The Adelaide & Meath Hospital, Dublin Incorporating The National Children’s Hospital. Children's Health Excellence of Care Tallaght is the only choice for Ireland's Children A submission on behalf of The Adelaide & Meath Hospital Dublin, Incorporating the National Children's Hospital for A new children's hospital to be co-located at Tallaght March 2006 Contents 1. In short, the case for Tallaght 2 2. The approach of this document 5 3. Demography and Social Issues 6 4. What Children Want 8 5. Quality First 9 6. The McKinsey report 12 7 The New Children's Hospital 16 8. Planning and Development Considerations 18 9 Co-location Values 23 10 Access 31 11 Governance 37 12 Beyond Mc Kinsey 39 13 Background to the Hospital 40 14 Architectural Outline of Proposed new Children’s Hospital and Women’s Hospital 46 15 Report from South Dublin County Council in Respect of Proposed New Hospital for Tertiary Paediatric Services Appendix 1 1 1. In short, the case for Tallaght This submission is based solely upon the evidence of what is best for the children of Ireland. It reflects the key strengths of the Hospital o Quality; o Co-location; o Access; o Governance for children. Only the Adelaide & Meath Hospital, Dublin Incorporating the National Children's Hospital at Tallaght (hereafter referred to as “the Hospital”) meets every one of the nine criteria defined by the government commissioned international experts Mc Kinsey & Co. These are - 1.1 The nine McKinsey criteria 1.1.1 Space. There is ample space on and beside the campus of the existing hospital. All existing services can be expanded to meet the needs of the new hospital. 1.1.2 Services. The National Children's Hospital at Tallaght, with a tradition of caring for children, is already there. This, combined with the experience of the adult hospital, will provide the basis for a hospital of international excellence. When the talents and resources of all the paediatric specialist hospitals in the state are focused on the Tallaght campus it will be a world class hospital. It will keep the needs of children at the forefront, and will maintain and sustain the integrity of child healthcare. 1.1.3 Co-location. The new children's hospital should be on the campus of or beside an adult hospital. The Hospital at Tallaght is unique in Ireland in that it is the only hospital that is currently so co-located. 1.1.4 Access. Tallaght is accessible from all parts of the country and the inner city of Dublin. It is therefore the logical place to offer a national children's service. It can easily be reached by ambulance, car, public transport and air. Also, the Hospital is situated in one of the fastest growing populations in Europe with a large proportion of young people. 1.1.5 Efficiency. Sharing with an adult hospital means greatly increasing efficiency in view of shared facilities. Co-location will ensure efficiency and continuity of care from cradle to grave. 2 1.1.6 People. The existing Hospital is a well designed, modern, attractive place to work and provides interesting career opportunities. The National Children's Hospital at Tallaght has a nationally and internationally known brand. 1.1.7 Teaching and Research. The Hospital has a long tradition of teaching and research with Trinity College Dublin. It provides undergraduate and postgraduate education to doctors, nurses and other health professionals at undergraduate and graduate level. 1.1.8 Financial Stability. The existing Hospital is financially stable and this will continue. 1.1.9 Full Project Plan. The full project plan set out in the following pages develop the criteria set by McKinsey & Co and adds further compelling reasons that demonstrate the inescapable logic of choosing Tallaght as the location for a hospital to serve the children of Ireland. 1.2 Five further unique benefits beyond the McKinsey criteria In addition to the Mc Kinsey criteria the Hospital has the following characteristics: 1.2.1 The Hospital has a proven track record in managing mergers between different hospitals with different cultures and in developing constructive partnerships. 1.2.2 It is a University Teaching Hospital with a Trinity College Academic Chair in Paediatrics and a well-defined research strategy that has already been incorporated into the research plan of the Trinity College Faculty of Health Sciences. Furthermore, the Hospital has been awarded the National Longitudinal Children's study. 1.2.3 The Hospital is totally patient focused and will protect both the privacy of the doctor patient relationship, and the wishes and needs of our children. 1.2.4 The Hospital is willing to accommodate the medical students of Trinity College Dublin, University College Dublin and the Royal College of Surgeons in Ireland. 1.2.5 The Hospital has the capacity and wish to develop a Women and Children's Hospital which will accommodate Obstetrics, Neonatology, Paediatrics and Adult care. 1.3 Governance In line with other world class tertiary paediatric hospitals independent governance and budget responsibility for the new hospital will be assured. 3 1.4 Minimising disruption. It would defy all logic to move Our Lady's Hospital for Sick Children, Crumlin and the National Children's Hospital away from the area which houses the most rapidly growing population and largest proportion of people of child bearing age and of young people. It would be particularly illogical to move these facilities to the inner city. It would make both tertiary and secondary services much less accessible and would deprive the most needy and concentrated part of our population of primary care services. 1.5 National strategy. This proposal is entirely compatible with the vision of the National Children's Strategy: "An Ireland where young children are respected as young citizens with a valuable contribution to make and a voice of their own; where all children are cherished and supported by family in the wider society; where they enjoy a fulfilling childhood and realise their potential" It is a matter of public record that international experts have set criteria that can only be met by the Hospital at Tallaght. The other unique characteristics of the Hospital add significantly to it being the only choice for Ireland's children's hospital. 4 2. The approach of this document 2.1 The goal. The establishment of a single common major tertiary paediatric hospital with substantial secondary services represents a development of enormous importance to the health of the children of Ireland. The first and overwhelming consideration for the new hospital must be excellence of care. 2.2 This document o presents some brief information on demography and social issues; o considers (in line with current thinking) specific issues with regard to what children want; o and then establishes why the new hospital must provide care of a quality that will make it world class; o sets out the criteria that will ensure that the new hospital will deliver a service of world class quality. Section 5, pages 9 to 11, of this submission. 2.3 Best international advice. The government commissioned international experts Mc Kinsey & Co. to prepare a report entitled "Children's Health First". This expert group set nine criteria for a children's hospital to serve all of Ireland. As set out in Section 6, pages 12 to 15, of this submission only the hospital at Tallaght meets or exceeds every one of these criteria. 2.4 Partnership. The Hospital at Tallaght would welcome a partnership with colleagues from Dublin's children's hospitals. It has a proven ability of partnership after its highly successful merger of the Adelaide Hospital, the Meath Hospital, the National Children's Hospital and St Loman's Psychiatric Hospital. 2.5 Further services. The section "Beyond Mc Kinsey" , page 39 of this submission shows how the Tallaght campus can and should accommodate a maternity hospital to provide care for mothers, Neonatology and Paediatric care, and adult services. 2.6 Background and history. Pages 40 to 45 of this submission carry some background information regarding the Adelaide & Meath Hospital, Dublin Incorporating the National Children's Hospital. This includes the merger, the hospital charter and its ethos and ethics. 5 3. Demographic and social issues While this section considers National demographics, the new children’s hospital may have a vital role in serving the children of the whole island. This would approximate to 1,500,000 children. 3.1 National Demography As a national centre, the new Children's Hospital will serve the children of a population of 3,917,203 (2002 census), an increase from 3,525,719 in 1991. Of these, 827,428 are 0 to14 years. 313,188 are 15 to 19 years. 328,334 are 20 to 24 years. 1,180,259 are 25 to 44. Close to one million children will need the services of this hospital as well as 1.8 million people of childbearing age. 3.2 Eastern Regional Demography The new hospital will provide both tertiary and secondary services to the Dublin area. The former eastern regional health authority population is 1.4 million persons. The South Western part of the area in particular has shown a striking population growth with the population of Kildare and Wicklow increasing by 11.7% since 1996. In particular, Kildare has shown a population growth of 21.5% in this time, making it the fastest growing population in the country. The Eastern region also has a higher proportion of persons of child bearing age than the rest of the country, and a lower proportion of people over 65 years of age.