National Children's Hospital

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Purple

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The cost of the new Children’s hospital in Dublin has gone from €450 million to €2000 million or more.

Why?

I don’t think many people thought that the €450 million price was realistic but what has changed?

It seems that the HSE signed the contracts before the design and spec was finalised. It the extra billion or so due to changes in specification or is it due to price inflation? All of the noise, political point scoring and deflection hasn’t informed us what the reasons are for the over run.

If the project managers don’t get sacked then the Minister for Health should (and maybe he should go as well). Oversight of a project of this scale has to be part of the ministers core responsibilities.


My initial reaction is this is the typical lethal mix of incompetence and lack of accountability which is endemic within most of the Public Sector.


That said I still think they should plough on and build it. If they don’t waste the money on this they’ll waste it on something else or, worse, give it out in pay rises which will cost the same every year.
 
+1 Purple. Every discussion I've heard in the media around this has been focused on point scoring. Nobody has explained why the costs have increased so much. Even since last summer the costs have spiralled. Somebody needs to explain how this could happen. Was it a case that the initial estimates left out a load of costs to try and get the project approved - surely inflation alone cannot account for such a difference?
It seems to be the nature of these things that politicians come out swinging first and the real questions don't get asked until there is some blood on the floor.
 
With a show pony Taoiseach and an upstart health minister with little life experience, I'm not at all surprised. It probably should have been built on the greenfield site they were offered on the Naas road. Anyway, all we really need is a divorce referendum and all will be well.
 
The Greenfield site proposal was rejected by just about everyone who looked at it since the new hospital has to be co-located with an existing general hospital.
Blanchardstown has lots of land and good access (it is a National hospital and not a Dublin one after all).
Tallaght also has land and access although not as much.

Somehow I don't think we'd be on budget and on time with a different Taoiseach and Health Minister.
The problem goes much deeper than the temporary political masters of the day.
 
That site on the Naas road was only a few mins from Tallaght hospital. Methinks it would have been co-located enough.
Purple said:
Somehow I don't think we'd be on budget and on time with a different Taoiseach and Health Minister.
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Sadly, I suspect you're right. Although I'd hope it wouldn't be as late or over budget with different leadership.
 
To put the HSE into context the Texas Medical Center in Houston employs 106,000 people, provides over 10 million consultations a year and has a very high density of critical clinical facilities and does it all for €22 billion a year. That's 106,000 people providing critical hospital care.

The HSE gets about €16 billion from the State but also has a large income from private insurance patients, well into the hundreds of millions and probably into the billions.
 
No one sacked, no one demoted, no one with their golden pension taken away. We are forever doomed to keep repeating the same mistakes and the media/political establishment wonder why people across Europe are turning to Populists for an alternative!

Today's IT
The Government has asked consultants PWC to report into the overrun by March.
The terms of reference, seen by The Irish Times, state the review will “develop further recommendations necessary to address major residual risks, control and oversight issues and establish additional measures required to bring greater oversight of performance” and will “deal with the role and accountability of the relevant key parties” but will “stop short of determining culpability at the individual level.”
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Ultimately the decisions made re cost estimates were made by individuals, the Hospital Board, the HSE, or in the Dept of Health. So “culpability at an individual level” needs to be identified.
If this happened in the real world of the private sector, people would lose their jobs. But we all know that that does not happen in the Public Sector. Indeed if anyone was sacked, they would probably leave with “added years” to top-up their pension.
I have some sympathy for Simon Harris as clearly he did not run the estimates but rather relied on what was sent to him by those working on the project. So if the individuals actually making the errors are not held to account (fired or at least demoted) what message does it send to the rest of the Public Service?
As taxpayers we deserve a more accountable Public Service.
 
Do we think an organisation with its eye so off the ball for a big ticket item like this, has its eye on the ball when it comes to the cost of medicines, lightbulbs, cleaning products, food, utilities, service providers, waste disposal etc?
 
Purple said:
If the project managers don’t get sacked then the Minister for Health should (and maybe he should go as well). Oversight of a project of this scale has to be part of the ministers core responsibilities.
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Are you cracked?

Since Harney created the HSE by stapling the rotten ply-wood and damp chip-board of the old Health Boards together, neither the Minister or even the head of the HSE would accept responsibility for a project on this scale.

Committees reporting to and supervising other committees and project teams with Tom Costelloe's committee, The National Paediatric Hospital Development Board, whose purpose is to "Design, Build, Equip" the new national children's hospital. Beautifully crisp 3-word purpose statement, an apparent object lesson in OD principles. However, I wonder was there buy-in given the lousy job they did/are doing?

Jump right in get your feet wet folks, here is all of it and not a politico, public servant or HSE bod visible at any level of singular responsibility, but still taking the huge wages & expenses and any reflected glory. "Hey, see what I did, ain't I clever?" A bit like Tony O'Brien who set up the disastrous Cervical Check service and got the top HSE job as a consequence.

The National Paediatric Children's Hospital Development Board - "Delivering the right care in the right place" http://www.newchildrenshospital.ie You can do a computer-generated walk-through of the new hospital although it hasn't been designed yet. Lots of PR-speak at this level, the usual tits-and-teeth stuff

Moving down a level in the committee hierarchy we encounter The Project Team aka "Children’s Hospital Ireland" aka The Client overseen by The Children’s Hospital Ireland Board, see [broken link removed]
They have a bunch of other project teams reporting to them and their overall purpose is to "ensure that the hospital is designed to enable future paediatric services to be delivered as efficiently and effectively as possible" They have a group of 4 hospital project teams reporting to them.

The next level down in the hierarchy is The National Paediatric Hospital Development Board, whose purpose is to "Design, Build, Equip" the new national children's hospital. http://www.newchildrenshospital.ie/the-project/the-national-paediatric-hospital-development-board/

On the next level down are The Design Teams whose rather obscure handle is "Proven capability combined with local knowledge" which probably explains why they failed their boss, Tom Costello, in spades. Or conversely, he didn't kick enough ass and failed them, by not giving them a meaningful purpose, something like "design, plan, execute and equip the best children's hospital in the world. Bar none" [broken link removed] At this level we dissolve into an alphabet soup of MLAs and TLAs, but still not a sign of even a back-bencher or clerical officer with singular responsibility.

I hope that makes it clear why this project was "doomed, I tell ya doomed" from the start and why no-one will be called to account, jailed or sacked. Yet again
 
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mathepac, that's more clarity and detail than anything I've read or heard in the media. Excellent.

Oh, I said "should" be sacked. I have zero expectation that anyone will.
 
Why do we need to re invent the wheel when the country requires new infrastructure ?.
Let me explain my reason for asking.
In this particular project millions are being spent / squandered on " design " . Why ?
Why is there not a standard European or international best design established for a hospital , school , library police station etc . The client then simply picks the plans off the shelf for a one hundred , five hundred or thousand bed hospital ( fully equipped ) and puts it out to tender at a FIXED CONTRACT price.
You may say that perhaps sites may be different and that may be the case so therefore a separate contract for groundwork ie a concrete slab of appropriate size .
If international companies like McDonalds , Aldi , Lidl have decided on this approach to construction it must have some merit.
Now do not jump upon my idea and suggest that there is no similarity whatsoever in the requirements of a fast food establishment and a hospital because I agree BUT there is no reason why construction methods cannot be similar.
 
In Limerick they are getting a 60 bedded modular building. Is that just a fancy way of saying they are getting a prefab?

Sounds s bit like the McDonald way to me.
 
beautfan said:
In Limerick they are getting a 60 bedded modular building. Is that just a fancy way of saying they are getting a prefab?
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No, it doesn't mean that at all.
We have to get away from the stupid notion that Modular Build means something like a 1980's school prefab.

Stuff built in factories with accurate computerised machines is to a higher standard that stuff built by a guy with a saw in a muddy field.
In other words 21st century building methods are better than 19th century building methods.
 
W200 said:
Why is there not a standard European or international best design established for a hospital , school , library police station etc . The client then simply picks the plans off the shelf for a one hundred , five hundred or thousand bed hospital ( fully equipped ) and puts it out to tender at a FIXED CONTRACT price.
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There should be. And greenfield sites would be ideal for such. As to why it's hard to know . . it seems that Irish politicians are good at getting elected and clinging to power when there, but not much else. Perhaps sub-optimal decisions, delay, and waste are the price we have to pay for democracy in Ireland.
 
Purple said:
It is generally accepted that a green field site was not a suitable option.
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At the risk of boring everyone I still suggest that at this point in the evolution of medicine plans should exist for " Standard hospital " with the only variable being the number of rooms . For that the client requires a concrete plinth of suitable size so no requirement for massively expensive designers .
This is on foot of reading that some of the extra costs are being caused by last minute design changes requested by doctors / consultants .
 
W200 said:
At the risk of boring everyone I still suggest that at this point in the evolution of medicine plans should exist for " Standard hospital " with the only variable being the number of rooms . For that the client requires a concrete plinth of suitable size so no requirement for massively expensive designers .
This is on foot of reading that some of the extra costs are being caused by last minute design changes requested by doctors / consultants .
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Did the look for the underground tunnel to Dublin 4 yet,;)
 
W200 said:
At the risk of boring everyone I still suggest that at this point in the evolution of medicine plans should exist for " Standard hospital " with the only variable being the number of rooms . For that the client requires a concrete plinth of suitable size so no requirement for massively expensive designers .
This is on foot of reading that some of the extra costs are being caused by last minute design changes requested by doctors / consultants .
Click to expand...
What sort of half-assed design planning process did they go through?
Were there no consultants or doctors involved at the planning stage?
 
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