The oral hearing on the National Children’s Hospital is taking place in the Hilton Hotel, Kilmainham at the moment.  They plan to make a decision before 16th February (in time for an election)  You can follow progress here http://www.pleanala.ie/casenum/PA0043.htm

I am not convinced that this is right plan.  You can see the submission I will be making below:

Inspectors, ladies and gentlemen,

I am a local resident (Railway Works Inchicore, ) parent of small children, patient (previously of Crumlin Children’s Hospital, recently of James’s), and representative for the Green Party in this part of Dublin.  I am also a hospital pharmacist, and have a postgraduate qualification in Health Services Management.  Over the past few weeks I have had the opportunity to speak to residents at their doors, and am now going to bring what I have learned to this observation on the children’s hospital.

I am taking as read the written submission I made to the hearing, and dealing today with issues over and above those I raised.

As an environmentalist, and someone interested in long term sustainable planning, I fully support locating the children’s hospital in a brown field city centre site, close to  public transport links.  I support the WHO/Dept. of Health aspirations of Health in All Policies (see Healthy Ireland) and, as a corollary, do not think that building projects for hospitals should be given any dispensation when it comes to good planning, design, environmental impact or consultation.  We need the new children’s hospital to be as good as we can get for our children, without impacting on the rights, health or amenity of those living around the chosen location.

The plans for the new children’s hospital, unfortunately, fall short of many of these aspirations.

As I said, the site is a brownfield city centre site.   However, I have grave reservations about the design in terms of scale and size, the manner in which public consultation was not carried out,  and issues of traffic, transport and road management around the site.

Scale and Size

The chimneys of the current SJH waste management facility on Old Kilmainham/Mount Brown are visible from many locations in the south city.  The new Children’s Hospital Building will be located next to these, and so visibility of the building can be imagined.  The scale and size of the structure is the wrong fit for the current location and site overlooking small dwellings such as those in communities which have existed for almost a century in Ceannt Fort and on Mount Brown/Old Kilmainham.  The scale of the plans are inconsistent with the historic character of this part of Dublin and would be constantly visible and overshadowing to residents living here.  Inchicore and Kilmainham have a historic role in the life of the city and the state, from the South Dublin Union location, to the development of small industry around mills on the Camac and resulting development of homes surrounding these.

The development  of the site also assumes future development such as the relocation of facilities located in the footprint of the new buildings and the future transfer of a maternity hospital onto the site, which would further add to the bulk of buildings in St. James’s and could lead to overdevelopment.

This is also the wrong site for the children who will be using the services.  Patient and family-centred healthcare is based around looking after the patient as close to their home and their normal life as possible.  Centralising everything to one oversized building only takes place to suit the construction industry and the doctor.

I have had the experience of having a child with a bleeding head wound in my arms, in Dublin 8.  Instead of being able to get medical attention nearby, we had to drive through evening rush hour traffic to an A&E department.  When we got there, all that happened was a few hours observation and a steri-strip.  The A&E was filled with minor cases like rugby injuries etc.  These cases should be treatable locally, and are not what we need to build a world class referral centre for.

In fact, if James’s hospital is to be the centre of excellence for the country, should there be an emergency department at all, even in the adult hospital?  A more modest sized children’s hospital could then be built for those specialized situations which require that level of service, and other cases should get the care that they need in drop-in clinics and Emergency Departments of Model 3 hospitals throughout the country.  This would require the retention of some of the excellent emergency services at Crumlin.

Consultation

The consultation by the applicant fell short of good practice in a number of ways.

Most notably, a spokesperson for the applicant, reminiscent of Margaret Thatcher, or some Saudi prince, rather than someone tasked with spending public money in a democratic state,  the chairman of St James’s Hospital, Paul Donnelly, was widely reported in the media to have said that anyone one who opposes the new hospital needs to “shut up” and “move on with it”.  That’s not good public consultation and does not build confidence in the system.

I live locally, have been watching the media for information and only received one invitation to a public event in Fatima, and that only days before when I was already committed to childcare arrangements, and the plans had almost been finalized for submission.  I have heard many other similar stories.

The question is whether St. James’s Hospital have a track record of being good neighbours?  Are we to trust them?  Have they done anything during this process or in the recent past to show that they can be trusted, are have we to rely on promises, which will not be published as part of the planning decision, being delivered upon?  The stories I have heard at the doors do not make me hopeful.  Long running problems with vermin, and parking by patients and staff outside local homes being one part (I understand that this has already been covered)

I would also like to discuss issues of transport and access

I understand that the hospital have a plan to encourage a large number of staff to change their transportation arrangements so that they do not have to park on the site.  This is laudible from a public health and an ecological point of view.  However, why have these plans not been put in place before now?

I have, as a health professional who cycles to work, on occasion had cause to attend meetings in St. James’s.  The car has been king on this campus for quite some time, and there are stories of a previous chief pharmacist who used to drive from the pharmacy to the canteen for his tea break!  Being a cyclist or a pedestrian within the campus has always been a dangerous occupation, with any space not assigned to parking being assigned to driving.  Roadways on the site leave no space for cyclists, and pedestrians are forced to cross and recross roadways, where the motorists have poor visibility due to poorly placed hedging and fencing.

Again, if I could draw the boards attention to the Department of Transport and Department of the Environments Manual for Urban

The bus stop on St. James’s Street, opposite the band hall and outside the Trinity Medical Centre does not have a bus shelter.  This bus stop is used frequently by patients and visitors to the hospital returning from outpatient appointments.  Why has no attempt (other than my own) to get a bus shelter at this stop not been documented?

To support a modal shift to public transport, walking and cycling some significant planning and changes will be needed.  Recently Dublin Bus reconfigured bus services in the area. Was any attempt made to include measures to improve bus commuting to the hospital in these plans?

What resources are being put in place to ensure take up by hospital staff of either the taxsaver scheme for commuter transport tickets or the bike to work scheme.  We have heard about the showers being provided for cyclists – I doubt that they will be important to that many cyclists, but the overall cycling infrastructure in the area is a bigger problem.  Evidence shows that infrastructure is important in encouraging commuters to make the change from cars to bikes, and Dublin 8 has been lagging behind in this regard.

The Garda Ombudsman has examined a complaint that the traffic corps have a  non-enforcement policy with cycle lanes in this part of the city, with particular reference to the cycle lane outside of this hotel.  What assurance is that to anyone thinking of cycling to the new hospital?

Despite the assurances, I see absolutely no evidence that the traffic experienced in Kilmainham, Mount Brown and James’s Street can in any way not be made much worse by the addition of thousands of additional journeys, by HGVs initially and then by motorists, once the hospital is built.  The board of the children’s hospital must leave at 3 every afternoon, or else work late into the evening,  if they haven’t experienced it themselves!

The volume of traffic will be such that it would be appropriate to create a new Street accessing the front of the hospital directly down to Route R148 at Heuston Station to carry pedestrians, buses, ambulances and motorists up from the major arterial route, through HSE and St, Patrick’s Hospital Land, over Bow Lane, demolishing a disused bedding factory and a number of derelict and ruined buildings on St. James’s Street itself.  These buildings, although historically important, as probable “Dutch Billys’ have been allowed to decay and are probably not recoverable.

Such a route would allow further development of parking at Heuston Station which could be part of a park and ride facility for the hospital, further enhancing the use of public transport, and taking the pressure off Mount Brown.  There would be further effects on traffic at the junction of SCR and Con Colbert Road (Junction 63)

Such a route could also pass under James’s Street to take traffic directly into an underground car park, which would be approximately at the street level of Bow Lane, if appropriate.

In Summary

Our children deserve a world class hospital.  The scale and size of what is proposed here, in the contstrained site which is St. James’s Hospital is not that.  The plans should be scaled down with less specialized work moved out to remote locations.

Our children also deserved a better consultation process.  We have to move away from an approach where consultation means ticking boxes and forcing ideas through, to one where meaningful dialogue takes place and plans are actually modified in line with what people need and want, and not what was decided behind closed doors.

The work to have a modal shift from cars to other form of transport is laudible, but we should be seeing the results of the change now, instead of relying on the reduction in traffic just to make space for more cars!