Dublin's Mater Hospital site could once again become the preferred location for the new National Children's Hospital under a new proposal which will allow the height and scale of the structure to be reduced.
Reports this week suggest the Sisters of Mercy have given their backing to a plan in which the original Mater Hospital building would be handed over to the State to use as teaching and research facilities for the new paediatric hospital.
The plans to develop the vital new world-class facility for sick children at the north inner-city site took a severe knock-back in February when the planning application was refused by An Bord Pleanála due to the impact the 16-floor building would have on the local skyline.
Opinions remain divided at all levels in the political and medical worlds about whether trying to shoehorn this critical new hospital facility into such a small site in a relatively congested area of Dublin is the best way forward, but all are agreed that this country badly needs a new world-class children's hospital that will facilitate excellence in the delivery of clinical services, including teaching and research.
The new Children's Hospital of Ireland is the largest, most complex and significant capital investment project ever undertaken in healthcare in Ireland. Its project team says its business case clearly demonstrates the clinical benefits and value of such a capital investment to transform paediatric services in this country. The new hospital is designed to accommodate 392 beds, 13 operating theatres, overnight room-in beds for parents and a family resource centre. There will also be a number of play areas and a hospital school.
However, the project has been dogged by controversy and delays and a recent survey by Irishhealth.com found that, in the wake of the refusal by An Bord Pleanala, more than half those polled said the Mater was the wrong site for the hospital and that it should be constructed on a greenfield site or adjacent to another major hospital. Less than one in five believe the hospital should still be built on the Mater site.
A review group set up by the government is now looking at all the options for the new children's hospital in the wake of the Bord Pleanala decision to refuse planning permission. This group is due to report back to the government with a series of recommendations by May. Over a dozen potential sites for the new hospital in the Dublin area have been put forward, including several identified by Nama.
The latest move at the Mater site sees the Mater Hospital joining forces with the Rotunda Maternity and Temple Street Children's Hospitals - both of which have major capacity constraints themselves - in 'tri-locating' adult, maternity and paediatric services there, saying this plan would best fulfil cost and value for money criteria. The trio of hospitals say, on this basis, the new hospital could be built with minimal delay.
However, there remains a sense that this is simply a case of trying to fit a square peg that's too big into a round hole that is still too small. A number of medical experts have come out this week and said they still cannot see merit in this revised plan.
Adequate hospital space when caring for sick children is of crucial importance and there are concerns that, even with these new changes at the Mater site, there will still not be enough room provided. Surely the priority in all of this should be that the country's children are put first and that they get the very best facilities that will give them the best possible medical outcomes when it comes to building a hospital facility on this scale. While this site may be the most accessible for Dublin residents, it is not for the rest of the country where the majority of the population resides.
There is some merit in the suggestion of using a scoring system to rank the various sites being put forward as possible locations. This type of system of choosing locations for hospitals has been used in the UK, for instance. Jonathan Irwin of the Jack & Jill Foundation has added his voice to the debate this week, calling for the review group to employ a "transparent and logical scoring system when assessing all the options" for the new hospital.
He said it was not about making a speedy decision, but about making the correct one.