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THIS WEEK, THE government came under more pressure over the controversy surrounding the new National Children’s Hospital.
Questions have arisen over the escalating costs of the project, specifically about how the Taoiseach, the Minister for Health and the Minister for Public Expenditure have been managing the country’s finances.
A figure of €983 million for the development was approved by government in 2017, but the Public Accounts Committee heard last week that the cost could rise to over €2 billion.
The latest furore over the project only arose before Christmas, but problems with the hospital – or versions of it – have been going on for decades.
Here’s how the project has gone from controversy to controversy over the years.
The ‘grand plan’
When it opens, the new facility will consolidate the resources of three existing children’s hospitals in Dublin: Our Lady’s Hospital in Crumlin, Temple Street Children’s Hospital and the National Children’s Hospital in Tallaght.
Plans to merge the three hospitals were first put forward by the faculty of paediatrics at the Royal College of Physicians in 1993.
However, the recommendation was ignored by successive governments, who felt that upgrading the three facilities separately was a better idea.
An upgrade to Temple Street became something of a precursor to the current hospital project, with the government deciding to relocate it to the nearby Mater Hospital – later the original site for the current NCH project – in 1989.
Within a few years, however, problems began to arise, with concerns over planning and financial implications leading to uncertainty about the development.
“In one way the grand plan has inhibited smaller plans which might remedy the problems,” then-Minister for Health Michael Noonan said in the Dáil in 1995.
The cost is huge and I cannot indicate when progress will be made.”
Déjà vu
After years of false starts, the HSE decided to commission a review into tertiary paediatric services, resulting in the ‘Children’s Health First’ McKinsey report in 2006.
It found “compelling” evidence to build a single children’s hospital in Dublin, 13 years after the idea was recommended by the Royal College of Physicians.
It also recommended that the new hospital was easy to access, had space for future expansion, and – notably – was co-located with an adult hospital with academic facilities, all of which were seen as crucial in the decision to select the St. James’s site later.
Permission refused
Following the publication of the McKinsey report, a joint HSE and Department of Health group was formed and decided that the new hospital should be built at the Mater site.
In 2007, the government established the National Paediatric Hospital Development Board (NPHDB) to oversee the project, but the selection of the Mater site brought yet more problems.
The plan was opposed by both the National Children’s Hospital in Tallaght and Our Lady’s in Crumlin, while questions about the selection process were raised in the Dáil.
However, Minister for Health Mary Harney defended the choice, citing its central location and its ability to bring about the quick delivery of the project.
Plans for the hospital moved slowly along, before the chairman of the NPHDB, Philip Lynch resigned in 2010 citing “significant and fundamental differences” with the Minister over the choice of the Mater.
Lynch was replaced by businessman John Gallagher, but a new chairman and a change in government the following year didn’t free the project from controversy.
Gallagher lasted just six months in the role, resigning after the new Minister for Health, James Reilly, announced yet another review into the decision to build at the Mater.
After the review found in favour of the original choice, a planning application was finally submitted that summer.
But the project hit a brick wall in February 2012, when An Bord Pleanála refused permission to build.
It found that the height, scale and form of the proposed facility meant it would have “a profound negative impact on the appearance and visual amenity of the city skyline”.
It was back to the drawing board for the government, which now had to choose a new site for the project, six years after it was first decided to locate the NCH at the Mater.
Dolphin report
After this, yet another review group was established, led by Dr Frank Dolphin, to look at the options now available to the government.
Six adult hospitals in Dublin were considered: a revised project at the Mater, Beaumont, St James’s, Tallaght, and Connolly Hospital, as well as a proposal from the Coombe.
Following the publication of its report in June 2012 the government announced its decision to build at St. James’s in November, projecting a delivery between late 2017 and early 2018.
The site was seen as advantageous because the hospital already had teaching facilities, “excellent public transport” access and was close to The Coombe maternity hospital.
It was also felt that the St. James’s site met the terms outlined by the McKinsey report, in particular the adult teaching facilities that existed on site.
But the Dolphin report also warned that the construction of new children’s and maternity hospitals on the site would stretch the site’s capacity, and that it would be more expensive than building on a greenfield site.
More delays followed, and St. James’s soon attracted similar criticisms to those that were made of the Mater, many of which were to do with its location in the city.
Planning permission was granted in 2016, but the project still hadn’t gotten off the ground when Leo Varadkar, then Minister for Health, announced more cost increases for the project, rising to €650 million – €150 million more than was initially envisaged.
At the time, Varadkar was so confident the hospital would open by 2020 that he claimed it would happen “short of an asteroid hitting the planet”.
But it wasn’t until April 2017 that his predecessor Simon Harris signed off on the hospital when planning permission was granted, with a delayed opening date of 2021.
By then, the projected cost had risen to over €1.07 billion. Harris was denying that the budget had spiraled out of control, however.
The Phoenix naming controversy
Finally that year, construction began on the hospital, and the project appeared to be firmly up and running with the government announcing a name for the facility – Phoenix Children’s Health – in October.
However, questions arose about the choice of name after it emerged that it was similar to another facility: the Phoenix Children’s Hospital in Arizona in the US.
Others, meanwhile, felt that the name was problematic for different reasons.
Sinn Féin’s Louise O’Reilly told TheJournal.ie that the focus should have been on building the hospital first:
It’s a handy distraction for the government that we’re talking about the name and we’re not talking about the health and safety issues that have arisen.
Then came a report in the Irish Times, which revealed that the US-based Phoenix Children’s Hospital had threatened legal action if the naming went ahead as planned.
The name was subsequently abandoned in April 2018, after the Children’s Hospital Group had already spent over €40,000 on it.
Records later released to TheJournal.ie under the Freedom of Information act also revealed that the American hospital had contacted the CHG at least three weeks before the name was announced to the public.
Costs controversy
During this time, discussions were taking place between officials from the Department of Health and the Department of Finance and Public Expenditure about the rising costs of the project.
In August 2018, Harris was made aware of the potential overruns, but has since claimed that he didn’t know the exact figure and asked officials to investigate what the final cost would be.
The controversy really caught fire in December, when Taoiseach Leo Varadkar told the Dáil that the project may cost even more than what was, at the time, a €1.433 billion price tag – €450 million more than what it was projected to cost in April 2017.
Varadkar also acknowledged that several capital health projects may have to be delayed due to the overspend, but was not initially drawn on whether anyone would be held responsible over the issue.
There were more indications that the cost of the project would rise again in January, when the Public Accounts Committee heard that the final figure could exceed €2 billion.
Last week Tom Costello, the latest chairman of the NPHDB, stepped down, but that didn’t stop pressure intensifying on the government this week.
As the Opposition sought to clarify who knew what – and when – about the overspend, Minister for Finance and Public Expenditure Paschal Donohoe said the government had become aware of the cost overrun before November.
Donohoe continued to maintain that he did not have any knowledge until then, despite an official from his department being on the board of the project.
Then on Thursday, documents released by the Department of Health showed that Harris was informed about some of the overrun on 27 August last year.
That came a day after the Minister told PAC that he was not aware of the cost implications in the run-up to last year’s Budget.
Varadkar claimed he had “total confidence” Harris, and described the potential impact on the budget as “a red herring.”
But with claims the Taoiseach and Donohoe were not informed about the potential overrun until November, a month after Budget 2019, there are questions as to why Harris didn’t inform them if he knew about the problems in August.
There have also been calls for Harris to resign, with Sinn Féin’s Louise O’Reilly calling his position “untenable”.
Next week will likely to see more scrutiny brought upon the government, and the controversy could yet claim political scalps before the heat is taken out of it.
With additional reporting from Christina Finn.
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They’ve known this for years but still have done nothing about it. Forward thinking and Irish Government don’t go together in a sentence.
@Ciaran Farrelly: they don’t shine at any kind of thinking really
What about using windfall money to invest in infrastructure like our decrepit water pipes?
@Phil O’ Meara:
or housing;
or roads;
or schools;
or hospitals;
or trains;
or giant printers!!
Why has the journal not reported any of the recent good news on the economic front? Lower unemployment again, higher tax receipts, evidence that one of the multinationals based her pays more than the headline 12.5% rate?
If you only read the Journal you’d swear that the country is struggling while in fact it’s booming!
@joe:
But you can’t complain if booming is about!
@joe: booming fot the few..
@joe: that wouldn’t fit with the Left Wing bias.
@joe: less people on the dole can easily be made to look well when you see people being dumped into the likes of seetec or tus, and the fact is the higher tax receipts are coming from people already over stretched with crappy pay packets and stealth tax after stealth tax……you might want everyone to be all happy because in your eyes its a wonderful time, but sadly for lots of people there is no recovery and most are barely keeping their heads above water
@Michael Patrick Newell: Well you have that because one million people in Ireland pay little or no tax at all.
@Michael Patrick Newell: look around you and open your eyes. There are jobs for anyone who wants them. You have to start somewhere, start in a low level job and work your way up.
The prospects that come from having a job are much greater than those that come from not having one.
Life is what you make it!
@joe: its a false economy.
More in work than a few years ago but also more shitty jobs. Far less permanent jobs, lower real wages. Unaffordable rent.
When a person earning an average wage hasn’t a hope of buying a house the society is in serious trouble.
The rich poor divide is growing rapidly we are heading towards having a lower income tier of society who can never own property with a very small proportion owning everything….
sound familiar? Is should because we have had it here before with the landed gentry. We are heading for a return to feudal times with pesants and elite.
@joe: What is booming Joe ? does that mean theres a bust coming too..
Its Booming for bankers and Property Owners .. while people with even decent jobs struggle to pay rent
@joe: Yeah, all those cribbing and moaning should “commit suicide”.
@Gowon Geter: there’s always a busy coming. It’s just a question of when! That’s how economics works!
@Gowon Geter: tourism, restaurants, bars, tech, construction. A knock on from that is a load of support jobs in the wider services sector.
@joe: Ok Joe. You get a job in the service sector, then try to afford rent (haha), health insurance (because wouldn’t want to wait a week on a trolley or a year for a scan), groceries, utilities, you’ll probably need a car because good luck finding suitable accommodation within walking distance from your wonderful new job and public transport is just not a viable option in many places so then there’s motor tax, car insurance, petrol, (a carbon tax coming down the tracks, and if you own a laptop, phone or TV you’ll probably be hit for a TV licence eventually too), oh and also try to save for a mortgage that you’ll never qualify for on your salary from this wonderful job but don’t worry, as you put it it’s all about work ethic and Ireland is a bountiful land of plenty for those who don’t want to just sit on their ass on the dole, why, work your way up in that job and in maybe 10-15 years you won’t be in the red every month. Hurrah. Seriously, have you actually been paying attention to the state of this country and challenges workers face, how expensive it is just to live here? or are you in some sort of little wealthy bubble where none of this affects you so you look down at the great unwashed and assume they must not be as smart or talented as you are, sure why else would they be struggling?
When the shinners get into power they will bring in a sustainable corporation tax policy that will cover everything…. bring forth the shinners
@Tony Henry: tell you what muppet, look around the country its in a terrible mess, and guess what it’s not SF in government!!
@Tony Henry: well they cant be any worse than the role over for a brown envelope or cushy job FFG circus act who would rather pucker up to large corporations and then expect the joe soap tax payer or irish business to pick up the tab……bring fourth the clowns of the FFG clown college
@rumug: don’t SF have majorities on councils?
@milton friedman: here and there they are. What’s your point? County councils have little to no power.
The first paragraph says it all about this Government, “reliance on using corporate tax receipts to plug spending overruns”
Why is there so many spending overruns is the first place. Tax payers money been wasted every day while so many worthy causes are crying out for extra funding. Disgraceful
The people’s money trough can add more and more tax under FFG rule…
@Willy Mc Bride: What?
We’re a high cost economy that can’t afford itself anymore they should of let the troika sort out the place before the kicked them out ,
Possibly but, when all you have is a hammer, everything starts to look like a nail.
Strange I didn’t hear a peep from the IFAC when the government were signing off on the dodgiest of dodgy deals in relation to the 3 billion euro broadband. Cos if they think that made any economic sense given how its been done and where it will be sold to after, then these lot really aren’t good with numbers. Don’t worry lads in order to avoid the multinationals from ever paying the full amount they are meant to, we will just lump another tax on the irish and label it something to do with the climate or health, that usually works and gets a nice juicy tax robbery i mean take
Same old story the have and the have nots , the poor are been forced to pay even if it leaves them hungry as the rich continue to feed their bank accounts .
It’s cool, we have an entire population of idiots who will continued to vote FFG and pay a whole battery of new income taxes, stealth taxes, property, water, carbon taxes, air, death etc so that the poor, struggling mega-corporations aren’t out of pocket.
have your say