On top of the long-awaited national children’s hospital in Dublin 8 sits the first rooftop helipad at an Irish hospital.
The yellow-painted H is high above rows of redbrick houses, with small play parks on either side of the landing point.
Julia Lewis, transformation director with Children’s Health Ireland (CHI), who is responsible for the commissioning of the hospital on the St James’s Hospital campus, says this air service is one of the many things she is excited about when it comes to the much-delayed facility opening.
“This is phenomenal,” she says. “Currently they would be landing in Phoenix Park, you’d have to put them in an ambulance. Here, they will come directly in.”
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CHI, which is responsible for paediatric medicine in the State, has received permission for 200 landings a year, though it is aware that the number may need to be scaled up in future.
The helipad is one of many innovations in the €2.2 billion hospital project, which has dominated news headlines for years due to consistent cost overruns and delays.*
A planning application was lodged for the development in 2015, with an estimated price of €650 million and completion date of 2020.
The hospital’s substantial completion is now scheduled for June, with a nine-month technical commissioning period to follow. It means the first patients are likely to be treated in the hospital around this time next year – six years later than originally envisioned.
Phelim Devine, project director at the National Paediatric Hospital Development Board (NPHDB), the body overseeing the construction, says it is at a “very, very advanced” stage.
Devine, who got involved with the project in 2014, said it has been “fantastic” to witness the building evolve from nothing to this stage.
“We were very ambitious and innovative in what we were trying to achieve for the children of Ireland and it’s great to see that come to fruition now,” he said.
“This is a 50- to 100-year investment in children’s health so we have to get it as right as possible. Healthcare is something that evolves all the time so you have to try to build into the design as much as you can, that flexibility. We’ve done that.”
Standing at 160,000sq m, the hospital is roughly the same size as Dundrum shopping centre, says Devine, with the building’s length almost equalling that of Grafton Street.
He says the hospital has been built to a scale “maybe slightly bigger than it needs to be” but with a view to accounting for future growth.
“We looked at the census 20 years in the future. We looked at grey space. We know the building will get bigger and they can develop into those spaces in the future,” he adds.
“There’s an [area] at the end that’s designed for a future six-storey structure so we can add another 15 per cent on to the size of the hospital. There are other areas around the site or on top of the building where we can add more space.”
Upon completion, the hospital will have 380 inpatient rooms, 300 of which will be ensuite with fully accessible showers and sofa beds for parents to sleep in when necessary.
There will be 22 operating theatres, though it is envisaged only 18 will be open initially, with four others to accommodate the forecast increased demand in future. This, Lewis says, will reduce waiting lists, though she declined to say by how much.
It is not just the sheer size of the hospital that stands out. The attention to detail, and taking of children into account, is also apparent.
The operation will be fully digital, with the hospital using electronic healthcare records and state-of-the-art technology.
Once the hospital opens, children will be able to lie in their bed and order their food at a time that suits through a hospital-provided tablet. The food, which is to be nutritionally balanced, will then be delivered to them in 45 minutes by robots.
There are 14 play areas and artwork decorates the curved walls, while windows and handles on doors are at lower than typical heights to allow children to be able to use them.
There are lots of meeting spaces and plenty of natural light and greenery, all of which aims to make the place feel less clinical for patients, and provide a more homely feel.
The design team considered input from children about what they wanted – often meeting the youth advisory committee, a group of 13- to 22-year-olds who shared their experiences of using hospital services – to better inform their plans.
Grace McIntyre (17), who has been attending CHI at Temple Street for orthopaedic treatment since she was a toddler, took part in the committee because there “were so many things I noticed in Temple Street that I’d like to see changed”.
“The accessibility is one,” she says. “I’m in a power wheelchair and there are some areas [at Temple Street] that you cannot get through. The sinks are way too high. The sockets are above the bed, so if you’re lying there you can’t go on your phone if it needs to charge because it won’t reach.
“I think it’s nice they’ve included us and looked at things from our perspective.”
This modernisation of infrastructure is something acutely felt by the medical staff, too.
Paddy Fitzpatrick, a consultant in paediatric emergency medicine at Temple Street, and clinical lead for the project, says what excites him is the “opportunity to give children and families the care they deserve”.
“In our sites at the moment, children are getting world-class healthcare but they’re getting it in an environment that’s not conducive to getting better,” he says.
“In our current sites, Temple Street is two Georgian houses that were converted to a hospital 150 years ago and since then bits of extensions have been added on. It’s a remarkable feat that so much healthcare has been provided for such a long time in such a constrained environment but it’s equally inappropriate.”
At times, Fitzpatrick says, parents accompanying children to hospital do not have a bed to sleep in, so “they’ll sleep in a chair or sometimes on a floor” beside their child’s bed.
“We don’t have enough isolation cubicles, and sometimes we have to cohort patients in non-isolation settings which is not ideal,” he adds.
The layout of the new hospital does not provide for large waiting areas, but the clinician says this is because it is designed in such a way that there should not be a need for big waiting areas.
Imaging is close to the emergency department (ED) and the resuscitation area, which should help to streamline patient flow.
“We will have times when we have a surge of activity where patients will wait longer than we’d like them to wait ... if it’s a busy winter or a surge in critical care,” Fitzpatrick says. “But certainly as we design our service we will focus on how we can get patients flowing through the department.”
Standing at the entrance to the ED, St James’s Hospital is visible. At the time of its announcement, the chosen site was criticised due to concerns about accessibility for those outside Dublin and the potential for traffic congestion.
The hospital is beside the red Luas line and a few stops away from Heuston Station. Lewis says Dublin Bus has increased the number of routes servicing the hospital to cater for the children and families that will be attending.
For those who are driving, there are just under 1,000 parking spaces, of which 675 are for visitors.
“In terms of spaces that are readily available for the public, it’s over a third greater than we have in our current facilities. Will it be enough? There is no hospital in the world that has enough car parking,” says Lewis.
“You will have to pay and I understand the cap that the previous minister put on it of €10 a day is being retained.”
Devine says the visitor parking is “actually bigger” than what is available for adults attending St James’s.
“We have built that into the design and construction to support families,” he says.
There is accommodation provided beside the hospital through the Ronald McDonald House charity, which is partnered with the fast food chain McDonald’s.
Lewis notes that 70 per cent of CHI’s patients are not from Dublin, meaning they and their families are in need of accommodation.
There is also an underground tunnel between the accommodation and the hospital to allow patients to be brought into the hospital if needed without having to send them out into the cold of the night.
With a project that has faced delay after delay, are there concerns among those in CHI that the envisioned opening date next spring is too optimistic?
Lewis is steadfast in her confidence that they will meet this time frame.
“We will be able to do that within nine months providing there is nothing that comes along that we are not aware of,” she adds. “At this point in time, we have planned everything within a day of how long it’s going to take to do things.”
- This article was amended on March 18th to clarify that the hospital helipad was not the first rooftop helipad to be built in Ireland.
