Promise of a 'world class' hospital is put to its final test
The plan to build a National Children's Hospital has been beset with delays and setbacks since the project was first proposed almost a decade ago.
With the planning application for its latest - and it's hoped final incarnation - set to be lodged within weeks, the stakes are high.
Eilish Hardiman, the CEO of the Children's Hospital Group and John Pollock, the National Paediatric Hospital Development Board Project Director - two of the leading figures guiding the project - are confident it will proceed on this occasion, with construction expected to begin early next year.
They say the €650m project in Dublin's south city will be a "world class" hospital, and a major boost to the greater Dublin region.
The ambitious project has had its critics.
When plans for a National Children's hospital were first touted, it was supposed to open its doors in 2011. That was before the various set-backs and delays.
The project was moved from the Mater Hospital to the St James's campus after planning permission was refused at the northside site by An Bord Plenala.
There was seemingly endless debate about where to put the hospital after the planned Mater site fell through, with many still arguing that it should be located on a green-field site on the M50, with Connolly Hospital, Blanchardstown, the most frequently mooted alternative.
The hospital is now not scheduled to open until the second quarter of 2019.
But this is dependent on obtaining planning permission from An Bord Pleanala, a decision that may not be known until next January or February.
But both Ms Hardiman and Mr Pollock believe that the preparation work carried out as part of the current planning application process - including engagement with the local community - means that the project will proceed as planned.
Ms Hardiman said that when she engages with the local community in Rialto and Inchicore, she has gotten overwhelming support for the new hospital on their doorstep.
"I think because many of the people have families, and they see it's great to have a children's hospital on their doorstep," she said.
Concerns have been raised about impact on surrounding communities during the construction phase.
Work is ongoing to address the concerns of the local residents whose houses are on the boundaries of the hospital, Mr Pollock said.
"What we agreed we would do, we need to go and see what the condition of their houses are. Normally we wouldn't do condition surveys on houses until builders are appointed. We have instructed our engineers to carry out condition surveys. We will pay for it, we will share the reports with them."
The offer was made to around 70 houses, and over 40 have accepted to date. "We are saying, let's go in and see the conditions of your houses, and then we will be in a better position to respond to whether we think there are issues," Mr Pollock said.
"If we cause any damage to anybody's house, we will have to make it good obviously. It's as simple as that, and obviously our builders will need to have all the appropriate insurances," he said.
When the building is underway, vibration limits and noise monitors will be in place. "We will monitor dust, which is very important in a live hospital campus. Not alone are we concerned about the residents, we are concerned about the patients, who could have respiratory ailments," he said.
Measures are being put in place around the issue of subsidence. "We don't believe it is an issue. We are sufficiently far away from the houses, but that's for us to demonstrate to the residents that we are confident in that."
Concerns have been raised that the St James's site won't have sufficient parking space for parents of sick children, and that the location is less easily accessed than an M50 site.
Mr Pollock addressed both of these questions. He said that 1,000 car parking spaces will be provided at the new hospital.
"All of those are underground. There are two entrances to the basement car park, one from Rialto and one from Mount Brown. They can access lifts that bring them right into the middle of the concourse," he said.
"In terms of prioritising those spaces, 675 are being provided for visitors," Mr Pollock explained.
He said this is a major increase on the number of spaces currently provided. Temple Street doesn't have dedicated visitor spaces, but Tallaght and Crumlin have about 255 car parking spaces for visitors.
Mr Pollock said also that detailed traffic analysis has been done.
"We have done travel time surveys from the N4 and the N7, getting from those junctions to the site here. We have done those surveys at off-peak, and we have done those surveys at peak hours.
"Basically, the difference between getting to the site at off-peak hours - and that is the middle of the afternoon or mid-morning - and peak hours, which is the first thing in the morning, the difference in travel time is about 12 minutes on average," Mr Pollock said.
As part of the plans, two satellite centres will be established at Tallaght and Connolly hospitals to enhance urgent care facilities.
However, they will not offer a 24-hour accident and emergency service. "That is based on good clinical reasons," said Ms Hardiman.
"On average, we have nine children coming into our emergency departments after 12 o'clock at night," she said.
The opening hours of the satellite centres are being worked out at the moment. "We have a group of doctors, nurses and health and social care professionals, measuring the data of where the children turn up at the existing children's hospitals," Ms Hardiman said.
She said that it is envisaged at the moment that the earliest opening time would be 7am and 9am, and closing somewhere between 10pm and midnight.
"Ambulance cases will not be going to the satellites, they will be going to the hospital," she said.
"About 90pc of the children who turn up in our emergency department can be discharged. What we will have in these satellite centres is short-stay observation beds - that is because paediatric healthcare is different to adult healthcare.
"In contemporary paediatric care, it is best practice to keep some children under observation for up to six to eight hours and then discharge them," she said.
This could include a head injury which requires observation, a child with asthma that needs several doses of nebulisers, or even a child who is dehydrated from vomiting and diarrhoea who needs IV fluids," she said.
One of decision that has yet to be made is selecting a name for the new hospital.
"We will have a process, and we will certainly involve the staff in the naming of this," Ms Hardiman said. "We see it as the naming of a service, as opposed to the naming of a building.
"The most important thing is that it's about the values that the staff have in providing services for children, that becomes part of our vision and mission and that drives our brand," she said.