There is still no sign of promised upgrade to CUH paediatric unit

Clinical director Dr David Mullane says the CUH paediatric department's accommodation is not fit for purpose, and a promised €60m overhaul is long overdue

'Each year the funding doesn’t come the staff are getting more despondent': Dr David Mullane, consultant paediatrician and clinical director for paediatrics at Cork University Hospital.  Picture: David Keane

Dr David Mullane, a Cork native, knows the wards of Cork University Hospital (CUH) well. He’s been in and out of them since his childhood when one of his siblings suffered, and thankfully recovered from, leukaemia. Other members of the family, including himself, suffered from asthma too. All this combined to ignite an interest in paediatric medicine, followed by a speciality in respiratory illnesses. When he returned to CUH as a doctor, the children’s wards hadn’t changed much since he was a kid, and since then he has been part of the push to get the paediatric facilities upgraded.

As a regional centre, the paediatric department at CUH handles everything but the most specialist cases. 

“We have children with very complex conditions that have all their management here because we have the skillset locally to manage 98% of cases that walk in the door,” says Dr Mullane.  The paediatric team saw nearly 16,000 children as outpatients last year and now, due to Covid-19, are managing the logistical challenge of catering to the same numbers while restricting patient movement around the hospital and moving to virtual clinics, over the phone and videoconferences.

“The biggest piece of our work is outpatient ambulatory care — children with chronic conditions who are at home, like children with cystic fibrosis (CF). We have 110 children with CF in our care, and they were understandably very anxious and concerned about Covid-19.” 

While becoming a parent deepened his insight within his work, he says in some ways that more intense connection made it more difficult. 

“Unfortunately, sometimes I have to deal with tragic situations and if they are the same age as your own kids, you’re looking at them thinking, ‘that could be me'. 

I suppose it makes you connect more. I hope I never lacked empathy but it makes you relate more and you have an understanding about parents’ frustrations.” 

As the clinical director for paediatrics, Dr Mullane’s working life is split between his clinical responsibilities and management role on the board of the hospital.

“The model of clinical leadership in how hospitals are run has come more into practice here over the last number of years,” he explains. "I would much prefer to be in clinics with patients than in meetings, but you need to have clinical presence at an executive level so that there’s a broader understanding of what goes on and what’s necessary.” 

Consultant paediatrician David Mullane in the paediatric care unit with colleagues, clinical nurse manager Marie Watson, and Karen Nixon. Picture: Dan Linehan

The plan is for the children’s unit in the Mercy University Hospital to amalgamate with the one in CUH but, currently, there is not adequate space for that to happen: “We need to be together in one unit, It makes no sense having two separate ones. In order for us to do that we need a facility here. We don’t currently have the capacity for the Mercy unit to move up here; We wouldn’t have enough beds and we don’t want children on trolleys.” 

Change is promised but seems to be constantly pushed back. A new paediatric outpatients unit has finally come to fruition, but the in-patient wards are still in their temporary home, waiting for a purpose-built, child and family-friendly unit to be built — somewhere designed to accommodate the parent who wants to sleep beside their sick child, and bring cheer, hope and a friendly environment to scared and overwhelmed children. “CUH is the largest regional paediatric centre outside of Dublin, even without the Mercy unit coming here, but we are working out of facilities that are not fit for purpose.” 

A father of three children himself, he can empathise with the concerns and fears of parents of sick children. 

“We’ve done our best to do what we can with the temporary space — it got a lick of paint, some bright colours, and nice curtains — but it’s very basic. We did a lot of fundraising which paid for equipment and things like reclining chairs for parents to sleep on, because the rooms aren’t big enough to allow for a full bed for them. 

“The people of Cork have been very generous in terms of fundraising and we’ve always been fundraising towards the new build, but each year the funding doesn’t come the staff are getting more despondent. We do need to be resourced to allow us to deliver the standard of care. We have excellent doctors, nurses, and health professionals here, but we are working out of facilities that are not great.”

Seeing the unfolding fiasco of the rising costs of the new National Children's Hospital has certainly rubbed salt on the wound when the sums required by CUH seem paltry in comparison. “My understanding is that the cost of the new unit is going to be €60m, and I was told that we were cash flowed for up to €40m from this year, on the capital plan,” explains Dr Mullane.

“We don’t begrudge our colleagues in Dublin but it is frustrating when we’re told the regional centres will get a boost as well and we haven’t seen it.

“We have been told that planning permission will be submitted in Q1 of next year, but I was told the same this time last year, and the year before. We have to just keep saying this will happen — we can’t let it not happen.”