Mr. David Gunning:

Absolutely. I will have to take it away and take note of it to consider how we can do better to fulfil these particular requirements. I have given a commitment that we will do that.

I will continue with the opening statement. I thank the committee for inviting the National Paediatric Hospital Development Board to assist it in its examination of our 2020 financial statements. I am the chief officer of the NPHDB and I am joined by Mr. Phelim Devine, Dr. Emma Curtis, our medical director, and Mr. Jim Farragher, our financial manager. The NPHDB was appointed by the Minister for Health in 2013 to design, build and equip the new children's hospital on a campus shared with St. James's Hospital, a paediatric outpatient and urgent care centre at Connolly and a paediatric outpatient and emergency care centre at Tallaght. Both outpatient centres have been handed over to Children's Health Ireland, CHI, and are fully operational.

The new children's hospital project represents a unique and unprecedented investment in children's and young people's health and well-being and will deliver on the vision of creating one of the finest children's hospital in the world. This much-needed investment will enable the delivery of expert care and treatment for all children and young people - who represent 25% of our population - from a bespoke, modern space. It will have world-class, state-of-the-art facilities where paediatricians, doctors, nurses, clinicians and all medical and support staff will deliver care leading to better health outcomes for all.

Progress on the construction of the new children's hospital has advanced significantly since we were last here with the committee almost 12 months ago. The facility is now 70% complete and is well established on the city's skyline. I thank the members of the committee who visited the site over the past year. The advanced progress means the layout the hospital is clear and visible to all those who walk through the various departments that are starting to reach completion. On behalf of the development board, I extend an invitation to each of the members to visit the hospital to see the progress first-hand.

The committee can see from the images that accompany this statement that the hospital is progressing, with the most advanced areas having intact floors, walls, ceilings and joinery such as nurse stations already installed. The intensive care unit, ICU, pendants that hold all medical equipment, along with bathroom fittings, are being installed, as are the sliding doors with the interstitial privacy lines. The fitting out of ceilings, walls and glazed screens within the concourse at all levels of the north and south entrances is well under way, including the cone structures that host the third-level seminar and library spaces, the 350-seat lecture theatre, cafés and an all-faith centre, as well as the performance steps.

As the committee can see from the images, the 22 operating theatres' ceilings, walls and floor fit-out is under way, with medical equipment already being installed. Other areas, such as the emergency department, imaging, critical care and therapy areas are progressing at pace. The clinical rooms and bedrooms with windows to the gardens with views to the Dublin mountains and Phoenix Park are all there to be viewed. It is not hard to imagine the voices of children and families as we navigate the corridors. As we move to complete the final 30%, we are moving quickly to the completion of finishes. It is expected that the first rooms will be completed in August this year and will be ready for system commissioning. The other 4,600 clinical rooms will follow in a planned sequence.

It is worth reminding the committee that at the heart of this infrastructure project is the policy commitment to co-locate the children’s hospital with an acute adult hospital and, in time, tri-location with a maternity hospital. Critical pieces of infrastructure linking these facilities are the shared logistics and service yard, the facilities management tunnel linking to the St. James’s adult hospital and the future maternity hospital and the shared helipad and ambulance canopy, which will optimise access for patients, staff and services.

The medical and clinical equipping of the hospital that also falls within our remit is advancing. Medical equipment, such as theatre and ICU pendants, autoclaves and storage and catering equipment are already being installed. The clinical decontamination unit, which cleans and sterilises the surgical equipment, has been procured, as have the automated guided vehicles that will traverse the segregated facility management lifts and corridors 24 hours a day to deliver and collect various medical materials and products vital to deliver hospital operations. Three MRI machines have been procured to accompany two that will transfer from the existing hospitals. The process to buy computed tomography, CT, scanners, biplane imaging for theatres, X-rays, fluoroscopy, dental chairs, etc., will be completed next month. Over the next 12 months, the board will execute multiple contracts with several specialist vendors for this equipment.

I will speak to the expenditure for 2020 and 2021. The 2020 accounts have been audited and approved by the Comptroller and Auditor General. I will not go through the expenditure because it has been covered by the Comptroller and Auditor General. In the interests of time, I will move to the final comments.

On the question of wider construction challenges, it is widely acknowledged that the global construction sector is facing challenges related to supply of market essentials due to widespread turbulence in the industry caused by Brexit, Covid-19 and the war in Ukraine. All of these have led to production disruption, Covid-related factory shutdowns, import delays and constraints and inventory depletion, resulting in increased global demand and shortages in the market. According to the SCSI/PwC 2022 Construction Market Monitor, the top three factors indicated by surveyors as affecting firms' activity levels were shortage of labour, shortage of materials and project viability. This is a global challenge not unique to the construction sector but one that is having - and will continue to have - potential impacts on this project while also bringing additional uncertainty. The contractor continues to work through these challenges.

With respect to the construction timeline, the National Paediatric Hospital Development Board and BAM remain fully aligned around reaching substantial completion of the hospital by the end of January 2024, with the hospital then being handed over to Children's Hospital Ireland for a period of commissioning. There are, however, a number of factors that put pressure on this forecasted timeframe so we continue to work with the contractor to understand what implications these external factors may have on the programme, and as a result the contractor's programme is under constant review and evaluation.

On the question of construction costs, in December 2018, the Government approved an investment of €1.433 billion for the design, build and equipping of the children's hospital project. This investment excludes items where no price certainty is possible due to factors such as construction inflation, statutory changes and other changes in project scope that may arise over the course of construction. In addition to these factors, programme delay, Covid-19 and Brexit will all bring additional cost to the project. It is not possible to provide a final estimated cost at this time for the completion of the project but the combination of all these factors means that the final amount will be above that already approved by the Government. In particular, the current period of high inflation is inevitably having a major impact on costs for a project of this scale, which remains the largest current infrastructure development in the State.

On a project of this scale and complexity, any delay has a cost implication. There is ongoing engagement taking place to determine the implication of all contributing factors to the costs. Any speculation or discussion on what these additional costs might be could potentially compromise the existing contractual arrangements with the contractor and jeopardise the development board's ability to negotiate on behalf of the State. The National Paediatric Hospital Development Board and stakeholders will continue to work together to ensure any additional funding that is required and requested is appropriate and justified. The development board will also continue to vigorously review any claims for additional moneys and only those that are deemed appropriate will be paid.

Claims and disputes are an inevitable part of construction projects of this scale. They arise for myriad reasons and given the large amounts of money involved, it is imperative that the development board evaluates each claim and robustly defends those that are not justified. The National Paediatric Hospital Development Board has a comprehensive process in place for the assessment of claims and has extensive project controls to help manage costs. While management of this is consuming by way of cost and time, the processes ultimately help to manage and defend costs so that the project can reach the best possible outcomes.

In 2021, a moratorium agreed between the National Paediatric Hospital Development Board and the main contractor was applied on disputes, including on conciliations and adjudications and High Court proceedings. This moratorium was designed to allow both parties to concentrate on delivering the project in the shortest possible timeframe and is ongoing. Information on claims and adjustment management and dispute management has been provided to the committee separately, as per the template requested by the committee.

Progress on the construction of the new children’s hospital has progressed significantly in the past 12 months. This progress is evident in the new structure and building that is emerging in Dublin 8 and the visible impact on the Dublin skyline. There is 70% of the construction work now complete. The progress that has been made on the new hospital is in addition to the successful completions of both CHI at Connolly and CHI at Tallaght, both of which are an important part of the overall national children's hospital project.

We continue to ensure our stakeholders are informed on progress and challenges. We remain engaged with the contractor, constantly assessing the potential implications of the wider construction sector challenges so that they can be mitigated where possible. The project has encountered delays, some of which are inevitable for major infrastructure developments of this scale and others unprecedented, as I outlined. However, all parties remain committed to delivering substantial completion of the new children's hospital within the shortest possible timeframe. I will end by repeating my invitation and that of the National Paediatric Hospital Development Board to all committee members to visit or revisit the hospital site and view first-hand the state-of-the-art facility that is emerging and will serve children and their families for generations to come.