Mairead Farrell (Galway West, Sinn Fein)
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1472. To ask the Minister for Health if the enabling works for the new national maternity hospital are now complete; if so, the final cost of these works; the breakdown, in tabular form, of the cost by the categories of work undertaken (details supplied). [19772/22]

Mairead Farrell (Galway West, Sinn Fein)
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1475. To ask the Minister for Health the reasons for the current cost overrun for the new national maternity hospital for the enabling works rising from the initial estimate of €20 million to at least €51.2 million, broken down by cost category. [19775/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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I propose to take Questions Nos. 1472 and 1475 together.

The Government is committed to the development of the new National Maternity Hospital (NMH) planned for the St. Vincent’s University Hospital Campus at Elm Park, as set out in the Programme for Government: Our Shared Future.

Enabling works were undertaken to prepare the site of the new NMH and de-risk the campus in advance of the construction works for the new hospital. These works comprised of the carpark extension and relocating some SVUH departments that were located on the proposed site of the new NMH, such as the pharmacy, and diverting utility services to other locations on the SVUH campus.

The pharmacy and multi-storey car park extension were completed in 2021 and both are fully operational. The enabling works to prepare the site of the new NMH and de-risk the project and campus in advance of the construction works for the new maternity hospital are nearing completion.

A breakdown of the expenditure to date is detailed in the table below:

The contract for the Pharmacy and extension to existing multi storey carpark were awarded as a single construction contract and are not apportioned separately.

*As the construction contracts for a number of these works are ongoing, the individual contract costs are commercially sensitive and therefore are not broken out separately.

Mairead Farrell (Galway West, Sinn Fein)
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1473. To ask the Minister for Health the justification for an enhanced replacement pharmacy in the new national maternity hospital; and if the business case that was submitted in 2018 for same will be provided. [19773/22]

Mairead Farrell (Galway West, Sinn Fein)
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1474. To ask the Minister for Health the justification for extending the existing multi-storey car park in the new national maternity hospital, which is owned by a private company (details supplied) in 2018 given that is yet to be approved. [19774/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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I propose to take Questions Nos. 1473 and 1474 together.

Planning permission for the new National Maternity Hospital (NMH) at St. Vincent's University Hospital (SVUH) was secured in 2017 and in December 2018, the then Minister for Health approved the awarding of the contract for the first phase of the new NMH relocation project to proceed-enabling works.

The purpose of the enabling works undertaken to date have been to prepare the site of the new NMH and de-risk the campus in advance of the construction works for the new hospital. These works comprise of relocating some SVUH departments currently on the site of the new NMH, such as the pharmacy, and diverting utilities to other locations on the SVUH campus. The pharmacy and multi-storey car park extension were completed in 2021 and both are fully operational.

The requirement to replace the outdated pharmacy had been recognised for some time as part of the wider SVUH Campus Development Plan and was a necessary campus project in its own right, as well as being necessary to allow the NMH development to proceed. The original SVUH pharmacy was located on the proposed site for the new NMH and needed to be relocated, commissioned, and operationalised prior to commencement of construction of the new NMH.

The new pharmacy is designed to meet current regulatory standards and includes a Pharmacy Automated Dispensing System (PADS) and  supports the implementation of the Falsified Medicines Directive, as well as bringing efficiencies to the delivery of pharmacy services for SVUH and the delivery of certain campus-wide pharmaceutical services, including the new NMH. The Pharmacy is located at roof level of the existing Main Ward Block, at the heart of the SVUH. This new central location will bring greater efficiencies in the delivery of pharmacy services within the hospital. In turn, the relocation of the pharmacy releases the existing site for of the development of the new NMH.

The early programme delivery of the additional car-parking spaces and junction upgrades is a specific requirement of the Strategic Infrastructure Development (SID) planning permission, required to reduce the impact of the NMH construction works both on the operation of the campus and on the surrounding residential area. These works also unlock key elements of the campus for the Main Development works.

The additional spaces arising from these works support the relocation of the NMH to the SVUH campus. In addition, the car park works help to deliver the optimum approach to efficient car parking on the campus. The car park works also provided enhanced facilities for disabled users, additional accommodation for cyclists, and general improvements to the surrounding public realm. As such it will serve the entire SVUH campus, including the new NMH.

The Pharmacy and extension to existing multi storey carpark works were procured in accordance with Capital Works Management Framework guidance for public works contracts and all relevant Irish and EU procurement rules and guidelines.  The tender was advertised both on e-tenders and OJEU. It was a 2-stage tender process, and the Pharmacy/Car-park works was advertised and awarded as single tender/contract.

Mairead Farrell (Galway West, Sinn Fein)
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1476. To ask the Minister for Health if the business case for the new national maternity hospital that was approved by the HSE board in November 2021, as per the public spending code, will be made available; and if the business case will be published. [19776/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Public Spending Code (PSC) is designed to ensure that capital investment decisions are underpinned by a clear policy rationale, and that costs are well understood. In 2019, the PSC was updated and introduced a new project lifecycle, tightening the arrangements for project decision-making, and clarifying the roles of the parties involved including the responsibilities for Sponsoring Agencies and Approving Authorities. The PSC also provides detail on the business case requirements at each stage of the new project lifecycle.

All capital development proposals must progress through several approval stages, in line with the new lifecycle approach of the updated PSC, including detailed appraisal, planning, design and procurement before a firm timeline or funding requirement can be established.

The specific requirements that must be included in a business case at the various stages of the PSC, are detailed at www.gov.ie/en/publication/public-spending-code/, including the points at which business cases are to be published.

The National Maternity Hospital (NMH) relocation project was initiated prior to the publication of the updated Public Spending Code (PSC), and therefore the NMH Project Board undertook additional work on the business case to ensure full compliance with the new PSC requirements.

A business case for relocation of NMH has been submitted to the Department by the NMH Project Board for review at Gate 2 of the PSC. The Business Case is now subject to technical review by the Department of Health, including through the External Assurance Process recently introduced by the Department of Public Expenditure and Reform. Pending favourable review under the Spending Code, a Memorandum for Government will then be brought forward to progress the programme for the NMH.

If approval in principle is granted, the project can move to preparation of tender documents in line with EU law and deployment of a tendering strategy.

A further Business Case will then be developed by the NMH Project Board, and if approval is granted at Decision gate 3, the Business Case will be published in line with the Public Spending Code.

Mairead Farrell (Galway West, Sinn Fein)
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1477. To ask the Minister for Health if he will provide a copy of a review (details supplied). [19777/22]

Mairead Farrell (Galway West, Sinn Fein)
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1478. To ask the Minister for Health the analysis and justification that has been completed since 2008 that demonstrates that the relocation of the new national maternity hospital to Elm Park is still the best solution for the women in the greater Dublin area 14 years later and complements the updated relocation sites for the Rotunda and the Coombe hospitals given that a key goal of the 2008 report was to balance births evenly across the three relocated maternity hospitals. [19778/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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I propose to take Questions Nos. 1477 and 1478 together.

It is Government policy, as reiterated in the National Maternity Strategy, to co-locate stand-alone maternity hospitals with adult acute hospitals. Co-location of maternity services with adult services provides mothers with access to a full range of medical and support services should the need arise, in line with international best practice. In order to be successful in terms of enabling immediate access in an emergency, co-location requires physical adjacencies and specific corridor-linkages from one hospital to the other. The availability of these services helps ensure the delivery of an optimum, safe service, particularly for high-risk mothers and babies.

The 2008 KPMG report recommended that the NMH should be co-located with St Vincent’s, the Coombe with Tallaght and the Rotunda with the Mater, tri-located with the new children’s hospital then planned for that site. This configuration was designed to optimise access and the locations were therefore interdependent.

Following the Government decision in 2012 that the new children’s hospital would be co-located with St James’s Hospital in Dublin 8, there was a need to provide for tri-location of maternity services on that site. In the context that the project to relocate the NMH to St Vincent's had commenced and a design team was in place, a review was undertaken to determine which hospital (the Coombe or Rotunda) would be tri-located with the children's hospital and St James’s Hospital, and what the optimum location would be for the remaining hospital. The review took account of attendance patterns and access overall, as well as clinical criteria and site considerations. Further information in relation to the relocation decision is available here:

wayback.archive-it.org/11501/20190626194030/https://health.gov.ie/blog/press-release/department-of-health-announces-sites-for-redevelopment-of-coombe-and-rotunda-hospitals/

In relation to the NMH, co-location with SVUH will make the wide range of general medical, surgical and diagnostic facilities on the Elm Park campus available to any woman who needs to be transferred from the adjacent maternity hospital, resulting in care provision that is far superior to the existing situation. This co-location will also build on the longstanding working relationship between the NMH and SVUH, given that a significant proportion of the consultant staff at the NMH are employed by and work between the two hospitals.

Mairead Farrell (Galway West, Sinn Fein)
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1479. To ask the Minister for Health if the Comptroller and Auditor General is examining a value-for-money assessment of the new national maternity hospital; and if so, when his report will be completed and available for review. [19779/22]

Mairead Farrell (Galway West, Sinn Fein)
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1480. To ask the Minister for Health the findings of the Comptroller and Auditor General's audit on the enabling works that were to be completed by the end of 2021; and if a copy of the report will be provided. [19780/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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I propose to take Questions Nos. 1479 and 1480 together.

The Department of Health has not received any correspondence from the Comptroller & Auditor General (C&AG) in relation to an audit as described by the Deputy. My understanding is that the HSE are engaging with the C&AG regarding an audit relating to works to support the new National Maternity Hospital project.

As this is a matter for the HSE, I've asked it to reply directly to the Deputy.

Mairead Farrell (Galway West, Sinn Fein)
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1481. To ask the Minister for Health the most recent estimated cost for the new national maternity hospital (details supplied). [19781/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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The capital project to co-locate relocation of the National Maternity Hospital (NMH) to the St. Vincent's University Hospital (SVUH) Campus is progressing. Site preparatory and enabling works were required to support the relocation of the new NMH.

These preparatory works commenced on the campus in early 2018 with a programme of Aspergillus prevention works. Construction of the new pharmacy and the multi-storey car-park were completed in 2021 and both are fully operational. The costs of all works to date are €51m (including VAT).

With the exception of the construction works referenced above, no further contractual commitments have been entered into with respect to works to the new NMH project.

It is important to recognise that all capital development proposals must progress through a number of approval stages, in line with the Public Spending Code, before a firm timeline or funding requirement can be established.

A Final business case has been submitted to the Department by the NMH Project Board and is now subject to technical review by the Department of Health, including the External Assurance Process for major capital projects recently introduced by the Department of Public Expenditure and Reform.

Pending favourable review under the Spending Code, a Memorandum for Government will then be brought forward to progress the programme for the NMH. If approval in principle is granted, the project can move to preparation of tender documents in line with EU law and deployment of a tendering strategy.

The final decision to proceed with the construction and therefore to estimate the cost for the new NMH cannot be made until the tender process has been completed and the costings reviewed to ensure that the proposal delivers value for money and remains affordable.