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National Children's Hospital

Dáil Éireann Debate, Tuesday - 15 September 2020

Tuesday, 15 September 2020

Ceisteanna (35, 47)

Pa Daly

Ceist:

35. Deputy Pa Daly asked the Minister for Health the reason for the delay in the construction of the new children’s hospital; the new estimated date of completion; if the total cost of the hospital will now exceed the figure of €1.73 billion from the independent review; the legal costs arising from the current legal challenge; and the total legal costs to date. [16604/20]

Amharc ar fhreagra

Alan Kelly

Ceist:

47. Deputy Alan Kelly asked the Minister for Health the status of the national children's hospital; the details on the level of spending to date in 2020 on legal fees; and if he will make a statement on the matter. [23651/20]

Amharc ar fhreagra

Freagraí ó Béal (8 píosaí cainte)

Tá sé soiléir ón gceist gur cuireadh isteach í tamall maith ó shin. It is clear from the question that it was submitted some time ago but hopefully the answer will be no less relevant. What is the reason for the delay in the construction of the new children's hospital? What is the new estimated date for completion? Will the total cost of the hospital exceed the independent review figure of €1.73 billion? What legal costs have arisen to date?

I propose to take Questions Nos. 35 and 47 together.

Like many other sectors of the economy, the construction sector was impacted by the Covid-19 pandemic. This resulted in construction-related work on the site of the new children's hospital stopping on 31 March due to Covid-19 restrictions. On 18 May, the restrictions in respect of the construction sector were eased. From this date, the National Paediatric Hospital Development Board, NPHDB, engaged with the main contractor to ensure the earliest possible reopening of the sites. I am informed the main contractor of the new children's hospital project returned to the site on 13 July.

There will be delays associated with Covid-19, but it is too early to assess fully the impact of the pandemic on the new children's hospital project and the paediatric outpatient and urgent care centre at Tallaght Hospital. The NPHDB continues to engage with the contractor and is monitoring progress on site in the interests of completing the project as quickly and economically as possible.

On that note, I want to say I am acutely aware of how urgently the new children's hospital is needed and I want to see it delivered as quickly as possible on behalf of children, young people and their families. I have no doubt the Deputies share that view; we have waited far too long for this hospital. Under the contract, the new children's hospital is due to be completed by the end of 2022 and handed over to Children's Health Ireland to be opened in 2023 after a period of commissioning. I am advised that as of March 2020, when the site closed due to Covid-19, the NPHDB was of the view that the main contractor was behind schedule on the construction works.

The NPHDB is continuing to engage with the main contractor to obtain an updated programme of works that is in line with its contractual commitments. Any delivery outside of the timelines agreed under the contract could be a matter for dispute resolution, so I wish to be careful in respect of what I say here, but I reiterate that it is a priority of the Minister and the Government that the hospital be completed as quickly as possible.

The €1.73 billion figure mentioned by Deputy Daly is the total overall project cost advised to the previous Government in December 2018. That figure comprises €1.43 billion, which is the overall cost to complete the capital project, and also a broader programme of activity associated with the integration and transfer of the services of the three children's hospitals to the new site under development. This includes, for example, investment in ICT, an electronic health record system and the children's hospital integration programme, which is the merging of the three paediatric hospitals.

The PwC report makes clear that the guaranteed maximum price established through the two-stage tender process does not provide a contractual ceiling on cost, and that significant residual risks of further cost remain. The residual risks, for which there cannot be cost certainty, include items such as construction inflation, claims and certain uncontrollable risks, such as potential costs relating to Brexit. I am advised the main contractor has submitted a significant number of claims that it alleges are outside of the agreed scope. The NPHDB has a robust process in place for the assessment of claims by the contractor in accordance with the construction contract. This process is a commercially sensitive one between the contractor and the board.

An instruction to commence with phase B, above ground works, was issued to the main contractor in January 2019. In February 2019, the main contractor informed the NPHDB that it was disputing the validity of that instruction. As the matter is now before the courts, it would be inappropriate to comment further at this stage, even as regards the legal fees. I will, however, outline the legal fees in my follow-up response.

I thank the Minister of State for the comprehensive history of what has gone on but, unfortunately, neither of the two main questions was answered in the long response she gave. The budget is approaching and a proper one is needed, including for University Hospital Kerry. The hospital is at serious risk of being downgraded because it is underfunded, and the cost of the children's hospital will be a very significant factor in that. It is unfortunate that although this question was submitted three or possibly four months ago, and given the record number, the answer has come back only today. Still there is no answer to my two main questions.

To divert the issue slightly, there is a serious risk that Kerry General Hospital will be downgraded. There is no cardiology and little oncology. Rheumatology is gone. Pathology, nursing and radiography have all been outsourced. Ambulances often have to come from Dingle to Tralee if there has been an incident and somebody needs one. Research in infrastructure is gone and there is a fear among staff and the people of Kerry that the hospital will be downgraded. It needs to be fixed.

I thank all three Ministers of State for standing in beyond their briefs and wish the Minister the best.

There is no doubt that the children's hospital will not be built on time and that it will cost much more than expected. I was across this issue quite a bit in the previous Dáil, as many will be aware. What we need now is a projection of timelines and costs. Covid-19 will bring additional costs to everything, including all construction projects. We need to know the Government's position on this project.

It found €600 million to be announced on Thursday. From a capital point of view, many other projects are required throughout the country, including extensions because we need more space across a whole load of disciplines. Are we going to profile out further the children's hospital because we need the money? Let us answer that question. Many of the legal challenges taking place in court are for fairly small sums. Let us be honest and straight up with the people. There is no massive criticism of this Government on the issue; it is a legacy of the previous one. What are the timelines and the projected costs as of now?

The question that Deputy Daly initially asked related to the timeframe for the construction of the new children's hospital. I answered that by saying it would be completed at the end of 2022 and opened in 2023. Those are the dates I have been given.

The Deputy also asked about the legal fees. In respect of legal costs, the NPHDB has statutory responsibility for planning, designing, building and equipping the new children's hospital. I have been informed that its legal fees were €409,000 in 2017, €128,000 in 2018 and €691,000 in 2019.

To respond to Deputy Kelly, he made a very fair point about projections of the timeline and the costs. As we all know, Covid is delaying matters. The Deputy asked about reprofiling the project into the future, but I will have to defer to the Minister on that and seek a written reply for the Deputy, if that is acceptable.

On the legal costs, the Minister of State referred to the costs of the board. Are they the total legal costs, including those of anyone who is claiming against it? It is possible to fix the problems at Kerry General Hospital. In February, there were three ICU beds at University Hospital Kerry, whereas one month later, there were 17, thanks to the great efforts of the ICU staff and the additional resources that were put in place due to Covid. We were able to get some answers more or less straight away, but now I fear we are back to circumstances in which a PR firm has been engaged on behalf of the hospital. The reply to this question came faster than it would have come from the PR firm. I thank the Minister of State, therefore, for the efforts she made in her contributions.

There are so many competing issues going on. For instance, we all know we need budgets throughout the country for hospital prevention measures. The HSE has been excellent in my county, producing an elderly care unit in Thurles, which is fantastic and fair play to them, to analyse those who are elderly and to prevent them ending up in hospital in the first place. I encourage more of that throughout Ireland. For mental services, in fairness, the Minister of State is battling for a capital budget to renovate the unit in Clonmel or to secure another location. That is the type of information we need to know straight up. If the children's hospital needs to be reprofiled, given the massive budget there will be, let us just say it. Sometimes the Government just has to make decisions and sometimes we in opposition have to be honest and accept that. Let us just say out straight that budgets will need to be diverted, if needs be.

I thank both Deputies for their constructive replies.

Deputy Daly has issues in regard to County Kerry. I regret I am unable to answer them. There is probably not a Deputy in the country who does not have issues in regard to their constituency. I agree with Deputy Alan Kelly that the pilot programme rolled out in Tipperary is fantastic. There is a similar programme in Waterford, Waterford Integrated Care for Older People. It is about keeping older people in their communities with geriatrician care. Reablement in the community is important. Going forward, we need to strive to keep our older people safely and securely in the comfort of their own homes with the correct wraparound supports.

I will take up the matters raised by the Deputies with the Minister and I will seek a written reply for both in that regard.

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