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Child Item

Childrens' Hospital Planning Refusal [PR]

MadsL

Thankfully ABP are able to see through the political nonsense about siting this at the Mater. Hopefully a more logical site will now be found..

AT press release:

“The decision on the Children’s Hospital by An Bord Pleanála will protect Dublin’s Future - An Taisce”

An Bord Pleanála has made one of the most significant planning decisions in its history in refusing the application by the National Paediatric Hospital Development Board for the 16 storey National Children's Hospital adjoining the Mater Hospital in Eccles St.

An Bord Pleanála refused the application on the grounds of height, scale as well as mass, and that it would contravene the provisions of the Dublin City Development Plan.

Were permission to be granted, it would "result in a dominant visually incongruous structure and would have a profound negative impact on the appearance and visual amenity of the city skyline", including O'Connell St, according to the Board.

Ian Lumley, Heritage Officer of An Taisce, stated “The decision supports An Taisce’s stance in protecting Dublin City and reflects a consistent pattern by An Bord Pleanála in refusing overscaled development in Dublin city centre over a long number of years. In effect, the Board is maintaining Dublin's predominant low-rise character and its tourism cache, upon which so much revenue depends.”

An Taisce has always supported the requirement to provide appropriate children's hospital facilities and action is urgently required. In this context, consideration of the long-standing €102m enhancement plan for Crumlin Childrens Hospital may be timely.

An Taisce is calling for greater attention on frontline staff. A great many medics are completely over-stretched as key positions are being left vacant. There must also be greater priority on securing and retaining frontline staff rather than locking ourselves into long term repayments for medical buildings which remain understaffed.

The Board’s decision itself raises serious questions as to why a State-appointed board and its professional advisers wasted so much time and money in pursuing such an unsuitable development proposal.

From ordinary visitors to film directors, attention is constantly drawn to the coherence of Dublin's skyline and its economic importance to Ireland for which An Taisce has long fought. This decision by An Bord Pleanála re-inforces that wealth base, and should help pave the way to make a proposal for World Heritage status for Dublin, providing a further boost to employment over time.

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xflyer

Never mind the size of the building. The siting of the building is absurd and obvious to anyone who has ever had the unfortunate experience of having to visit the Mater will agree.

The stupidity of building right in the centre was obvious to all apparently except the people involved. Dublin city centre is the worst possible place to build it. It's not even convenient for Dublin people.

The obvious place is somewhere on the outskirts of Dublin, close to motorways and trains. So that people coming from outside Dublin has easier access. Anyone with half a brain can see that.

There has to have been some form of corruption in the decision to build it there. Bertie Ahern's old consituency, no surprise there.

MadsL

A few renders for the forgetful...

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one foot in the grave

The best childrens hospitals in the world that deliver the best outcomes for the children they are there to serve are located beside adult teaching hospitals. They are able to utilise the expertise and resources a large teaching hospital has to offer.

The joint Task Force believed siting the paediatric hospital at the Mater would place it between the neurosurgical and transplant teams in Beaumont Hospital and the haematology/radiotherapy and burns staff in St James Hospital thereby maximising access to the relevant off site expertise and utilizing the expertise in the Mater (cardiothoracic surgeons in the Mater carry out paediatric cardiothoracic surgery in Crumlin. The Mater also carries out heart and lung transplants in adults, houses the national spinal injuries unit, has a child psychiatric unit and is a designated cancer care centre. It is minutes away from the The National Maternity Hospital).

It's having access to this expertise that will provide a better outcome for the children who will attend a national childrens hospital. If the Mater is dead then James is the only other option.

Icepick

Sometimes correct decisions are made for the wrong reasons.

one foot in the grave

xflyer wrote: »

Never mind the size of the building. The siting of the building is absurd and obvious to anyone who has ever had the unfortunate experience of having to visit the Mater will agree.

The stupidity of building right in the centre was obvious to all apparently except the people involved. Dublin city centre is the worst possible place to build it. It's not even convenient for Dublin people.

The obvious place is somewhere on the outskirts of Dublin, close to motorways and trains. So that people coming from outside Dublin has easier access. Anyone with half a brain can see that.

There has to have been some form of corruption in the decision to build it there. Bertie Ahern's old consituency, no surprise there.

That would not deliver the best level of care if it is not co-located with large teaching hospital. Only three hospitals in the country would be suitable, Mater- James - Beaumont.

The Joint Task group (HSE) felt that Tallaght does not offer the same breadth and depth of teriary services as the other Dublin hospitals they looked at. It has a orthopaedic surgery team and work into stroke assessment and management.

St James is responsible for severe paediatric burns management, houses the national bone marrow transplant unit, a major haematology unit, a designated radiotherapy centre underway and is the national maxillo-facial surgery centre.

The cardiothoracic surgeons in the Mater carry out paediatric cardiothoracic surgery in Crumlin. The Mater also carries out heart and lung transplants in adults, houses the national spinal injuries unit, has a child psychiatric unit and is a designated cancer care centre. It is minutes away from the The National Maternity Hospital and has a close working relationship with Temple St Hospital.

The joint Task Force believed siting the paediatric hospital at the Mater would place it between the neurosurgical and transplant teams in Beaumont Hospital and the haematology/radiotherapy and burns staff in St James Hospital thereby maximising access to the relevant off site expertise.

oppenheimer1

Why is this in Irish Economy?

I still believe that the Mater site is still the best place for it, despite the ABP decision. That said looking at the renders, the architects have a lot to answer for. Such a radical design was always going to be extremely difficult to get planning for in north central Dublin, which is a designated conservation area afaik. That said I'm not sure what they are conserving - much of it has already been destroyed.

The hospital will be built in Mater, or won't be built at all. A reappraisal of the architecture and reduction in overall height should see it be built. I also think they will use other legislation to get planning in the revised plan.

Irish Steve

THe only new hospital that's been built since the ark is Tallaght, all the others are massively constrained by their location, and access, for both patients and staff, and even Tallaght is a nightmare in terms of parking, especially for fundamental things like deliveries, let alone for patients and others.

The Mater site is about the worst place in Dublin to enlarge the existing facility. Parking in that area is a nightmare, access for staff is diabolical, public transport is (along with the rest of Dublin) too rigid in terms of hub and spoke design, so Finglas and Blanchardstown, along with Santry and Swords are not too bad, but forget easy access from somewhere like Tallaght, or Howth, etc.

Now, let's live dangerously for a moment, and if there'd been a thread on this in AH, it would have been there, but there isn't.

How about building a New Modern, very capable facility at Thornton Hall, not just a children's hospital, but an all discipline facility that could also have residential facilities on site for the people training. The space is there, and it's 10 minutes from the M50, would have no problems facilitating a helicopter pad for emergencies, and things like parking would be easy. If the Mater was moved out there as well, it would even be possible to expand Mountjoy Prison on to the old Mater site, and then when that was done, redevelop the Mountjoy site to correct the problems with the building on that site. OK, so we're cash strapped, that's not new.

Thornton Hall is bought and paid for, and the CMH can't go there now because it's not going to fit. The replacement for Mountjoy is too expensive as well, so maybe the best thing to do is to use a green field site for the new hospital, and do the job properly. A dedicated access road has been built that avoids the local developments, and all in all, it could make a good site for a world class new facility, rather than trying to make do and mend on sites that are clearly and plainly unsuitable.

Hospitals need parking, lots of it, for both staff and visitors. They work better on a low level, things like lifts have to be duplicated and maintained, and there still has to be emergency access capabilities for use in the event of the lifts failing. Far better to have a more spread out facility with more than adequate parking than to try and squeeze yet more into an already almost impossible area like the Mater.

Chances of that happening? About as good as the chances of Ireland being allowed to burn the bondholders in the same way that Greece has. Pity, as for once, a real chance of doing something worthwhile might have been available here.

oppenheimer1

Irish Steve wrote: »

THe only new hospital that's been built since the ark is Tallaght, all the others are massively constrained by their location, and access, for both patients and staff, and even Tallaght is a nightmare in terms of parking, especially for fundamental things like deliveries, let alone for patients and others.

The Mater site is about the worst place in Dublin to enlarge the existing facility. Parking in that area is a nightmare, access for staff is diabolical, public transport is (along with the rest of Dublin) too rigid in terms of hub and spoke design, so Finglas and Blanchardstown, along with Santry and Swords are not too bad, but forget easy access from somewhere like Tallaght, or Howth, etc.

Now, let's live dangerously for a moment, and if there'd been a thread on this in AH, it would have been there, but there isn't.

How about building a New Modern, very capable facility at Thornton Hall, not just a children's hospital, but an all discipline facility that could also have residential facilities on site for the people training. The space is there, and it's 10 minutes from the M50, would have no problems facilitating a helicopter pad for emergencies, and things like parking would be easy. If the Mater was moved out there as well, it would even be possible to expand Mountjoy Prison on to the old Mater site, and then when that was done, redevelop the Mountjoy site to correct the problems with the building on that site. OK, so we're cash strapped, that's not new.

Thornton Hall is bought and paid for, and the CMH can't go there now because it's not going to fit. The replacement for Mountjoy is too expensive as well, so maybe the best thing to do is to use a green field site for the new hospital, and do the job properly. A dedicated access road has been built that avoids the local developments, and all in all, it could make a good site for a world class new facility, rather than trying to make do and mend on sites that are clearly and plainly unsuitable.

Hospitals need parking, lots of it, for both staff and visitors. They work better on a low level, things like lifts have to be duplicated and maintained, and there still has to be emergency access capabilities for use in the event of the lifts failing. Far better to have a more spread out facility with more than adequate parking than to try and squeeze yet more into an already almost impossible area like the Mater.

Chances of that happening? About as good as the chances of Ireland being allowed to burn the bondholders in the same way that Greece has. Pity, as for once, a real chance of doing something worthwhile might have been available here.

There is no heavy public transport access to Thornton Hall. It also doesn't have co-location which was highlighted in the report for Minister Reilly to be the most important consideration, dwarfing issues with access etc.

Have everything nice and spread out? You think Pier E length walks are a great idea for sick children then? The hospital, it its the right size, is going to be a long narrow high rectangle or a number of long narrow high rectangles joined together.

MadsL

oppenheimer1 wrote: »

That said I'm not sure what they are conserving - much of it has already been destroyed.

Sigh. I even posted pictures.

MadsL

If Guinness is reorganising production at James' Gate, isn't there opportunity for collaboration/regeneration in the St James' Gate/Liberties area. On a LUAS and not too bad from the M50.

Gumbo

MadsL wrote: »

If Guinness is reorganising production at James' Gate, isn't there opportunity for collaboration/regeneration in the St James' Gate/Liberties area. On a LUAS and not too bad from the M50.

Guinness have a current planning application in for their site.

oppenheimer1

MadsL wrote: »

Sigh. I even posted pictures.

Its not much worse than Bolton St and Dorset St with its gaudy shopfronts, and hideous council flats, which have a much more negative effect on the area than a well constructed building.

Dublin is not a pretty city, lets not delude ourselves. This wouldn't have made it much worse. I really oppose the blanket rejection of hi rise buildings in Dublin as a policy. It has led to the severe loss of vibrancy in the city centre, with many buildings now run down.

Preserving the Georgian core, but at what cost? The city must be useful for its current residents, not just a preserved relic of times past.

murphaph

Hmmm, I like the structure. Some bold architecture is nothing to be afraid of, so long as it's constructed well and of very long life and low maintenance materials. It's no more imposing than Croke Park, so I don't get the hysteria. It's not even that tall.

The proper thing to do, if Ireland were a proper country, would be to go ahead with construction at the Mater (by far the best choice for patient care) and build the blasted Metro North and DART underground and let people access the site by quality public transport.

Building it on the M50 "to make it easier to get to" is nonsense. We need to move away from this donut development for heaven's sake.

rodento

I can't get over the fact that so much money and time was spent on an application that failed the planning process.

Surely they could have come up with a plan that either fit within current planning constraints or have come up with a way bypass them

Pete_Cavan

murphaph wrote: »

The proper thing to do, if Ireland were a proper country, would be to go ahead with construction at the Mater (by far the best choice for patient care) and build the blasted Metro North and DART underground and let people access the site by quality public transport.

Building it on the M50 "to make it easier to get to" is nonsense. We need to move away from this donut development for heaven's sake.

I agree, we will never have decent public transport if we stick everything on the side of the M50. This will also increase car dependency and will result in the M50 becoming more congested and rather than acting as a motorway you are then left with a half a billion euro road with slow moving traffic. Access to good public transport is vital as otherwise you have to provide car parking for 1,500 staff, and I dont think Luas Red Line counts as I would doubt the current spare capacity is sufficient. Metro North and Dart Underground are needed for something like this.

Having the hospital in the city will mean more shops/restaurants/hotels/amenities etc. within walking distance which will be a good thing for families using the hospital so they are not just confined to the hospital.

Clearly the Eccles Street site is too small to accommodate a hospital of this size. IMO the solution is to use the Mountyjoy Prison site and relocate the prison to Thornton Hall as planned.

nice_guy80

If public transport is the issue, then surely along the M50 with access to the Red Luas Line is the solution????

Simple

murphaph

nice_guy80 wrote: »

If public transport is the issue, then surely along the M50 with access to the Red Luas Line is the solution????

Simple

Public transport is not the primary issue. The primary issue is that the best care for children's hospitals is achieved when they are co-located with adult teaching hospitals. This is internationally proven.

The Mater is the best place for quality of care. Building (needed and planned anyway) public transport to connect to it just makes sense.

Hotblack Desiato

murphaph wrote: »

Public transport is not the primary issue. The primary issue is that the best care for children's hospitals is achieved when they are co-located with adult teaching hospitals. This is internationally proven.

The Mater is the best place for quality of care. Building (needed and planned anyway) public transport to connect to it just makes sense.

Moving the Mater to the M50 makes more sense than building this inaccessible monstrosity. There's room at James's to expand, and even some at Crumlin (more if parking goes underground and some of the old buildings are knocked.)

20Cent

I'd be driving around that area pretty regularly its a pain in the neck. With a screaming, injured or sick child in the back it would be a nightmare. Would rather just get on the M50 and go there much easier access, this is from someone who lives a few miles from the Mater I'd rather be getting on the M50.

stackerman

A green field site in the area suggested is by FAR the best location, both now and for the future. Easy acess, cheeper build, no restrictions, plenty of parking, and a bloody park next door (if your lucky enough that your child is well enough to go outside). Anywhere else is simply putting other interests ahead of the children.
Co-location can be achieved on a new site, and provide 21st century care going forward. Not the 19th tha we currenty have with regard to infrastructure.

jimmycrackcorm

The Mater site is a case of attempting to bring the mountain to Mohammed instead of vice versa.

Solair

one foot in the grave wrote: »

That would not deliver the best level of care if it is not co-located with large teaching hospital. Only three hospitals in the country would be suitable, Mater- James - Beaumont.

Eh, actually on that basis you would be better off locating it next to CUH in Cork. It's the largest university teaching hospital in Ireland and the only one with everything on a single campus. It has over 40 different medical and surgical specialities and close to 1000 beds and a huge, brand new, state of the art (albeit understaffed) maternity facility co-located with it.

Other than Belfast City Hospital, it's the only level 1 trauma centre (capable of handling anything on a single site) on the island of Ireland.

The downside being that it's inaccessible to 50% of the country.

The Dublin hospitals, for historical reasons, (rival orders of nuns mostly), have their services split and duplicated across several sites. None of them have the full gambit of services and specialties. For many services, patients will always end up being driven around the city anyway. E.g. if you're in the Mater for cancer treatment, it's common that you'll be ferried out to St. Lukes for radiotherapy and specialist scanning. If you've a major neurological issue or need neurotology, you'll be ferried to Beaumont etc etc

I don't really understand why it would be located at the Mater though. The site is way too small and struggling to cope with its current load of adult patients.

I've two elderly relatives undergoing cancer treatment there and, quite honestly, it's absolute chaos. The whole place is quite rundown and the site is already overpacked.

St James's site is completely jam-packed too, although it's by far the most accessible hospital in the entire country, given its proximity to both Heuston station and Connolly via Luas and the motorway network isn't too far away either.

Perhaps it could be squeezed in some how!

Beaumont has ideal space for such a hospital and I really don't think it's THAT inaccessible. It's not far from the M1 and it has excellent bus routes and they could be enhanced even further.

The other option which I think could be considered is St Vincents, but I would suggest that the Government looks at perhaps.

We should be looking at what land NAMA owns near these hospitals to see if something could be done!

MadsL

kceire wrote: »

Guinness have a current planning application in for their site.

Was my point, as there already some re-organisation of that site planned there could be some opportunities for landswaps etc.

Gumbo

MadsL wrote: »

Was my point, as there already some re-organisation of that site planned there could be some opportunities for landswaps etc.

Dont think it would work, Guinness land along the quays is too valuable and historically joined to guinnes imo of course.

murphaph

Why don't we just abandon Dublin City Centre and leave it to rot? All this "move it to the M50" talk really bugs me: not everyone is in a position to own a car. The hospital's location should not be determined by "how easy is it to get to by car".

Sometimes the harder option is the right one: develop the Mater site and provide the quality public transport a capital city like Dublin actually needs anyway to get to it. We always seem to look for the easy option in Ireland, whcih is why the country is such a shambles probably.

All this talk of "if I have a screaming sick child in the back seat" is emotive and unlikely. If you have a seriously ill child you won't be taking the time to look for a parking space. You'll stop outside A&E and leave your car with the keys in the ignition as you run in with your child - you won't be looking for a pay and display machine ffs.

If we are talking about visiting chronically ill kids in hospital then we are back to the public transport debate.

pauld123

Firstly the permission was not denied because of access. location was not an issue for ABP in terms of access.

People need to understand the truth. Access would be easier to get to Tallaght, that is true. But just getting to the hospital is not the only important issue. What happens when you get there is vitally important too.

If you are not in a hurry then an increase in access time of approximately 30 minutes is hardly a critical factor. If you are in a hurry then you are in an ambulance and the difference is actually very little. Parking and access are only really issues for non time-critical journeys and visitors.

Much more important is a need to have a fully functional teaching hospital beside it, Maternity, Adult care, and specialist treatment centres. The Mater has the best care on site of all the hospitals. It is ideally located to avail of the specialists in the near hospitals. By having a teaching hospital there it is a centre of the state of the Art medical training and immediately accessible for a sick patient. The Mater site has the country's best facilities for treatment.

Please, in your concerns about parking do not forget that the chance of saving a critical child's life is based on the standard of treatment. Would you really rather have easy parking and lower standard of treatment, than a bit of delay getting to a hospital to visit a seriously ill child who, when you get there, is receiving the best care available anywhere in Europe?

The Mater is the correct site, it was the building that was wrong. Right site, wrong design.

Ben D Bus

Unusually for me, I've skipped reading most of this thread before replying.

But it actually makes me angry to listen to the objectors. Their only concern seems to centre around parking. Surely healthcare is more important? But is doesn't seem to get much of a mention.

The only people who seemed happy on the news yesterday were the Jack&Jill foundation & the Tallaght Action Group.

The healthcare experts insist co-location is essential so would people with visions of the M50 & giant carparks please desist. And I mean in the real world, not just boards.

Tragedy

With regard to 'research' on the importance of co-location, people are aware that this research is a McKinsey Report commissioned when the HSE had already chosen Mater(albeit not publicly)?

Who commissioned a report is as, if not more, important as the contents of the report.

Furthermore, the report interview 29 'experts' with regard to the benefits of co-location of whom only 16 were actual clinicians. Of the Hospitals they examined, only a small number were roughly equivalent to the new NCH in terms of size, staff, population covered etc.

The report found "what they(Children's Hospitals) do to achieve this goal (of providing the highest quality of care) breaks down into five components: breadth and depth of service (the most important); access;
efficient use of resources; recruiting and retention; and teaching and research."
It continues with "To achieve sub
specialist critical mass, tertiary centres virtually always (1) serve a large enough
population to support a full complement of paediatric sub specialists, and (2) colocate with an adult teaching hospital to access specialities that generally split
between adult and paediatric patients (for example neurosurgery, transplant and
increasingly cystic fibrosis and cardiac services) to facilitate clinical and academic
‘cross-fertilization,’ and to attract the top staff."

Ah, I see. So already the issue of co-location being the most important feature of a new NCH has been ridiculously watered down compared to what people say it is. While co-location no doubt brings benefits, it hasn't hampered Great Ormond Street(with the same amount of beds as the new NCH) from being one of the top teaching and research Children's Hospitals in the world and a true centre of excellent in Paediatric Medicine.

Feck it. Forget all that. Just go look at who commissioned the reports on the Mater site, and look at their terms of reference. Look at who supported/opposed it, look at why the old CEO of the board stepped down in 2010. Make up your own mind after doing your own research.

Solair

I'm not objecting but, I don't think there's a hell of a lot of difference between the Material, St James's and St Vincent. None of them are full service adult hospitals and none of them have maternity hospitals.

My major concern now is that the damn thing is basically designed. Not going ahead would be a vast waste of money.

Ideally, the Dublin hospitals should have been reorganised over the past few decades to create two or three CUH or Belfast City Hospital type integrated medical science campuses, ideally near a the medical schools. That is exactly what was achieved in Cork, but it took 30 years. Bit by bit, the CUH absorbed more and more departments and it is a 10 min walk from the UCC medical school and medical science facilities, which are state of the art and totally rebuilt.

In Dublin, Grangegorman would have been an ideal site to colocate all the remaining city centre hospitals together with a decent maternity unit and this children's hospital.

Beaumont and Vincents should be the other two centres.

Also, given its a small city, the facilities should be specialised. Each major hub should have some focus eg Cardiac care and Cancer etc. As it stands facilities in Dublin are scattered, disorganised and overcrowded. It really does not need all these scattered general hospitals. They belong in a different era!

There have been too many vested interests, private interests and empire building in healthcare in the Dublin region. I seriously thinking the whole voluntary hospital model is disastrous.

The reality of the situation is the solution will never be ideal.

The long term goal should be to shut Mountjoy and integrate that into a proper public medical campus in that area, fully integrated with a medical school.

mikemac1

APP wrote: »

Were permission to be granted, it would "result in a dominant visually incongruous structure and would have a profound negative impact on the appearance and visual amenity of the city skyline", including O'Connell St, according to the Board.

Belfast city hospital is a large part of the the city's skyline
And nobody is bothered at all, it's a good hospital in the biggest city in the region

I quite like the computer generated pic of the Mater though I suspect I'm one of the few

Here's Belfast, oh it's not a looker but it's part of the city, people would miss it if it got torn down

I don't know enough about teaching hospitals to comment on that.
Just I saw the skyline as part of the reason for rejection, that's all