Explainer: Will the latest National Children’s Hospital controversy delay its opening?

Remind me what all the fuss about this hospital is?

Located on the site of St James’s Hospital campus in Dublin, the NCH is set to be the most expensive in the world once it is finally completed. Although around 85pc finished, it has been mired in controversy and beset by delays and cost overruns for years.

The official price tag currently stands at around €1.7bn but there are widespread expectations that the final bill will top €2bn. It was supposed to open this year, but the Covid-19 pandemic and construction shutdown prolonged the delays. The current plan is for the hospital to be completed in March next year and open some time after that, before the end of 2024.

What’s this latest issue?

It has emerged that last month, the hospital’s management team, the National Paediatric Hospital Development Board (NPHDB), wrote to the lead contractor BAM directing it to stop work on the ceilings and any services installed in or above 11 of the 22 operating theatres.

Documents obtained by Sinn Féin TD David Cullinane show these theatres could require remedial work. He claims the issue relates to the ventilation system. Work includes possible modifications to installed ceilings along with changes to electrical and mechanical services.

In the Dáil, Sinn Féin leader Mary Lou McDonald said independent experts commissioned by the hospital’s operators, Children’s Health Ireland (CHI), had identified “major generic faults” and “non-compliances” with the theatres over a year ago.

It is understood that consultants STS reported to CHI again last November on the severity of the issues, and said: “They are not snagging lists but rather indicative of the major generic faults, non-compliances, unresolved issues found during the walk-arounds.”

STS warned that the longer these issues take to get resolved “the more expensive and time consuming they become” and further warned that the systems would fail final validation. Sinn Féin believes the board’s direction to Bam to stop works is indicative of these systems failing validation tests in March of this year.

What could this mean?

Mr Cullinane has said that based on information from a source, the problem could cost €50m to remediate, while also delaying the hospital’s completion date. He has gone so far as to suggest that it could take up to 12 months to complete the changes. “Do I have confidence that that date of March 2024 will be met? I don’t,” he told the Irish Independent. “The Government has dropped the ball on this.”

What does the hospital board say?

The NPHDB disputes much of Mr Cullinane’s characterisation of the problem. “This will not cost ‘tens of millions of Euro’, as is being claimed, and is not expected to have an impact on the completion date of the hospital,” the board said in a statement today.

It said that the works are “minor” and “are not on the critical path”. It confirmed it had been aware of it but said it is being addressed in a “timely and appropriate manner”.

Health Minister Stephen Donnelly also downplayed the issue today, accusing Sinn Féin of “catastrophising”. He asked the party to identify its source.

In a further statement, the NPHDB said it has instructed BAM to review the impact of moving ceiling grilles in the 11 affected operating theatres. “Initial findings would indicate that the works, if instructed, would be undertaken in parallel with other works and would not impact substantial completion or hospital opening,” the NPHDB said.

It said that while a standard test to validate the ventilation systems had been successful, the outcome of a second non-standard test to observe the air distribution within the theatre had not been agreed between consultants STS and the hospital's design team.

Does this mean everything is on track?

Not quite. Perhaps more concerning is that both Mr Donnelly and the NPHDB have said that BAM has failed to provide a “compliant programme of works”. This would show that the hospital is going to be handed over as agreed next March. NPHDB said: “This has still not been provided and therefore BAM is in breach of contract.”

What does BAM say about all this?

Bam has denied claims made privately by some in Government that it was behind leaks to Sinn Féin. "BAM’s sole focus is on delivering the Children’s Hospital. Work is progressing well and is now over 80% complete," a spokesperson for the developer said.

"We are continuing to prepare the programme update as required under the contract based on the scope as currently known.

We are working closely with our client’s design team to support development of the revised scope of work for the operating theatres. BAM has not engaged with any third parties on any of these matters."

What does all this mean in terms of when the hospital will open?

The cost overruns have spiralled to such an extent that the public are unlikely to look kindly on whatever the final bill is, even if it comes in under €2bn.

The NCH is the single biggest piece of health infrastructure in the country’s history but it has become a byword for the failure of the State to control costs on major capital projects.

A succession of timelines and delivery dates have already fallen through. Nonetheless, Taoiseach Leo Varadkar confidently declared today that the Government anticipates “the first patients will be seen there at some point in 2024”.

It is worth noting that, as health minister in 2016, Mr Varadkar declared that “short of an asteroid hitting the planet”, the NCH would be built by 2020.