Build the National Paediatric Hospital!

I am very disappointed at recent developments in relation to the proposed new Irish National Paediatric Hospital, which had the endorsement of so many, and was to be constructed at the site of the Mater Hospital. The process of replacing existing inadequate facilities has been far too protracted, but to have had a fully designed, developed and agreed plan rejected by An Board Pleanála, seemingly without appropriate forewarning, when so much time and money had been invested in the project, is deplorable. Ireland is a democratic country and there are planning processes in place. However, this present situation begs that the processes of democracy, good governance and planning step up to meet the challenge of preventing further unjustifiable delay and waste.

Evolution and change are occurring as rapidly today in medicine as they are in information technology—in fact, many of the developments in medicine depend on information technology. I don’t see anybody using a computer that is fifty years old! In my humble opinion, in Ireland, there is too great a tendency to retain the edifices of society beyond their duration of suitability and hospitals are a particular case in point. In technological terms, I do not see how one could assume that a hospital built today will still be suitable for purpose in, let’s say, fifty years, without major upgrades. After fifty years or so it may well make perfect sense to demolish the hospital and build a new one at the same location or elsewhere. I hope the new paediatric hospital, whenever it is eventually completed and whenever it has eventually fulfilled its useful purpose, will not then be seen as yet another ‘Wonder of the World’ that has to be preserved as a historical record for posterity. Nature recycles the very crust of the Earth (on various time scales, some very long). The human body, and perhaps all life forms, have ageing and death built-in, in such a way that life, as distinct from one individual’s life, is continually renewed. For me, this is part of the wonder of nature, life and creation. Our bones return to dust and it is natural that our buildings should too and be replaced by new buildings to satisfy current requirements.

As a citizen of Ireland, who works in Dublin city centre, commuting from Newbridge, Co. Kildare, I wish to see a city that is continually renewed and provides modern, appropriate facilities for its inhabitants and users (given that is the capital city of Ireland). I appreciate the character of the historic city, but I am also aware that its historic buildings were once modern, appropriate buildings of their day. Similar statements can be made about the streetscapes. Of course, balance, taste, judgement and common sense are required in undertaking renewal. Each generation and community of residents, workers and passers-through has a loan of the patch of earth on which individuals live, work and do business. It would not seem right to me to deny the current local community or the national population the benefits of a modern capital city environment through insisting on perpetual maintenance (or virtual fossilization) of the ‘character of the historic city and the established character of the local area.’ I do not believe we can do without a proper national hospital for children. I do believe we can tolerate an altered skyline from O’Connell Street and North Great George’s Street.

Many Irish and local Dublin residents have recently emigrated, through lack of jobs, and others are following. They may never now become the ancestors of those who, in the future, could enjoy the skyline (altered or unaltered) of the historic city of Dublin. Somehow, I feel, the immediacy and urgency of that reality and the present economic situation needs to be faced in the context of the National Paediatric Hospital, and of getting our priorities right generally.

Let’s suppose that every time a new national hospital is to be constructed it will take six years to design it and reach agreement on the plans and as to where it is to be located (for maximum usefulness and convenience and minimum costs and access times) and four years to construct and commission it. That amount of time could easily represent twenty percent of the useful life of the hospital. If, at a given moment, we find that we are encumbered by hospital facilities that are already seriously outdated and unsuitable, then some exceptional and extraordinary steps would be justified to try to get back on track. Children are only children for so long and many of the current children, and their families, are losing out on what modern Irish society should be able to offer them.

I suggest that the National Paediatric Hospital, exactly as rejected by An Board Pleanála, should be built at the Mater site and that this work should proceed with all necessary speed and all necessary attention to efficiency, quality of build, on-time completion and keeping within budget. The hospital is needed now. The jobs that its construction will create are needed now.

I respect, but disagree with, those who raise objections on the grounds that the hospital will ‘spoil the skyline,’ or that it is too ‘massive.’
Large, massive and tall buildings are the norm in modern cities around the world. I would like to see that fact (which is related to cost effectiveness, convenience, sustainability and efficiency) taken into consideration. Croke Park, the Aviva Stadium, Smithfield and the Eircom offices at Heuston Station are examples of large modern edifices. There should be a lot more! Dublin should also have more skyscrapers! Sustainable modern cities need to use space intensively. For such cities, appropriate transportation infrastructure and services can be provided cost-effectively. Using space intensively and sustainably in cities makes it possible, technically and economically, to have more unspoiled and unpolluted countryside. There are many shameful examples of dereliction in Dublin city, for which unsuitable planning and retention policies are somewhat to blame, e.g. between the Four Courts and Jervis LUAS stops. Much of the unsightliness is below the skyline!

Experts have advised that three existing Children’s hospitals should be amalgamated and that the National Paediatric Hospital needs to be co-located with an existing adult university hospital and needs to be readily accessible by public transport. The Mater site meets these requirements. It might be nice to have a fabulous, excellent paediatric hospital that was located at the proposed site without impinging on the skyline, as seen from the streets of Dublin. Technically that could be done by constructing the Hospital underground, but the cost would certainly be unjustified and human beings—adults and children—need natural light. Rather, there is an existing very good option that has the inconvenience of being massive and of occupying part of the skyline. For my part, I would take that option even if additional storeys had to be added to create the National Paediatric Hospital.

In contrast, I would object vehemently if the existing design were to be reduced in size. It would seem very unwise to me to amalgamate three existing hospitals into a new unit of insufficient size or of a nature that does not fulfil the vision of the qualified experts who proposed it or the medical experts who support it. It is well known that bureaucratic bodies with power of decision but insufficient real insight or direct involvement can ruin excellent projects by pruning the specifications, thereby undoing the real and necessary potential benefits of excellent new facilities.

Some may consider the proposed National Paediatric Hospital at the Mater site ugly and I respect their opinions. My own opinion is that the proposed Paediatric Hospital will be a construction of great beauty. This beauty comes from its functional and appropriate form, just as the beauty of the human body does. My hope is that the government and the citizens of Ireland will reverse the Board Pleanála decision and will do so quickly. Lessons need to be learned too in relation to allowing critically important national projects to be stymied or delayed. Let there be no doubt: real damage is still being done by the failure to put an appropriate national paediatric hospital in place by now.

I strongly disagree with the finding of An Board Pleanála that the proposed development would be ‘contrary to the proper planning and sustainable development of the area.’ I suggest immediate steps are taken to reconsider the justification for ‘policy SC18 of the Dublin City Development Plan, 2011-2017, which seeks to protect and enhance the skyline of the inner city and to ensure that all proposals for mid-rise and taller buildings make a positive contribution to the urban character of the city.’ Also, I do not accept that the proposed development would fail to make a positive contribution or that a proposal that involves altering the skyline is incompatible with making a positive contribution.