Has the Government altered or varied in any way the Cabinet decision of last June concerning the siting of the national children's hospital? Did the Taoiseach read today's edition of the Irish Examiner, which has secured information under the Freedom of Information Act to the effect that the Government was counselled during the month immediately prior to the Cabinet decision that the most feasible solution was a hospital under single governance with a campus on the north and south sides of Dublin? I refer to the advice of Professor Denis Gill, a kidney specialist, who wrote to the Taoiseach stating that such a solution would make historical, geographical, religious and, perhaps, political sense. He also stated that it is difficult to envisage there not being a paediatric service on both sides of the River Liffey. Having regard to the controversy caused by the decision made on the site of the new hospital, the acute distress caused to many parents by the prospect of having to travel in today’s congested traffic conditions to a single inner city site, and the decision of the board of Our Lady’s Hospital for Sick Children at Crumlin, will the Taoiseach state clearly whether the Cabinet decision of last June stands or has been varied?

Will the Taoiseach comment on the fact that when one reads more deeply into this matter, one finds that McKinsey & Company consultants were brought in and recommended a single, 300-bed hospital as the ideal solution for a population of 4.2 million? The previous Government plans for the relocation of Temple Street and Crumlin hospitals show it was planned to construct 650 beds. Consultants were then brought in, however, and we were told that 300 beds would be the ideal solution.

It seems the Government can no longer make any decision without relying on an extremely expensive consultants' report, or hiding behind it as the case may be. In many instances these consultants — I do not necessarily refer to McKinsey Consultants — are told by some senior person what answer is sought. When they produce that answer, they get bucket loads of money in return. One hears some of these consultants on the radio telling us that although their names decorated the notepaper on which the reports are written——

The Deputy's time has concluded.

——they were spoken to on the telephone for some ten minutes. That was their international expert advice.

The Standing Order allows the Deputy two minutes to submit his question.

Has the decision been altered or varied in any way?

He has already gone over double that.

I would have finished sooner if the Ceann Comhairle had stopped banging that bell.

There has been no review of the decision of last summer. The position some years ago was that there were three children's hospitals in Dublin, each providing secondary care services for their respective catchment areas, and two providing tertiary care services on a national basis.

Following its establishment, the HSE set up an external review of paediatric tertiary services. This review found that the population and projected demands of the State could support only one world-class tertiary paediatric hospital. The joint HSE and Department of Health and Children group was established to progress the necessary actions to set up a world-class tertiary paediatric hospital. That was the decision and the process that took place. There is no change in this regard.

This means that the children's wing of Tallaght Hospital will continue to function except for the national element, that is, work that cannot be done other than in a state-of-the-art facility. Children's beds will continue to be provided in several hospitals around the country. The recommendation, however, is that there should be only one centre of excellence to deal with specialised cases. Two units are not required.

Prior to this recommendation, the position was that Crumlin Hospital would either stay where it was or that Temple Street Hospital would move to the Mater campus and that both would handle what would be considered sophisticated and more complex cases. The review group said "No" to this option on the basis that it was not necessary for a country this size. The recommendation was that simple cases would be facilitated in several locations, which, in Dublin, would include Tallaght Hospital, and that specialist work should be done in one unit. Negotiations are ongoing between the various groups because there is not agreement in this regard.

The Deputy is correct that Professor Gill gave me the advice that there should be two sites, which is what was going to happen before the external review was undertaken. Professor Gill's view was that agreement would never be reached between the medics on two separate locations. Previous to that, there was concern that the position of Temple Street Hospital would be eroded and that all the work would move to Crumlin. This issue has been ongoing for some years. Following the external review, the recommendation was that our population and the State's projected demands could support only one world-class tertiary paediatric hospital, wherever it was to be located.

Nobody is disputing that complex and specialist medical procedures ought to be done at one site. The issue raised by Professor Gill is whether it is feasible not to have a campus both northside and southside, taking into account also that some 40% of the children seeking treatment will come from outside Dublin. Has Professor Gill's view not been borne out? The Government's position sounds credible enough until one looks at it closely. The Government is sheltering behind the review group which, as the Taoiseach put it, said "No" to the original plan. Prior to that, however, other Government bodies recommended 650 beds in two locations.

So what if the review group recommended one site with 300 beds? The Government was previously proceeding with the plan to provide 650 beds on two sites and a large amount of money had already been spent on the Mater site as part of this plan. We are now proceeding on the basis that Tallaght Hospital has been seriously downgraded and commitments given on the charter are not being observed. Crumlin Hospital says it refuses to be "shoehorned" into the site at the Mater. There is serious traffic congestion in Dublin city and one cannot park a bicycle at the Mater Hospital. Yet the Taoiseach says there is no change in the Government decision and that it will go ahead with a single-site solution based at the Mater Hospital.

I do not believe this decision will persist regardless of which parties are on that side of the House after the election. There is widespread acute distress among thousands of parents in west Dublin, north Kildare and west Wicklow about the deprivation of services at Tallaght Hospital. In respect of the catchment area and high reputation of Crumlin Hospital, nobody knows what will happen in circumstances where it refuses to co-operate with what is now proposed. The Taoiseach has not told me much that is new. I am surprised to hear him reaffirming the Government decision.

The Deputy asked me whether there is a change in the position and I said there is not. I am sorry I cannot tell him anything new. The Deputy is well aware of the history of this issue, as am I. The position several years ago was that we had three hospitals in Dublin providing secondary care services for their respective catchment areas. I do not see any change in the Tallaght position, whatever happens. Tallaght Hospital has not undertaken sophisticated specialised work and so there is no change in its position. There was a question, since Harcourt Street Hospital closed down, whether cases have been taken in either Temple Street or Crumlin hospitals. There is no question that both of these are excellent hospitals.

Before the establishment of the HSE, the intention and plan, for some 20 years, was to move the Temple Street site to the Mater campus and set up a new unit there, something I strongly supported. The view was that Crumlin Hospital, because it was an old hospital built when the State had few resources, should be rebuilt on that or some other site and should continue as a children's hospital. The HSE's view, however, was that to go ahead and build new hospitals at the Mater and Crumlin was the wrong action to take. This was the professional view of Professor Drumm and others. The HSE brought in an international team to examine the issue and it formed the view that there should be only one specialist unit — not one children's hospital — to do the sophisticated work. That is its position and there is no change from that.

That was not its position. It recommended one hospital.

Allow the Taoiseach without interruption.

There will not be one hospital. There will be children's services in a range of hospitals, including Tallaght Hospital. The latter will not change.

The review group recommended urgent care centres and one hospital.

Deputy Rabbitte should allow the Taoiseach to continue without interruption.

The external review of paediatric tertiary services recommended that the population and projected demands of the country could support only one world-class tertiary paediatric hospital. It did not mean there would not be children's facilities or beds in other hospitals.

It means there would be clinics.

We cannot have a debate on the matter. The Taoiseach should address his remarks through the Chair.

That is the position. I would have been happy to go along with the view some years ago but to duplicate the services is a mistake, a misuse of money and should not happen.

So there will be only one if there is no duplication.