Let's Clear up Some Misunderstandings – C4KH Replies

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CONNOLLY FOR KIDS HOSPITAL GROUP (C4KH) REFUTES ARGUMENTS PUT FORWARD IN FAVOUR OF ST JAMES BY THE NATIONAL PAEDIATRIC HOSPITAL DEVELOPMENT BOARD AND THE CHILDRENS HOSPITAL GROUP BOARD.

Let’s clear up some misunderstandings about the new children’s hospital project… C4KH Replies in Right hand column.

Questions by Answers by NCH Comments by Connolly for NCH management to their Kids Hospital group to the Management own questions Q&As of the NCH management

• The New children’s • WRONG! The McKinsey Is there any hospital has been Report’s principal room for designed to meet requirement for the expansion at projected child site for the new the campus at population growth Children's Hospital was St James’s and unmet clinical "Space". The design of Hospital? need. the new Children's Hospital on the St James's site is • The campus at St constrained by the James’s Hospital has limited space available. in excess of 50 acres The new hospital is of land. 12 acres are required to establish being made available “breadth and depth of for the new children’s service ”-specialist and hospital and the site sub-specialist has been designed paediatric expertise for future expansion. and sufficient numbers of patients to ensure excellence of care and • The new children’s outcomes. hospital design is based on meticulous • WRONG AGAIN! St. healthcare planning James’s is 48.13 acres which will result in a in total (stated in

1 facility which can NPHDB Panning provide for very application), 10 acres significant expansion of which is leased to (25-30%) in delivery Trinity College and 38 of healthcare. acres leased to the Beyond this, a further Board of St. James’s 20% expansion Hospital, almost all of capacity has been which is already built identified outside of on. The NCH will be on the current building 12 of the 38 acres. footprint. • We understand that internal 'expansion' would require decanting of service such as pathology, pharmacy, educational facilities etc. The expansion capacity of 20% for future lateral expansion (as advised by Martin & Clear) is grossly inadequate. Toronto Children's Hospital has doubled in size every 10 years since its foundation in the 1950's. Clinical space at Our Lady's Children's Hospital in Crumlin has increased by 75% in just the past 15 years. The only, and narrow,entry/exit points (one at either end of the campus) are a major hazard both for effective hospital function, patient safety and future construction need. How can you • There are a number • WRONG! The Rainbow build a of outdoor areas at Garden is on the children’s the new children’s ‘sunken’roof of the 4th hospital if hospital, including the floor and is surrounded there are no Rainbow Garden on all sides by four outdoor which is the length of additional areas? Croke Park. floors(15.3.m high,with • The development of no view of the outside the hospital on the St world other than the James’s Campus will sky). It is not in any result in a greater way comparable to area of publicly Croke Park as the

2 accessible open NPHDB claims. It is in spaces and green two separate halves areas, with a higher each with approx 0.3 standard of design acres of usable space. and quality of The Meadow Garden, to materials than the north, is currently exists on approximately one acre the campus, or in the in size and is the main exisiting children’s area designated for hospitals. future expansion of the hospital.

Have you • Access for families at • WRONG AGAIN! While considered the campus at St some new 970 spaces the access James’s Hospital will be provided in the needs of NCH underground car families – The design of the new park, (at enormous should you children’s hospital has expense) it will result not be recognised the need of most in only a net gain of locating it at parents to access the 400 spaces on the Connolly hospital by car and ample entire campus. 675 Hospital parking has been provided spaces for patient and where there is for families based on visitors (27 of which unlimited current and projected future are outside the parking for demand, with treble the emergency families and current available parking at Department) is grossly staff? the existng three children’s inadequate for a major hospitals in Dublin. There children’s hospital. will be 1,000 car parking Public transport is spaces in the new children’s rarely an option for sick hospital and An children, over 90% of BordPleanála has whom access hospital adjudicated that 675 of by car. If the Coombe these spaces will be Maternity Hospital reserved entirely for were ever to transfer to families. The parking the site, not a single system will allow families to extra parking space will reserve spaces ahead of be provided. arriving to the hospital and specific car parking spaces • It is ludicrous to boast are also planned for that the parking being emergency parking outside provided for families at the Emergency Department. the St James's will be treble the current available parking at the existing three children's hospital's in Dublin - as Temple Street Hospital doesn't even have a car park, no specific parking allocation for children’ s families exists at Tallaght. Crumlin in

3 2010 had 480 spaces. Its Development Plan called for an increase to 980 spaces - at Crumlin alone. • The proposed NPH has the smallest parking allocation of any recently built children's hospital with only 2.0 spaces(patient and staff) per bed - Melbourne Children's Hospital, opened in 2011, provides 6.8 spaces per bed and the Alder Hey Children's Hospital in Liverpool, opened in 2015, provides 4.4 spaces per bed.

Access for staff at the • GROSSLY INADEQUATE campus at St James’s PARKING! The 312 new Hospital staff spaces under the The St. James’s Hospital NCH will be shared with Campus Smarter Travel the adult hospital staff. Programme is up and The adult hospital is running and, in accordance losing >600 surface with planning guidelines has spaces to make way for ambitious targets to reduce the NCH. The targets staff required to reduce staff car dependency and for • Car dependency. St staff to use public James’s Hospital is transport are so centrally located in ambitious that they have Dublin and has more never been achieved or public transport links imposed in any major than any other hospital acute-care hospital in the in the country. The world (8%of staff may inspector’s report from have a car space). An BordPleanála stated • An Bord Pleanála that: “There is nothing received no evidence to on file to indicate that indicate that the public this (is) not achievable transport network could or deliverable’. meet the needs of staff. Many staff commute • Public Transport at the from satellite towns in St James’s the Greater Dublin Area. HospitalCampus Many work shift hours There are Dublin Bus when public transport is routes through the not available. Lack of

4 campus and along the parking has huge streets immediately implications for adjacent to the campus. recruitment and The Red Luas line has retention of professional three stops serving the staff and therefore of campus: James’s, Fatima effective working of the and Rialto, and that Red campus hospitals. It is a Luas line is soon to be very serious problem – connected to an and a major reason why expanded Green Luas the NCH should not be line serving the north built in the inner city. and south of the city, and is also to connect to Connolly Hospital the Maynooth rail line has(Dolphin Report, p57) commuter service at dedicated slip road Broombridge. The Red access (off M50/N3 Luas line connects the interchange), bus site to nearby Heuston services x 12, 2 on site, Station where a number no parking restrictions, of rail commuter walking distance from services from the south- Castleknock train station west of the GDA (on Dublin-Sligo terminate. It also mainline) and a helipad connects the campus to at ground level is Connolly Station where possible. The Clear Dart services and diesel Martin planners Report commuter services (p8) lists regional buses serving the south-east, stopping at the nearby the north-east and the Blanchardstown north-west of the GDA Shopping Centre and a pass through. It also separate staff access via connects the site to Waterville Rd linking ‘park and ride’ facilities from Snugboro Rd. at the Red Cow and Underpass access from Cheeverstown, the St Blanchardstown village James’s Hospital Campus can, the Report states, Smarter Travel be made available via Programme has recently Mill Rd for local access. introduced free parking for staff at these • "The inspectors point facilities. There are two regarding unfettered DublinBikes outlets on access and unfettered the campus currently car parking in my view and a third just outside conflates location the existing Rialto Gate specific constraints with Entrance. more generic national, regional and local • Access and parking at a (authority) policy, with site at Connolly Hospital the latter assumed by The assertion that the Inspector to trump unlimited parking would the former. Considering be available at Connolly constraints, it was (or any other site) is acknowledged by the untrue. To quote the applicant (National

5 inspector’s report from Paediatric Hospital An BordPleanála: “There Development Board) that is a flaw, in my opinion, the limit of 2,000 car in the argument put parking spaces was forward by some of imposed by Dublin City those who advocate a Council due to concerns greenfield site adjacent relating to prevailing to the M50. They appear traffic conditions and to assume that development impacts on unfettered access off the the road network national and primary surrounding that route and unfettered particular site. (St access to an on-site car James's). So while the parking can be Inspector is right to accommodated. The acknowledge that the same national, regional same policies apply, the and local transportation constraints are clearly policies are equally location specific, with a applicable at that City Centre site location as they are at substantially more the application site and constrained, both do not support such a internally in terms of strategy.” space to accommodate The limited public development and car transport options parking, and externally available at the Connolly in terms of the capacity Hospital site would also of the road network to invariably affect accommodate additional access and have a traffic. As the planning significant impact for process is intended to staff and visitors,.local consider the evidence residents, and approach (based on an roads such as the Environmental Impact already busy M50. While Statement), it seems St James’s Hospital is regrettable that the recognised as having the impacts don't seem to best public transport have been given due links of any hospital in consideration by the the country. Inspector". Comment from Ciaran McKeon, Managing Director, Transport Insights(who gave evidence to ABP Oral Hearing, on behalf of The Jack and Jill Foundation). Blanchardstown Shopping Centre has 7,000 car parking spaces.

How can • The new children’s • MATERNITY NEEDED you proceed hospital will be tri-located NOW! The terms "In

6 without a with St James’s Hospital time" (Minister maternity and in time, with the Harris) and hospital? relocated Coombe Women "ultimately" (Minister Connolly and Infants University Reilly) are repeatedly Hospital will Hospital. used as reassurance have the • The relocation of both the that Maternity will be Rotunda on Coombe Women and co-located with the its site so Infants University Hospital NCH and are simply this is a to the campus at St unacceptable when better James’s Hospital and the speaking about the option Rotunda to Connolly risks to newborn surely? Hospital are both at the children’s lives. same stage; both are • In a recent newspaper included in the National interview (Irish Medical Maternity Strategy and Times, 2016), the both have yet to advance Master of the Rotunda, to planning. Professor Fergal Malone • In a recent interview on said that he the Sean O’Rourke Show expected“to cut a (May 3, 2016) the Master ribbon for the new of the Rotunda, Professor hospital in Connolly in 5 Fergal Malone said that it or 6 years” . That will be 5 to 7 years means that planning is before the Rotunda moves well advanced. to Connolly. • It is acknowledged in two reports, the International Independent Review of 2011 and the Dolphin Review of 2012, that it would be 25% cheaper to build on a greenfield site compared to the brownfield site at St James's. If the Connolly site were chosen, then the new National Children's Hospital and the relocated Rotunda Maternity Hospital could be built simultaneously on that site for the same cost as building the Children's Hospital alone on the St James's site. In fact the savings made would be significantly greater in view of the fact that, prior to

7 attempting to build the Coombe Women and Infants on the St James's site, the entire adult Out Patient Department will have to be demolished to make room for the Maternity Hospital and will have to be rebuilt somewhere else. In addition, at least a new adult Accident and Emergency Department and a new Adult Intensive Care Unit and Facility Management Hub will have to be built as part of the building shared with the Maternity Hospital (‘Draft Site Capacity Plan’, NPHBD Planning Application, 2015). The planning for relocating the Rotunda hospital to Connolly site is significantly further advanced than that for the Coombe hospital to the St James site. Could we • Permission has been • YES! CHEAPER AND not get the granted for the new QUICKER AT new children’s hospital on a CONNOLLY! We could hospital campus shared with St “get the new hospital quicker if it James’s Hospital. This quicker”. Mr James were follows a two-year period Sheehan, located on a of design and consultation orthopaedic surgeon greenfield with children, young and hospital site at people, families, staff and developer, states Connolly representatives from the that a new hospital Hospital? local community. The can be opened at the location was selected Connolly site three following a years after a comprehensive and ‘decision to proceed’ detailed process. The is given. fundamental aim of this vital project is to ensure • REDICULOUS the best possible health REASON! The

8 outcomes for children and location for the new young people in Ireland. Children's Hospital St James’s Hospital was was made by the selected as it is the Cabinet on the advice hospital that best of the then Minister supports the children’s for Health, James hospital. Enabling works Reilly. Dr. Reilly will commence this claimed that co- summer and the hospital locating St James's will be ready for hand Hospital with the over by the end of 2020. National Children's Hospital would allow children with very rare disorders, who currently had to travel abroad for treatment , to be treated in Ireland through "bringing together the experts, the ‘super specialists’ who deal with adults and A suggestion that it would be children for these cheaper and easier to build very rare conditions" the hospital at a campus and that this "was a shared with Connolly Hospital primary concern and is pure speculation. No the primary clinical costings have been driver" of the considered for an alternative decision. This is site, however given the scale complete and utter of the project, the much nonsense. Children longer timeline and with the rarest construction inflation would disorders, such as be expected to have a conjoined twins or significant impact on project children requiring costs and this, together with liver transplantation, expenditure on the project to should and will date, could offset much if not continue to travel all of any hypothetical abroad for savings that supposedly treatment. Was the could be obtained from Minister suggesting building on a greenfield site. that doctors who are Should the location of the trained to care for hospital be changed at this adults, in some point, construction would not mysterious way be expected to commence despite any training until 2019 or 2020 – when or experience in the new children’s hospital at caring for children, the campus at St James’s develop skills to care Hospital is planned to be for the sickest of near completed. children in a way that those who actually trained to do so

9 cannot? There isn't a single scientific publication which supports the claim for improved clinical outcomes for children when a children's hospital is co-located with an adult hospital. • Crucially, the new YES - 25% CHEAPER! children’s hospital and St The Independent James’s Hospital are both Review,2011 (part 1- large acute teaching financial analysis) hospitals, meaning they and the Dolphin have matching levels of Report 2012 service complexity (Appendix 4) both delivered by highly concluded that the specialist staff. To bring cost of building the Connolly Hospital up to a children's hospital on comparable level would a greenfield site as require very significant opposed to an urban investment and a brownfield site like reconfiguration of specific St James's would specialties in the adult result in a saving of hospital system in Dublin at least 25%. The – both of which would build time at delay the ambition to Connolly would not deliver a world class be constrained as it children’s hospital in doesn’t have the Ireland even further. constraints of being a tight urban site that the St James's site has. Planning risk is “low”according to the Dolphin planners report. The cost savings associated with building at Connolly would fund the critical co- location of a maternity hospital. The claim that the children's hospital will be completed on the St James's site by the end of 2020 is extremely optimistic- 2022/2023 is much more realistic.

• Highly experienced

10 children’s doctors cannot understand the obsession the HSE/DoH have in suggesting the necessity for adjacency of unrelated and non- interdependent adult and children’s specialties . Clinical specialties in adult hospitals relevant to children’s medicine are few, and becoming fewer as paediatric sub- specialist consultant numbers and teams increase. They were listed by the Task Group on Location in 2006. They are in various hospitals. Beaumont Hospital has already indicated a willingness to transfer its National neurosurgical, cochlear implant and kidney transplant services as well as its trauma orthopaedics, to the spacious James Connolly Memorial Hospital site.

Co-location On foot of a series of reports with Connolly and consultations, the Hospital is Government determined that, equal to co- as one of Ireland’s leading location with adult teaching hospitals, St St James’s James’s Hospital is the most Hospital isn’t appropriate adult partner for • NO BENEFIT! The it? the new children’s hospital "bigger" does not with which to co-locate. There mean the "better" are many reasons for this, co-location hospital including: - so let’s knock that argument on its • St James’s Hospital is head . Ireland’s largest and Brisbane children’s leading adult did not co-locate

11 teaching and with the biggest research-intensive Adult hospital in hospital. It has the Brisbane(2014). greatest number of The Glasgow clinical specialties and children’s did not national services in the co-locate with the acute adult hospital biggest adult system. It also has the hospital in widesst range of adult Glasgow(2014). sub-specialties that can Melbourne support paediatric children’s (2011) services, ensuring and the Alder Hey patients with conditions in Liverpool(2015) whose prevalence does did not co-locate at not warrant paediatric- all and they are only consultants, get both smaller than the best support. For the proposed NCH example, St James’s in Dublin. Hospital is home to the Space, Maternity national Radiation co-location, Access, Oncology (cancer) Parking, Parkland, department and the Parent Irish Blood Transfusion accommodation, Service Board. It also Staff recruitment has one of the leading and retention, cardiac department in Educational and the country. Research capacity , are all significant considerations in • The new children’s location decision. hospital and St James’s Hospital are both large • It beggars belief acute teaching that neither hospitals, meaning they parents of sick have matching levels of children nor any of service complexity the staff at the delivered by highly three existing specialist staff. To bring children's hospitals Connolly Hospital up to had any part to a comparable level play in choosing would require very the site for the new significant investment – children's hospital. something that would The "series of delay the ambition to reports and deliver a world class consultations" children’s hospital in which influenced Ireland even further. the Government’s decision to locate the new children's • Synergies between hospital on the St adult and paediatric: James's site Co-location with St resulted in Dr James’s Hospital Reilly's ludicrous, ensures access for unsupported claim

12 children to adult for improved specialties in conditions clinical outcomes which are more resulting from common in adults. Joint adult hospital co- management of these location. conditions by specialists who work with both • There is absolutely children and adults no evidence provides better quality whatsoever for of clinical care to the improved clinical children and young outcomes for people concerned. children when a Examples include children's hospital cardiac surgery, is co-located with ophthalmology, plastic an adult hospital. surgery, ENT, burns and The critical co- maxillofacial surgery. In location for the Ireland, because of our National Children's population these cases Hospital is with a are better managed by physically those surgical connected specialists who work maternity hospital with both adults and so that dangerous children, as they can ambulance transfer develop and maintain can be avoided. their skills through their Critically ill work with the greater newborn babies do numer of adult patients not cope well with and they can apply the handling and skill and expertise to transfer by corridor the care of children and is essential to their young people with optimum survival. similar issues. (It is Of every 100 likely to be some transfers from a decades before the new maternity hospital, children’s hospital has a 5 are sick mothers fully individual and 95 are sick consultant staff, and babies. Once a this may never be maternity hospital practical (given our is co-located with a population) for some children's hospital, specialties.) There are then a co-located many clinicians that are adult hospital working between St becomes a James’s Hospital and necessity to care the children’s hospitals for any sick already (in areas such mothers, so Tri- as immunology, location is best. haematology, plastic Upgrading Connolly surgery, dermatology, adult hospital for radiation oncology and specialist care of maxillofacial surgery), mothers is a and this will increase relatively simple once the new children’s exercise and is

13 hospital opens. Having currently being them on the same negotiated. campus will lead to inevitable efficiencies • Children who as currenty, consultants outgrow paediatric have to travel between services will, in the hospitals for general, transition appointments. to their local adult service. For adolescents and • A Model for transition to young adults in the adult services for Greater Dublin children and young Area, some may people with chronic transition to St conditions will also be James's but the best served from co- majority will locations with St transition to the James’s Hospital. most appropriate Examples of this adult hospital in include cystic fibrosis, Dublin. Children arthritis, epilepsy, with cystic fibrosis gynaecological or arthritis will disorders, chronic skin transition to the conditions and National Centres at immunodeficiency’s. St Vincents Hospital, children with congenital heart or metabolic disease will transition to the Mater Hospital, children who had undergone neurosurgical procedures will transition to Beaumont Hospital, children who had major orthopedic operations in childhood will be followed up in either Tallaght Hospital or in Cappagh Orthopedic Hospital, depending on which adult hospital their surgeon works in. • Research: Research • The National will play a central part Children’s Research at the new children’s Centre at Crumlin will

14 hospital. ‘Today’s transfer with the research is tomorrow’s three children’s cures’. St James’s hospital to the new Hospital is one of NCH, wherever it is Ireland’s leading built. It must be research hospitals. It embedded in the new has an excellent, hospital, allowing the internationally “ bench to bedside” recognised, clinical, research-intensive research and eduction atmosphere to culture and flourish. Adult infrastructure. The new academic institutions Children’s Research and have been competing Innovation Centre and for the Children’s the provision for active Research centre as it research within the would enhance their hospital and on the income and status , wider campus, will Children’s Research foster the type of being a magnet for research intensive philantropic environment that is donations. At St. required on a campus of James’s , it would be healthcare excellence. built on a confined site at the far end of the campus from the • Attracting and NCH, and would retaining the best owned by Trinity staff: The new College. children’s hospital will be a world-class facility, • HUGE PROBLEM! The custom built to deliver new NCH will have the best care and enormous problems treatments that are retaining current and available. It was recruiting new staff if recognised in the at St. James’s because McKinsey Report that of woeful car parking co-locating with an facilities and limited adult teaching hospital accommodation facilitates clinical and options for families of academic ‘cross- staff. The public fertilization’, helping to transport system is attract and retain top limited, expensive and staff. often overcrowded and considered unsafe at night. Reflecting • Economies of scale: this, currently only 2% Co-locating with St of St James's staff use James’s Hospital will the Red Line Luas. mean that the new Accessing public children’s hospital will transport from where have access to highly people live can be specialised equipment difficult, if not that it would not impossible, for shift otherwise have access workers, adding

15 to. An example of this is unacceptable hours to a PET scanner; St commuting time. James’s Hospital is the only adult hospital in • The new NCH will have Dublin to have a public its own PET scanner. PET scanner. No public hospital currently has PET-MRI. As new technologies rapidly evolve, imaging and treatment requirements change – SPACE is the future- proofing required.

Regarding economies – it is surprising to hear the CEO of the Children’s Hospital Group state (Oct 2016) that 600 more staff will be required in the new hospital as at the time of the Mater planning application, one of the boasts of the Development Board was that fewer staff would be required after amalgamation of the Children’s hospitals. How can you • The area at St James’s • THIS IS SIMPLY NOT build a Hospital does not TRUE! The data children’s breach and EU ambient presented in the hospital in a air quality standards as Applicants location incorrectly presented by Environmental Impact where the air experts at the An Statement (EIS) and in is polluted to BordPleanála Hearing the Statement an on behalf of those presented to ABP oral unacceptable against the project. Hearing , Dec 2015 by level? Existing levels of TMS for the Jack and nitrogen oxides (NOx) Jill Foundation clearly are in fact higher at shows that the EU Air Connolly Hospital than Quality Standard for they are at St James’s nitrogen oxides (NOx) Hospital based on is exceeded in the St nearby EPA recording James Location. Even stations. the Applicants own EIS agrees that this standard is exceeded. The claim regarding • Commenting on this nitrogen oxide levels

16 subject in his report, at Connolly Hospital is the An BordPleanála also incorrect. The Inspector said: “ Having measurement location regard to, inter alia: the is approx 300m away submission of Dr from the closest Edward Porter, building on the Environmental Blanchardstown Consultant for the Campus and therefore applicant, at the is not an appropriate Hearing on the description of air 02/12/15; the quality at the clarifications submitted hospital. The by the applicant at the Blanchardstown Air Hearing on the Quality Monitoring 10/12/2015, and the location is right submission of the beside the N3 14/12/2015 in relation carriageway and to air quality concerns within the zone of raised by the observer, influence of the I am of the opinion that extremely significant the proposed M50/N3 junction. development will not There is nowhere else adversely impact on in Ireland, with the the air quality of the possible exception of receiving environment the middle of the Red at either construction Cow Junction , with stage or operational higher NOx levels in stage. I also consider it ambient air. This EPA reasonable to conclude station measures air on the basis of the quality associated information on the file with traffic and since that the proposed the traffic pollutants development, reduce in individually or in concentration within combintion with other about 10 metres of plans or projects would the carriageway, the not adversely affect the levels will have integrity of any reduced to European site (see also background levels at ‘Appropriate 300metres distance. Assesement’ under TMS Ireland Ltd. have s.3.1.26 of this report). carried out It should be noted that measurements on the the applicant’s Blanchardstown calculations took Campus and the air account of not just the quality there is NCH but also the unpolluted and maternity hospital and representative of a expansion for both the rural location and not NCH and the maternity a major roadway. hospital.”

17 How can the • The vast majority of • NOT TRUE! The hospital the clinical NPHDB and the succeed when professionals (doctors, CHGB ‘s claim of there is no nurses, health and professional support support social care for the St. James’s amongst the professionals) working location is without medical in the three children’s any evidence. All community hospitals and eight “clinical and and families paediatric services in nursing leads” with for the Ireland support the one exception were development development of the appointed by of the new new children’s hospital management (not children’s on a shared campus elected by their hospital on a with St James’s peers) AFTER the shared Hospital. One public location choice – so campus with articulation of this cannot be presented St James’s support was a letter in as reflecting staff Hospital? the Irish Times before opinion. Staff were the planning never consulted on application was location. The submitted, which was Medical Board at signed by all the the biggest hospital clinical and nursing (Crumlin) never leads across the three approved the children’s hospitals. location contrary to what is claimed by the NPHDB and • The Boards of the CHGB – it was three Dublin based simply not children’s hospitals consulted. Tallaght are unequivocal in Children’s does not their support for the have a Board but is new children’s hospital part of the main on a site shared with adult Tallaght St James’s Hospital. Hospital. • BEST FOR CHILDREN! • With the greatest of Furthermore, respect to all families Connolly for Kids who use our services, Hospital could the three children’s equally say that we hospitals deal with deal with families families and parents and parents on a on a daily basis who daily basis who believe that the believe the St James location chosen for the location is the hospital is the right wrong one . one and who are We further believe delighted that we are that, were adult now one step closer to medical and delivering a purpose university politics, built facility that is DCC and local best positioned to political interests in

18 deliver the best care Dublin 8 removed and treatments from this decision available. and what is best for the children of Ireland given centre stage, that common sense would prevail and a paediatric and maternity facility to serve the 21st and into the 22nd century would be built at the 145 acre site alongside Connolly adult hospital in Blanchardstown - with less delay and at less expense to the taxpayer than at St. James’s. Is this the • The statement that • Two out of every three right location ‘75% of children children in the Greater when 75% of attending the hospital Dublin area live children will come from outside OUTSIDE the M50. attending the the GDA (Greater • Nine out of every ten new Dublin Area)’ is children in Ireland live children’s untrue. 77% of OUTSIDE the M50. hospital will children attending the • Therefore, 90% of the come from existing children’s sickest children outside the hospitals come from (tertiary –eg cancer, greater INSIDE the GDA. heart disease) will Dublin area? • Less than 23% of the travel from OUTSIDE children admitted to the M50. They will be the existing 3 the heaviest users of children’s hospitals the National hospital – are from outside the they account for over Greater Dublin Area. half of all day case • The new children’s admission in Crumlin hospital will provide and over one third of secondary care for all inpatient children living within admissions. Their the M50 and also families requirements tertiary level of are very different from specialist care for those of a child from children from all over the Greater Dublin Ireland. Area who may attend • The two new once in childhood e.g. Paediatric OPD and for appendicitis or an Urgent Care Centres anaesthetic to set a at Tallaght and broken bone. Connolly Hospitals will provide secondary care for children who live in the Greater

19 Dublin Area, and outside of the M50 • The regional paediatric units around the country will also play an important role - the vast majority of paediatric services are delivered on a same day basis and as close to the child’s home as medically appropriate.

Can • There will be an • WRONG LOCATION! The helicopters elevated helipad at site of the Children’s land at the the new children’s Emergency Department new hospital, which will (inappropriately at the children’s have direct and rapid back of the hospital hospital? access to the Critical where big future Care, Theatre and construction by the Emergency adult hospital is Departments within planned!!) and of the the hospitals. There helipad was will also be direct determined more by access through the the need of the adult new children’s hospital hospital for a helipad helipad to the St than children’s needs. James’s Hospital for Accident and services as required. Emergency access to • The helipad has been both hospitals will be designed in close compromised for years consultation with the to come. Air Corps and • Not having a ground Department of helipad, which could Defence. accept Irish Sikorsky • Air Corps helicopters Coast Guard can land on a raised Helicopters ( which are landing site or the roof not licensed for roof- of a building which is top landings), is designed and certified contrary to recent for such operations. (2014) Government Use of elevated recommendations for landing sites on the new hospitals. roof of buildings is • The likely significant widespread in the UK increase in helicopter and Europe. transfers of adult • The design of the patients appears elevated helipad is an unjustifiable in the accordance with the centre of the heavily ICAO Heliport Manual residential area around which is in accordance St James’s. with Irish Aviation

20 Authority standard. • The Irish Coast Guard also provides aerial support, if required, through its Sikorsky S92 search and rescue fleet. These are not licensed to land on roofpads and, for access to the St James’s campus would land in the Royal Hospital Kilmainham from which patients would be transferred by road (as currently happens for patients being transported to St James’).