick child on a bus or the Luas to get there.

The justification was improved clinical outcomes from co-location with an adult tertiary hospital.

Do you have a reason to dispute this conclusion?

Those suggesting the hospital location was chosen for political convenience or pressure are bordering on conspiracy theory lunacy. The factors for deciding the location were based on the Dolphin Report and it was shown that co-location was the most important factor. Thus the Mater initially and then SJH were chosen for this reason. What you are looking for is the politicians to override the expert opinion on where the hospital should have been built. you are ASKING for political interference.

Podge_irl wrote: »

At a guess, children with severe and urgent brain injuries might also go to Beaumont seeing as its the national centre for neurology and neurosurgery. The NCH is not the designated A&E for every child in the country...

There's also Cappagh.

The majority of patients do not attend A&E. But it will be the national center for a lot of treatments.

Podge_irl wrote: »

It is the most accessible hospital site by public transport in the country by quite a wide margin. You can access it easily from Heuston meaning its open to public transport for a large part of the country. It has tram and bus lines literally running through it.

Yes, I am aware that not everyone going to the hospital can use public transport. GOSH has no problem advising that as many people as possible attending the hospital should use public transport and doesn't even have a car park. The expert report that decided the location came to the not unreasonable conclusion that clinical outcomes were more important than ease of parking. There is a large car park being built and if it is only used by those who actually need it then there will be sufficient space.

On top of all this, you have 70% of Dublin households which do not have a car. How are they supposed to get to this hospital off the M50?

GOSH is historical location. It predates cars. Using GOSH as an example of an ideal location makes no sense. Its location was not planned around its current use.

So what about Dublin car ownership. Its relevant. Its about how many people use a car to get to the current children's hospitals. Also its not a Dublin hospital. Its a national hospital.

The whole point about locating it in Dublin is to have excellent public transport. If you say you can't get to the M50 using public transport. What happened to the excellent public tranport? Did it vanish? Does it only exist in the center of Dublin?

Podge_irl wrote: »

St James has excellent public transport options.
GOSH is located beside the National Hospital for Neurology and Neurosurgery but its location ulimately pre-dates the research that suggests colocation is one of the most important factors in deciding location.

I'm sure when they say "one" of most important factor. They didn't mean it had an unlimited budget, that it would effect the entire Health service budget and indeed the country.

Podge_irl wrote: »

SJH is one 2 luas stops away from the Cork-Dublin line terminus...

Everyone realises that not everyone using the hospital even can drive right?

This is bit like saying most of the people in school can't drive so we'll plan that most people will not be drive or be driven to school.

Podge_irl wrote: »

The justification was improved clinical outcomes from co-location with an adult tertiary hospital.

Do you have a reason to dispute this conclusion?

There was more than one consideration. It wasn't wasn't solely about co-location. I would wonder considering our massive wait-lists in children hospitals the wisdom of building the worlds most expensive hospital and ending up with the exact same bed capacity. Will that have a greater effect on clinical outcomes, than co-location. Considering the the majority of cases will not be effected by co-location with James.

Podge_irl wrote: »

Those suggesting the hospital location was chosen for political convenience or pressure are bordering on conspiracy theory lunacy. The factors for deciding the location were based on the Dolphin Report and it was shown that co-location was the most important factor. Thus the Mater initially and then SJH were chosen for this reason. What you are looking for is the politicians to override the expert opinion on where the hospital should have been built. you are ASKING for political interference.

I guess you give them free reign to spend as much as they like on it so. They could build it on the top of the sugar loaf and no one should question it. Spend 100 billion on it. No problem. They are experts.

The experts picked the Mater. In fact different groups picked different locations. Originally they wanted the existing hospitals upgraded and not moved. If they picked the Mater then it was found to be suitable, does that not call into doubt the process that picked the Mater in the first place.

Like I keep saying none of this matters now. Its over.

Once we've finished building the worlds most expensive hospital we should expect dramatic improvements in outcomes and throughput and a dramatic reductions in wait-lists.

Hopefully.