Hospitals
Irish hospitals comprise three types, voluntary, public and private.
Almost 40 infirmaries were established under legislation of the Irish Parliament in the 18th century.
Many public hospitals were originally workhouses or workhouse infirmaries. Over time they were transformed into basic institutions for sick, infirm people or older people without accommodation. . The County Hospitals developed principally from workhouses when the workhouse system was abolished in the 1920s.
There has been significant investment in public hospitals since the 1940s. A number of major regional hospitals were developed and have achieved high standards.
Historically , voluntary hospitals were independent of the public system. However, they have relied on public funding to deliver services in much the same way as public hospitals. The distinction between public and voluntary hospitals has become minimal over time. A number of voluntary hospitals have become centres of excellence.
The Sisters of Charity in 1834 founded st Vincent\’s University Hospital. The Sisters of Mercy in 1861 founded the Mater Hospital. The Sisters of Mercy in 1857 founded the Mercy University Hospital in Cork.
The Mater Misericordiae University Hospital was established by the Sisters of Mercy in the middle of 19th century. This is associated with the National University of Ireland. It is a tertiary referral centre for certain illnesses.
St. Vincent’s University Hospital was founded in 1834 on Saint Stephen\’s Green.
The Royal City of Dublin Hospital Upper Baggot Street was built in 1832.
The Royal Victoria Eye & Ear Hospital is public teaching hospital situate Adelaide Road, Dublin. It houses the national ophthalmic pathology laboratory and Registry of Ireland. It was established by Parliamentary Act of 1897 on the amalgamation of two separate institutions.
Connolly Hospital Blanchardstown formerly James Connolly Memorial Hospital is a public university teaching hospital. It was founded in 1955 as a tuberculosis asylum. It was re-designated in 1973 as a General Hospital for the Dublin Northwest area. It was extended and redeveloped in 1990.
Temple Street Children’s University Hospital is children\’s hospital formed in 1872. Its running was taken over by the religious Sisters of Charity in 1876.
Cappagh National Orthopaedic Hospital in Finglas arose from a bequest from the Religious Sisters of Charity to provide a school for the poor children of the neighbourhood from Sir Richard Martin deceased in 1907. It was expanded up to 1950s. It was modified in the 1960s to provide orthopaedic operations.
Our Lady\’s Hospital for Sick Children in Crumlin is Ireland\’s largest paediatric hospital. It was established in 1956 and has a staff of over 1,200.
The National Maternity Hospital, Holles Street is the largest maternity hospital in Ireland and is due to move to St. Vincent’s University Hospital, Elm Park, Blackrock. The Coombe Women & Infants University Hospital was established in 1826 and granted a royal charter in 1867 receiving public and private funds. It moved to new premises at Cork Street in 1967.
Tallaght Hospital is known as the Adelaide and Meath Hospital and incorporating the National Children\’s Hospital. It incorporated three very prestigious voluntary hospitals the Meath, the Adelaide and the National Children\’s Hospital, Harcourt Street.
Many of the smaller district hospitals provided respite and rehabilitation care primarily. The district hospitals were staffed by nurses, served by a local GP as Medical Officer.
Several specialist hospitals which treat particular conditions or diseases were established as voluntary hospitals. Many continue.
Private hospitals have been relatively small in number. In some cases, private hospitals have been established on the grounds of public hospitals notably would be St. Vincent\’s Private Hospital and the Mater Private Hospital and are run by the same religious order.
The Hospitals Commission was established in the 1930s to assist in funding the hospital system. It advised on distribution of the proceeds; generated funds generated by the Irish Hospital sweepstakes.
The Hospitals Commission Report 1933 suggested the development of hospitals at 12 main centres with county hospitals in more remote areas. The municipal towns would be served by district hospitals, with Dublin served by a number of smaller hospitals and two general hospitals on each side of the City. The government favoured a program of building, extending and developing county hospitals with money generated by the Hospital Sweepstakes.
A number of reports have recommended the establishment of specialist regional hospitals on a larger scale in place of smaller county hospitals. There has been resistance over the last 20 to 30 years from community interests to the closure or downgrading of smaller county hospitals.
Comhairle na nOspidéal which was appointed in 1972 and sought to rationalise hospital services. It published the General Hospital Development Plan in 1975
After several policy announcements by different governments, the cutbacks of 1980s, generally driven by economic circumstances, rationalised the number of smaller public voluntary hospitals. Several were closed. Thousands of hospital beds were removed, as much as 30 to 40% of the total.
Ultimately, the Dublin hospitals were rationalised along the lines of the proposals in the General Hospital Development Plan 1975 more by circumstance than design. The Plan envisaged six general hospitals, and this has effectively been established, three on each side of the Liffey.
Beaumont Hospital is a public voluntary hospital, the second largest in Ireland. It is managed by a Hospital Board and provides acute care services to Northeast Dublin city and North County Dublin.
It was planned and commissioned between 1978 and 1984 and represented a £50 pounds investment. It opened in 1987 following the closure of the charitable infirmary known as Jervis Street Hospital and Saint Lawrence Hospital known as the Richmond. It also manages St. Joseph\’s Hospital Raheny since 2004.
Tallaght Hospital is known as the Adelaide and Meath Hospital incorporating the National Children’s Hospital. It is academic partner of the University of Dublin, Trinity College. The hospital was established by parliamentary charter in 1996. It succeeded the Adelaide Hospital 1839, the Meath Hospital 1753 and the National Children\’s Hospital 1821.
Planning commenced in 1981 when the Tallaght Hospital Board was established to oversee the planning and equipment of the hospitals. Construction was completed in 1998. Both the Meath and Adelaide Hospitals were voluntary hospitals, as was National Children\’s Hospital. Meath Hospital was established in 1753 to service the sick and poor of the liberty. The Adelaide Hospital was found in 1839 to serve the poor Protestant population of Dublin.
1991 saw the extension of free hospital care to the entire population. However, waiting times remained very long. Delays in A&E were frequently criticised.
The Hanly Report 2003 suggested that acute services be reorganised on a population basis. It proposed a regional hospital centre for a population of about 350,000. The regional hospital would be at the centre of a network of smaller hospitals.
County hospitals would no longer be acute hospitals but would provide outpatient services clinics with convalescent beds and other services. Small injury clinics would be run by nurses. General hospitals rather than regional hospitals would serve remote areas. There was significant downgrading of county hospitals once again.
All the older private hospitals were established by religious orders. This is the case with the Mater Private and Vincent\’s Private Hospital mentioned above. Private patients are more commonly treated in beds allocated in public or voluntary hospitals for that purpose.
Laterally, religious orders have withdrawn from private hospitals. A number have been sold or closed. A number remained on by religious institutions but financed by the state.
In the early 2000s there was a policy of encouraging the private sector to invest in co-located hospital. Tax incentives were given by way of capital allowances. The objective was to increase a number of private beds available, to free up private beds in public hospitals.
A number of private hospitals and clinics have been established particularly in the last 20 years. These include the Blackrock Clinic the Beacon Hospital, the Hermitage Clinic.
Independent hospitals have formed the Private Hospitals Association. Hospitals include
- the Bon Secours Health System,
- Blackrock Clinic,
- Whitfield Clinic,
- St. Vincent\’s Private Hospital,
- Shankill Hospital,
- Beacon Hospital,
- Mater Private,
- Saint John of God,
- Sports Surgery Clinic,
- Saint Patrick\’s University Hospital.
- ount Carmel Medical Group,
- Galway Clinic,
- Hermitage Medical Clinic,
- Clane General Hospital,
- Barrington’s Hospital, Limerick,
- Bon Secours Hospital, Glasnevin.
The Irish Independent Hospital Association, lobbied for private hospitals and nursing homes to be included for capital allowance purposes under the tax code. By the end of 2008 -19 hospitals, clinic and health parks had been established with several more in the pipeline.
The rationale of co-locations hospitals was to free up beds, The policy of co-location was n criticized on the basis that the class of patient using private hospitals is more likely to elective and those using public are more likely to be emergency, so that that was not a displacement of the need for – private beds in a public hospital for private patients.
The Hanly Report made a number of proposals for reconfigurations of certain aspects of hospital care. There has been opposition from local groups and some consultants to the proposed closure of local hospitals. The Phase I group dealt with the Midwest and East. The Phase II group was ultimately abandoned. In 2009 HSE proceeded with an action plan for reconfiguration of hospitals in the Midwest along the lines of the Hanly Report.
An area of particular controversy has been a new Children’s Hospital. The Children’s Health First report published in 2006 recommended a new hospital in Dublin with 380 beds adjacent to an adult hospital. This would have involved relocation and a significant change for the existing Children\’s Hospitals within Dublin.
A task force was established by HSE and Department of Health. A site adjacent to the Mater hospital near Temple Street was selected. Ultimately, the proposal was rejected by Bord Pleanala.
A National Cancer Strategy was published in 2006 recommending a number of cancer centres for each of the four main regions. Hospitals designated to provide specialist cancer centres were
- Beaumont and Mater, Dublin North and Northeast region;
- St. James and Vincent; Dublin Mid-Leinster,
- Cork University Hospital,
- Waterford Regional Hospital,
- University College Galway,
- Limerick Regional Hospital.
vices would be provided for the HSE West region, at Letterkenny.