The Minister for Health, Simon Harris TD, today announced that the Government has approved the investment required to enable the National Paediatric Hospital Development Board to award the construction contracts for the building of the main children’s hospital on the St James’s Hospital campus and the two Paediatric Outpatients and Urgent Care Centres on the Tallaght and Connolly Hospitals campuses. This decision means that the project can proceed without delay. Construction of the new children’s hospital will commence within weeks.
At the site of the new children’s hospital, Minister Harris said: “Today is a huge step forward for the children’s hospital project, ending years of doubt as to whether it would ever be built. Today, there is no more doubt. This hospital will be built. The new state of the art children’s hospital, and the two Paediatric Outpatient and Urgent Care Centres, will provide a fitting place where we can provide our children with the best modern clinical care.
“Our children have waited a long time for this new hospital but there is light at the end of the tunnel now. Site clearance work, which began last year, is almost complete and so we’ll start building works in the next few weeks. I anticipate that the new hospital, which will serve all of the children of all Ireland, will open in 2021, with the two Outpatient and Urgent Care Centres at Tallaght and Connolly opening well in advance at the end 2018 and the first quarter of 2019”.
The two Paediatric Outpatient and Urgent Care Centres at Tallaght and Connolly Hospitals will provide consultant-led urgent care, with observation beds, diagnostics and secondary outpatient services including rapid access general paediatric clinics, developmental paediatrics and multidisciplinary care for children with chronic stable conditions.
The establishment of the new children’s hospital provides a unique opportunity to establish a new model of care that will optimise how paediatric services are provided in Ireland. The hospital will provide tertiary and quaternary paediatric services for the children of Ireland, including on an all-island basis, where agreed between the Department of Health and the Department of Health, Social Services and Public Safety in Northern Ireland.
Integration of the three existing paediatric hospitals, the opening of the OPD and Urgent Care Centres and the transfer of services to the new hospital facilities represent a highly complex project in its own right. The major programme of work of clinical integration, people and change management and commissioning required to achieve a successful transition to the new facilities is already underway. The Minister will bring the Heads of a Bill to Government next month, to establish a single entity to integrate the services currently provided by the three hospitals, prepare for the transition to the new facilities and ultimately to run the children’s hospital and OPD and Urgent Care Centres when they open.
The St James’s campus will also be home to the Coombe Women & Infants University Hospital thus achieving tri-location of adult, paediatric and maternity services. A site for the proposed maternity hospital is identified in the Site Master Plan for the St James's campus, and the new children's hospital design has incorporated the required operational links with both maternity and adult hospitals.
While the construction of the new maternity hospital on the campus will not commence until the new children’s hospital is completed, progress will be made on the work required to advance the new maternity hospital design, which must be done before a planning application is prepared.
Minister Harris thanked all those who have worked long and hard on this project and whose commitment has been unwavering. In particular he thanked Tom Costello, Chair of the National Paediatric Hospital Development Board, Dr Jim Browne, Chair of the Children’s Hospital Group Board, John Pollock, Project Director, Eilish Hardiman, Children’s Hospital Group CEO, their teams and the Board and staff of the three children’s hospitals.
Notes to Editors
1. Tender Process
The recently concluded tendering process for the main construction works for the new children’s hospital, and for the Paediatric Outpatients and Urgent Care Centres at Tallaght and Connolly Hospitals determined the actual market cost of the construction elements of the project, which were included in the Final Project Brief. Local and international companies participated in the highly competitive tender process undertaken by the National Paediatric Hospital Development Board (NPHDB). More than 35 people participated in review panels for the tenders. The tenders were reviewed and measured against a number of technical and financial criteria and were independently peer-reviewed by construction experts with extensive experience of projects of this size and complexity. The preferred, and most competitive, contractor for construction of the new children’s hospital is BAM Building Ltd., has been selected.
2. Final Project Brief
Under the NPHDB establishing legislation (SI 246 of 2007), the statutory approval process for constructing the hospital requires the NPHDB to submit a Project Brief to the Minister for his consent prior to the HSE giving approval. Accordingly, with the Children’s Hospital Group, it prepared a Definitive Business Case which sets out a detailed analysis of the costs of the new children's hospital and Outpatient and Urgent Care Centres and the associated benefits. The Final Project Brief, which includes the Definitive Business Case, was submitted to Minister.
The Final Project Brief sets out the costs and funding proposals for the construction of the core hospital and Outpatient and Urgent Care Centres, including equipment, VAT provision, risk provision, all fees, decant, external works, enabling costs, project management costs, commercial spaces (underground carpark and retail space), and higher education facilities. It also provides details on two options for the procurement of equipment for the hospital.
On foot of today’s Government decision, the Minister will officially consent to the Final Project Brief and this will be followed by HSE approval of the Brief.
3. Award of Contracts
Today’s decision by Government means that the NPHDB can now proceed to award the contracts to the successful bidder BAM Building Ltd. The contracts are being awarded for the building of the new children’s hospital and Outpatient and Urgent Care Centres, third level education facilities, hospital school, car park and retail space. The NPHDB is finalising the contract arrangements and contract award details are commercially sensitive.
4. Capital costs
The total capital cost for the delivery of the project at St James’s Hospital and the Outpatient and Urgent Care Centres is €1.07bn, of which €1.004bn is Exchequer related, made up of €916m Exchequer capital and €88m Exchequer ICT capital as set out in the table below. Car park and retail facilities are not intended to be Government funded on the basis that they are commercially viable businesses which can be commercially funded. The project will be managed and delivered within these parameters. Item 2017 Cost Estimate
(€m) Identified Funding Source
Exchequer Capital sub total 916.00m Exchequer Health, Department of Education & Skills Capital Funding
CHGB fundraising l, Carpark & Retail 67.00m Non Exchequer – philanthropy and commercial funding
NPHDB Capital Build sub total 983.00m
CHGB ICT 88.00m Exchequer Health ICT Capital Funding
Total NPH & CHG Capital Cost 1.07bn Of which €1.004bn is Exchequer Funding
5. Cost Comparisons
HSE capital funding of €650m was approved in 2014 following an initial cost estimate of the construction aspects of the project. This covered core (main children’s hospital and 2 Outpatients and Urgent Care Centres) elements of the hospital construction only. The €650m funding did not include equipment, educational facilities or commercial elements such as retail and carparking. Alternative funding sources were identified for these elements, estimated to cost €140m. This brought the NPHDB 2014 cost estimate to €790m. In 2015, additional shared services for the campus were included in the project (energy centre, clinical decontamination, facilities management) bringing the overall budget to €800m.
Since the cost estimates were completed in 2014/15, the final cost of the design, build and equip programme for which the NPHDB is responsible has increased.
There are three factors that have driven this increase - these are:
• Increase in projected construction inflation over the project duration 2014 to 2021 – at the time of the cost estimate in 2014, inflation was running at 3% per annum and it is now running at over 9% per annum.
• the extended programme timeframe (longer than anticipated planning, procurement and approvals processes)
• market costs of the tenders came in higher than forecast.
These three factors bring the cost from €800m to €983m.
An internationally recognised design team supported by an experienced Board and Project Team are in place to drive the project to develop the new children’s hospital and focus on delivering the project in accordance with national policy to optimal design and value for money. They have followed best international design, planning and procurement processes at each stage of the project. The final construction elements of the project compare favourably when benchmarked against the costs of international projects of a similar size and scale.
6. Scheduled opening of the hospital and Outpatient and Urgent Care Centres
Clearance and enabling works are nearly complete on the St James’s Hospital campus, making way for construction to begin on site within the next few weeks. It is anticipated that the new children’s hospital will open its doors in Q3 2021. The Outpatient and Urgent Care Centres at Connolly Hospital and Tallaght Hospital, which will provide Urgent Care and Outpatient Care to children in the Greater Dublin Area, including Co. Dublin, Wicklow, Meath and Kildare, will open before the main hospital, in late 2018 and Q1 2019.
7. Capacity and accommodation
The buildings have been designed to ensure that children and young people are treated in the best organised and most clinically suitable setting. In the main hospital at St James’s, there will be 380 single rooms all with en-suite bathrooms and a parent’s bed. There will be 93 daycare bays, 22 operating theatres and procedure rooms, and 122 consulting rooms in total. The rooftop rainbow garden is a central feature of the design and it will provide a secure and sheltered environment adjacent to the wards. The planned accommodation will include facilities for inpatients, day care patients, outpatients, operating theatres and emergency care. The elements of the hospital will include:
• Outpatients, daycare, theatre, emergency department and critical care units
• Laboratory, medical imaging and diagnostic services
• Specialist therapy and play facilities
• Age-appropriate facilities for children and young people
• Hospital school
• Reception, concourse and public realm including retail spaces in the main atrium
• Operational communication links into the adult hospital and maternity hospital
• Education, training, research and innovation facilities
• Underground carparking
Inpatient accommodation (all single rooms, en-suite, in-room parent accommodation)
• 300 generic inpatient rooms
• 60 critical care inpatient rooms incorporating paediatric intensive care/high dependency and neonatology intensive care/high dependency
• 20 child and adolescent mental health beds (incorporating eating disorders and acute Child and Adolescent Mental Health Services (CAMHS))
Day care facilities
• 61 general medical and surgical day care bays
• 4 nephrology/urology day care bays
• 22 haematology/oncology day care bays
• 6 cardiology day care bays
Operating theatres and procedure rooms
• 12 general theatres
• 6 specialist theatres
• 1 PIR suite
• 2 endoscopy rooms
• 1 catheterisation laboratory
Outpatients
• 110 outpatient consulting/examination rooms at the main hospital
• 12 outpatient consulting/examination rooms at the Outpatient and Urgent Care centres (six in each)
Emergency Facilities
ED and urgent care facilities will be provided at the main hospital, with urgent care facilities at the Outpatient and Urgent Care Centres also. There will be 24 short stay observation beds across the hospital and Outpatient and Urgent Care Centres (6 in each Outpatient and Urgent Care centre and 12 in the main hospital), and 56 assessment bays (10 in each Outpatient and Urgent Care centre, and 36 in the main hospital).
Outpatient and Urgent Care Centres at Tallaght and Connolly Hospitals
The Outpatient and Urgent Care Centres will improve geographic access to urgent care for children in the Greater Dublin Area. Consultant-led urgent care, with 4-6 hour observation beds, appropriate diagnostics and secondary outpatient services including rapid access general paediatric clinics as well as child sexual abuse unit examination, observation and therapy rooms will be provided in the Outpatient and Urgent Care Centres. The centre at Connolly will also include two HSE paediatric care primary care dental services operating theatres.
8. Integration Programme
The capital project to build the new children’s hospital and Outpatient and Urgent Care Centres will only provide buildings. The overall programme to deliver the new children’s hospital will entail both a complex merger of three different voluntary hospitals and a new build (in addition to a major ICT programme and co-location with an adult and the tri-located maternity hospital). Integration of the three existing paediatric hospitals, the opening of the Outpatient and Urgent Care Centres and the transfer of services to the new hospital facilities while maintaining existing services, patient safety and quality at three existing sites until transition is complete represent a highly complex project in its own right. The major programme of work of clinical integration, people and change management and commissioning required to achieve a successful transition to the new facilities is already underway. Revenue funding has been made available in 2017 for this work.
9. Legislation
It is the Minister’s intention to shortly bring to Government Heads of a Bill to establish a single entity to integrate the services currently provided by the three hospitals, prepare for the transition to the new facilities and ultimately to run the children’s hospital and Outpatient and Urgent Care Centres when they open.
10. Children’s Research and Innovation Centre
More than a hospital, the new children’s hospital and Outpatient and Urgent Care Centres will be a research-intensive academic healthcare institution. Excellence in modern paediatric practice cannot be achieved without an embedded culture of, and focus on, research, education and innovation. To deliver this vision, the main facilities for research and innovation will be located at the Children’s Research and Innovation Centre (CRIC) on the St James’s campus, which has a rich history in clinical research. Clinical management and research staff at the new children’s hospital will be able to study, evaluate, and improve the healthcare services provided to children and young people in Ireland. The CRIC on the campus will be non-Exchequer funded and will be built using separately raised philanthropic funds.
11. Economic and social benefits
There are significant economic and social benefits to be gained from the new children’s hospital development for the Dublin 8 community, both during the construction phase, and afterwards when the hospital is operational. The An Bord Pleanála Inspector’s Report 2016 concluded that there was no doubt in relation to the significant urban regeneration potential arising from the development and the Inspector noted the NPHDB’s commitment to community gain.