Why do hospitals cost more to build here than anywhere else in the EU?

Where can a sick hospital go?

The first ailment the new National Children’s Hospital has to deal with is a very unusual one.

It is altitude sickness. When it comes to new children's hospitals, Ireland provides the Himalayas. If the final bill is €1.7 billion (and we are afraid that the ambitious paperless ICT plan will push the plan into the stratosphere) the NCH at St James's will be our Everest compared to the peaks around Europe.

Alder hay Children's Hospital in Liverpool with its 309 beds cost €270million. The 233-bed Royal Children's Hospital in Edinburgh will cost €200 million. A 140-bed in Helsinki cost €150 million. A 200-bed hospital being built in Copenhagen will cost €350 million. The Hospital de Lisboa Oriental in Portugal, while not a children's hospital, will have an extraordinary 875 beds and cost €330 million.

Even without over-runs the new NCH with its 473 bedrooms (€3.7 million per bed, Stephen Donnelly of Fianna Fáíl tweeted yesterday) will cost a multiple (and a big multiple) of those hospitals. Even if it had stayed to the €973 million price tag, it would have been ghastly expensive compared to the other sites. Even at the the price of €650 million that was mooted when Leo Varadkar was health minister, it would not have represented good value.

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The fatal flaw

There seems to be a flaw here and it is this. Capital projects in Ireland seem completely out of kilter with other EU countries. Why? The promoters of the hospital have said it will be a world-class facility. I daresay all of the other hospitals being built around Europe will be world class facilities too, and won’t skimp on details.

Are they fitting gold taps in each room? Did they go over the top when deciding that every single bed would be an individual room with en suite facilities and parents sleeping quarters? Did the materials and designs they chose reflect cost and indulgence over functionality? Was the brief given to the expert group that chose the location completely wrong? Did it really need to be tri-located? Was that so critical? Why did the Department of Health and the HSE go with cost estimates and time scales about decanting of a very tight site (the protected church there had to be removed brick by brick) that bore no relation to reality? Why did nobody interrogate the original estimate (of a laughable €300 million to €450 million) that was posited back in 2014?

Then there is the separate saga of cost over-runs which needs a very expensive PwC report to divine why it happened. There is evidence now that knowledge of the over-run was apparent by the summer of last year. The insistence by Tom Costello that the steering group sign a confidentiality to ensure no issues, pertaining to Bam and the budget, would be discussed " outside of the people that need to know" was extraordinary.

As Mattie Lennon points out in our letters page this morning: “Surely the taxpayers of Ireland needed to know?”

Any way, it is Simon Harris who is in the firing line today. The Sinn Féin motion of no confidence in the Minister for Health will be debated this afternoon from 3.50pm and Simon Harris will know his fate shortly before tea time.

It looks like the Government will scrape through despite the volte face of Michael Harty. Much of yesterday’s ‘debate’ featured the main Opposition party Fianna Fáíl being attacked by Sinn Féin and Labour for not supporting the motion, for criticising Harris with one side of its mouth, while supporting him with the the other.

The Government looks like it will get about 57 votes.

No Deal has turned out to be a Big Deal

The Government will publish its massive 15-section omnibus Bill on Friday that will be used in the event of a no-deal Brexit. While Denis Staunton reports that there is some optimism in Westminster today that a breakthrough can be found on Brexit, there is less optimism here.

Our main story today reminds us the Government is only two weeks away from critical decisions on the future in the event of a no deal Brexit. The Cabinet plans to hold three meetings in successive days to arrive at a plan to buffer the State in the event of the worst eventuality.

Yesterday’s Cabinet meeting majored in Brexit. Ministers approved an omnibus Bill to update a raft of legislation, mainly to do with extradition and immigration, all of which needs to be revised to accommodate Brexit, if it occurs at the end of March.

Government chief whip Sean Kyne confirmed that the debate on the no-deal Bill will commence in the Dáil next week with Committee stage scheduled for the session beginning March 4th. Unusually committee stage will be taken in the main Dáíl chamber with all relevant ministers attending to answer questions, or field amendments relating to their area.

As can be seen from today’s committee schedule, scrutiny of the Bill is the main work item for three of the committees.

Best Reads

Eoin Drea argues there are positives in Brexit for Ireland.

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Our editorial praises Simon Coveney for his Middle East initiative where he hosted foreign Ministers in Farmleigh this week to see if new thinking could be brought to the stalled peace process.

A thoughtful column from Kathy Sheridan about the Sunday Times article on asylum candidate Ellie Kisyombe.

The review of local property tax is nearing completion.

Meanwhile, if Brexit was not enough, the Labour Party in Britain has lost an eighth MP.

The Malthouse compromise has finally been dropped, according to the FT.

PLAYBOOK

DÁIL ÉIREANN

10.30: Parliamentary Questions to Minister for Housing, Planning and Local Government Eoghan Murphy. Dublin City Manager Eoin Keegan’s comments on homelessness will be sure to feature.

12.00: Leaders’ Questions. Given the Sinn Féin no confidence motion is debated later today the National Children’s Hospital is sure to feature yet agin.

Expressions of Sympathy: On the death of former member Donal Creed who died in 2017. He was the late father of Minister for Agriculture Michael Creed.

15.50: The main event of the day, the motion of Confidence in the Minister for Health Simon Harris, tabled by Sinn Féin. The vote will take place just before 6pm.

17.50: Four pieces of legislation will be debated over five and half hours: the Data Sharing and Governance Bill 2018; the Aircraft Noise (Dublin Airport) Regulation Bill 2018; the Companies (Amendment) Bill 2019; and the Civil Registration Bill 2019.

The Dáil adjourns at 11.15pm.

SEANAD

The Seanad also has two pieces of legislation to consider today: the Criminal Law (Sexual Offences) (Amendment) Bill 2018; and the Judicial Appointments Commission Bill 2017, which is subject to a continuing filibuster from independent senators.

There is also a private Sinn Féin motion on the National Minimum Wage (Protection of Employee Tips Bill) 2017. This purports to protect the tops of waiting staff in restaurants and bars and will not be opposed by Government.

The Seanad is due to adjourn at 8pm.

Committees

09.00: Justice and Equality is conducting committee stage consideration of the Criminal Law (Extraterritorial Jurisdiction) Bill 2018. Charles Flanagan, Minister for Justice, will attend.

09.00. The Health Committee is considering the Health Service Executive (Governance) Bill 2018 with Minister for Health Simon Harris.

09.30: The Committee on Housing, Planning and Local Government is conducting detailed Scrutiny of the Anti-Evictions Bill 2018 and the Residential Tenancies (Greater Security of Tenure and Rent Certainty) Bill 2018 . These are private bills being forwarded by Labour and Solidarity/PBP.

09.45: The Committee on Justice and Equality is loling at reform of the family law system.

10.00: The Committee on Rural and Community Development is discussing sustaining small rural and community businesses, smart communities, and remote Working with diverse groups from rural Ireland.

13.30: The Committee on Culture, Heritage and the Gaeltacht is considering the omnibus Brexit Bill with Sean Kyne, Chief Whip and Minister of State.

14.00: The Committee on European Union Affairs is also primarily looking at Brexit with Helen McEntee, Minister of State for European Affairs.

15.00: The Joint Committee on Employment Affairs and Social Protection is also scrutinising the Brexit Bill. Regina Doherty, Minister for Employment Affairs and Social Protection will attend.