Seán Crowe (Dublin South West, Sinn Fein)
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The purpose of today's meeting is to consider issues relating to the development of the proposed national children's hospital with the Minister for Health. This follows the committee's recent meeting with representatives of the National Paediatric Hospital Development Board. I am pleased to welcome the Minister for Health, Deputy Stephen Donnelly.

The Minister is accompanied by Mr. Derek Tierney, Ms Tracey Conroy, Ms Fiona Ross, chair of the National Paediatric Hospital Development Board, and Mr. Patrick Lynch, lead director for project and programme assurance in the HSE.

I will read a note on privilege. Witnesses are reminded of the long-standing parliamentary practice that they should not criticise or make charges against any person or entity by name or in such a way as to make him, her or it identifiable or otherwise engage in speech that might be regarded as damaging to the good name of the person or entity. Therefore, if witnesses' statements are potentially defamatory in relation to an identifiable person or entity, they will be directed to discontinue their remarks. It is imperative that they comply with any such direction.

Members are reminded of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside the Houses or an official either by name or in such a way as to make him or her identifiable. I remind members of the constitutional requirement that they must be physically present within the confines of the Leinster House complex to participate in public meetings. I will not permit members to participate where they are not adhering to the constitutional requirement. Therefore, any member who attempts to participate from outside the precincts will be asked to leave the meeting. In this regard, I ask any members participating via MS Teams to confirm that they are on the grounds of the Leinster House campus prior to making their contribution.

To commence our consideration of issues relating to the development of the proposed national children's hospital, I invite the Minister to make his opening remarks.

Stephen Donnelly (Wicklow, Fianna Fail)
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I wish the Chair and our colleagues a good morning. I welcome the opportunity to provide an update on the completion of the new children's hospital. I am joined by Fiona Ross, Derek Tierney, Tracey Conroy; and Patrick Lynch.

We are all here today with a single focus, which is to see the new children's hospital completed and open and supporting the delivery of the best care possible to children across the island as soon as possible. Many colleagues have visited the site and been impressed by the scale of the project. The hospital will have 473 beds, including 300 inpatient en suite single rooms, each with a dedicated bed for a parent. It will have 60 critical care beds, 18 of which are for the establishment of a new neonatal intensive care unit. It will have 20 much-needed dedicated child and adolescent mental health beds, 22 operating theatres, specialist procedural rooms, 93 day beds and a hospital school and third level education centre. It will be Ireland's first fully digital public hospital. It will undoubtedly be a unique and special environment befitting our exceptional paediatric doctors, nurses, health and social care professionals and all of those who dedicate their lives to caring for our sickest children. Most importantly, it will be a unique and special environment befitting the children of Ireland and will make sure that they can get access to world-class care.

We are all aware of the challenges the project has faced. In the past two weeks, the committee was joined by David Gunning, chief executive of the National Paediatric Hospital Development Board, and Phelim Devine, project director, who provided it with a comprehensive update. Colleagues will be aware that I recently met with the hospital development board to discuss challenges with the main contractor. As a result of that meeting, I wrote to the Taoiseach and party leaders in the interests of providing an update. After that, I met with Royal BAM, the parent company of BAM Ireland, to make the Government's position very clear. At the meeting, which was held last week, I also sought a commitment from Royal BAM to provide early access for the commissioning team from Children's Health Ireland, CHI. This is to expedite operational commissioning activities.

Alongside the construction of the new hospital, there is a significant programme of work to prepare for its opening. This is the new children's hospital programme, which is overseen by the CHI board, and is essentially the commissioning. It involves the ongoing integration of hospitals and workforces, which is under way, the commissioning process for the new children's hospital, which is at an advanced stage, and the implementation of the new digital or electronic health records system, which is also at an advanced stage with the design and configuration phase concluded. There is a dedicated transformation director in CHI. This director has responsibility for the children's hospital programme. The programme is supported by commissioning experts Newpark Healthcare, which has commissioned 24 hospitals around the world.

Under the revised governance structures approved by Government in November 2021, the national oversight group oversees and monitors the progress of the children's hospital project and programme. The group, which is chaired by my Secretary General, Robert Watt, is informed by the lead director, Mr. Patrick Lynch, who engages continually with both the national paediatric hospital development board and CHI.

As part of the oversight measures and to enable a smooth transition to the new hospital, my Department and the HSE requested an expert external review of CHI's operational readiness to commission and commence operations at the new children's hospital. This represented important due diligence. The operational readiness review was led by an international expert with extensive clinical and change management experience. After this, an implementation plan informed by the recommendations of the review was drafted by the HSE and CHI. The implementation plan was submitted to the national oversight group, which reviewed and accepted it. CHI's progress against the implementation plan is being monitored closely by the lead director with progress reported to the national oversight group, which is chaired by my Department's Secretary General.

The Government is committed to seeing the new children's hospital open for the treatment of the children of this island as soon as possible. On 2 October, BAM submitted an updated programme to the board confirming that the date on which it believes it can achieve substantial completion of the hospital is June 2025. That programme must be subject to scrutiny and review by the independent contract administrator, the employer's representative, to determine its contractual compliance and validity. We all want to see this much-needed and much-anticipated hospital open for children, for their families and for our dedicated healthcare professionals without further delay.

Bernard Durkan (Kildare North, Fine Gael)
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I welcome the Minister and his colleagues. I also welcome his ongoing commitment to the children's hospital. It is the biggest single project of that nature ever undertaken in this State. It is not, by a long shot, the most expensive hospital in the world, despite comments from some people. It is ten times bigger than any similar project ever undertaken in this State. It is very important to the fundamentals of children's healthcare in this country and to bring it from where it was into the 21st century in a meaningful way. I compliment all those involved in the creation of the concept in the first instance and in the development works that have taken place to date. It is almost 94% complete. Every day, people in these Houses comment unwisely on the hospital and compare it with the bike shed in Leinster House, suggesting that it is a waste of money. It is not. That has to be firmly rejected at every level. As politicians, we have to take responsibility for all of our actions in this House. Regarding attempts the undermine the concept on the basis that it was built in the wrong place, the response must be "It has been built, so what about it?" It is already there. It will be a major contribution to children's healthcare in this country. It has been sought for many years. While every day we hear people say that something or other is wrong with it, that it should not have been here and that it should have been there, I have been in and out to that particular site numerous times in a private capacity over the past year or two and I am amazed. To have a working hospital continue to work as it has while at the same time replacing a large portion of the site with a brand new hospital is something extraordinary.

The other matter I will comment on is the ongoing row, or what has blazed up into a row, between BAM and the project team. At these meetings of the committee, I have advocated for representatives of BAM to come before us. That would be helpful. Far too often, we rely on third-party information, although it is given in good faith.

We need to talk to the firm itself, which may be asked to stand over some of the things. We know that many of the issues have already gone to arbitration and have been successfully resolved. What appeared to be large issues that could bring the whole scheme to a halt when announced first were not so large, as we heard at the last meeting of this committee in respect of the famous grilles that were supposed to hold up the development of the hospital for years and double the cost. We need to move away from these exaggerated claims on all sides in this debate, from the point of view of the Government and Opposition. If we persist with sabotaging our own projects, we will not need any assistance from anywhere else.

The Minister's comments this morning and the commitments made so far are to be hugely welcomed. The next phase, as someone said in the last couple of days, involves the hospital being fitted out but all hospitals have to be fitted out. There has not been one yet that did not need to be fitted out. I remember when Beaumont and Tallaght hospitals were being fitted out that somebody predicted a crisis and said there would be no money. That is the job of the Minister. There are Ministers charged with responsibility for providing the money and it is there, as required. Notwithstanding all of that, it is important to supervise the construction work and all associated with it. If we look, for example, at the famous grilles that were supposed to take years to resolve, the issue was resolved in a few days and for only a few euro in the context of the totality of the project.

We have a funny attitude in this country. Of course, we have been overtaken by electionitis now. It is a severe condition that cannot be treated, not even in the children's hospital. It is there and at almost every juncture we find reasons why we should go to the country. That is not the way things work. The Government has a job to do and that job has to be done. The Department of Health has a job to do and it has to be done. Its job is the delivery in full and in accordance with the specifications. In relation to possible overruns, there are almost 6,000 rooms in the children's hospital. We have all heard people say that they could build a whole plethora of houses for this kind of money. If anybody contracted to build 6,000 houses in the environment in which we have lived in this country over the past five years, he or she would soon find out that there is a slight increase in the costs, for want of a better description.

For a change, we should be supportive of the project. We should encourage the project towards its final fitting out and the implementation of the start-up works as soon as possible. The project is 95% complete at this stage. There are suggestions from certain quarters that we should go to court and have a pow-wow there but that does not come without a price tag as well, incidentally. We should use the procedures that are there already to negotiate and resolve the outstanding issues. If the contractors want an audience at this committee, I would certainly support that. Indeed, I have supported that idea from the beginning. They, like everybody else, would obviously have to hear our questions and I have no doubt they would be able to give answers but all within reason and all in recognition of what is a flagship project.

As I said, this is the biggest project ever undertaken in this State. It is fundamental to paediatric medicine. It is as simple as that and we cannot falter or hesitate. Some have decided to compare the costs with the bike shed, the security hut or whatever the case may be, and these projects are rightly subject to criticism. There is a lot more to regard there than there is in the children's hospital. The children's hospital is a positive development in this country. I assure the Minister that I support it fully. The Opposition needs to do the same thing. It is in everybody's interest.

The last point I want to make is that the rest of the project should be speeded up as much as possible. The emphasis has to be on delivery. Of course there will be snags in a project of this size. In terms of the resolution of any snags that may arise, the procedures already in place to deal with these situations must be put into operation. We must recognise that the project needs support to finish the last 5%. If we have got that far, I cannot understand why, even with electionitis, which cannot be treated in that hospital or anywhere else for that matter, we cannot continue with our proposals satisfactorily and deliver to the Irish people something that will last and be of benefit to them for centuries, as we know from experience.

Seán Crowe (Dublin South West, Sinn Fein)
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Minister, you have about a minute and a half to respond.

Bernard Durkan (Kildare North, Fine Gael)
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I am sorry about that.

Stephen Donnelly (Wicklow, Fianna Fail)
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Electionitis is definitely diagnosable but is, as of yet, untreatable. I thank Deputy Durkan for his support. Colleagues here and in the wider Oireachtas have a job to do in holding the Government to account, as they should and must do. What has been helpful, and I thank colleagues for this, is that while they have asked tough questions of me and the Government - as they must do and I am sure they will also do so today - the Oireachtas has been unified in shining a light where it needs to be, which is on the contractor meeting its deadlines.

When there is time I will ask Ms Ross to give her thoughts on this because I do not think the committee has heard from the chair of the national paediatric hospital development board to date. Essentially the advice from the board is that this boils down to three things that we need the contractor to do. We need it to do the finishing correctly. There is a massive snagging operation under way and the level of quality required has not been met yet. BAM is a highly experienced contractor. It completes many capital projects on time for the State but that has not been the case here. BAM is more than capable of meeting the quality standards and we need that to happen. The second issue is resourcing. We have information we can share with the committee but the board's estimate is that the project is resourced, in terms of the number of workers on site, at about half of what it should be and this is probably the single biggest contributor to the delays. The third issue is management. There is a management deficit on site which would speak to the finishing, scheduling and acceleration.

Again, I thank the Deputy for his support.

David Cullinane (Waterford, Sinn Fein)
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Members of the board were in before us last June and again last week, updating us on progress, or rather the lack of progress, in completing the children's hospital. I want to put on the record what they said to us last week, which I assume the Minister accepts. They said that in the last four years the main contractor, BAM, has shifted its completion date 14 times. Is that correct?

Stephen Donnelly (Wicklow, Fianna Fail)
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Yes.

David Cullinane (Waterford, Sinn Fein)
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They also said that in the last 12 months alone, BAM has shifted its substantial completion date four times, pushing it out by a total of eight months. Does the Minister agree with that?

Stephen Donnelly (Wicklow, Fianna Fail)
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Yes, I do.

David Cullinane (Waterford, Sinn Fein)
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They also said that in 2019 BAM committed to 1,700 so-called "productive operatives" - I am presuming they were talking about feet on the ground or human resources - to complete the project. However, on average since 2022, there have been about 774 productive operatives on site and the highest or peak that it reached was 1,260. Essentially, as the Minister just said in simple terms, BAM is not deploying feet on the ground to meet the targets set. Is that correct?

Stephen Donnelly (Wicklow, Fianna Fail)
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Yes, that is the information we have.

David Cullinane (Waterford, Sinn Fein)
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They also said that since September 2023, BAM has, on average, achieved 64% of its planned progress. In fact, when they were before the Oireachtas committee last year, they said it was 67% so what they were telling us last week was pretty much the same information. They also told us that of the 3,128 rooms which BAM has submitted as complete to its standard, none were completed to the required standard. The Minister would have heard them say to the committee that not one single room or "space", as they put it, was completed to the required standard. The cost of the hospital, as we know, is now about €2.2 billion. The Cabinet signed off last year on €500 million of additional money to fund that €2.2 billion total cost.

Am I right on those figures?

Stephen Donnelly (Wicklow, Fianna Fail)
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The €500 million figure would be slightly off but the figure of €2.2 billion is correct.

David Cullinane (Waterford, Sinn Fein)
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Okay but it was slightly less than €500 million. The Minister was the Minister for Health during all of that so when he paints the picture of four years, of 14 completion dates that have come and gone, four times over the last 12 months where BAM has missed its completion date, not providing the human resources to get the project done, no room of standard that is complete, and additional money having to come from the taxpayer and be signed off by the Cabinet, I do not believe anybody can describe this as a success story. I assume if the Minister for Health was sitting in my place he would make exactly the same argument to me that this is unacceptable under the watch of a Minister for Health.

One of the things I asked the Minister to do was to take a more hands-on approach and meet with all of the stakeholders. When I argued that the Minister should meet with all of them, including the contractor, this was pushed back. We were told that we cannot believe anything the contractor says, not to fall for that, and accept the word of the board. Yet, as we know, last week the Minister met the parent company, Royal BAM, which I believe was the right move. When did the Minister reach out to the parent company?

Stephen Donnelly (Wicklow, Fianna Fail)
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I do not have an exact date but in the last number of weeks. It was after I met the board. With regard to the sequence of events I have not got the exact date.

David Cullinane (Waterford, Sinn Fein)
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So it was in the last week. I do not need the exact date.

Stephen Donnelly (Wicklow, Fianna Fail)
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I will give the committee a quick sequence of events so that colleagues have it. The Department was contacted by the board to signal that BAM had moved its completion date. Ms Ross and I met and on the back of that meeting I met with the full board. On the back of that I wrote to the Taoiseach, and subsequent to that I wrote to the chair of Royal BAM group.

David Cullinane (Waterford, Sinn Fein)
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Okay, this was a number of weeks ago.

Stephen Donnelly (Wicklow, Fianna Fail)
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Yes. This is all in the last two months or so.

David Cullinane (Waterford, Sinn Fein)
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When the Minister met them did he put it to them that they had missed their completion date 14 times, and four times in the last 12 months?

Stephen Donnelly (Wicklow, Fianna Fail)
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I did.

David Cullinane (Waterford, Sinn Fein)
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Did they accept that?

Stephen Donnelly (Wicklow, Fianna Fail)
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They did not disagree.

David Cullinane (Waterford, Sinn Fein)
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Did the Minister put it to them that they committed to 1,700 productive operatives but, according to the board, that they only provided, on average, 774? Essentially, the board and the Minister have been telling us that BAM is not committing the resources and this is why the completion dates have been missed. Did BAM accept, when the Minister met them last week, that it was the case they had under-resourced the project?

Stephen Donnelly (Wicklow, Fianna Fail)
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No. The Deputy's first question was whether I had put it to them. It was not exactly as the Deputy has said, but I did make it very clear that the view of the Government and the view of the board was that the project-----

David Cullinane (Waterford, Sinn Fein)
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But why not? The Minister went to great lengths to write to his Cabinet colleagues. I am not sure what the value was of doing that but the Minister sent a letter to his Cabinet colleagues, and while the Minister may not have used this language it was reported by the media as BAM holding the country to ransom. Those were the headlines coming out. The Minister did meet with the parent company and I would have assumed he used the facts that were presented to us by the board and said very strongly to BAM that they had committed to 1,700 productive operators and yet we are told it is only 774 and that this is why there have been 14 missed completion dates, and asking if they could accept this was a fact. Did the Minister put it to them to confirm that? Did they accept failure on their part to resource the project?

Stephen Donnelly (Wicklow, Fianna Fail)
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We had a very clear and forthright discussion. Just before the Deputy came back in I said that, yes, I had very clearly put it them that it is our view the project was consistently and substantially under-resourced. I did not use those exact figures but the same point the Deputy is making was very clearly delivered.

David Cullinane (Waterford, Sinn Fein)
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The second figure we have, again according to the board, was that since last September 2023 BAM has on average achieved 64% of its plan. Did the Minister put this to the parent company?

Stephen Donnelly (Wicklow, Fianna Fail)
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We had a very clear discussion about the under-resourcing. I just want to use my language carefully because I do not want to put words in the mouth of the chief executive of Royal BAM. I am very happy to say to the Deputy what I had put to him but I do not think it would be fair for me to say that he accepted or did not accept that. BAM have their own view and I imagine if the committee were to call them in the members could ask them. In the interest of accuracy I am very happy to say what I said. I cannot really infer BAM's position.

David Cullinane (Waterford, Sinn Fein)
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I accept that, but I am also hearing from the Minister that they certainly were not agreeing with what the board was saying about BAM not fully resourcing the project. If BAM are not even prepared to accept the facts the board has presented to us, then how can I, the Minister, or anybody else on this committee have any confidence in what they are now telling us, which is that they will still meet the deadline by June and this is when it is going to be done? How can I take any assurance from what the Minister has said that this deadline is going to be met? Since the Minister met them last week has there been any step change or any additional human resources on the project that would give the Minister any confidence?

Stephen Donnelly (Wicklow, Fianna Fail)
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As it happens, the question the Deputy just asked me is more or less exactly the question I put to their chief executive, which was that BAM's UK-Ireland operation has missed its deadline 14 times and missed its deadline four times this year so why should I believe that June is not going to be the 15th missed deadline. I asked for Royal BAM to stand over that date. I said that I cannot have confidence, and I do not imagine any of us here can have confidence, in a 14th deadline. Regardless of what happens a 14th deadline would be a lot to ask anyone to simply accept on faith. I have asked Royal BAM as the parent company to stand over that date. They, needless to say, would take that very seriously. They did stand over that date. They have gone back to interrogate that in detail with their own people. I asked for a very intensive round of engagement between the board, led by Ms Ross and Mr. Gunning, the chief executive, and BAM - both Royal BAM and BAM UK and Ireland. The question Deputy Cullinane has just asked me is ultimately the core question and one I put to the chief executive-----

David Cullinane (Waterford, Sinn Fein)
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Perhaps I could just come back in. This project strikes to the heart of the credibility of the State in relation to how it funds and delivers big projects. There have been acres of coverage on this children's hospital and all of its failures. My focus is on getting the hospital built. I want it built for children. I publicly called on the contractor to do what is right and resource the project, but there has to be political accountability and political responsibility as well. I had put it to the Minister consistently over the course of two years, including every time the board came before us, that the Minister needs to take a more hands-on approach, that the Minister's job is to protect the public interest and get stuck in the middle of it, and to meet everybody that needs to be met. Yet it was only last week, or a number of weeks ago, when the Minister reached out to the parent company. Since the board was before the committee last June 16 months have passed. Completion dates have come and gone. Not one single room is finished to the appropriate standard. Nobody has confidence that the June deadline will be met. Additional money has been signed off by the Cabinet. Why in God's name did it take the Minister that length of time to actually meet with the parent company and do what I was asking him to do for the best part of two years, which is to do his job as Minister for Health, protect the taxpayer and actually get this moving? If the Minister is not stuck in the middle of it and if he is a bystander watching on and commentating on what is happening, it is no wonder that the contractor was running rings around us, as the board is suggesting. Why did it take the Minister so long? Was it just because there was an election coming and he wanted to tick a box "I need to meet the contractor" to show that he had done everything? Why did it take the Minister, so long to reach out to the parent company?

Stephen Donnelly (Wicklow, Fianna Fail)
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With the Cathaoirleach's permission can we take a bit longer? It is a charge the Deputy has made many times. I have no issue with the charge and I fully appreciate why the Deputy would make it. I will answer directly the Deputy's first question as to the timing of the meeting with Royal BAM. Then, rather than hearing from me about my involvement in the project, I will ask Ms Ross, as the chair of the board, for the board's perspective in terms of the level of interaction and the hands-on approach, or not. The committee can hear it from the person we charged with leading this on our behalf. On the question of why we reached out to Royal BAM now, it was for one very clear reason. Members will recall that we were all expecting to get the keys of this hospital in the coming weeks. When we were all talking about this at the start of this year we were looking to get them in the coming weeks. The view from the board, which is a view I agreed with, was that we needed to work with the contractor - and the board needed, on our behalf, to use the leverage available under the contract - to get the keys. As we know that date then moved to March, which we were all very frustrated with it. Then it moved to June and at that point one had to be careful.

As Minister, I have to be careful about intervening because one of the unintended consequences of doing so is that the contractor might think it no longer has to deal with the board as it now has direct access to the Government. In trying to help, I could end up cutting the legs out from under my people and I need to be careful about that. When I met the board recently, it is fair to say that its unanimous and strongly held view was that any attempt at partnership had run its course and a fundamentally different approach was required.

David Cullinane (Waterford, Sinn Fein)
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It told us that 16 months ago.

Seán Crowe (Dublin South West, Sinn Fein)
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The Deputy should hold on and wait his turn.

David Cullinane (Waterford, Sinn Fein)
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I held on for a long time.

Stephen Donnelly (Wicklow, Fianna Fail)
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That is why.

With the Chair's permission, I will ask Ms Ross to give a view as well.

Ms Fiona Ross:

I thank the Minister and the committee, which approved my appointment and reappointment in recent months, for inviting me to join the discussion today.

The Minister is correct that things changed when the June date became apparent. It created a different imperative in respect of substantive completion and the opening of the hospital. However, throughout the project there has been significant engagement between all the stakeholders. I sit on a number of State boards and a number of other boards in the UK and I can attest to the level of engagement of all the key stakeholders on the State side on this project. The executive reports monthly to the board. That report then goes to the lead director, which is the HSE or the client in this case, and then onwards from the HSE to the relevant stakeholders. I have had extensive engagement with officials and the Minister on the project. It is fair to say the Minister has been very engaged with this project.

The issue of "why now?" and "why then?" on the call to Royal BAM was the June date and the opportunity for an opening in 2025.

David Cullinane (Waterford, Sinn Fein)
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The Minister does not need to hide behind the chair of the board. People will make up their own minds on his performance. I will leave it there.

It was not appropriate to ask the chair essentially to answer a charge that I believe stands up or to cover the Minister's back.

Seán Crowe (Dublin South West, Sinn Fein)
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The Deputy has made that point.

Stephen Donnelly (Wicklow, Fianna Fail)
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May I respond? With respect, it is a charge the Deputy has made many times. I answered it here directly and I have answered it many times.

David Cullinane (Waterford, Sinn Fein)
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It was for the Minister to answer.

Stephen Donnelly (Wicklow, Fianna Fail)
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I did. I have no problem doing so and I do not blame the Deputy for asking the question. This is the chair of the board's first appearance before the committee. The Deputy has made the charge many times. It is not reasonable to suggest that asking for the board's view on the Deputy's challenge is inappropriate.

David Cullinane (Waterford, Sinn Fein)
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My charge was that the Minister did not meet the contractor over the course of two years, which he did not.

Seán Crowe (Dublin South West, Sinn Fein)
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Hold on. We are five minutes over time. I will go to Deputy Shortall.

Róisín Shortall (Dublin North West, Social Democrats)
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The development board has been before the committee several times, as the Minister will be aware, and it has appeared before the Committee of Public Accounts several times. Both committees have been utterly frustrated for a long time, because every time the board came to speak to us, its members were throwing their hands in the air and seemed completely helpless. There was a stand-off between BAM and the board and nothing was happening to break that logjam. They were before the Joint Committee on Health two weeks ago and were here previously in July last year and it seemed that no progress had been made in the intervening period. That is why it is so difficult to understand why there was no political intervention at an earlier stage to break the logjam. Significant time and, presumably, cost have been lost as a result.

I will ask the Minister about his meeting with Royal BAM Group. What exactly was the upshot of that meeting?

Stephen Donnelly (Wicklow, Fianna Fail)
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I hope it was a productive meeting. Let us see what comes out of it. The message I delivered to Royal BAM Group was that the Government and I could not have confidence in a June deadline being reported to us by BAM UK and BAM Ireland and I requested that Royal BAM Group stand over that date. We discussed the fact that BAM has had a good relationship with the Irish State on other capital projects. It is involved in many capital projects around the country, including building schools and primary care centres, but the scale of the delays and of the dysfunction in the relationship between BAM and-----

Róisín Shortall (Dublin North West, Social Democrats)
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I apologise for interrupting. Time is ticking. What was the upshot of the meeting?

Stephen Donnelly (Wicklow, Fianna Fail)
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The upshot of the meeting was that Royal BAM Group said it would stand over the June deadline. It has agreed to have intensive engagement with its UK and Ireland operation and with Ms Ross, Mr. Gunning and the rest of the board so that there is a project, for which the board and the independent assessor can say they have confidence the deadline can be met.

Second, we have also agreed to accelerated access to the site for the commissioning team, because the piece we have more control over is the bit CHI is leading, which is the commissioning.

Róisín Shortall (Dublin North West, Social Democrats)
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Two weeks ago, the Minister was quoted as saying that BAM Ireland was seeking to extract as much money from the Irish taxpayer as possible. Did he repeat that charge to Royal BAM Group?

Stephen Donnelly (Wicklow, Fianna Fail)
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It was certainly raised at the meeting.

Róisín Shortall (Dublin North West, Social Democrats)
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What was its response?

Stephen Donnelly (Wicklow, Fianna Fail)
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I do not want to characterise its responses, but the Deputy will appreciate that it did not enter the meeting accepting that it was fully at fault for everything.

Róisín Shortall (Dublin North West, Social Democrats)
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Did it strenuously deny the charge or did it accept the Minister had a point? What was its response? It is a serious allegation to have made.

Stephen Donnelly (Wicklow, Fianna Fail)
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It is and I stand over it. Obviously, it is something it would dispute.

Róisín Shortall (Dublin North West, Social Democrats)
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Did it dispute it?

Stephen Donnelly (Wicklow, Fianna Fail)
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I do not want to mischaracterise things. These matters were raised over the course of a long meeting. I will not put words in Royal BAM Group's mouth. I think it would be fair to say that I imagine if it were here, it would dispute it. I can be more helpful than that. It wrote a letter in response, in which it refuted that allegation.

Róisín Shortall (Dublin North West, Social Democrats)
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Was that Royal BAM Group or BAM Ireland?

Stephen Donnelly (Wicklow, Fianna Fail)
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I think it was BAM Ireland, but I would have to check.

Róisín Shortall (Dublin North West, Social Democrats)
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At the meeting in July last year, at the meeting two weeks ago and indeed at previous meetings, when I asked Mr. Gunning what needed to happen for the project to get back on track, he said two things needed to happen: first, sufficient staff needed to be on site, which would be approximately double the current number, and, second, BAM Ireland needed to produce a compliance programme. Will those two things happen? What did Royal BAM Group say about those key requests?

Stephen Donnelly (Wicklow, Fianna Fail)
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It has committed to the June deadline. There are several moving parts. As the Deputy mentioned, it includes the compliance work schedule. The board also believes there is a need for more senior management to be on site.

Róisín Shortall (Dublin North West, Social Democrats)
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What commitment, if any, was given about staffing levels and doubling the current number of staff?

Stephen Donnelly (Wicklow, Fianna Fail)
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The commitment was that Royal BAM Group would review the full proposal and come back with one it can stand over.

Róisín Shortall (Dublin North West, Social Democrats)
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That is not very strong, saying it will review the current proposal.

Stephen Donnelly (Wicklow, Fianna Fail)
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I think it is.

Róisín Shortall (Dublin North West, Social Democrats)
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We got those figures-----

Stephen Donnelly (Wicklow, Fianna Fail)
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In fairness-----

Róisín Shortall (Dublin North West, Social Democrats)
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Mr Gunning said that approximately double the number of staff was needed on site. Did the Minister get into the detail of that with Royal BAM Group?

Stephen Donnelly (Wicklow, Fianna Fail)
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No, the meeting was not to begin to deconstruct the draft proposal. It was to discuss getting to deadlines and doing what is required to do so.

Róisín Shortall (Dublin North West, Social Democrats)
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Mr. Gunning said two things needed to happen. Did the Minister pursue those two matters with Royal BAM Group?

Stephen Donnelly (Wicklow, Fianna Fail)
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We discussed all these issues.

Róisín Shortall (Dublin North West, Social Democrats)
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What did Royal BAM Group say about staffing levels?

Stephen Donnelly (Wicklow, Fianna Fail)
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It said it would review its current proposal with the board, so it can stand over it.

Róisín Shortall (Dublin North West, Social Democrats)
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Has Royal BAM Group been in touch with the board since?

Ms Fiona Ross:

Yes.

Róisín Shortall (Dublin North West, Social Democrats)
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When does the board expect to reach an agreement on the level of staffing required?

Ms Fiona Ross:

BAM submitted a new programme the night before the meeting, on Wednesday before a meeting on Thursday. As the Deputy will be aware from many engagements, a process is under way to evaluate that programme. It has not yet been deemed compliant. The programme drives and the number of resources required are linked, in that if we say we will do something we need to know how many people we will need to do it.

We are at the stage of reviewing the programme that was submitted to us on the Wednesday night prior to the Thursday meeting.

Róisín Shortall (Dublin North West, Social Democrats)
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This is all taking up a huge amount of time. When does the Department expect to be in a position to have agreed the number of staff and the compliance programme? When are we going to see progress and a breakthrough?

Ms Fiona Ross:

The review of the programmes tends to take from a couple of weeks up to a couple of months, as the Deputy knows. It is a long process because these are major programmes. I am hoping that the difference will be the part played by Royal BAM in this. The global CEO came to Dublin last week and spoke to us. We hope that this will make a difference in speeding up the decisions.

Róisín Shortall (Dublin North West, Social Democrats)
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Are we just at the point of hoping at this stage?

Ms Fiona Ross:

Yes.

Róisín Shortall (Dublin North West, Social Democrats)
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It would be great to get something more positive and concrete out of that meeting. When does the Department expect to be able to announce progress?

Ms Fiona Ross:

I think-----

Róisín Shortall (Dublin North West, Social Democrats)
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Everything is very vague, and Ms Ross is saying it could take weeks or even months. When will we find out when this project is going to get back on track? When will we have a completion date we can believe and a final cost for the project?

Ms Fiona Ross:

This is on the contractor in terms of the speed with which it responds.

Róisín Shortall (Dublin North West, Social Democrats)
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Sorry, but it is not on the contractor. It is on the development board and the Government. This is a major public contract that is costing a vast amount of money. The public wants to know when will it be completed and what the final cost will be. Despite all the spin that has been going on in the media in recent weeks, we are still no nearer to having those two vital pieces of information. When are we likely to get them?

Stephen Donnelly (Wicklow, Fianna Fail)
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We are getting them. The final cost, as referenced by Deputy Cullinane, is the amount that the Government stated, namely €2.2 billion. I was very clear with Royal BAM that the Government is not putting more money on the table. The public has the answer to one of those two questions.

In answer to the second question, it is not reasonable to ask the board as to what day it will be able to say that the project is now compliant. There has been an agreement that BAM and Royal BAM will engage with the board in that regard. None of the people involved in the process can say whether that will be Friday or Friday week, but they are endeavouring to get to a compliant project as quickly as possible.

Róisín Shortall (Dublin North West, Social Democrats)
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If BAM needs to double the number of staff on site in order to meet the June 2025 completion date, it is very difficult to understand how this will not have cost implications. Was that issue raised with Royal BAM? Was a commitment obtained from Royal BAM that it will substantially increase the number of staff on site from now on and that it will stick with the original cost?

Stephen Donnelly (Wicklow, Fianna Fail)
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It is not a question of whether it is sticking with the original cost. I made it very clear that the Government has allocated funding and that that is the end of it. Regarding the number of staff, we would categorically refute a position to the effect that we should pay the company more if it fully resources the site. We expect the site to be fully resourced. There will not be additional payments for the project.

Róisín Shortall (Dublin North West, Social Democrats)
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What was the commitment, if any, obtained from Royal BAM? Was it to fully staff the site and bring the project in on budget?

Stephen Donnelly (Wicklow, Fianna Fail)
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The commitment is for the company to meet its June 2025 deadline and to engage intensively with the board on everything required to do that, which obviously includes the level of resourcing.

Róisín Shortall (Dublin North West, Social Democrats)
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I will come back in on the second round.

John Lahart (Dublin South West, Fianna Fail)
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For the benefit of the public, it must be stated that if one is involved in public life or in dealing with contracts for a long time, it can be easy to form the view that the State is always the malign player if things go wrong with a contract. I am not suggesting that there are malign players in this instance, but I have been dealing with school building and road projects in my constituency for long enough to know that contractors sometimes do not step up to the mark in the context of what they commit to. In many of the cases with which I am familiar, they absolutely squeezed the pips out of the boundaries of a contract and were very skilled and experienced at doing so. I am not suggesting this is the case here because I do not know enough about it, but it does happen. There always seems to be an assumption at meetings of this committee that the State has screwed up or behaved irresponsibly. There are at least two key players here.

One of the things we did not get a chance to tease out the last time because of a lot of noise and the time constraints was the position relating to the air conditioning grilles. The National Paediatric Hospital Development Board provided a brief account that got lost. From memory, a change was suggested. The Minister might be able to comment on this. BAM suggested that this change was going to cost millions. It was also suggested that it was not going to cost millions. It was further suggested that it would delay the contract by months. Will the Minister provide a summary of the position in that regard?

Stephen Donnelly (Wicklow, Fianna Fail)
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It is a good example of the frustration involved. I included details of it in my letter to the Taoiseach. During what might have been my most recent appearance before the committee to discuss this matter, Deputy Doherty raised the issue. As I have stated previously, I believed he was acting in good faith. I do not believe he was trying to help the contractor out. At the time, I pointed out that the net effect of the position might be to help the contractor but, obviously, I fully accept the Deputy's bona fides to the effect that he was carrying out his duties.

Deputy Doherty claimed that these grilles would delay the project for many months or even a year. I do not recall exactly, but it was stated that it would delay the project for a long time and would cost tens of millions of euro. I did not have the detail to hand. The information he had was very new. Ultimately, it did not cost the €25 million that was being suggested. It cost €200,000, which is considerably less.

John Lahart (Dublin South West, Fianna Fail)
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How long did it take to complete?

Stephen Donnelly (Wicklow, Fianna Fail)
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It was completed in a matter of weeks.

John Lahart (Dublin South West, Fianna Fail)
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If I am to interpret this correctly, a change was required, BAM costed this change and this cost is on record?

Stephen Donnelly (Wicklow, Fianna Fail)
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Yes.

John Lahart (Dublin South West, Fianna Fail)
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The cost ran to €25 million, or millions of euro anyway, and was going to delay the contract by months, which was the evidence given to us. To conclude matters in respect of that piece of the jigsaw, what did it cost?

Stephen Donnelly (Wicklow, Fianna Fail)
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It cost less that 1% of the amount originally stated. It cost less than €200,000 and it took a few weeks to complete. It is worth saying that, mistakenly or not, BAM still issued an invoice to the State for the full €25 million. Perhaps this was an administrative error on the part of the company.

John Lahart (Dublin South West, Fianna Fail)
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In the public interest, will the Minister give us two or three takes from that meeting with Royal BAM? What was the significance of its involvement as opposed to that of its Irish subsidiary?

Stephen Donnelly (Wicklow, Fianna Fail)
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The reason I wrote directly to the CEO of Royal BAM was that I simply could not have confidence in the June 2025 deadline for completion. When I met the board, the members were very clear that they could not have confidence in it either. The programme of works the company had submitted to meet that was either deemed non-compliant or as yet had not been deemed to be compliant. As I said to the CEO when I met him, the UK and Ireland unit of Royal BAM's operation had missed its own deadlines 13 times previously. This was the 14th deadline and it was simply not reasonable to ask anyone to take it on faith. At this point, the Government needed Royal BAM to stand over its timelines, to engage with the board, with good faith on both sides, and to make sure that there was a work programme, including feet on the ground and management, and all the things required to meet the June 2025 deadline.

In fairness to BAM, it accepted at the meeting that the hospital's commissioning teams could be given early access. That is important. This had not been agreed up to that point. There is something called the "hot block", which involves laboratories and various other things that take a long time to commission, but if you can essentially-----

John Lahart (Dublin South West, Fianna Fail)
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Will the Minister explain this for members of the public who are watching? I am sure most of them get what is involved. What does the commissioning of the building mean?

Stephen Donnelly (Wicklow, Fianna Fail)
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Commissioning the building is essentially everything required from when we take over an empty, finished building to children walking into that building with their parents to be treated and walking out again.

It is a huge operation. We are bringing several children's hospitals into one. There are new operating theatres, new rooms, new ways of working and new nurses' stations. It will be our first fully digital hospital. There is a vast amount of work.

John Lahart (Dublin South West, Fianna Fail)
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There is fitting out, trial and error testing and all of that.

Stephen Donnelly (Wicklow, Fianna Fail)
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It so happens that there are things that can be accelerated. Some things cannot be accelerated but other things can be, including the laboratories and other complex back office systems. If the contractor can give us or CHI access to that early, which it has agreed to do, we believe that the commissioning can be accelerated and de-risked to some degree.

John Lahart (Dublin South West, Fianna Fail)
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There are suggestions that, because there is a delay, things in the hospital are obsolete, not fit for purpose or out of date. Will the Minister comment on that?

Stephen Donnelly (Wicklow, Fianna Fail)
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I will ask Ms Ross to answer that.

Ms Fiona Ross:

Some of the bigger and more substantive equipment is going in, but it will be covered by warranties regarding its useful life and so on. We are hopeful, with the substantial completion date in June, that that will not be an issue, and we do not expect it to be. The Deputy is right that time is of the essence. It is important that we complete the hospital so that we can operationalise and commission the equipment for use.

John Lahart (Dublin South West, Fianna Fail)
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Who attended the meeting?

Stephen Donnelly (Wicklow, Fianna Fail)
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Which meeting?

John Lahart (Dublin South West, Fianna Fail)
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With Royal BAM.

Stephen Donnelly (Wicklow, Fianna Fail)
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On the BAM side, there was the global chief executive, its UK and Ireland chief executive or general manager, whatever the title is, and its chief operating officer. On our side, it was Ms Ross, me, Robert Watt, my Secretary General, Derek Tierney, who is the assistant secretary over this, Bernard Gloster, chief executive of the HSE, and my special adviser, Susan Mitchell.

John Lahart (Dublin South West, Fianna Fail)
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I have one final question for Ms Ross. This is the first time I have encountered her. I wish her the best of luck in her role. What are her takes from that meeting with Royal BAM?

Ms Fiona Ross:

It was a very substantive meeting for us, bringing Royal BAM to the table and, as the Minister outlined, getting its commitment to meeting the date. I know I used the word "hopeful". You have to have optimism and focus on the goal in sight, which is the completion of the hospital. We have been frustrated by the contractor's performance to date, as is well known and well rehearsed in this committee room. We are hopeful that the arrival of Royal BAM-----

John Lahart (Dublin South West, Fianna Fail)
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What has given Ms Ross the grounds for that? Was it the meeting, its tone, or the engagement? What justifies it when talking to a taxpayer?

Ms Fiona Ross:

Royal BAM is a large internationally listed company. It is a tier one contractor. For its global CEO to sit in a room with a state and agree that it will honour a date was an important meeting for us. We have to work hard to put the pieces in place behind the scenes to make that happen.

John Lahart (Dublin South West, Fianna Fail)
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What is the significance of the early access for commissioning? That is maybe lost on me as a layman.

Ms Fiona Ross:

As the Minister said, the job of turning a building into a hospital is very substantial, and the sooner we can get started on that important early work and getting the technical commissioning under way, which Mr. Gunning and Mr. Devine outlined at the previous meeting, the better. The CHI commissioning side needs to start as soon as possible in order to have a speedy opening of the hospital. People will understand how much is involved in turning a building into a hospital, including all the lighting, heating, ventilation, water systems and so on, and the equipment we talked about a moment ago, and I could probably speak to other colleagues about the CHI side of commissioning. It is a big job but we want to get started as soon as we can.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Was the meeting with Royal BAM the first in-person meeting involving the board and the Minister with the higher echelons of the company in the lifetime of this project?

Stephen Donnelly (Wicklow, Fianna Fail)
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It was my first meeting with the chief executive of Royal BAM.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Had other members of the board ever met the chief executive of Royal BAM?

Ms Fiona Ross:

Before my time, there had been some engagement with some of the Royal BAM executives in Holland about the project, but not in recent times. This was the first meeting.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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At that meeting, was Royal BAM in any way contrite about the ongoing issues? Did it say that mistakes were made with the logistics of this project?

Stephen Donnelly (Wicklow, Fianna Fail)
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I do not want to characterise Royal BAM. It is for its representatives to say how they felt at the meeting. I can say that it was a very open conversation. The frustrations on both sides were aired. We need to wait and see but there is the possibility that it will have been a productive meeting. Given that deadlines have come and gone, we would all be naive to walk away and think that it is sorted. We need to see substantive action and change now. I think it was a productive, respectful meeting and a frank exchange of views.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Did Royal BAM give any commitment about the contribution from its side to the extra costs of this project from where it was initially a number of years ago to where it is now? The people who have to pay it are the taxpayers of this country.

Stephen Donnelly (Wicklow, Fianna Fail)
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Regarding the costs, I made the point on behalf of the Irish people that the Irish Government agreed to an amount earlier this year and that is the amount on the table, which we do not intend to add to. It has been made clear that the budget has been set. It is in everybody's interests, including obviously the children of Ireland but also the contractor, for the contractor to accelerate its work and move on to other projects.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Does Royal BAM accept that it is an extraordinary amount from where this project started to where it is at the moment? It is multiples of what the cost was going to be five or six years ago to where it is now. Does it accept that this is an extraordinary amount that the State has to pay, for what is an impressive structure, by the way?

Stephen Donnelly (Wicklow, Fianna Fail)
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I would prefer not to try to characterise BAM because it would be fully entitled to come back and say that is a matter for the company. I apologise for repeating myself. The full gamut of issues was discussed in a frank and open way.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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How confident is the Minister that it will be completed by June of next year? How confident was he before the meeting and what is his analysis afterwards?

Stephen Donnelly (Wicklow, Fianna Fail)
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For me, the purpose of the meeting was because I did not have confidence in the June date and the board, acting on all our behalf, certainly did not have confidence in the June date. That was the genesis of the meeting. From my perspective, one of the core points of the meeting was to say this is BAM's fourteenth deadline, that we cannot possibly have confidence, and the board most certainly does not have confidence in this deadline based on past performance, so we need Royal BAM, as the parent company, to stand over this and for all parties to engage and make sure that a real proposal is put on the table.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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What did BAM say at that meeting that gives the Minister more confidence that it will complete this project by June 2025? The board was before the Joint Committee on Health a number of weeks ago and it was aghast and extremely frustrated about where the project was going. Considering that critique, this project might take much longer than to June 2025. What commitment did BAM give about handing the keys over, as the Minister said, in June 2025?

Stephen Donnelly (Wicklow, Fianna Fail)
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I will reserve judgment on that until Ms Ross, Mr. David Gunning and the team-----

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Why is that?

Stephen Donnelly (Wicklow, Fianna Fail)
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Because we need to see the change. It is all well and good for me and the global chief executive to meet and commit to an improved approach to this, but I want to see the change.

Ms Ross and I will be staying in regular contact. I want to see the change. I want to see a programme of work in which David Gunning, Fiona Ross and all the board, acting on our behalf, will be able to say that if the work schedule is adhered to, they believe the hospital can be handed over in June 2025. I am, therefore, going to wait to see what comes out of this current intensive round of engagement.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Has BAM said to the board it would commit to that work engagement, in terms of workers on site, etc? It was obvious from the board's critique that there are just not enough workers from BAM on site. None of the rooms have been signed over, which is not a great sign in terms of a structure like that.

Stephen Donnelly (Wicklow, Fianna Fail)
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Yes, that is exactly it. It has been a very open point of dispute between the board and the contractor on an ongoing basis.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Again, getting back to the commitments, what exact commitments did BAM give? It is an enormous and very profitable company. What did it say in terms of doing X, Y and Z to get the job finished by June 2025? What did it say to the Minister and board regarding what it is going to do?

Stephen Donnelly (Wicklow, Fianna Fail)
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I think three things are relevant to children being treated in this hospital. First, there was commitment to the commissioning teams going in early. That is something that had not been agreed and can accelerate the opening of this hospital, potentially by several months. That is important. I acknowledge that BAM has said it will facilitate this and make it happen. That had not been agreed. Second, Royal BAM has stood over the June date. Third, rather than us trying to resolve issues and do project management in the room, which would not have been helpful, the company has committed to an intensive round of engagement with David Gunning and his team and the board so we can have a proposal we all believe at least can meet the June deadline. We must then watch the situation, however, and manage it very carefully.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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On a more positive note, when will the hospital be open to children? When will the first child go into the national children's hospital when it is complete? Is there a particular date if that deadline in June 2025 were to be met? Is there a possible timeframe in terms of when children will be cared for in what will be this amazing, though expensive, structure when it is finished?

Stephen Donnelly (Wicklow, Fianna Fail)
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It is an extraordinary facility. I believe we need to keep a very clear focus on next year. If Royal BAM and BAM UK and Ireland can hand us the keys in June 2025, we have been consistently told by CHI that there is a minimum six-month commissioning phase. We are looking to accelerate some of that process. As the Deputy will appreciate, nobody can give a precise deadline, but I think we must be laser-focused on the end of next year. Now, the commissioning team in CHI, and Mr. Lynch may have a view on this point, has strongly stated previously that a transition in winter is not what is preferred because of the pressures we are all aware of. We need to be led by the clinicians on this, because it involves a clinical view as well as an operational view. However, it is worth noting that there has been a very significant increase in staffing in CHI during the lifetime of this Government. We have now for the first time funded the RSV vaccine, which should make a difference in terms of winter pressures, at least in the national children's hospital in the accident and emergency department and in critical care units. This is, therefore, something we will be asking the commissioning team to review-----

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Realistically, then, it will probably be 2026 when we will-----

Stephen Donnelly (Wicklow, Fianna Fail)
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I do not think we should be going there. I think we need to keep the focus very much on 2025.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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It is realistic if things work to plan-----

Stephen Donnelly (Wicklow, Fianna Fail)
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Well, they are telling us-----

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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We all want to see the hospital open as soon as possible. Given the history of this build, though, logistically, we are probably looking at 2026 as the date when children will be there.

Stephen Donnelly (Wicklow, Fianna Fail)
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I appreciate where the Deputy is coming from-----

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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I hope the Minister is right-----

Stephen Donnelly (Wicklow, Fianna Fail)
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-----but it is very important that we do not start talking about 2026. It is extremely important that we keep talking about 2025. Armies of people are on site and involved in commissioning to that effect. Just before I ask Mr. Lynch to come in on this, I wish to acknowledge the workers on site.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Yes, grand.

Stephen Donnelly (Wicklow, Fianna Fail)
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Even though the project may be resourced at what we believe is half what it should be, nonetheless, a large number of very dedicated people are working day and night to build what looks like will be the finest children's hospital in the world. What an extraordinary thing that is for a little country like us to be saying. Those workers have been building the hospital in the context of huge negativity-----

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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I know that.

Stephen Donnelly (Wicklow, Fianna Fail)
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-----and it is not their fault. I thank the Chair for his latitude on the time, so I acknowledge the women and men working on that site day in and day out, in winter and summer and in rain, hail, sleet and snow. I thank them for the work they are doing. They have been building this incredible facility for our nation and they have been doing it in a context where all they hear about, obviously, is the negativity associated with it. I just wish to acknowledge and thank those workers, and the workers from the two main subcontractors too.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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I second that.

Stephen Donnelly (Wicklow, Fianna Fail)
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They really have been working very hard. It is not the fault of anyone on site-----

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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No.

Stephen Donnelly (Wicklow, Fianna Fail)
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-----that the resourcing has not been where we want it to be. I acknowledge that fact. If the Chair is happy, I ask Mr. Lynch to come in on the issue of the commissioning and to provide some detail in this regard.

Seán Crowe (Dublin South West, Sinn Fein)
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One of the questions I had concerning the commissioning is that we know not one room or space has been finished and signed off on. How, therefore, can the commissioning happen with that background? How can that happen when the rooms are clearly not finished? Last week, I asked about MRI machines, CT machines and other similarly very expensive machines. Will this aspect be prioritised in relation to the finishing off of rooms? I would imagine that will be clearly be key in this context. Again, however, we were told two weeks ago that no room was finished to the requirements specified. It would be interesting, therefore, if Mr. Lynch could address this issue.

Mr. Patrick Lynch:

I will start with that point. There are 6,000 rooms, and 4,600 of them are clinical spaces. If we walked into many of the rooms, we could say they are substantially completed but not to the quality we would expect in terms of a handover. In the context of this accelerated programme, that would be one of the priorities for us. Commissioning sounds like you would just put in all your equipment, but about 100,000 pieces of equipment must be brought in and located in the hospital. More importantly, though, about 36,000 individual pieces of equipment will have to be connected to what is now a single digital hospital. That is a very complex process in itself. Some of the equipment is almost next-generation equipment.

Regarding the staff who will be coming in and working the hospital, this will involve not just the integration of three teams from three different hospitals, who have different histories and cultures and will now have to work together, but every single process in the hospital will be different. Commissioning, therefore, is not just about getting the equipment in and plugging it in. It must all integrate and work properly with a paperless hospital, where every part of the record for a child will be live. The diagnostics will be available live. Probably for the first time ever for children in Ireland too, the family will own that record and have access to it. Equally, every clinician will have access to it in real time.

Much of that work can be done and set up. It will, however, only be when staff can get into the building and start to simulate what it will actually mean and what every new process will mean clinically that it will be possible to continue it. We would then think of some of the urgent areas like the theatres or critical care unit. All the equipment there is going to be new and the ways of working are going to be new too. These are really high-risk situations, so this cannot be done sort of before the staff go in. People really have to be embedded first. There is then a need to test all those processes, because on day one when the children start coming into the hospital, you want to be able to clinically stand over the fact that every single process has been rigorously tested to ensure every child transferring in will be safe. There is massive complexity to this. That is maybe to give a flavour of some of it

Martin Conway (Fine Gael)
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Picking up on that point and reflecting on this whole issue, clearly the commissioning is a major project. We need to be realistic and honest with people that, yes, we might be able to shed some time off the delivery date and get some back office work done, but clearly a hospital can only be commissioned effectively when you have the keys and take it over.

My first question for the Minister is how much time, realistically, does he think it will take to go into the hospital ahead of the handover to do the commissioning-----

Stephen Donnelly (Wicklow, Fianna Fail)
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I thank Senator Conway for that. I will ask Mr. Lynch to come in with some of the detail but at a high level-----

Martin Conway (Fine Gael)
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The detail that I want is at high level, to be honest.

Stephen Donnelly (Wicklow, Fianna Fail)
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Okay, I will give the Senator the high level detail and then I might come back to Mr. Lynch regarding the likely time saved. There is an area in the hospital which they call the hot block. This is the laboratories, emergency department, theatres and intensive care floor. For obvious reasons, this is where an awful lot of the time has to be spent. The clear view is that it is on the critical path and if we can pull that forward, it gives us the opportunity to pull forward the end of the commissioning. That is the short answer. We want to get into that block because it has all this very complicated stuff in it.

Before I hand over to Mr. Lynch, I will point out that one of things we could control is workforce. The original estimate for the new hospital was a workforce of 3,905 people. I am very happy to say, and colleagues will be aware, that we have been in an expansionary phase in the lifetime of this Government in terms of workforce. Rather than being at 3,905 people, CHI is now over 400 ahead of that at 4,334 people. These are all needed. We have introduced new services, for example, since that original number was estimated. It is one of the things we can control. We can make sure we have scaled up the workforces in Crumlin and Temple Street hospitals so that on the day of the move, so to speak, we have the full workforce available.

Martin Conway (Fine Gael)
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That is fine. I might bring Mr. Lynch in in round two but I want to stick with the Minister for the moment. Following on from Deputy Kenny's question regarding the timeline, and I appreciate the Minister does not want to get into picking a date, he might tell us when he is expecting this intensive round of engagement with BAM to conclude? Bear in mind, we have had four extensions of deadlines in the past 12 months. Most people are realistic and know it would be a miracle if we did not have another extended deadline beyond June.

Stephen Donnelly (Wicklow, Fianna Fail)
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It is not possible to say if it will be Friday, Friday week or Friday fortnight.

Martin Conway (Fine Gael)
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The Minister must have an indicative date.

Stephen Donnelly (Wicklow, Fianna Fail)
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I want to give BAM Ireland and UK, Royal BAM Group and the board the space they need to come back with a proposal that everybody can stand over. It would not be helpful at this point to say that it will be Friday week or Friday fortnight or to give a specific date.

Martin Conway (Fine Gael)
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Does the Minister expect it in the next couple of weeks? I presume it will not be a couple of months but a couple of weeks.

Stephen Donnelly (Wicklow, Fianna Fail)
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I do not believe we have a couple of months.

Martin Conway (Fine Gael)
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Good.

Stephen Donnelly (Wicklow, Fianna Fail)
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This has to be done urgently.

Martin Conway (Fine Gael)
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With regard to the cost of €2.2 billion, my understanding is that there are claims of over €900 million. Again, realistically, we have to be prepared that the cost of the hospital is going to be in excess of €2.2 billion. Ultimately, some of these claims will be settled in the courts. I would like the Minister's view on the €2.2 billion. I assume, and I think we all need to be realistic here, that the figure is going to be higher than that.

Stephen Donnelly (Wicklow, Fianna Fail)
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If I could be so bold, and apologies if I am overstepping here, it is not helpful for Members of the Oireachtas to state that we will be paying the contractor more money than the Government has already stated. It does not help the taxpayer for Members of the Oireachtas to essentially throw more money on the table.

Martin Conway (Fine Gael)
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I will put it to the Minister another way then.

Stephen Donnelly (Wicklow, Fianna Fail)
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Apologies, Senator, but-----

Martin Conway (Fine Gael)
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We have to be realistic because we are talking about taxpayers' money. We have to be somewhat forthright with people. Has the Minister at any stage looked at designing out some of what has been proposed for the hospital in order to keep it in budget or to reduce the budget?

Stephen Donnelly (Wicklow, Fianna Fail)
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All of the structural design and the things that really cost the large sums of money are done. We are in a snagging phase right now.

Martin Conway (Fine Gael)
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Did the Minister at any stage over the past four years look at designing out any of the components or some of what might be considered non-essentials?

Stephen Donnelly (Wicklow, Fianna Fail)
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It is something that would be reviewed by the design team and by the board. In 2019 when it became clear that this was going to cost considerably more than had been communicated, there was a lot of activity at that time. Certainly, by the time this Government was formed, the core structural design was settled.

Martin Conway (Fine Gael)
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At any stage, did the Minister look for resignations along the way in terms of the constant overruns from any of the board? The accountability issues are important and while the Minister might not like people asking the questions, he would have asked them himself. Indeed, when the Minister was before the committee as a Deputy, he asked the very hard questions and rightly so. I am asking the Minister some of the questions he might have asked when he was on this side of the table. The Minister asked at one stage if the former Minister for Health, Deputy Simon Harris, had requested any resignations from any member of the board at the time. I am putting the same question the Minister asked in 2019 to him now.

Stephen Donnelly (Wicklow, Fianna Fail)
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The Senator will appreciate that the reference made was in the context of a massive increase in the communicated cost.

Martin Conway (Fine Gael)
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This has obviously continued.

Stephen Donnelly (Wicklow, Fianna Fail)
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It has not continued. The amount of money the Government authorised earlier this year was linked to the 2019 agreement so the cost overruns did not continue in the lifetime of this Government. I am afraid the €2.2 billion was referring back to the 2019 agreement.

Let me answer the Senator very directly. I have full confidence in the board acting on our behalf. I believe Ms Fiona Ross, Mr. David Gunning and the team have done the very best job they could and have used the contractual levers available to them. At this point, it would be futile to second guess the contract and the levers put into that contract. I have full confidence in the board. It has done the best that could be done in what is a very difficult situation. On that basis, there would be no grounds for me to seek resignations.

Martin Conway (Fine Gael)
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Obviously the Minister made a decision at a particular point that he needed to move the engagement and discussions with BAM in a different direction. In the past week or two, the Minister met with the Royal BAM Group. Does the Minister think it would be useful for the Royal BAM Group to come into this committee to give its side of the story?

Stephen Donnelly (Wicklow, Fianna Fail)
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That is a matter for the committee. It is not for me to say.

Martin Conway (Fine Gael)
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The Minister made obviously well-founded charges from his perspective regarding the financial situation and gave a view to the Taoiseach in his letter. If I was the Royal BAM Group, I would have been very upset and annoyed about that. I sincerely hope that relations have not irreversibly broken down and that we will see the type of commitments the Minister is hoping for in the coming weeks.

John Lahart (Dublin South West, Fianna Fail)
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It sounds like Royal BAM is in the room already.

Martin Conway (Fine Gael)
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On a point of order, can the Deputy explain that?

John Lahart (Dublin South West, Fianna Fail)
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It is what it is.

Martin Conway (Fine Gael)
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There are two sides to the story. I want to be fair. We have a responsibility. Obviously, the Minister's clearest objective is to open what we know, when it is completed, will be the best hospital in the world. I am very confident and hopeful that this will happen. However, it is coming at a cost and with delays. We have a responsibility here to interrogate and drill down to see why these delays happened and how they can be mitigated going forward so that they do not continue to delay the project. If people have a problem with me asking these questions, that is their problem.

Seán Crowe (Dublin South West, Sinn Fein)
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I thank Senator Conway. I will let Deputy Alan Kelly in now.

Alan Kelly (Tipperary, Labour)
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How long do I have?

Seán Crowe (Dublin South West, Sinn Fein)
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Ten minutes for your questions and then the answers.

Alan Kelly (Tipperary, Labour)
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I thank the Minister and to the committee for facilitating me. I have a number of questions. I will direct the first to the Minister. I am one of these people who thinks there are two sides to every story. I have huge issues with BAM and how this was designed from day one. If we all went at it again we would not go at it the way it has been done. That is across politics and across everyone. We need to learn that this two-stage process for large-scale projects is just crazy stuff. I am one of the people who would complement the Minister on the fact that he went to meet Royal BAM. It was a good idea. I can understand why he did it late in the day rather than earlier, from a cost point of view, and not to build up leverage it had access to all the time. However, in the actual meeting, the Minister came out and said that BAM had agreed to June. I am delighted with that. However, were there any conditions attached to agreeing to June? For instance, was June agreed on the basis of there being no more design changes or was it June, full stop? The second part of that question is since Mr. Gunning and his team were in before this health committee a number of weeks back, and since the Minister met Royal BAM last week, how many design change orders has there been?

Stephen Donnelly (Wicklow, Fianna Fail)
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In response to the Deputy's first point, are there lessons we can and have learned? Most definitely. Mr. Tierney is the lead in the Department of Health on the National Maternity Hospital and on the elective hospitals and there was a comprehensive piece of work done which Fiona Ross fed into as well. It has to be remembered we are commencing five other hospitals-----

Alan Kelly (Tipperary, Labour)
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Yes, I get that. I will concentrate on this one in the limited time.

Stephen Donnelly (Wicklow, Fianna Fail)
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Lessons have most definitely been learned. Regarding the criteria for June, I will give my understanding of it. I fully accept BAM may agree or disagree with that. Where I believe we got to was that it was willing to stand over the June deadline with a proviso that there were not design changes that would reasonably delay the project. You might have very minor design changes. In fact, the information which I hope has been furnished to the committee shows that the development board has submitted changes over time. Actually, BAM has submitted slightly more changes. In a project of this complexity, there will always be minor changes. It would not be reasonable if the board or the design team were to start submitting more big changes that simply slowed the project down-----

Alan Kelly (Tipperary, Labour)
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It would not be reasonable.

Stephen Donnelly (Wicklow, Fianna Fail)
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Yes. We would have to accept that. Where I believe we have got to is that there would be no substantive design changes. Obviously, I cannot speak for BAM. It may have a different view but certainly that is my clear understanding.

Alan Kelly (Tipperary, Labour)
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How many changes have there been since?

Ms Fiona Ross:

I do not have that number. We updated it about two weeks ago but I will get that number of any design changes.

Alan Kelly (Tipperary, Labour)
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There has been changes.

Ms Fiona Ross:

I do not know if there have been changes since last Thursday.

Ms Fiona Ross:

You do not know?

Ms Fiona Ross:

I do not know, no.

Alan Kelly (Tipperary, Labour)
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The Government has set aside €0.5 billion to finish off this project.

Stephen Donnelly (Wicklow, Fianna Fail)
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It has committed a totality between the commissioning and the project of €2.2 billion.

Alan Kelly (Tipperary, Labour)
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We know the standing conciliator has made big award towards BAM. What is the €0.5 billion for?

Stephen Donnelly (Wicklow, Fianna Fail)
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Ms Ross can correct me if I am wrong-----

Alan Kelly (Tipperary, Labour)
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The Minister said before that not a penny more would be given. What is the €0.5 billion more for if it is not a penny more? The standing conciliator has made awards on a number of occasions, unfortunately for the taxpayer. What is that money for if the standing conciliator is making all these awards and the Minister is saying there is not a penny more? A standing conciliator is there as a person who is appointment by the board. It is a contract with the contractor and it is agreed, etc. What is the €0.5 billion for so?

Stephen Donnelly (Wicklow, Fianna Fail)
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I will address the point on claims very quickly and then ask Mr. Tierney to give the Deputy the detail.

Alan Kelly (Tipperary, Labour)
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Briefly, yes.

Stephen Donnelly (Wicklow, Fianna Fail)
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The totality of claims is €863 million. To date, there has been an agreed €31 million against that.

Alan Kelly (Tipperary, Labour)
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Can you answer on how much the conciliator has actually given? In other words, the next step is the courts obviously. What is that total?

Stephen Donnelly (Wicklow, Fianna Fail)
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To the best of my knowledge, Ms Ross can correct me if I am wrong, there has been one major recommendation in BAM's favour.

Alan Kelly (Tipperary, Labour)
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Yes. One is €108 million and there are 17 or 18 others.

Stephen Donnelly (Wicklow, Fianna Fail)
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The main one is €107 or €108 million. That is strongly contested by the board and that is going before the courts. The advice I have from the board is that it has a very strong case on that. If the Deputy would like Ms Ross to say more, she can.

Alan Kelly (Tipperary, Labour)
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No, that is fine.

Mr. Derek Tierney:

The Government approved the overall capital budget with an increase of €446 million. That was to recognise the recommendations in the PwC report of 2019. It was to cover off a number of headings including inflation and inflation recovery, costs incurred by the project, to include, up to that point, any true costs the contractor was entitled to claim and will claim, and then lastly to cover off the overhead cost to augment the capability of the paediatric hospital development board.

Alan Kelly (Tipperary, Labour)
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Okay, I get that. That is fair. It is all accurate.

Mr. Derek Tierney:

It is not a true construction increase.

Alan Kelly (Tipperary, Labour)
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I do not want to run down the clock on this, so I will not go any further but my point is if this has been allocated towards it and we are saying not one penny more, but yet the conciliator, who is independent, recognised as such and has a long history in these projects, is giving a big award like that. That means we are saying not a penny more but we cannot stand over it because if the funding that has been allocated does not include potentially that €108 billion, we have an issue. I need to move on with the clock. My other question-----

Stephen Donnelly (Wicklow, Fianna Fail)
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I am really sorry to interrupt and we may be able to add a bit of time at the end but it is important to respond to that point if we could.

Alan Kelly (Tipperary, Labour)
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Okay.

Mr. Derek Tierney:

A conciliation is but a recommendation. It is not binding; it is a recommendation and can be disputed and resolved through the legal process.

Alan Kelly (Tipperary, Labour)
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I understand.

Mr. Derek Tierney:

In fairness to the project, it has transferred the money recommended by the conciliator but BAM has bonded it. BAM has access to that money to flow into its supply chain, to fund the project and keep it moving but there is now a dispute three years on in the courts.

Alan Kelly (Tipperary, Labour)
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I understand the process but my point still stands. It is really not one for Mr. Tierney; it is really more a political point. To stand over this not one penny more to BAM statement is impossible because that process has to be complete.

Mr. Derek Tierney:

Even with that conciliation, we are still within budget.

Alan Kelly (Tipperary, Labour)
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I know but it does not allow us to stand over the not one penny more statement.

Stephen Donnelly (Wicklow, Fianna Fail)
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Can I respond very quickly?

Alan Kelly (Tipperary, Labour)
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I have some really-----

Stephen Donnelly (Wicklow, Fianna Fail)
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Within the €2.2 billion, there is an amount allocated for these settlements.

Alan Kelly (Tipperary, Labour)
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How much is that?

Stephen Donnelly (Wicklow, Fianna Fail)
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It is commercially sensitive. I cannot say.

Alan Kelly (Tipperary, Labour)
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That leads us down an alleyway where my question cannot be answered.

I want to ask the chair of the board, Ms Ross, a few questions. First, is she satisfied with the executive team?

Ms Fiona Ross:

Yes.

Alan Kelly (Tipperary, Labour)
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Have they the skills appropriate to seeing out this project? Is she always happy with all of them?

Ms Fiona Ross:

Yes, I am.

Alan Kelly (Tipperary, Labour)
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Did any of them require any further skills or educational training? As part of this process, did the board sign off on anything for members of the executive team in that way? If so, how much did that cost?

Ms Fiona Ross:

There is always continuous development for all our executives and our team. At any point in time, some of our executives are taking on additional education.

Alan Kelly (Tipperary, Labour)
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Is there anything this committee needs to be made aware of in that situation?

Ms Fiona Ross:

No. I am not aware of-----

Alan Kelly (Tipperary, Labour)
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No senior executives have been on courses that cost a lot to the project.

Ms Fiona Ross:

Some of our senior executives have taken courses, yes.

Alan Kelly (Tipperary, Labour)
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How much did they cost?

Ms Fiona Ross:

I do not have that number but I can furnish it to the committee and the Deputy.

Alan Kelly (Tipperary, Labour)
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Ms Ross is happy with signing off on that.

Ms Fiona Ross:

Yes, I am.

Alan Kelly (Tipperary, Labour)
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Was it previous to Ms Ross, to be fair to her?

Ms Fiona Ross:

I would have to get that detail. I am not sure what happened before my time.

Alan Kelly (Tipperary, Labour)
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Okay. At any point during the project, did any of the contractors, of which there are multiple and not just BAM, for any part or parcel of the project not register with the regulatory agency for any part of the work on the project that Ms Ross is aware of?

Ms Fiona Ross:

That is a detail I am not aware of but I can get that information for the Deputy.

Alan Kelly (Tipperary, Labour)
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Ms Ross cannot confirm that that did not happen.

Ms Fiona Ross:

I assume that all of our contractors are regulated and appropriately registered, but I do not have that detail.

Mr. Derek Tierney:

The Deputy is aware of the recent media coverage on the status of electrical trades, not just on this project but a wider dispute by the union. That relates to a distinction between those who are certified on the Register of Electrical Contractors of Ireland, RECI, and those who are supporting those who are RECI-certified. We will get the Deputy a note on that.

Alan Kelly (Tipperary, Labour)
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I really just want to know if anyone is working on the site who has not been registered for any period. It is as simple as that. You would be checking those all the time.

Mr. Derek Tierney:

Yes. That is an obligation on BAM for the subcontractors.

Alan Kelly (Tipperary, Labour)
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It is, in fairness, but some do not report to BAM. Some are sideways, as I understand it.

I have rigorously gone through the whole process by which disputes happen because I am on the Committee of Public Accounts. I have gone through the issues of the employer representative, the board process, the meeting between the board and BAM, and then it comes down to the standing conciliator. The standing conciliator is a very eminent person. The witnesses can verify if this is accurate. If I am not accurate, they should please tell me. Remember that this independent person has found substantial claims. One is for €108 million, which in anybody's book is a lot of money. Another is for €18 million, as I understand it, which is a lot of money too. Why was there a requirement to bring in an eminent retired judge to look at that person's contract at some stage? Why was there a requirement to do that and what was the outcome of it?

Ms Fiona Ross:

As we made clear at the last outing-----

Alan Kelly (Tipperary, Labour)
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I have raised this in the Dáil previously, so Ms Ross knows.

Ms Fiona Ross:

-----the board does not have confidence in the standing conciliator.

Alan Kelly (Tipperary, Labour)
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That is incredible, for one simple reason. A couple of weeks ago, the chief executive of the board said directly to me, after I asked him a number of times, that he did have confidence. What has happened in the last couple of weeks to change that? Mr. Gunning had confidence, because he nodded at me, but Ms Ross does not have confidence.

Ms Fiona Ross:

That is correct.

Alan Kelly (Tipperary, Labour)
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What has changed?

Ms Fiona Ross:

Nothing has changed.

Alan Kelly (Tipperary, Labour)
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So Mr. Gunning was wrong.

Ms Fiona Ross:

If we look back, Mr. Gunning did not reply to the Deputy's question.

Alan Kelly (Tipperary, Labour)
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He did reply. He had confidence. A few weeks later, Ms Ross does not have confidence. That is frankly incredible, Chair.

Seán Crowe (Dublin South West, Sinn Fein)
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People are asking two questions about the hospital, one of which is when it will open. We are being told it will be June 2025 but we are not sure on that.

Stephen Donnelly (Wicklow, Fianna Fail)
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To be clear, it is not being stated that it would open in June 2025. That is when we are looking to take over the hospital completely, at which point much of the commissioning then happens.

Seán Crowe (Dublin South West, Sinn Fein)
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We are not sure of the exact date when we will open. Is that what the Minister is saying?

Stephen Donnelly (Wicklow, Fianna Fail)
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I will give my view. If BAM meets its 14th deadline, if we take full charge of the hospital in June, as it is stating we will, if our commissioning teams get early access to this so-called hot block and if the commissioning work proceeds as it is being planned, then the timeline would suggest the end of 2025. There is then a clinical decision about whether it is appropriate to move in the eight most intensive weeks of winter. We will be led clinically on that. However, as we have all said here, the genesis of my meeting with Royal BAM was that I did not have confidence and the board did not have confidence in the June deadline. I am saying that if it meets its deadline, if it gives the commissioning teams early access and if this commissioning happens according to the schedule, then I think we all have to be focused on the end of 2025.

Seán Crowe (Dublin South West, Sinn Fein)
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We do not have an exact date. We have a ballpark time for when it may or may not happen depending on the works that are carried out. The frustration that we heard the last time, when the board was in, was that there was no baseline contract. In other words, there was no work schedule that the board was confident would go ahead. On the back of the Minister's meeting with Royal BAM, have we now a baseline contract and a work schedule that he is confident it will finish by June 2025?

Stephen Donnelly (Wicklow, Fianna Fail)
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We now have a date that Royal BAM says it is standing over and intensive engagement on exactly the baseline programme of work the Cathaoirleach is talking about, such that BAM, Royal BAM and the board, on our behalf, can say this is real and can be done. Let us hope they emerge with that. Even if and when they emerge with that, we will then have to manage that programme of works closely to make sure it is implemented.

Seán Crowe (Dublin South West, Sinn Fein)
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The concern I have and, I suppose, most people would have is in relation to that contract. It was said that lessons were learned from that. Could the Minister outline what lessons were learned? There is a backdrop of a maternity hospital that is to be built. Will we have to go through the same difficulties with that? This process has dragged out. There was clear frustration from the members of the board who were here last week. The general public would share the same frustration, particularly the families of those children who were hoping to go into that hospital. They must be pulling their hair out at this stage. I am thinking in particular of children with scoliosis, but not exclusively them. What lessons have been learned about the contract? What will be done differently? It seemed the last contract was based on a sketchy design for the hospital. Does the Minister have it in mind that this will not happen again? Will we repeat this? If it is repeated, it will be unforgivable.

Stephen Donnelly (Wicklow, Fianna Fail)
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I will ask Mr. Tierney to come in with some of the detail in a moment. I would like to make two quick points in response to what the Cathaoirleach said. First, for children who are waiting on spinal care, be that outpatient appointments, diagnosis, surgery or aftercare, that care and sorting out what we need to do for those children are not contingent on this hospital opening. We have added significant capacity in Crumlin and Temple Street hospitals, with an extra operating theatre, double the MRI capacity, 24 more beds, and many more staff. The Taoiseach and I, the chief executive and others had a very constructive meeting with several of the patient advocacy groups on Monday. We were able to outline to them the reductions through this year and the number of children on the active list. We are pursuing that relentlessly. It is not contingent on this hospital. I just want to make that point.

On the Cathaoirleach's point, if I can back it up further, the last hospital the State built was, I think, Tallaght University Hospital, 20 or 25 years ago. The State has not done this in decades. In fact, it has never done any hospital of this complexity. Not including the children's hospital, we now have five other hospitals that we are committed to building. One has commenced, which is the maternity hospital, and we have four elective hospitals too. A thorough lessons-learned exercise has been done. I ask Mr. Tierney to give some of the top lines on that.

Mr. Derek Tierney:

We have taken a different procurement approach and a different approach as we enter into the contract.

What we did on the maternity hospital is well under way. We separated the enabling works from the main works contractor to de-risk the main works contractor under specialties going in. Those works are under way and that contract is now live. If one goes out to St. Vincent's, one can see that is up and running and we are clearing sites. We are getting that site ready.

When I look at the process around how have we structured the procurement, we have a detailed design going into the procurement. We have not just once, but twice, carried out two independent third-party reviews of that design for robustness to ensure that it reflects a true bill of quantities to support that and all our budget estimates are based on a quantified risk assessment around that design taking the learnings from not only this project but international projects as well to inform what the budget construct should be.

Ultimately, the budget will be set once we complete procurement of the main works and the specialties. That will be brought to Government for sign-off and agreement.

There is another thing we are doing in the construct of lessons learned. Before we sign any contract with a construction contractor or reserve specialists we will enter into a six-month pre-service contract period. This is to bring all the parties together, integrate all the parties and make sure everybody is clear about what the intent is and that any open questions are answered before we sign down contracts.

We have put more granular tender delay costs into the contract and we are also increasing the higher threshold claim amount. Currently, a claim can be triggered from around €500. We are increasing that to €2,500 to, I suppose, encourage collaboration and that issues are dealt with at the very outset rather than letting them snowball and introducing an opportunity to just keep piling in claims over the course of that contract. Therefore, we have taken a different tendering approach and we are talking a different approach in how we set up the contract and how it can be administered.

Seán Crowe (Dublin South West, Sinn Fein)
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At some stage, maybe Mr. Tierney could provide the committee a note on it-----

Mr. Derek Tierney:

Absolutely, yes. That will not be a problem.

Seán Crowe (Dublin South West, Sinn Fein)
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-----because we are all worried. We do not want to see this repeated. In relation to the maternity hospital, will we see that built by the end of the decade?

Mr. Derek Tierney:

In the current programme, it is late 2028 to early 2029. Enabling works are under way. They are programmed to finish in quarter 3 of 2025. The main works and the reserve specialists are out to tender. We want to see that tender process complete by the end of November and then we are into a three-month evaluation period so that it runs concurrent too. When we finish enabling works, we will have boots on the ground in terms of the main works.

Seán Crowe (Dublin South West, Sinn Fein)
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Lastly, the last time the board was in, they were saying that they were withholding the 15% in relation to payment. Is that still in place following the board's substantive meeting with Royal BAM?

Ms Fiona Ross:

That is intended. There is obviously a process associated with that. That does not happen overnight. We are intending to withhold 15% unless things change significantly in relation to the timelines and the progress on the site, which we are hoping, as we discussed earlier, will be the case.

Seán Crowe (Dublin South West, Sinn Fein)
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Has that not changed?

Ms Fiona Ross:

Our position on withholding 15% has not changed but, obviously, if progress improves and things are working and going in the right direction towards the 25 June day, we would review that.

Seán Crowe (Dublin South West, Sinn Fein)
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In relation to the baseline contract that the board kept coming back to in relation to that work schedule, is that what the board is waiting on now, coming back from BAM?

Ms Fiona Ross:

Yes.

Seán Crowe (Dublin South West, Sinn Fein)
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Is Ms Ross saying that could be a number of weeks or months?

Ms Fiona Ross:

It was issued to us last Wednesday and it will take some time for the ER to deem it compliant or non-compliant. That takes some time.

Seán Crowe (Dublin South West, Sinn Fein)
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I thank Ms Ross. I propose we take a comfort break for-----

John Lahart (Dublin South West, Fianna Fail)
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I made a comment and Senator Conway would have been hurt and taken back by it. It was off the cuff about Royal BAM being the room. I withdraw it. It was not intended. It was in the heat of the moment.

Martin Conway (Fine Gael)
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I knew that. I appreciate that because I never had any engagement. I had never spoken to the people.

John Lahart (Dublin South West, Fianna Fail)
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I was not suggesting that. It was an inappropriate comment and it was not intentional.

Martin Conway (Fine Gael)
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Okay, I thank the Deputy.

Seán Crowe (Dublin South West, Sinn Fein)
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As a committee, we have never formally discussed any requests about meeting with BAM or not in relation to that.

I propose we take a break for five minutes. Is that agreed? Agreed.

Seán Crowe (Dublin South West, Sinn Fein)
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I call Senator Kyne, who will lead us off.

Seán Kyne (Fine Gael)
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I welcome the Minister and witnesses. Having visited the hospital site on two occasions, no doubt it is an impressive building and it will be a world-class facility. It will be something we can be rightly proud of when it is concluded and workers are off-site and we have it fully staffed and operational. We all hope we will never have to visit there, attend there or see somebody there but if we do, we will know it will be a world-class facility with the highest standards and the highest quality.

Regarding their statements, did their concerns and their asks and the information that they provided come as a surprise to Royal BAM?

Stephen Donnelly (Wicklow, Fianna Fail)
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I cannot speak for whether or not they were surprised. They did not hear anything that was not in public domain in terms of the Government's position but, obviously, as to whether they were surprised or not, only they can answer that.

Seán Kyne (Fine Gael)
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Were representatives of BAM UK and Ireland present at that meeting with Royal BAM?

Stephen Donnelly (Wicklow, Fianna Fail)
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Yes. The Royal BAM chief executive was there and he was accompanied by the chief executive or the general manager - whatever the title is - for BAM UK and Ireland and the chief operating officer for BAM UK and Ireland.

Seán Kyne (Fine Gael)
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Did the representatives from BAM UK and Ireland push back at that meeting in terms of what the Minister saying to Royal BAM?

Stephen Donnelly (Wicklow, Fianna Fail)
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Rather than trying to characterise their position, what I have no hesitation in saying is that BAM disputes a lot of what we have all discussed. It would be unfair of me to suggest that BAM simply said that it was sorry about all that and it will try harder. It is clear from the interactions the board has had with BAM over a long period that BAM has its view and it is a different view to the State's view.

Seán Kyne (Fine Gael)
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Were the board in agreement with the Minister intervening at this stage or did they suggest that he should? Did they request it? Did they suggest it earlier or was there any pushback?

Stephen Donnelly (Wicklow, Fianna Fail)
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The decision to contact Royal BAM was one I took subsequent to the meeting, first, with Ms Ross, and then, second, with the full board, on the back of BAM signalling that it was moving out to a June deadline.

Seán Kyne (Fine Gael)
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Was it not suggested at board level before this? Was exasperation expressed about the moving out of the deadline 14 times? Was exasperation expressed to the board and a suggestion that this needed to go higher than the board?

Stephen Donnelly (Wicklow, Fianna Fail)
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I do not know if there was any such suggestion. There may well have been. Minutes were taken at the meeting. I do not recall it. I can say that there was a very high level of frustration when I met the board. Ms Ross is the chair of the board. We might ask her for the board's view, if that is okay.

Ms Fiona Ross:

As I said earlier on, it was the shifting of the date to June 2025 and then the risk to the opening date that triggered a new phase of concern regarding the completion of the project. There was a consensus and it was a collaborative decision taken by all the stakeholders regarding the Minister making the decision to write to Royal BAM. We were very comfortable with him doing so.

John Lahart (Dublin South West, Fianna Fail)
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Was the board not concerned before this?

Ms Fiona Ross:

We have had ongoing engagement with BAM and Royal BAM over many years. We have written to them in the past. As I made the point earlier, we have been in touch with Royal BAM in the past, just not at the level at which the Minister wrote. I had written to the chair of Royal BAM in the last couple of months and had not received a reply.

Seán Kyne (Fine Gael)
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Was the board's engagement with Royal BAM prior to this being passed off to BAM UK and Ireland or was it actively engaging?

Ms Fiona Ross:

It was before my time. I would not call it an active engagement but its representatives did attend some meetings around the time I took over but certainly before my time, so I cannot attest to the level of engagement in detail.

Seán Kyne (Fine Gael)
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Royal BAM did not reply to the board but it subsequently agreed to meet the Minister. Would Ms Ross say that his intervention was important?

Ms Fiona Ross:

Yes.

Seán Kyne (Fine Gael)
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Regarding the staffing levels, would it be the Minister's view that BAM has prioritised other projects over this because for some reason it sees the State as a softer touch than private operators?

Stephen Donnelly (Wicklow, Fianna Fail)
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I cannot say what BAM's motivation is but the facts, as I see them, are we have very clear evidence, I believe, from the board, based on gate receipts, noting day by day, how many people are on site. We have very clear evidence, which BAM may dispute, but the evidence as I have seen it is very strong that the hospital project has been consistently and substantively under resourced. That is one point and, conversely, BAM is involved in a lot of projects in Ireland, including roads, schools and primary care centres which appear to be finishing on time. I am not familiar with the level of resourcing on those projects but it is certainly true that BAM has a very substantial workforce across multiple projects around the country. This is at the same time that we believe that the hospital project is under-resourced. Whether or not there is a link between those would be for BAM to say.

Seán Kyne (Fine Gael)
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Is the Minister aware of the number of direct employees of BAM or subcontractors in terms of the different pieces of the project?

Stephen Donnelly (Wicklow, Fianna Fail)
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Does the Senator mean nationally across all of its projects?

Seán Kyne (Fine Gael)
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No, in the children's hospital.

Stephen Donnelly (Wicklow, Fianna Fail)
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I do not but I think Ms Ross has that detail.

Ms Fiona Ross:

I wish I did have that specific detail. In terms of operatives on the site, we can get the breakdown between BAM contractors and the subcontractors. I can get that information but I do not have it at the moment.

Seán Kyne (Fine Gael)
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If BAM is subcontracting out then presumably the subcontractors would be able to provide the staff to ensure the delivery of the project. I know the issue of the grilles was discussed earlier on. I was surprised that 94% of the project has been completed, going on the figures Mr. Gunning gave two weeks ago. However, at the same time, none of the rooms are at a level to be signed off on. There is a snag list and some of the snags are issues that are repeated in every room. I have not been able to understand why there was not some sort of oversight of the completion of the first 100 rooms, for example, and why those issues were carried forward to all of the rooms. Obviously, I do not expect the Minister to be out there inspecting the rooms but where was the oversight if this has become an issue at the end of all the rooms being ready for handover?

Ms Fiona Ross:

That is the responsibility of the contractor. There are processes in place, under a normal contract, that would allow for what the Senator has described, where there is an exemplar room or set of rooms that are exactly perfect and which get matched across. This allows them to be cycled through much quicker in terms of approving them. However, the contractor has not adhered to this requirement.

Seán Kyne (Fine Gael)
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Where is the oversight of the contractor?

Ms Fiona Ross:

The oversight is when the design team goes in and says the room is not compliant. That is the oversight and that is what is happening.

Seán Kyne (Fine Gael)
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When was that happening?

Ms Fiona Ross:

This has been ongoing since we discussed the 3,000 rooms that have been submitted. A sample of 500 of those were reviewed by the design team and deemed to be non-compliant with the required standards. We would have hoped that the standards would have been met prior to the review by the design team.

Seán Kyne (Fine Gael)
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Had they been inspected earlier, these issues could have been ironed out.

Ms Fiona Ross:

Mr. Devine covered quite a lot of that in the last session. I do not want to misremember the details. He is the project director. Of course there would be ongoing engagement on-site about common issues that come up. I cannot speak about any of them specifically but there would be common issues that would have been identified. It is an iterative process but at a certain point in time they are offered for inspection and they are either passed or not but there is certainly an iterative process that goes on prior to that.

Seán Kyne (Fine Gael)
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Yes, but the initial offering should have raised red flags. It would have allowed the board to say these rooms were not up to standard and direct the company to not offer any more rooms for inspection until the issues were sorted out.

Ms Fiona Ross:

That is exactly what is going on right now, the remediation of the rooms to be re-offered.

Seán Kyne (Fine Gael)
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If the issues had been noticed earlier, that would have pre-empted these delays, I would assume.

Stephen Donnelly (Wicklow, Fianna Fail)
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It is not the case that 3,000 rooms were handed over and then the quality assurance people took a look. They are on-site all the time. The board and the quality assurance people would have raised concerns early and on an ongoing basis. I think the Senator's point is that it went too far before anyone flagged any concerns. My understanding is that those concerns were flagged early but even with this done the company still has to keep proceeding with all of the other rooms, if I am understanding the concerns that the Senator is probing.

Seán Kyne (Fine Gael)
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If a number of rooms were completed, handed over and inspected and assessed as to their meeting the requirements, then the company could have been instructed to do all the other rooms to the same standard. I believe that would have alleviated some of this issue.

Ms Fiona Ross:

That is what we would expect to see from any contractor and that is what we still hoped to see but that did not happen.

Bernard Durkan (Kildare North, Fine Gael)
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We should recognise that all my questions are questions. The Chairman knows that. I usually finish on time as well, which often does not apply to everybody.

Seán Crowe (Dublin South West, Sinn Fein)
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We will do seven-minute slots because everyone wants to come back in on this.

Bernard Durkan (Kildare North, Fine Gael)
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Can we start again? We are coming to the most intricate stages of the contract. It is important that everybody, the client and the builder concentrate on that. The smallest of things can cause an alarm and can lead to bigger things. Then, bigger things can go unnoticed. I have had occasion in the past to look at a number of contracts. I was surprised at some of the things that had gone by without demur but that should have been noticed at an earlier stage.

Earlier I mentioned the bike shed as being a norm against which everything else is now going to be measured. This is slightly more complicated than the bike shed and it is likely to be of major significance in the future. As the contract progresses, are we now reaching the stage where we can engage on a very local basis with the contractor on-site, with a view to identifying issues that we have and discussing them?

If there are issues, can we resolve them? Normally, this is the case on a building site or with the construction of a housing estate or even one house. Traditionally, those responsible for the construction side of a contract do not want to hear too much about the extra stuff that the client wants to add on, but the latter may be necessary. The technique is to ensure that the changes to the contract are minimal but are sufficient in order to meet the requirements that are designated as being the ultimate terms of the contract. Can we be assured that the client is engaging sufficiently early with the contractor in order to alert the builder to the fact that we need to deal with all of this down the road? How are we going to deal with it in such a way as to ensure that there will a resolution before it becomes a problem?

Stephen Donnelly (Wicklow, Fianna Fail)
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My very clear understanding is that the answer is "Yes". I will ask Ms Ross to speak to the matter as well.

Ms Fiona Ross:

Absolutely. I can give the Deputy complete assurance that this level of engagement is happening on the site every day.

Bernard Durkan (Kildare North, Fine Gael)
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That is good. In recent times, this committee has asked particular questions and the contractor has stated that there have been changes to the contract. We know that there have to be some changes. There will always be changes to a contract. Some are instigated by the client and others by the contractor. Is the Minister satisfied that sufficient provision has been made? Is he also satisfied that there is sufficient recognition on both sides that this is an important contract and that it is essential from the point of view of all involved, including the client and the contractor, that matters should be resolved to everybody's satisfaction, including the taxpayer, who has an ongoing interest in this? I say this in the interests of ensuring that we do not get into a blame game. Doing so does not solve anything at all. It does not provide hospitals, schools or anything else. We need to be assured of that. Can we be assured?

Ms Fiona Ross:

Yes. I can give an assurance at this stage. As the Minister pointed out, the project is 94% or 95% complete and is being snagged. There has been no substantive design change since 2019. Any change orders at this late stage relate exclusively to regulatory compliance.

Bernard Durkan (Kildare North, Fine Gael)
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That is understood. I presume the changes are due to changes in regulatory compliance that have arisen since the contract was originally signed.

Ms Fiona Ross:

Yes.

Bernard Durkan (Kildare North, Fine Gael)
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Is it recognised on both sides that this is a requirement that has to be dealt with.

Ms Fiona Ross:

Yes . Wherever the employer - the client - has instructed change since the start of the project, the contractor has been compensated.

Bernard Durkan (Kildare North, Fine Gael)
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We are aware from previous discussions that some of these matters remain unresolved and may have to be dealt with after the hospital is in operation.

Ms Fiona Ross:

Correct.

Bernard Durkan (Kildare North, Fine Gael)
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I happened to have been on the hospital site in a private capacity on numerous occasions in the past 12 months. I learned an awful lot. One can learn from a site inspection. Mine was not an official site inspection, I might add. I was there, and I must say it is a complicated project. Any complicated project will require the minutiae to be dealt with as part of the overall project.

Can I obtain reassurances on other aspects of this matter? For instance, I meet people in the street who say that there is no helicopter landing pad, no controlled car parking and so on. Is it possible to address these issues. I know the answers to the questions, but officially we need to have them. We also need to know if there are other issues that we might need to add on, given the passage of time and regulations that might come into play.

Ms Fiona Ross:

I assure the Deputy there is a helipad and a car park.

Bernard Durkan (Kildare North, Fine Gael)
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I know. Presumably, part of the car park is in the concourse adjacent to the hospital.

Ms Fiona Ross:

I am not quite sure I understand the question.

Bernard Durkan (Kildare North, Fine Gael)
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Adjacent to the main entrance to the hospital there is a concourse where one can come up from the car park and go into the hospital. That is part of the hospital's effective design in order that patients, consultants or nursing staff can get to where they are supposed to be in the shortest possible time without going having to ask for directions, etc.

Mr. Derek Tierney:

To resolve the myths, there is a functional helicopter pad built for the new children's hospital, there is an underground car park with at least 650 spaces - I can get the exact number - with a small allocation for staff and the remainder for parents and their children, as well as the on-site facilities for parents who are trying to work and care for their children who are receiving clinical care in the new hospital. I just want to give that assurance.

Bernard Durkan (Kildare North, Fine Gael)
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I thank the witnesses.

David Cullinane (Waterford, Sinn Fein)
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I want to deal with the funding side. I am aware that some of this was dealt with earlier, but I want to circle back on some of the issues that were raised. There is a huge number of outstanding claims. BAM has placed a value of about €800 million or whatever on these. That has been disputed by the Minister, the State and, obviously, the board. Where we have total agreement is that we all want to make sure we limit any additional exposure to the taxpayer. If I am right, there seems to be a strategy - as it was put - that the total cost is €2.2 billion. In the Minister's view, the State will not be going above that. I had a discussion with the board on this matter last week when they were before the committee and discovered that it is not as simple as that. I will explain why. Am I right in stating that earlier this year or last year, the standing conciliator awarded BAM €108 million, excluding VAT, for a portion of the claims? The Minister included that in the letter he issued to his Cabinet colleagues. Is that correct?

Stephen Donnelly (Wicklow, Fianna Fail)
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That is right.

David Cullinane (Waterford, Sinn Fein)
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It is my understanding - the Minister might confirm this - that those claims centred around delays. While the total ask from BAM or the value BAM put on it might have been double what was awarded it was still awarded €108 million. How in God's name was it awarded €108 million if, as the board has stated, the delays were almost entirely or exclusively down to the contractor? How did BAM end up with an adjudication of €108 million?

Ms Fiona Ross:

It is not the board-----

David Cullinane (Waterford, Sinn Fein)
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I am sorry, I asked the Minister.

Ms Fiona Ross:

Apologies.

Stephen Donnelly (Wicklow, Fianna Fail)
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The award for €107 million or €108 million is contested very strongly by the board.

David Cullinane (Waterford, Sinn Fein)
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I know it is, and it can be appealed to the court. The standing conciliator made a recommendation or however you want to put it. The conciliator adjudicated and made a recommendation in the amount of €108 million. The board contested this. I accept all of that. I went through this with the board. It was, however, the decision of the standing conciliator. Is that correct? The Minister had that in his letter.

Stephen Donnelly (Wicklow, Fianna Fail)
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It was the recommendation.

David Cullinane (Waterford, Sinn Fein)
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Ultimately, any of these claims may well end up in the court. It could be the High Court that decides this claim or any others if they are not resolved. Neither the Minister, Ms Ross, Mr. Tierney nor can guarantee what a court is going to do. If the matter goes to court and there is about €800 million in claims involved, it is conceivably possible or probable, given the conciliator's judgment, that BAM may be awarded something, although it may not be €800 million. With regard to whatever additional money was made available, and the Minister said it was just short of €500 million, was a contingency built into that to cover the State for some of the potential liability if the High Court were to decide that BAM was due more money? In other words, it would not matter what the court said. Even if the court were to say that BAM should get 40% or 50%, can the Minister guarantee that this is covered as part of the €2.2 billion?

Stephen Donnelly (Wicklow, Fianna Fail)
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The Deputy asks if there an amount included against full and final awards. There is. In addition, in the context of the Government decision, there is freedom - or whatever the right word is - such that the board is authorised to reach a full and final agreement.

David Cullinane (Waterford, Sinn Fein)
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My question is more straightforward. Hypothetically, the matter could go to court and there could be a judgment. We do not know what the amount involved might be. How can the Minister guarantee that it will not go above €2.2 billion? Surely it is impossible to say because it is out of his hands, my hands or anybody else's hands.

Stephen Donnelly (Wicklow, Fianna Fail)
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There has been a thorough evaluation of the claims. The recommendation of €107 million or €108 million is strongly contested. The board will bring that to court if necessary. The view of the board is that it has a very strong case in that regard. The total amount that has been agreed against €863 million is €31 million. The Deputy will appreciate that I am not in a position to share the total provision, but significantly in excess of that amount is built into the €2.24 billion. My preference and, I think it is fair to say, that of BAM is that this would not get dragged out in the courts. The only people who win there are the lawyers.

David Cullinane (Waterford, Sinn Fein)
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I ask the Minister to hear me out. I am not saying it is the wrong strategy. The Minister and the board have told us not a penny more will be paid. Either BAM walks away from its claim or a deal is done. I asked the board if there was a possibility of a deal and was told it did not see it or it would go to court. Does anybody see the contractor walking away from it? No. The Minister stated that built into the additional money, which was made available and signed off by the Cabinet, is an amount to deal with claims. I do not know what that figure is. I cannot say for certain - I would contend that nobody can - that the final amount will not go above €2.2 billion. I do not want the matter in the courts either, but that will happen unless it is resolved and there is agreement. My question to the Minister - I have dealt privately with some of his officials - relates to whether the current approach in respect of BAM has worked? One could argue that it has not worked. I do not think any of us can give a guarantee.

I will let the Minister back in. I wish to make one final point. There has been considerable public commentary about the children's hospital and what people in opposition and the Minister have said. The Minister has to defend his position, which is fair enough. Many people are looking at all the failures in this. We went through them earlier. They are: the completion dates that have come and gone; all the cost overruns; and difficulties potentially now with staffing once the hospital is built whenever that might be. As Deputy Shortall stated, there is still no guarantee, certainty or confidence in any of the dates we have been given. It is fair to say that the blame game between the board and BAM is unseemly regardless of who might be right or wrong. There will be plenty of blame to go around. I know people hate hearing the words "lessons learned", but I have no doubt that when this hospital is finished there will be many learnings going back to the contract and all of the issues there.

I was struck by the Minister's earlier contribution regarding the meeting he had with BAM's partner company. He said he did not go under the bonnet or deconstruct the programme of works. That was a mistake. It would have been absolutely right to hold it to account for what it clearly has not done and to present evidence in that regard as opposed to having a general conversation. I am not confident that matters have moved on since he had that meeting. He said that we will wait and see. My view is that we have been here too often. I think the Minister would accept that. It does not matter whether in government or opposition, we have had God knows how many debates in the Oireachtas, including in this committee. Every time we are given a date, it changes. Every time we are given an amount, it becomes more and all the problems continue. I am not satisfied that what the Minister related to us today about that meeting with BAM's partner company has substantially moved anything on. I also put a lot of the responsibility on the contractor which needs to do what is required of it to resource the project, but there also needs to be political accountability.

Stephen Donnelly (Wicklow, Fianna Fail)
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I can understand where the Deputy is coming from. On a number of occasions, he has made the charge that I am hands-off. There are many things I can be fairly accused of in my time as Minister for Health, and I have made plenty of mistakes. The Deputy would be hard-pressed to find someone in the Department or the HSE who would have considered what I have done in the past four to five years as evidence of a hands-off approach. Sometimes they would have much preferred a more hands-off approach.

In response to the Deputy's point about the meeting, maybe at some stage in the future he will be having that meeting or similar meetings. It was not the place to begin unpacking the detail around a hugely complex programme of work. Of course, we referenced certain details. However, if we put that on the table and actually got into the nitty gritty of it, we would then be having a conversation about specific rooms not being compliant, why there were not more people over here and change orders, we would have lost the conversation. We need a conversation with the chief executive of Royal BAM to say that the Government is furious about what is happening. There is a long-standing relationship with BAM.

The Deputy will have seen my comments about future EU procurement law. The Taoiseach has publicly made similar points. That is the conversation we need to be having with the parent company. The moment we get into the work of David Gunning and his team, we have lost the opportunity to have the conversation we need to have. That is my view. I fully respect the Deputy has a different view. There is no right answer to this.

David Cullinane (Waterford, Sinn Fein)
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I just want another 20 seconds.

Seán Crowe (Dublin South West, Sinn Fein)
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We are way over time.

David Cullinane (Waterford, Sinn Fein)
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I am not suggesting the Minister go into every single detail, but cover the headline issues of feet on the ground, the data we have been presented with and rooms not completed. Those certainly should have been front and centre.

Stephen Donnelly (Wicklow, Fianna Fail)
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I apologise for interrupting. Those details were discussed.

David Cullinane (Waterford, Sinn Fein)
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That is what I meant.

Stephen Donnelly (Wicklow, Fianna Fail)
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Sorry. That is okay.

John Lahart (Dublin South West, Fianna Fail)
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I echo the Minister's appreciation for the workforce. I think I speak for all of us who have been down there when I say that the employees, both from the board and the contractor, clearly have one aim in mind. They are very proud of their work.

Deputy Kelly referred to the conciliator and confidence in the conciliator. I do not want to dwell on this matter. He is saying that David Gunning has confidence but that Ms Ross does not have confidence. However, the record does not seem to reflect the first part.

Ms Fiona Ross:

No. I believe David Gunning did not reply to Deputy Kelly's question at the previous meeting.

John Lahart (Dublin South West, Fianna Fail)
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There is agreement on the lack of confidence.

Ms Fiona Ross:

There is.

John Lahart (Dublin South West, Fianna Fail)
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What happened there?

Ms Fiona Ross:

The standing conciliator is in post, and we just have to work with that.

John Lahart (Dublin South West, Fianna Fail)
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It cannot be changed.

Ms Fiona Ross:

No.

John Lahart (Dublin South West, Fianna Fail)
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We have already heard that BAM, the contractor, priced a particular change at €25 million and said it would take months to complete. It eventually cost €200,000 and was done in a matter of weeks. That was stated on the record of this committee. I share the view expressed by Deputy Cullinane about it being unseemly and unedifying. The public is aghast. However, there is another aspect that the public should know. As a public representative, I am aware of contractors who were granted contracts by the State and who had to be chaperoned on a daily if not an hourly basis, and I am not talking about BAM. They attempted to cut corners on the contracts they were awarded. Were it not for intense project management oversight that consistently pulled them back and reminded them of their contractual obligations, they would have driven a coach and four through the terms of those contracts. While I am not saying BAM has done this, some contractors have done it with State contracts. It is not acceptable to do that with taxpayers' money, but certain contractors getting State contracts do it repeatedly. We need to have some kind of system in place to understand why they repeatedly are awarded contracts.

There are typical concerns around those projects to which I refer. I know of a school project where the contractor used materials and fittings that were inferior to those that had been agreed. That type of thing is only discovered when every room is inspected in detail. Is that the kind of detail we are talking about? The public are hearing that some of the rooms were inadequately fitted out or whatever. Will Ms Ross to flesh some of that out? I do not want to spend too much time on the matter.

It always seems to point to the State being at fault here. I am not assigning the comments I made about the contractors on other contracts to BAM. However, is this the kind of thing we are talking about? Stuff is agreed but when it is inspected, it is not passing muster.

Ms Fiona Ross:

When Mr. Devine was with the committee last, he outlined some of the snags in the rooms that were not deemed to be compliant and, for example, they included sinks and grab rails not being in place. There were a number of identifiable issues with the rooms that were not complete. I cannot speak to any more of the insidious bad behaviours that the Deputy has just identified as being relevant on this site. I cannot speak to that at this point in time and I sincerely hope that is not the case. However, there is a significant amount of review going on all the time of all the activity on-site. Everything is being counted, measured, videoed, photographed and so on, so we have very good records of the entire project from the start to what will, hopefully, soon be the completion.

Seán Crowe (Dublin South West, Sinn Fein)
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There is no suggestion that there is any substantial structural damage to the hospital. We are talking about a snag list, and that is what Mr. Devine outlined the last time.

John Lahart (Dublin South West, Fianna Fail)
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I thank the Chair for that intervention. I am not suggesting anything more. We have heard from the board that claims made by BAM were not stood up by the conciliator or, when they were settled, were settled for a fraction of what BAM was seeking and they are now resolved. Is that correct?

Ms Fiona Ross:

Yes.

John Lahart (Dublin South West, Fianna Fail)
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It amounts to a single-figure percentage of what was originally claimed.

Ms Fiona Ross:

Yes.

John Lahart (Dublin South West, Fianna Fail)
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I will come to Mr. Tierney with my last question and maybe this is a roundabout way of getting to the heart of some of the things that went on. We went to the new national maternity hospital and the Minister has mentioned a number of new hospital projects that are going to be undertaken under his stewardship, which I welcome. What are the significant lessons learned? What are the “We will not be doing that again” lessons? Maybe that is our way of trying to get to the heart of some of this.

Mr. Derek Tierney:

I will provide a follow-up note. To re-cover some of the ground dealt with with the Chair, we have taken a different procurement strategy. We are not delivering the maternity hospital with a single contractor doing both enabling works and main works. We have separated enabling works completely from the future main works. They are already under way and we expect to finish by mid-year next year. Within the tender for the main works, there is always a question about design completeness. It is a client design for the maternity hospital but we subject that to two independent verifications by independent third parties. We take the best of assurance around design completeness and the bill of quantities matches the design that we go out to tender with. As part of the business case construct and, ultimately, in getting to a baseline cost, we are now obligated under the infrastructure guidance, which was the public spending code, to subject the business case to an external assurance review by an independent third party, and a major projects advisory group on behalf of the Department of Public Expenditure, National Development Plan Delivery and Reform will also scrutinise it.

Before we get into a contract with anybody, we will have a six-month pre-service contract period where we bring the main contractor and the reserve specialists together with the designer to ensure that everybody is completely aligned on what it is we have asked the contractor to deliver. We have changed some elements of the contract, particularly around the entitlement to claims. Currently, on this project, the claim trigger is €500, that is, anything that could potentially add a time delay or cost value delay of €500, but we are stepping that up to €2,500.

Róisín Shortall (Dublin North West, Social Democrats)
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Could you-----

Mr. Derek Tierney:

Yes, you could. That is an attempt to bring all parties together at the earliest opportunity to engage and collaborate on any real change rather than playing the game of just firing in claims. At that stage, as one of the Deputies said earlier, you start to lose control very quickly.

Those are some of the enhancements. I will send a note on that to outline the procurement approach and the contracting strategy.

Stephen Donnelly (Wicklow, Fianna Fail)
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Deputy Lahart raised the point of what David Gunning said with regard to the €107 million. His exact words to the committee were:

We have issued our notice of dissatisfaction. Our claim is that the conciliator, in making those awards ... has made fundamental errors in that award.

That was his exact position in terms of the €107 million and the conciliator’s role in that.

Deputy Lahart rightly focused on that point. For very good reasons, in the Oireachtas and in the media, we tend to focus on what is not working, as we should. However, we spend very little time on what is working. From a public confidence perspective, not so much in this project but in healthcare capital expenditure overall, it is worth saying that the majority of projects are delivered on time and are state-of-the-art facilities. I have opened primary care centres all over the country, the new hospital is being built and there is a capital budget for health going into next year of €1.4 billion, and that €1.4 billion will be spent well. For example, the Portrane forensic mental health hospital is on time and on budget. We do not hear about those things. It is important for the public who are listening to understand that while this project is an outlier, and it absolutely is, taxpayers’ money for the capital projects in health is treated with respect and the projects that people will never hear about tend to be delivered on time and on budget.

Róisín Shortall (Dublin North West, Social Democrats)
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How is the standing conciliator appointed?

Ms Fiona Ross:

The person is appointed under the contract agreed by both parties. The conciliator would have been appointed at the outset, which was before my time.

Róisín Shortall (Dublin North West, Social Democrats)
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There is no option to change that person.

Ms Fiona Ross:

I understand there is no option to change that person.

Róisín Shortall (Dublin North West, Social Democrats)
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I would like to have that clarified because it is a key point.

Ms Fiona Ross:

I will do that.

Róisín Shortall (Dublin North West, Social Democrats)
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Following on from the Minister's meeting with Royal BAM, when he was asked if he had confidence in the June 2025 date, he listed out things and said if this happens, if that happens and if the other happens. There are a lot of “ifs” and there is really nothing concrete coming out of the meeting other than the Minister saying he had confidence that they would deliver by that date.

Stephen Donnelly (Wicklow, Fianna Fail)
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I am sorry, I did not say I had confidence they would deliver by that date.

Róisín Shortall (Dublin North West, Social Democrats)
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I thought the Minister said earlier “if they do” a number of things.

Stephen Donnelly (Wicklow, Fianna Fail)
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If. I am not saying I have confidence.

Róisín Shortall (Dublin North West, Social Democrats)
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The Minister said “if they do” a number of things that he listed. That requires a considerable leap of faith. We have been in this same position for a number of years, namely, if BAM does various things, everything will be fine. What is the arrangement for monitoring that those commitments will be adhered to?

Stephen Donnelly (Wicklow, Fianna Fail)
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It is every day, on-site, by the board.

Róisín Shortall (Dublin North West, Social Democrats)
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It is fine to say it but who is actually doing that and who is reporting on it?

Stephen Donnelly (Wicklow, Fianna Fail)
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The board. It is the people working for the board. They have project managers and quality assurance people on-site.

Róisín Shortall (Dublin North West, Social Democrats)
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Is there a schedule that needs to be met on a weekly basis to ensure those commitments are adhered to?

Stephen Donnelly (Wicklow, Fianna Fail)
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Yes.

Ms Fiona Ross:

That would be their own programme. BAM submitted a programme that will have those dates, milestones, activities and resources.

Róisín Shortall (Dublin North West, Social Democrats)
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It would be very helpful if the Oireachtas committee, for the benefit of the public, got updates on that on a regular basis. Something like 14 months elapsed between our meeting with the board the last time and virtually no progress was made. Can the Department provide us with those updates, say, on a monthly basis?

Ms Fiona Ross:

Yes, I think we can provide that.

Róisín Shortall (Dublin North West, Social Democrats)
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That would be good.

I want to move away from the physical provision of the hospital to look at arrangements for the transition to a new, merged hospital and the proposals for the functioning and operation of that hospital. We know from an RTÉ report that the HSE commissioned a confidential report from KPMG on the preparedness of the different players to function properly in a major new hospital. That consultants’ report was damning on a number of different fronts. People who were involved in the original establishment of Tallaght hospital, where the Adelaide, the Meath and the children's hospitals came together, were very critical of the lack of preparation for that and the lack of thinking through of what that merger entailed.

It is claimed that years after the merger the cultural tensions were still very strong and the relationships quite dysfunctional. I think most people would understand that and that the three hospitals were operating independently rather than there having been a cultural merging of three separate entities.

I refer to the report from KPMG. We are all concentrating on the shortcomings of BAM, but it seems that the HSE has not got its own house in order in this regard. This report raises serious issues. When did the Minister see that report from KPMG? It was completed in April, as I understand it. When did the Minister first see it and what actions is he taking on foot of it?

Stephen Donnelly (Wicklow, Fianna Fail)
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I thank the Deputy. I do not have the exact date, but I would have seen it shortly after it was finished. I was involved in the decision to commission the report. I discussed it with Mr. Gloster, and with Mr. Watt. It was proper due diligence to identify what gaps might exist in commissioning. As the Deputy said-----

Róisín Shortall (Dublin North West, Social Democrats)
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They are very significant.

Stephen Donnelly (Wicklow, Fianna Fail)
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Yes, there were significant gaps. Mr. Lynch, Ms Conroy and CHI have been involved in responding to those recommendations. There is a dedicated transformation director and the programme is supported by Newpark Healthcare, the commissioning experts. As the Deputy said, this has not happened-----

Róisín Shortall (Dublin North West, Social Democrats)
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Newpark Healthcare is a company expert in commissioning. That is somewhat different to merging the existing entities of the three children's hospitals.

Stephen Donnelly (Wicklow, Fianna Fail)
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Maybe, but certainly-----

Róisín Shortall (Dublin North West, Social Democrats)
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Commissioning is a physical thing.

Stephen Donnelly (Wicklow, Fianna Fail)
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Well, it is more than that. The commissioning is all the physical aspects, but also involves moving one hospital or sometimes multiple hospitals into a new site. There is a national oversight group that has been-----

Róisín Shortall (Dublin North West, Social Democrats)
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Who is dealing with the cultural issues?

Stephen Donnelly (Wicklow, Fianna Fail)
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It is being dealt with as part of the work being overseen by the transformation director.

Róisín Shortall (Dublin North West, Social Democrats)
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Is that a full-time role?

Stephen Donnelly (Wicklow, Fianna Fail)
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Yes.

Róisín Shortall (Dublin North West, Social Democrats)
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Is that person employed by CHI?

Stephen Donnelly (Wicklow, Fianna Fail)
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Yes.

Róisín Shortall (Dublin North West, Social Democrats)
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The KPMG report was very critical of the fact that there was not a permanent CEO and I am wondering what the Minister is doing in this respect. Additionally, at staff and management levels in the three existing hospitals, the report found that staff and management were overwhelmed because of the pressures on the hospitals. In fact, very little time and attention was being paid to the merger and the significant issues arising in that context. Does the Minister accept there is a need for additional staff at a very senior level in CHI to manage this transition?

Stephen Donnelly (Wicklow, Fianna Fail)
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I certainly accept that is what the report said in April. On that basis, for example, there is now a clinical transformation director. CHI did not have one of those in place. An interim chief executive has been appointed, as the Deputy will be aware. A recruitment process is also ongoing for the permanent-----

Róisín Shortall (Dublin North West, Social Democrats)
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It is not satisfactory that the post is an interim one.

Stephen Donnelly (Wicklow, Fianna Fail)
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I agree. The lady who has stepped into the interim role, who is the COO, has done and is doing a very fine job. We interact very regularly on children's spinal issues, for example. It is agreed, though, that we want a permanent chief executive.

Róisín Shortall (Dublin North West, Social Democrats)
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It is not a reflection on the individual. It is just a question of how all of this can be managed and a merger at the same time.

Stephen Donnelly (Wicklow, Fianna Fail)
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Yes. I agree.

Róisín Shortall (Dublin North West, Social Democrats)
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Is the Minister considering appointing a CEO?

Stephen Donnelly (Wicklow, Fianna Fail)
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Yes. The CEO is appointed by the board. I met the chair and a member of the board earlier this week in the Department of Health regarding exactly this issue.

Róisín Shortall (Dublin North West, Social Democrats)
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Is there Government approval for the appointment of a permanent CEO?

Stephen Donnelly (Wicklow, Fianna Fail)
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There has been no question of Government approval. It is a funded role, so when the outgoing chief executive left, the board moved to start recruiting.

Róisín Shortall (Dublin North West, Social Democrats)
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Why have we still got an interim person then?

Stephen Donnelly (Wicklow, Fianna Fail)
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CHI has not yet managed to find someone it believes to be suitable for the role.

Róisín Shortall (Dublin North West, Social Democrats)
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A recruitment process is under way.

Stephen Donnelly (Wicklow, Fianna Fail)
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It is, and it has been under way for a fairly long time. For what it is worth, I will give the Deputy my view. I do not think we pay hospital managers enough. We pay them significantly less than we pay the consultants, for example, and-----

Róisín Shortall (Dublin North West, Social Democrats)
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Yes, but the Minister has control of that, does he not?

Stephen Donnelly (Wicklow, Fianna Fail)
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I do not, unfortunately. I wish I did.

Róisín Shortall (Dublin North West, Social Democrats)
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Why is that?

Stephen Donnelly (Wicklow, Fianna Fail)
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It is a public spending issue. What we did get when I asked, and I must acknowledge the Minister, Deputy Donohoe, in this regard, is that the new REO roles, which I know the Deputy supports, would be linked to the consultant contract for this exact reason. I was in New York recently regarding the children's spinal issue. I asked how much the chief executives of the large hospitals there are paid and I was told $500,000 plus. I do not think we pay enough for the chief executives of the big, complex hospitals.

Róisín Shortall (Dublin North West, Social Democrats)
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Yes, sure.

Stephen Donnelly (Wicklow, Fianna Fail)
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Yes.

Róisín Shortall (Dublin North West, Social Democrats)
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Is the Minister taking steps to address this issue?

Stephen Donnelly (Wicklow, Fianna Fail)
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I have taken steps at an REO level. That is as far as I can push it at this point.

Róisín Shortall (Dublin North West, Social Democrats)
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As the Minister said himself, this is the biggest health infrastructure and the biggest project undertaken by the State. Surely it would have been ensured an adequate salary would apply.

Stephen Donnelly (Wicklow, Fianna Fail)
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It has worked at the REO level. It is an ongoing issue, and it is not just CHI. At a structural level-----

Róisín Shortall (Dublin North West, Social Democrats)
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It is very basic.

Stephen Donnelly (Wicklow, Fianna Fail)
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-----I think we should be paying more to our-----

Róisín Shortall (Dublin North West, Social Democrats)
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It is very basic.

Stephen Donnelly (Wicklow, Fianna Fail)
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I agree.

Martin Conway (Fine Gael)
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The REOs are on approximately €330,000 annually.

Stephen Donnelly (Wicklow, Fianna Fail)
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No, because that figure includes things like on-call and overtime aspects. I could be wrong because I am not sure they get those payments, but they are linked to the new public-only consultant contract.

Martin Conway (Fine Gael)
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I have no issue with that and I do agree with the sentiments expressed by the Minister. If we want to get the best people available internationally, then we will need to pay them. The health of our citizens deserves having the best possible managers in our hospitals. We will be talking tomorrow about UHL. I certainly concur with the Minister in this regard.

Returning to the issue of commissioning and its cost, is this a part of the €2.2 billion?

Stephen Donnelly (Wicklow, Fianna Fail)
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It is.

Martin Conway (Fine Gael)
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Of that €2.2 billion, how much is the commissioning going to cost?

Stephen Donnelly (Wicklow, Fianna Fail)
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It is €362 million.

Martin Conway (Fine Gael)
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That is a contract awarded to some commissioning experts.

Stephen Donnelly (Wicklow, Fianna Fail)
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No. It is the full cost-----

Martin Conway (Fine Gael)
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Okay.

Stephen Donnelly (Wicklow, Fianna Fail)
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It includes integration and commissioning, IT, the electronic health records and a contingency element. One of the many agents that will be involved in this process will be Newpark Healthcare. A very large workforce is involved in this commissioning process.

Martin Conway (Fine Gael)
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Are international experts involved? I refer to people who have experience in this type of thing. I ask because, clearly, this has not been done before here. Does the Minister have confidence in the people involved?

Stephen Donnelly (Wicklow, Fianna Fail)
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It has not been done in 20 or 25 years. Yes, the agent we just talked about is the international expertise.

Martin Conway (Fine Gael)
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The Minister must have been disappointed with the RTÉ report.

Stephen Donnelly (Wicklow, Fianna Fail)
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Which one?

Martin Conway (Fine Gael)
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The RTÉ report.

Stephen Donnelly (Wicklow, Fianna Fail)
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In my world, the Senator will have to narrow the reference down a bit.

Martin Conway (Fine Gael)
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Well, okay. In my earlier contribution, I did say that I would allow the Minister's colleague to give us the detail on the commissioning. I would like to afford him the time to allow him to talk us through this process step by step. I refer to how we can ensure the commissioning is not going to cause an undue delay. I ask this because we have gone through the issues with BAM ad nauseam. I have concerns as well, however, that at the end of the day there could be unintended issues involved in the commissioning process as well given we have not experienced this type of commissioning before. What due diligence has been done to ensure that we will see undue delays with IT systems, etc?

Mr. Patrick Lynch:

The report referred to by the Senator related to a point-in-time assurance review of CHI's operational readiness. It was conducted by Professor Melvin Samsom, through KPMG. He is an internationally-renowned expert and has been involved in very similar major projects like this, including in the Karolinska University Hospital in Sweden. In fact, then, the report was not all negative. He really acknowledged that massive amount of work. There is a big team in there. Even Newpark Healthcare, our external experts, are advising the internal team as opposed to there being an external team running the programme. Professor Samsom said real and significant work has happened in things like the labs and the electronic records. There were probably a few things he did point out. At this stage in the programme, it said the work is really about hearts and minds. The technical commissioning is not straightforward. It is very complex. This hospital will only work because of the staff who will work in it.

Martin Conway (Fine Gael)
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Great.

Mr. Patrick Lynch:

He was really just saying that we are at a point where the staff working in CHI need to be reconnected not just to the opportunity provided by the hospital, but to the vision it provides. When people are locked into business-as-usual activities, it is very easy to lose sight of the transformation involved, particularly when there are ongoing delays.

Martin Conway (Fine Gael)
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On the new agreement the Minister secured with Royal BAM when he engaged with it to allow early commissioning, how much of a real difference is that going to make? Has it been agreed in writing? Is there a service level agreement in place to facilitate it?

Stephen Donnelly (Wicklow, Fianna Fail)
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Is the Senator asking about the early access? That is part of the engagement that is going on but BAM has committed to facilitating it.

Martin Conway (Fine Gael)
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Will Mr. Lynch tell us what difference that will make as regards timelines? The Minister said earlier on this morning that it will take many months off the scheduled timeline. Will Mr. Lynch confirm that?

Mr. Patrick Lynch:

It is really critical. Everybody's concerns were heightened when the June date was introduced. We were working towards getting the keys on a date towards the end of November. The commissioning period, which will take at least six months, was lined up and there has been a really significant period of planning. As soon as the date moved to June, it became very difficult because you have teams-----

Martin Conway (Fine Gael)
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Have there been additional commissioning costs as a result of that overrun?

Mr. Patrick Lynch:

We will probably incur additional costs if it goes beyond June because of things like the team that is involved in introducing the electronic health record and ICT systems. If that team cannot get in to do its work, it will still have to be maintained. I will conclude with one final point. On the critical idea of transformation and the team, one of the key things that has happened is that we now have confirmation that Professor David Coghlan will be taking on the medical transformation. He will be lead director from Monday. Connecting the clinical organisation and providing focus will be critical. We will have the technical piece and they we will have the human part of commissioning.

Martin Conway (Fine Gael)
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That is all very welcome. We wish him well. If it goes beyond June, there is a risk that the €367 million that has been budgeted for as part of the €2.2 billion could be exceeded.

Mr. Patrick Lynch:

There is contingency-----

Stephen Donnelly (Wicklow, Fianna Fail)
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There is contingency within the commissioning budget.

Martin Conway (Fine Gael)
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That is good.

John Lahart (Dublin South West, Fianna Fail)
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I thank the Minister and his officials for their attendance before the committee on this very important matter. The Minister will take away with him the fact that the committee remains acutely concerned about the issues arising from the development of the national children's hospital. We will be monitoring it closely. Having visited, we know that, in spite of everything we have said today, when it is completed - we hope that will be on time and that children will be moving into it at the end of 2025 - people will see a hospital that was built to a very high standard. Officials from all Departments and all agencies of the State have been heavily invested in monitoring it. I thank the clerk to the committee and the committee officials. The meeting is now adjourned until tomorrow, Thursday, 10 October, at 1.30 p.m., when the committee will again meet with the Minister in public session to consider issues relating to University Hospital Limerick in the context of the mid-west region.