Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

The Government is breaking new records in healthcare all the time. It is spending a record €17 billion this year on health, which is up a record €3.5 billion in the past three years. A record 80,000 women are waiting for their CervicalCheck results. This figure has increased since the free test was stopped in December. A record 101,000 men, women and children are now waiting more than a year and a half to see a consultant. This figure has gone up from just 13,000 three years ago, a jump of 800%. A record 500,000 people are waiting for an outpatient appointment with a consultant. A record number of children are waiting for special needs help, mental health support and life-saving operations. It has never been harder for people in Ireland to access healthcare than it is today. At the same time, clinicians have never been so demoralised. A record number of doctors are leaving Ireland. Ireland has the record as having the lowest level of consultants per capitaanywhere in Europe. This year, we have seen a record number of clinicians going on strike.

All of this is happening in spite of vast spending increases, which suggests clearly that taxpayers' money, that is, public money, is being badly managed. Nowhere is this more evident than with the national children's hospital. It is one of the most important capital projects ever undertaken by the State and on this we can all agree. Just three years ago, we were promised by the then Minister, Deputy Varadkar, that the all-in cost would be €650 million. Then we were told it would be €1 billion. Now we are told it is €1.7 billion. Per room, it will be the most expensive hospital built anywhere in the world. It will be twice as expensive per room as the two most expensive hospitals ever built and four times more expensive per room than the children's hospital in Liverpool completed a few years ago and the newly planned children's hospital in Belfast.

The Government states it accepts responsibility, but when pressed the Taoiseach conceded that the only real responsibility his Government took on was not communicating the situation better. First it was the fault of inflation, then it was the fault of contractors, and then it was the fault of agents of the State. Now it is the fault of quantity surveyors for underestimating the costs. The Government has gone so far as to tell us and the people that €1.7 billion is, in fact, a reasonable price for the hospital. At the same time, paediatric consultants who hope to work in the national children's hospital are telling me their budgets are being squeezed. These are the very budgets that will provide what is needed, which are the actual services in the national children's hospital.

Now we have the PwC report at a cost of more than €500,000. It was meant to identify cost savings but it has not done so. In fact, it excluded 85% of the cost base because it stated it is already contracted, with a "sure what can you do" approach. It made no effort to outline options for redesign, of which there are many.

Let us remember that the national children's hospital has been designed as a huge, curved, glass building. It is about as expensive a design as one can think of. There is a reason why none of us live in curved glass doughnut houses. They are incredibly expensive to build and are a very poor use of space, which was critical on the St. James's Hospital site. The design of the building, not the project itself, has become a vanity project for the Government. It is a vanity for which the Irish people and sick children will pay dearly.

The PwC report was meant to identify individuals and individual companies but it did not. This is in spite of an assurance from the Taoiseach that the terms of reference would be changed - which they were - to allow for exactly this sort of identification. The PwC report was supposed to analyse the cost and timing implications of moving sites but it did not. A few days ago I asked the Minister for Health to clarify this. The Dáil had voted overwhelmingly for this analysis to be included in the PwC report and the Minister said he would revert to us on whether the will of the Dáil was passed on to PwC. In reality, most of what is in the PwC report is already covered in the Mazars report, which was available last September and which cost approximately one tenth of what the PwC report will end up costing.

This is not to say that the PwC report is useless; it is not. We have learned something very useful from the PwC report, namely, that the risk of the price going up from €1.7 billion is very real. This is important because it flies directly in the face of what we were told at the Oireachtas Joint Committee on Health, where we were assured that the great advantage of the two-stage process was that it gave the State a so-called guaranteed maximum price. We were told that the financial liability now rested with the contractor. The PwC report states that this is, essentially, complete nonsense. It blows that argument completely out of the water. PwC have identified numerous ways in which the State still holds liability and numerous ways in which the costs can rise very considerably, perhaps to the tune of hundreds of millions of euro. To its credit, the PwC report also provides a useful list of recommendations for controlling and mitigating further potential cost escalations.

There is, however, a problem. At the committee the HSE told us it had no reason to express any deal of no confidence in the National Paediatric Hospital Development Board. The HSE said it had no reason not to have confidence in the board but the Department said that if it was starting the process again, it would proceed as it did the last time and use the two-stage process again. The Government has admitted to no mistakes other than poor communications. This does not sound like a group of stakeholders who have learned serious lessons. That, unfortunately, makes it much less likely that this same group of people will do anything better than they have done up to this point.

I will conclude on a related note. We were all told that the most important condition for the national children's hospital was that it was co-located with a maternity hospital, which was to be the Coombe Hospital. The then Minister for Health, Deputy Varadkar, told us that the planning and design for the national children's hospital and the moving of the Coombe Hospital to the St. James's site would happen at the same time. He did nothing about the Coombe Hospital and it did not happen. Just a few weeks ago I received a reply to a parliamentary question I had asked the Minister for Health, Deputy Harris. I had asked at what stage was the project to move the Coombe Hospital. The Minister said that it had not started and that the planning and design phase for moving the Coombe had not begun. Last week at the committee I asked what funding the Government had allocated in this entire calendar year to get that process under way. The answer I got was zero euro. This is what we now know. We were told that planning and design for moving the Coombe to the St. James’s site would happen at the same time as the children's hospital. We have now found out that the earliest the Government is considering starting the planning and design will be 2020 because no money has been allocated for this year. We can be absolutely sure that the financial mismanagement and cost overrun at the national children's hospital will do two things. It will soak up money that could and should have been used to move the Coombe onto the site and it will terrify anybody thinking of building a second new hospital on the St. James’s site.

I imagine that most or all Members of the House have listened to women's testimony on national radio recently of their stories of childbirth and reproductive health. Enormous credit must go to many of our clinicians for their fantastic services but we have all heard what has happened to woman after woman after woman. We are also all aware of the completely unacceptable circumstances and buildings in which the maternity hospitals, women and their new babies find themselves. Women’s reproductive health should be one of the absolute top priorities for this and any future Government. Yet here we are with one of the most critical projects in women's reproductive health - the movement and upgrade of the Coombe to the St. James's site - and nothing has happened.

The Minister for Health has, unfortunately, left the Chamber so I will direct my questions to the Minister of State, Deputy John Paul Phelan, who might pass them on to the Minister. Will the Minister commit to allocating new funding immediately to start the process of moving the Coombe to the St. James's site? Will the Minister ask PwC to come back with more creative ideas around reducing the costs? Will the Minister undertake to pursue those individuals and companies found negligent to date in the building of the national children's hospital?

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