A systemic failure on an incredible scale

Paul Mulholland

 Has there ever been a construction healthcare project as mired in delay and controversy as the National Children’s Hospital? From the time the hospital was announced, a shadow has hung over the development. The need for the hospital was first put forward in 1993, when the RCPI proposed a single tertiary children’s hospital to be built on an adult hospital site. No further progress was made until more than 10 years later, in 2006, when a HSE taskforce chose the Mater Hospital site for the hospital, which was endorsed by the government. The decision was controversial due to doubts about whether the site had sufficient space for the facility and the fact that it was located in the constituency of Bertie Ahern, who became Taoiseach in 1997. Despite resignations of two Chairs of the National Paediatric Development Board, and a change in government, the project pressed ahead. An independent review of the site decision commissioned by the then Minister for Health Dr James Reilly reported that the correct site had been chosen. But, as everyone knows, the planning application was rejected in 2012. This meant that the significant costs accrued to date (€35 million) counted for nothing and the process had to start all over again. 

The Dolphin group, led by former HSE Chair Dr Frank Dolphin, was charged with deciding upon a new location. The issue received major scrutiny, with many suggesting that a ‘greenfield’ site was most appropriate, despite the commitment to co-location with an adult facility. Questions were raised about the eventual decision to situate the hospital beside St James’s Hospital, the chief objection again being access and the lack of physical space on the site. 

It was not until 2015 that the planning application was lodged with An Bord Pleanála. The estimated cost of the development was €650 million and a completion date of 2020 was given. In 2017, the construction budget had risen to €983 million. Now this figure looks cheap, with the revelation that the eventual cost could reach €2 billion. 

It is natural, when a scandal like this occurs, to seek individuals to blame. What the tangled history of the development shows is a systematic failure on an incredible scale. That is not to ignore clear mistakes, such as the Minister for Health Simon Harris not providing the Dáil with the full information on the budget over-run when questioned on the subject last year. The Minister is lucky the controversy has only cost him an apology and not his job. But the troubles with the hospital extend far beyond Minister Harris. The newly-proposed tender rules might help avoid a similar scenario. The sheer multitude of repeated mistakes made with this project over the past 20 years, however, makes one doubtful about whether genuine lessons will be learned. Anything less than a root-and-branch reform in how construction projects are greenlit and supervised will not be meaningful.