National Children's Hospital: Motion (Resumed) [Private Members]

The following motion was moved by Deputy Michael Healy-Rae on Tuesday, 12 March 2019:
“That Dáil Éireann:
notes:
— the desire of all political parties, groups and members to improve and prioritise medical outcomes for the nation’s sick children;
— the current cost of the construction of the National Children’s Hospital stands at €1.433 billion and rising;
— that this represents the most dramatic, fluid and unprecedented cost escalation level for any single health related project in the history of the State;
— that this escalation in costs is likely to be ongoing and represents significant challenges in the capacity to deliver urgently needed local health related or capital spending projects;
— that the urgent clinical necessity of co-locating a maternity hospital with the National Children’s Hospital is now seriously compromised if not fatally undermined due to site capacity issues;
— that fire safety and structural viability related concerns have been flagged around the decision to construct approximately 1,000 underground car parking spaces directly under the National Children’s Hospital;
— that the independent review of National Children’s Hospital project (2011) and the Review Group on the National Children’s Hospital (2012) stated that it would be 25 per cent less expensive to build on a greenfield site than on an urban site; and
— the decision by Government and the Health Service Executive (HSE) to commission a review by PricewaterhouseCoopers to establish the sequence of events in relation to the cost increases experienced by the project, establish what was known, when and by whom, and the reporting of relevant information from the project team to the relevant oversight and governance bodies including the National Paediatric Hospital Development Board and also its committees, the HSE and the Department of Health; and
calls on the Government to:
— immediately suspend construction of the National Children’s Hospital at the St James’s Hospital site pending the outcome of a time-limited independent investigation to assess the viability, cost and efficacy of re-tendering the project and transferring its location to a greenfield site with the capacity to include the co-location of a maternity hospital; and
— utilise any site preparation work already started at St. James’s Hospital to develop a satellite children’s urgent care centre, further adult services or any other services deemed most appropriate in the event that a recommendation for relocation is made following the outcome of the independent investigation.”
Debate resumed on amendment No. 1:
To delete all words after “Dáil Éireann” and substitute the following:
“notes:
— the need to develop an appropriately sited, world class facility to care for children and young people from all over Ireland who are in need of specialist and complex care;
— that clinical considerations were paramount in the decision by the Government in 2012 to co-locate the new children’s hospital with St. James’s hospital in line with independent reviews affirming the importance of co-location with a major adult academic teaching hospital;
— the Government’s decision to re-develop the Coombe Women and Infants Hospital on the St. James’s campus in the context of achieving tri-location of adult, paediatric and maternity services on that campus as the optimum configuration to best support paediatrics, highly complex foetal and high-risk maternal medicine and chronic disease management in young people;
— the capacity of the site at St. James’s Hospital to accommodate the new children’s hospital and maternity hospital, and the incorporation into the design of the children’s hospital of the required operational links with both maternity and adult hospitals on the St. James’s Hospital campus;
— that St. James’s is the hospital best served by public transport in the country, including easy access to the M50 and Heuston Station and that safe underground car parking, part of the Fire Safety Certificate granted by Dublin City Council for the hospital, will
be provided for 1,000 cars, including 675 dedicated to patients and families and 31 drop-off emergency spaces;
— the Government’s decision to develop satellite centres on the campuses of Tallaght University Hospital and Connolly Hospital, and that they will be easily accessible to local populations for the management of minor illness and injuries and attendance at outpatient and chronic disease clinics;
— that planning permission, unanimously granted by An Bord Pleanála in April 2016, supported the development of the hospital on the St. James’s site and the satellite centres at Tallaght and Connolly Hospitals;
— the vision of the new children’s hospital as a research-intensive academic healthcare institution and the potential to attract and retain specialised nursing and medical staff and health and social care professionals;
— the enactment of the Children’s Health Bill in 2018, and the establishment of Children’s Health Ireland as a statutory body to take over the services provided by the three existing Dublin paediatric hospitals, and run the new children’s hospital, outpatient and urgent care centres; and
— the link between the hospital and local and regional paediatric units through an integrated national clinical network aimed at delivering services to children as close to home as possible;
acknowledges:
— the desire of all political parties, groups and members to improve and prioritise medical outcomes for the nation’s sick children;
— the considerable increase in capital project costs over and above that notified to the Government in 2017, to a capital cost of €1.433 billion;
— the decision taken by the Government to proceed with the project, and the significant financial commitments given by the Government to complete the construction of the hospital and associated outpatient and urgent care centres;
— the commissioning of an independent review of the escalation in cost to identify the contributory factors and associated responsibilities so that any potential weaknesses are identified and comprehensively and speedily resolved in the interests of the successful completion of the project and the effective management of public funds, and to develop recommendations, if possible, which may identify any areas of potential cost savings or reductions;
— the significant progress made in the development of the new hospital at the St. James’s Hospital campus, and works relating to the Tallaght University Hospital and Connolly Hospital outpatient and urgent care centres, with the latter scheduled to
open in July 2019; and
— the Government’s investment plans as outlined in Project Ireland 2040 and the National Development Plan 2018-2027, which provides for a substantially increased capital funding commitment of €10.9 billion for the public health service, which includes the substantial capital investment in 2019 of €642 million which will, in addition to the new children’s hospital, and the urgent care centres at Connolly and Tallaght Hospitals, continue significant capital investment in the health services;
and supports:
— the Government’s priority to develop and deliver the new hospital on the St. James’s campus and centres at Connolly and Tallaght Hospitals to support best clinical outcomes for children and young people in Ireland; and
— the proposals recently announced by the Minister for Public Expenditure and Reform on a revised approach to major capital projects.”
-(Minister of State at the Department of Health, Deputy Jim Daly)

I must now deal with a postponed division relating to the motion regarding the national children's hospital. On Tuesday, 12 March 2019, on the question that the amendment to the motion be agreed to, a division was claimed and in accordance with Standing Order 70(2), that division must be taken now.

Amendment again put:
The Dáil divided: Tá, 47; Níl, 86; Staon, 0.

  • Bailey, Maria.
  • Barrett, Seán.
  • Breen, Pat.
  • Brophy, Colm.
  • Bruton, Richard.
  • Burke, Peter.
  • Byrne, Catherine.
  • Canney, Seán.
  • Cannon, Ciarán.
  • Carey, Joe.
  • Corcoran Kennedy, Marcella.
  • Coveney, Simon.
  • Creed, Michael.
  • D'Arcy, Michael.
  • Daly, Jim.
  • Deasy, John.
  • Deering, Pat.
  • Doherty, Regina.
  • Donohoe, Paschal.
  • Durkan, Bernard J.
  • English, Damien.
  • Farrell, Alan.
  • Fitzgerald, Frances.
  • Griffin, Brendan.
  • Harris, Simon.
  • Heydon, Martin.
  • Humphreys, Heather.
  • Kyne, Seán.
  • Madigan, Josepha.
  • McEntee, Helen.
  • McGrath, Finian.
  • McHugh, Joe.
  • McLoughlin, Tony.
  • Mitchell O'Connor, Mary.
  • Moran, Kevin Boxer.
  • Murphy, Dara.
  • Naughten, Denis.
  • Neville, Tom.
  • Noonan, Michael.
  • O'Connell, Kate.
  • O'Donovan, Patrick.
  • O'Dowd, Fergus.
  • Ring, Michael.
  • Rock, Noel.
  • Ross, Shane.
  • Stanton, David.
  • Zappone, Katherine.

Níl

  • Adams, Gerry.
  • Aylward, Bobby.
  • Boyd Barrett, Richard.
  • Brady, John.
  • Brassil, John.
  • Breathnach, Declan.
  • Broughan, Thomas P.
  • Browne, James.
  • Buckley, Pat.
  • Burton, Joan.
  • Butler, Mary.
  • Byrne, Thomas.
  • Cahill, Jackie.
  • Calleary, Dara.
  • Casey, Pat.
  • Cassells, Shane.
  • Chambers, Jack.
  • Chambers, Lisa.
  • Collins, Joan.
  • Collins, Michael.
  • Collins, Niall.
  • Connolly, Catherine.
  • Coppinger, Ruth.
  • Cowen, Barry.
  • Cullinane, David.
  • Curran, John.
  • Daly, Clare.
  • Doherty, Pearse.
  • Donnelly, Stephen.
  • Dooley, Timmy.
  • Ellis, Dessie.
  • Ferris, Martin.
  • Fitzmaurice, Michael.
  • Fitzpatrick, Peter.
  • Fleming, Sean.
  • Funchion, Kathleen.
  • Grealish, Noel.
  • Harty, Michael.
  • Haughey, Seán.
  • Healy, Seamus.
  • Howlin, Brendan.
  • Kelleher, Billy.
  • Kelly, Alan.
  • Kenny, Gino.
  • Kenny, Martin.
  • Lawless, James.
  • Lowry, Michael.
  • MacSharry, Marc.
  • McConalogue, Charlie.
  • McDonald, Mary Lou.
  • McGrath, Mattie.
  • McGrath, Michael.
  • McGuinness, John.
  • Mitchell, Denise.
  • Moynihan, Aindrias.
  • Moynihan, Michael.
  • Munster, Imelda.
  • Murphy O'Mahony, Margaret.
  • Murphy, Catherine.
  • Murphy, Eugene.
  • Murphy, Paul.
  • Nolan, Carol.
  • O'Brien, Darragh.
  • O'Brien, Jonathan.
  • O'Callaghan, Jim.
  • O'Dea, Willie.
  • O'Keeffe, Kevin.
  • O'Loughlin, Fiona.
  • O'Reilly, Louise.
  • O'Sullivan, Jan.
  • O'Sullivan, Maureen.
  • Ó Broin, Eoin.
  • Ó Caoláin, Caoimhghín.
  • Ó Cuív, Éamon.
  • Ó Snodaigh, Aengus.
  • Penrose, Willie.
  • Pringle, Thomas.
  • Ryan, Brendan.
  • Scanlon, Eamon.
  • Shortall, Róisín.
  • Smith, Brendan.
  • Smith, Bríd.
  • Stanley, Brian.
  • Tóibín, Peadar.
  • Troy, Robert.
  • Wallace, Mick.

Staon

Tellers: Tá, Deputies Seán Kyne and Tony McLoughlin; Níl, Deputies Mattie McGrath and Michael Collins.
Amendment declared lost.

I move amendment No. 3:

To delete all words after “Dáil Éireann” and substitute the following:

“notes:

— the cost escalation in the construction of the National Children’s Hospital, from €650 million in 2016 to €1.433 billion in November 2018;

— the additional €300 million in commissioning, Information and Communications Technology (ICT) and other costs, bringing the total costs to €1.733 billion;

— the fact that this will make the National Children’s Hospital several times more expensive per bed than the most expensive hospitals in the world;

— the complete failure of Government oversight which has allowed an overrun of this scale;

— the complete failure of the Government to accept any material responsibility for the overrun; and

— the pressure this overrun will put on numerous health projects across Ireland for several years, potentially including services provided at the National Children’s Hospital;

further notes:

— the dedication of clinicians at the current children’s hospitals in Dublin to provide the best possible standard of care;

— the intense pressure on sick children, their families and clinicians due to the out-of-date facilities at these hospitals;

— the urgent need for a new National Children’s Hospital;

— the reported clinical advantages of tri-location with adult teaching and maternity hospitals;

— the several hundred million euro in public monies already expended and associated with winding down the current site and contractual obligations;

— the sixteen years from when the Government made a decision to build a National Children’s Hospital to the projected opening date of that hospital, in 2022; and

— the material risks associated with moving the location of the National Children’s Hospital, at this stage, including the potential for a higher final cost, and many years of further delay;

acknowledges:

— the lack of consensus amongst clinicians and other stakeholders with regard to the choice of the current site for the National Children’s Hospital; and

— the genuine anger and concern felt by many parents of sick children regarding potential difficulties of access, and other issues, associated with the current site; and

calls on the Government to:

— ensure the on-going PricewaterhouseCoopers (PwC) report includes an extensive value-engineering analysis to identify options for reducing the cost overrun;

— urgently produce a costed and timetabled plan for the delivery of the new Coombe Women and Infants University Hospital, relocated with the National Children’s Hospital;

— redesign the process for public strategic capital projects, to enable more rapid timeframes from ideation to completion;

— include in the PwC report, in light of the massive cost overruns at the current site, an analysis of the total costs and delays associated with moving the site; and

— act on the chronic clinical recruitment and retention issues being experienced, to ensure successful workforce planning.”

Amendment put:
The Dáil divided: Tá, 112; Níl, 18; Staon, 3.

  • Adams, Gerry.
  • Aylward, Bobby.
  • Bailey, Maria.
  • Barrett, Seán.
  • Brady, John.
  • Brassil, John.
  • Breathnach, Declan.
  • Breen, Pat.
  • Brophy, Colm.
  • Browne, James.
  • Bruton, Richard.
  • Buckley, Pat.
  • Burke, Peter.
  • Burton, Joan.
  • Butler, Mary.
  • Byrne, Catherine.
  • Byrne, Thomas.
  • Cahill, Jackie.
  • Calleary, Dara.
  • Canney, Seán.
  • Cannon, Ciarán.
  • Carey, Joe.
  • Casey, Pat.
  • Cassells, Shane.
  • Chambers, Jack.
  • Chambers, Lisa.
  • Collins, Niall.
  • Corcoran Kennedy, Marcella.
  • Coveney, Simon.
  • Cowen, Barry.
  • Creed, Michael.
  • Cullinane, David.
  • Curran, John.
  • D'Arcy, Michael.
  • Daly, Jim.
  • Deasy, John.
  • Deering, Pat.
  • Doherty, Pearse.
  • Doherty, Regina.
  • Donnelly, Stephen.
  • Donohoe, Paschal.
  • Dooley, Timmy.
  • Durkan, Bernard J.
  • Ellis, Dessie.
  • English, Damien.
  • Farrell, Alan.
  • Ferris, Martin.
  • Fitzgerald, Frances.
  • Fleming, Sean.
  • Funchion, Kathleen.
  • Gallagher, Pat The Cope.
  • Griffin, Brendan.
  • Harris, Simon.
  • Haughey, Seán.
  • Heydon, Martin.
  • Howlin, Brendan.
  • Humphreys, Heather.
  • Kelleher, Billy.
  • Kelly, Alan.
  • Kenny, Martin.
  • Kyne, Seán.
  • Lawless, James.
  • MacSharry, Marc.
  • Madigan, Josepha.
  • McConalogue, Charlie.
  • McDonald, Mary Lou.
  • McEntee, Helen.
  • McGrath, Finian.
  • McGrath, Michael.
  • McGuinness, John.
  • McHugh, Joe.
  • McLoughlin, Tony.
  • Mitchell O'Connor, Mary.
  • Mitchell, Denise.
  • Moran, Kevin Boxer.
  • Moynihan, Aindrias.
  • Moynihan, Michael.
  • Munster, Imelda.
  • Murphy O'Mahony, Margaret.
  • Murphy, Catherine.
  • Murphy, Dara.
  • Murphy, Eugene.
  • Naughten, Denis.
  • Neville, Tom.
  • Noonan, Michael.
  • O'Brien, Darragh.
  • O'Brien, Jonathan.
  • O'Callaghan, Jim.
  • O'Connell, Kate.
  • O'Dea, Willie.
  • O'Donovan, Patrick.
  • O'Dowd, Fergus.
  • O'Keeffe, Kevin.
  • O'Loughlin, Fiona.
  • O'Reilly, Louise.
  • O'Sullivan, Jan.
  • Ó Broin, Eoin.
  • Ó Caoláin, Caoimhghín.
  • Ó Cuív, Éamon.
  • Ó Snodaigh, Aengus.
  • Penrose, Willie.
  • Ring, Michael.
  • Rock, Noel.
  • Ross, Shane.
  • Ryan, Brendan.
  • Scanlon, Eamon.
  • Shortall, Róisín.
  • Smith, Brendan.
  • Stanley, Brian.
  • Stanton, David.
  • Troy, Robert.
  • Zappone, Katherine.

Níl

  • Boyd Barrett, Richard.
  • Broughan, Thomas P.
  • Collins, Michael.
  • Connolly, Catherine.
  • Daly, Clare.
  • Fitzmaurice, Michael.
  • Fitzpatrick, Peter.
  • Grealish, Noel.
  • Harty, Michael.
  • Healy, Seamus.
  • Kenny, Gino.
  • McGrath, Mattie.
  • Nolan, Carol.
  • O'Sullivan, Maureen.
  • Pringle, Thomas.
  • Smith, Bríd.
  • Tóibín, Peadar.
  • Wallace, Mick.

Staon

  • Collins, Joan.
  • Coppinger, Ruth.
  • Murphy, Paul.
Tellers: Tá, Deputies Michael Moynihan and John Curran; Níl, Deputies Mattie McGrath and Noel Grealish.
Amendment declared carried.

Amendment No. 2 cannot be moved because amendment No. 3 has been agreed to.

Amendment No. 2 not moved.
Question put: "That the motion, as amended, be agreed to."
The Dáil divided: Tá, 113; Níl, 19; Staon, 3.

  • Adams, Gerry.
  • Aylward, Bobby.
  • Bailey, Maria.
  • Barrett, Seán.
  • Brady, John.
  • Brassil, John.
  • Breathnach, Declan.
  • Breen, Pat.
  • Brophy, Colm.
  • Browne, James.
  • Bruton, Richard.
  • Buckley, Pat.
  • Burke, Peter.
  • Burton, Joan.
  • Byrne, Catherine.
  • Byrne, Thomas.
  • Cahill, Jackie.
  • Calleary, Dara.
  • Canney, Seán.
  • Cannon, Ciarán.
  • Carey, Joe.
  • Casey, Pat.
  • Cassells, Shane.
  • Chambers, Jack.
  • Chambers, Lisa.
  • Collins, Niall.
  • Corcoran Kennedy, Marcella.
  • Coveney, Simon.
  • Cowen, Barry.
  • Creed, Michael.
  • Cullinane, David.
  • Curran, John.
  • D'Arcy, Michael.
  • Daly, Jim.
  • Deasy, John.
  • Deering, Pat.
  • Doherty, Pearse.
  • Doherty, Regina.
  • Donnelly, Stephen.
  • Donohoe, Paschal.
  • Dooley, Timmy.
  • Durkan, Bernard J.
  • Ellis, Dessie.
  • English, Damien.
  • Farrell, Alan.
  • Ferris, Martin.
  • Fitzgerald, Frances.
  • Fleming, Sean.
  • Funchion, Kathleen.
  • Gallagher, Pat The Cope.
  • Griffin, Brendan.
  • Harris, Simon.
  • Haughey, Seán.
  • Heydon, Martin.
  • Howlin, Brendan.
  • Humphreys, Heather.
  • Kelleher, Billy.
  • Kelly, Alan.
  • Kenny, Martin.
  • Kyne, Seán.
  • Lawless, James.
  • MacSharry, Marc.
  • Madigan, Josepha.
  • McConalogue, Charlie.
  • McDonald, Mary Lou.
  • McEntee, Helen.
  • McGrath, Finian.
  • McGrath, Michael.
  • McGuinness, John.
  • McHugh, Joe.
  • McLoughlin, Tony.
  • Mitchell O'Connor, Mary.
  • Mitchell, Denise.
  • Moran, Kevin Boxer.
  • Moynihan, Aindrias.
  • Moynihan, Michael.
  • Munster, Imelda.
  • Murphy O'Mahony, Margaret.
  • Murphy, Catherine.
  • Murphy, Dara.
  • Murphy, Eugene.
  • Naughten, Denis.
  • Naughton, Hildegarde.
  • Neville, Tom.
  • Noonan, Michael.
  • O'Brien, Darragh.
  • O'Brien, Jonathan.
  • O'Callaghan, Jim.
  • O'Connell, Kate.
  • O'Dea, Willie.
  • O'Donovan, Patrick.
  • O'Dowd, Fergus.
  • O'Keeffe, Kevin.
  • O'Loughlin, Fiona.
  • O'Reilly, Louise.
  • O'Sullivan, Jan.
  • Ó Broin, Eoin.
  • Ó Caoláin, Caoimhghín.
  • Ó Cuív, Éamon.
  • Ó Snodaigh, Aengus.
  • Penrose, Willie.
  • Phelan, John Paul.
  • Ring, Michael.
  • Rock, Noel.
  • Ross, Shane.
  • Ryan, Brendan.
  • Ryan, Eamon.
  • Scanlon, Eamon.
  • Shortall, Róisín.
  • Stanley, Brian.
  • Stanton, David.
  • Troy, Robert.
  • Zappone, Katherine.

Níl

  • Boyd Barrett, Richard.
  • Collins, Michael.
  • Connolly, Catherine.
  • Coppinger, Ruth.
  • Daly, Clare.
  • Fitzmaurice, Michael.
  • Fitzpatrick, Peter.
  • Grealish, Noel.
  • Harty, Michael.
  • Healy, Seamus.
  • Kenny, Gino.
  • Lowry, Michael.
  • McGrath, Mattie.
  • Murphy, Paul.
  • Nolan, Carol.
  • O'Sullivan, Maureen.
  • Smith, Bríd.
  • Tóibín, Peadar.
  • Wallace, Mick.

Staon

  • Broughan, Thomas P.
  • Collins, Joan.
  • Pringle, Thomas.
Tellers: Tá, Deputies Michael Moynihan and John Curran; Níl, Deputies Mattie McGrath and Noel Grealish.
Question declared carried.