To ask that HSE liaise with Children’s Health Ireland with a view to extending the hours of the so-called Urgent Care Unit in Blanchardstown which was originally to be a ‘Satellite Unit’ of the National Children’s Hospital without ‘appointment only’ visits.
Cllr Mary McCamley
Cllr Mary McCamley outlined the background the submission of her Motion, recalling that when the project began in 2018, it was intended as a satellite unit serving areas like Dublin 15, Blanchardstown and North County Dublin. The expectation was that it would handle emergency cases locally for children so families would not need to travel into the city unless more serious care was required. The councillor stated that over time, the understanding of the hospital’s role changed. Instead of functioning as an emergency service, it appears to operate on an appointment-only basis, which seems contradictory. There were also expectations that it would be open from 8:00am to 8:00pm.
Dr Patrick Fitzpatrick, Consultant in Emergency Medicine, Children’s Health Ireland, explained that the original model of care for CHI never included an emergency department at the Blanchardstown site, but rather an urgent care centre, which is different from an emergency service. Emergency care is centralised at St. James’s, while Blanchardstown and Tallaght provide urgent, unscheduled care for non-life-threatening conditions. The aim is to treat patients as close to home as possible and ensure they receive the right care in the right place, the first time. Dr Fitzpatrick stressed that allowing walk-in emergency cases at urgent care centres was found to be unsafe, as some critically ill children presented in facilities not equipped to handle life-threatening situations. He outlined that to address this matter, a same-day appointment system was introduced. This allows pre-screening of patients to ensure only appropriate cases attend the urgent care centre, improving safety. The system has been effective, reducing unsuitable and high-risk attendances by 68%.
Cllr Kieran Dennison sought clarification on whether it was always intended to be for urgent care rather than emergency care.
Dr Patrick Fitzpatrick reiterated that the facility was never intended to be an emergency department, as true emergency departments require full hospital support, including critical care, anaesthetics and surgical services, which a standalone centre cannot provide. Instead, it was always designed as an urgent care centre for non-life-threatening, unscheduled cases and was not intended to operate 24/7. In terms of capacity, the centre was originally projected to handle around 25,000 patients annually and was already close to that before the introduction of the appointment system. Since moving to appointments, attendance levels remain similar but capacity has increased to approximately 29,200 patients, a 17% rise, without additional cost or resources. However, Dr Fitzpatrick acknowledged that extended hours, such as later evening access, have not yet been achieved.
Cllr Dennison queried whether the urgent care centres in Tallaght and Connolly are standalone units and whether they are connected to Children’s Health Ireland, questioning if they operate independently or as part of CHI.
Dr Patrick Fitzpatrick confirmed that the Tallaght and Connolly centres are fully part of Children’s Health Ireland (CHI) and operate within the same Department of Emergency Medicine. However, they are not standalone children’s hospitals, they are CHI campuses co-located with adult hospitals, but without any clinical integration or access to adult hospital services. Because of this, they lack the necessary backup (such as critical care, anaesthetics, and surgery) to manage emergency cases, and therefore, cannot function as emergency departments. Dr Fitzpatrick also clarified the meaning of ‘urgent care’ in this context: it refers to non-life-threatening conditions that still require prompt attention but are not serious enough for an emergency department. Examples include injuries like sprains, wounds or minor illnesses that cannot wait for a routine outpatient appointment.
Cllr Mary McCamley asked if there is any possibility of expanding the service.
Dr Patrick Fitzpatrick emphasised that the goal is to expand the service while staying true to the original 2018 model of care. The urgent care centre is intended both to treat appropriate patients locally and to reduce pressure on the main emergency department (ED), helping prevent overcrowding and safety risks. Opening hours have gradually increased (from 10:00am–5:00pm to starting at 9:00am daily), with plans to extend further, potentially from 8:00am to 6:00pm, depending on staffing. However, extending later into the evening (e.g. to 8:00pm) would require significantly more resources and may not increase overall capacity, only convenience.
Dr Fitzpatrick stressed that resources are limited and must be prioritised. The main focus is ensuring that critically ill or seriously injured children receive the highest standard of care in the main ED. While this may mean some inconvenience or waiting for less urgent cases, the priority is patient safety and delivering the best care to those who need it most.
Cllr Dennison asked whether the unit exceeding its annual target of 25,000 appointments reflects the true level of demand, or if there is potentially even greater unmet demand for the service. He also sought clarification on why the report indicates a need for increased paediatric emergency attendances across CHI sites, and what is driving that need.
Dr Fitzpatrick explained that the service currently has a capacity of about 29,000 appointments per year, approximately 17% above the original target of 25,000. However, not all available appointments are filled, with actual attendances being closer to 24,000. He noted that since introducing the appointment system, the service is better directing patients to the appropriate place at the right time, rather than operating as a walk-in system. This change has contributed to a reduction in attendances at the main emergency department (Temple Street), which has decreased from about 50–52,000 annually to around 44–46,000.
Cllr Nick Killian asked whether the service is open on Saturdays and Sundays.
Dr Fitzpatrick explained that when the service first opened, it lacked the staffing to extend hours, but operating times have gradually increased as staffing has improved. It is now open seven days a week, with appointments available from 9:am to 5:00pm. Patients access the service online through a screening process that directs them appropriately. either to urgent care or, if necessary, to seek emergency care. The system uses a third-party booking platform, which has some operational limitations in how appointments are released. The goal is to ensure that patients can get timely appointments, ideally within a few hours, without the system being filled with cases better suited to GPs or emergency departments. Improvements are expected when the new electronic healthcare record system is introduced, which will allow better control and flexibility in managing appointments and improving patient access and convenience.
Dr Fitzpatrick also informed members that the current appointment-based system has been recognized at the HSE’s Patient Flow Academy and as a finalist for the Irish Healthcare Awards. He offered to meet or present further information to explain the service, its decisions and outcomes in more detail if required.
That the HSE immediately make a decision on lands at Jamestown, Ratoath to be used for the provision of a health care service for Ratoath. 2026 marks 25 years since the site was acquired.
Cllr Nick Killian
Cllr Nick Killian criticised the long-standing delay in developing a HSE-owned site in Ratoath, which has remained unused for about 25 years, stating that the site was originally purchased around 2000 when the population was much smaller, with plans for a paediatric or healthcare facility to serve the growing local area, including Ratoath, Ashbourne, Dunboyne and Dunshaughlin. He outlined that since then, the area’s population and housing have expanded significantly, but the site has still not been developed. Cllr Killian expressed frustration, describing the situation as wasteful and criticising inconsistent or unclear responses from the HSE over time. He highlighted growing healthcare pressures in the area, including a shortage of GPs and increasing population demands, arguing strongly that a primary care centre is needed. The councillor urged that the site be used or handed over to another body that will develop it for community benefit, stating that continued inaction is unacceptable given the needs of the growing population.
Cllr Alan Lawes strongly supported Cllr Killian’s concerns in relation to the long-unused HSE site in Ratoath, noting that the surrounding area has grown significantly over the past 25 years, with nearby communities expanding and effectively merging into Ratoath. He urged that the site be developed as soon as possible and called for a clear, definitive decision rather than ongoing delays or uncertainty. Cllr Lawes questioned the reliability of the proposed timeline for a decision in 2027.
Cllr Mary McCamley also expressed support for the Motion to develop a healthcare facility in the area, noting the rapid expansion in the area, a fast growing population and the shortage of GPs.
Ms. Rosaleen Harlin, Director of Communications and Public Affairs, confirmed that Integrated Healthcare Area Louth Meath was established in 2024. A decision on lands at Ratoath is a priority. The IHA Manager is part of a National Team reviewing Primary Care Centres and the most appropriate place to locate services based on population need. A decision on Ratoath is expected in Q1 2027.
She agreed to bring back feedback from the members.