This letter from Jack and Jill Foundation and the Connolly for Kids Hospital umbrella group was delivered in hard copy to all members of the cabinet, to Opposition Health spokespersons and to the Attorney General on the 13th February 2017. BAM (3rd February 2017)had announced it was the preferred bidder, before the business case was assembled by Ministers Harris and Donohoe and presented to cabinet for approval on the 24th April 2017. The letter, with references and appendices, was again sent to all members of the cabinet by email on the 17th February 2017. The Minister for Health was tasked by the government Chief Whip with replying “directly and with urgency” to the letter . No reply has been received.
The Oireachtas Public Accounts Committee on the 31st January 2019, and the Health Committee (16th January 2019) were given the breakdown by the NPHDB of the €1.7 billion expected cost (as of January 2019) of completing the project :
Total Construction cost €1,093,800,000, with the non construction costs bringing the total Building cost to €1,433,000,000. Other costs managed by Children’s Health Ireland of €293,000,000 gave a final total cost [as of 31.01.2019] of €1,700,000,000.
Cost per sq metre : This is the construction cost per metre of gross internal area. The Ambulatory /Urgent Care Centres : – €60million (cost of the two AUCCs inc VAT) of the total construction cost . Cost per sqm of AUCCs is €5586.
Main Hospital at St. James’s : – The remaining €1,033,800,000 of the Total Construction Cost is the construction cost of the main hospital. Gross internal area is 119,368sq m. Using figures supplied by the NPHDB as of 16. 01.2019 to the Health Committee and 31.01.2019 to the Public Accounts Committee,the New Children’s Hospital Alliance estimates that the cost per sq m is €8708 (not €6,500 as claimed by the NPHDB). This will further increase if construction inflation rises (as is anticipated) above 4% as from July 2019 . Other costs-VAT, design changes etc which are outwith the GMP (Guaranteed maximum price) are also expected .
It would appear that the NPHDB chose to include the area of the car park as part of the gross internal area, contrary to estimates for international comparator hospitals – thus falsely lowering the cost per sq. metre. The AECOM international comparator hospital document lists the most expensive hospital as being €8000 per msq. The Dublin NCH is the most expensive of all the hospitals studied.
Eilish Hardiman, CEO, issued a letter to Children’s Hospital staff, 16th January 2019, after meeting the Oireachtas Health Committee. Please note that a “key fact” included is incorrect. There are not “380 individual, ensuite inpatient bedrooms, each with a bed for parent”. There are, as per Bord Pleanála planning permission, 320 (not 380) en suite individual bedrooms
There are major question marks over the accuracy of many “key facts” issued by the Children’s Hospital Group Board. Truth would be helpful- and deserved by the Irish public.
On Wednesday last,16th January 2019, members of the New Children’s Hospital Alliance and the ExtraSpecial Kids group were present in the public gallery to hear Tom Costello, Chair NPHDB, John Pollock, Project Director NPHDB and Eilish Hardiman, CEO and Emma Curtis, Medical Director, Children’s Hospital Group being questioned by committee members regarding the out-of-control costs of the NCH project at St James’s.
2nd February 2017 – BAM states that the company had been notified that it is the preferred bidder for the NCH construction contract.
There is no DoH statement on the matter but Minister for Finance , Paschal Donohoe,states on RTE One’s ‘Morning Ireland’ that the process is ongoing and that a ‘business case’ was yet to be presented to him to make a decision on. He will be working with Minister Harris on this.
13th February – A letter is sent to all members of the Cabinet from the Connolly for Kids Hospital Group including the New Children’s Hospital Alliance(NCHA) and the Jack and Jill Foundation requesting that certain questions be answered on Cost and other matters before the contract is approved by cabinet.
6th March 2017 – Minister of Health, Simon Harris, is tasked by Cabinet with answering the questions in that letter “directly and with urgency” but despite repeated requests by the Government Chief Whip, Regina Doherty, no reply to the letter is received from the Minister – this is the Minister who prides himself in demanding “democratic accountability”
24th April 2017 – Minister for Health Simon Harris presents a formal memo to Cabinet . Cabinet approves the Definitive Business Case, including the full project cost.
3rd August 2017 – BAM signs the Construction Contract
The functions of the NPHDB, as outlined in S.I. 246 of 2007, are:
- to plan, design, build, furnish and equip a national paediatric hospital (‘the new children’s hospital’) in accordance with a brief approved by the Health Services Executive (“the HSE”) with the prior consent of the Minister, and subject to any subsequent variations to this brief as may be determined by the HSE in consultation with the NPHDB, and with the prior consent of the Minister; and
- do any other thing as is necessary for the performance of its functions.
The other functions of the NPHDB are currently undertaken by the Children’s Hospital Group Board (CHGB). These functions are as follows:
- in consultation with the relevant hospitals, prepare plans for the transfer of services from the relevant hospitals to the hospital;
- in consultation with the relevant hospitals, prepare a human resource strategy for the transfer to the new children’s hospital; and
- explore the possibility of securing philanthropic contributions to meet all or part of the capital cost of developing the hospital, and foster the philanthropic interests that already exist in relation to the provision of paediatric services.
Responsibility for these functions passed to the CHGB on the13th September 2013, as set out in an operational agreement between the NPHDB, the CHGB and the HSE and approved by the Department of Health.
The NATIONAL PAEDIATRIC HOSPITAL INDEPENDENT REVIEW , commissioned by James Reilly,Minister for Health, PART ONE : FINANCIAL ANALYSIS, July 2011 gives €650m as the budget for the NPH at the MATER site .
Connolly Hospital submission of NPH Construction Cost ,May 2012, to the Dolphin Group :-
St. James’s Hospital submission of Construction Cost,( May 2012) to the Dolphin group :-
NCHA’scomment 21Dec 2018
On 3rd February 2017 BAM announced it had been awarded the contract to build the Children’s Hospital though this was neither confirmed nor denied by the Government at the time (in fact in the days that followed Minister for Public Expenditure and Reform Paschal Donohoe is on record as saying the project was still to be approved and a business case had yet to be presented to Cabinet).
On the 13th February 2017 Connolly4Kids Hospital( C4KH) sent a letter(link above) to the Government ministers (and the AG) calling for specific issues to be addressed. This letter went unanswered and the project was formally approved / endorsed by the Minister for Health on the 25th April 2017. The C4KH letter called for a response in advance of the contract decision being made. This too was ignored. The picture this interaction paints is one of a closed shop where the decision making process is not in fact a process but a done deal. Ministers collectively failed in their duty to engage with the allegations in that letter. That is not to say they had to agree with the points made therein, but surely there was an obligation to acknowledge the points and at the very least state why nothing in the letter changed their position. In the absence of any acknowledgment or confirmation whether the issues raised materially impacted the awarding of the Children’s Hospital to St James’s, we cannot see transparency or accountability within the decision making process. That is a key failing on the part of the Cabinet for which the Taoiseach, Leo Varadkar and the Minister for Health hold greatest responsibility to the people of Ireland.