03 Feb 2006

Response to McKinsey report on paediatric services by Professor Jonathan Hourihane

Response to McKinsey report on paediatric services in Dublin by Professor Jonathan Hourihane, Department of Paediatrics and Child Health, University College Cork and City wide Division of Paediatrics, Cork

The children of Ireland deserve the best integrated medical care it is possible to provide and we therefore welcome the McKinsey report issued today. The benchmarking against services for comparable populations in other countries is particularly welcome. We hope many of the key recommendations are implemented as soon as possible, particularly related to consolidation of services to prevent continuing inefficient use of scarce human and financial resources.

We are concerned that the national context does not appear to have received adequate attention. Sick children in every county of Ireland and not just Dublin need appropriate access to specialist care as close to home as possible. Many specialist services for children are already delivered in centres outside Dublin (such as excellent neonatal services in many centres and diabetes, cystic fibrosis, neurology, allergy and haematology in Cork). Research from our department shows that the added burden of travelling to Dublin for care that can be delivered in their own regions adds considerably to the distress of families who have a sick child and such travel can occasionally complicate the medical condition itself.  

We note the recommendation to provide 350 paediatric beds in Dublin, which is a considerable reduction from the 600 beds currently being planned. We suggest that the savings made with this reduction should be ear marked to appropriately develop the paediatric services that will still be required in provincial centres  In the absence of parallel development of services in the larger provincial hospitals, particularly those with responsibility to train doctors, more patients than ever will be attracted to the brand new Dublin facility, overstretching the resources allocated to it specifically for national tertiary services and the delivery of secondary care specifically for the Dublin region.  We will welcome the application of the excellent principles underpinning the analysis of the service in Dublin to those delivered in other major population centres in Ireland.

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