THE CONTROVERSIAL COST of the National Children’s Hospital will be worth the “state-of-the-art”, complex piece of architecture that will stand out on the capital city’s skyline, according to members of the board tasked with its construction.
Progress on the long-awaited hospital’s construction was showcased during a tour of the site offered to journalists and TDs ahead of appearances by members of the National Paediatric Hospital Development Board (NPHDB) before two Oireachtas committees this month.
During this tour, when asked what the most expensive part of the hospital was to build, or what parts cost more than expected, Project Director of the NPHDB Phelim Devine told The Journal that the NCH is designed to last twice as long as the average national hospital.
“We have designed the building so that it can be expanded… [At the] meadow garden, there’s a space there designed for a future six storeys in 20-30 years’ time to allow for population growth.
“All of the mechanical electrical systems are designed to the highest level of redundancy, so if one system falls down there’s a back-up system. And that is across everything.
“The other thing that makes the building expensive is that we’re a small industry here in Ireland. People talk about the original budget and where we are now – the cost of construction has nearly doubled in about seven years in Ireland. That’s just a fact of life.”
During the tour of the site, members highlighted how the hospital will be tailor-made to suit the needs of children and their families, and will be a good space for specialised staff to work. In the in-patient areas, windows can be opened wider than average, with a mesh put in front of the window to allow for this.
“Every hospital room in the country is overheated, we worked hard to make sure that doesn’t happen here,” Devine said.
It will have 14 gardens and internal courtyards – including the Rainbow Garden which is the length of Croke Park (seen in the main picture above).
Irish artwork will be used throughout the hospital, emphasising colours, geometric shapes, and native Irish animals and plants.
There will be a playground and a small amphitheatre for groups who wish to perform for the children at the hospital, and there will be a private garden for immuno-compromised children on the fourth floor of the seven-storey building.
Chair of the Public Accounts Committee (PAC) Brian Stanley, who was among four TDs who visited the site of the National Children’s Hospital this month, told The Journal that despite this, issues remain in relation to cost and the timeline.
“We still have a number of questions about the hospital,” he said.
“It’s designed in such a way that it has a very complicated structure that’s expensive to build. There’s features in it that will add to the cost.
“There will be very high maintenance cost to it. Some of the ‘wow’ factors are going to make it very difficult to maintain.
“It’s more important to the people at this stage is that it’s a functioning hospital.”
Stanley also raised questions about the energy efficiency of the building, and why solar panels aren’t part of the design – though members of the board insisted during the tour that the windows and insulation will ensure it is heated efficiently.
The hospital has a ‘BREEAM Excellent’ rating, and is being built to meet an A3 energy rating, which includes energy systems that is hoped to deliver a 60-70% reduction in energy running costs when compared to the three existing children’s hospitals.
A quick briefing on the controversial Children’s Hospital
The suggestion to merge three existing children hospitals in Dublin – Tallaght, Crumlin, and Temple Street – to one hospital site was first put forward in 1993 by the Royal College of Physicians.
Between then and now, the hospital has been dogged by controversy over where it would be built, what it would be called, and in more recent years over the spiraling cost of the build.
The project was expected to cost €983 million in 2017; Taoiseach Leo Varadkar told the Dáil in late 2018 that it was expected to cost €1.4 billion; the last figure for the total cost was €1.73 billion in 2019 – it’s been said that the total cost of the project is “highly unlikely” to come in under €2 billion.
A group has been set up to independently assess the claims made for additional costs of construction – these include constriction inflation and delays related to the pandemic, which saw the Children’s Hospital site close for several months.
The Oireachtas Joint Committee on Health was told that 900 claims for additional costs have been made, and of that number, 15 have been discussed, and nine have been agreed, worth €2.5 million. The other six claims will be heard in the High Court.
In April 2019, NPHDB issued legal proceedings against developer and construction company BAM in the High Court over the requirements in the contract to have a design in place before construction, which BAM claims has still not been completed.
BAM “welcomed” the legal proceedings, adding that it will lead to “proper and careful analysis, and ultimately resolution”.
But the ongoing furore over the legal actions and cost of the hospital appear to be happening almost independently to the work on the ground to build the hospital.
Dr Emma Curtis, Medical Director of the NPHDB and a paediatric consultant spoke to The Journal about the clinical benefits of the purpose-built, modern children’s hospital, with the country’s specialists all under one roof.
During a tour of one of the 22 theatre rooms the hospital has, Dr Curtis said that each theatre will have an anesthetic room next door, so that the child won’t see the theatre room before undergoing surgery. Each theatre room will have natural light, which is unusual.
At the end of the corridor there is a ‘soft space’ where medical staff can gather, but this can be turned into more theatre space if required.
Dr Curtis said that “adjacency is crucial” for hospital care, with day care wards needing to be close to theatres.
In the above part of the hospital it was explained that designs were altered to let in more natural light into the in-patient wards. Above, there is a glass section that will allow for more light into the centre of this floor of the hospital.
Declan Roche, Construction Director at BAM, said of the cost of the building: “The building is a sustainable building. The quality of the materials – the windows, the insulation, the cladding – these are very high quality materials and they are going to create a sustainable building which is going to be more efficient to run in the future.
So while you have an initial investment, that’s going to pay back over the lifetime of the building, as the efficiency and the running costs of the building will be reduced.
Devine added: “The life cycle of a modern, contemporary hospital is generally 50 to 60 years, so we’ve designed this for 100 years.”
“As Declan says, that initial assessment versus the running costs of the hospital, it pales in insignificance.
Yes it’s a big investment by the State, but it’s the operating costs that really matters. It’s the efficiency that we’ve built into the design, and we’ve worked very hard at that: from the sustainability of the building, and adjacency to reduce travel distances so that care is as efficient as possible. That’s what people need to focus on.
You can view the National Children’s Hospital’s video giving a 3D tour of the plans here.
Stanley said that “we are where we are” with the Children’s Hospital, and that all and every measure possible needs to be taken to advance it and keep the costs “as modest as possible”. He said there were two lessons to be learnt from the capital project:
“More care needs to be taken in the design and the people who sign off on the design.
“Just because someone puts a flashy design in front of you, doesn’t mean that’s the best one,” he said.
As it stands, the hospital is expected to be opening in 2024, and is hoped to attract consultants who have moved abroad in recent years back to Ireland.
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