Lets be real here: The Children's Hospital is a scam

beauf

PhilOssophy wrote: »

It is expensive because there was poor management of the procurement process. If a bidder is 140m cheaper or whatever it was than 3 other bidders who were within a few million of each other, alarm bells should have been ringing with the board.

BAM played a 3-card trick, go in cheap and screw the HSE left right and centre once the job starts. That is why it is so expensive. I would bet my life that any reputable building contractor (e.g. Hegarty's, Sisk, etc) priced the job right and would have built it for roughly what they tendered for. BAM have history in this regard.

That one issue. There's also the issues specific this type of site. The complex design (and shape) of the building. There's duplication in the cost of trying to get it built at the Mater, then repeating the process to approve this very similar location. Mater site would also be expensive to build on, for similar reasons. Also all these delays, meant money had to spent on the existing hospitals too keep them going.

This won't end. They will run out of space here far quicker than anywhere else. Making more expansion even more expensive and difficult. The white elephant will still be delivering high cost for decades to come.

So what's the final bill estimated to be now?
As far at the location/access argument goes they probably could have done it outside the M50 with a couple of trainlines running to the front door for less at this stage.

PhilOssophy

beauf wrote: »

..and yet they had ballot for strike over that very issue, in this very location.



Well that kinda defeats the point that building it anywhere else would be much worse for accessibility then.

I don't understand your 2nd point but whatever.

I can assure you of 1 thing, it would be nothing compared to the ballot for strike action if they moved it out to beyond the M50. If you were a nurse/doctor/admin person living in Portlaoise, getting a train into Heuston to go to work every day, and instead you are told you need to get in your car and battle to some location in the sticks, there would be an even bigger strike.

AndrewJRenko

Nevaeh Ugly Textbook wrote: »

In pre Covid times it could take 1hr and 30 minutes to reach the Maynooth junction from Galway City. It could take another 1hr 30 mins to get as far as James with the traffic whic gets even worse past the M4/M50 turn off.

That location is appalling. James Connolly would have been better choice to serve the national interest. Surely specialist capabilities could have been transferred from James to there with an upgrade for Connolly.

Looking at the BAM tweet with the picture and having travelled that commute, the area is so compacted, it would fill you with anxiety looking at it.

Kip of a place too.

If only there was some other way to get to the hospital other than driving a private car?

beauf

PhilOssophy wrote: »

... If you were a nurse/doctor/admin person living in Portlaoise, g...

So if you know your staff are not in Dublin...

PhilOssophy wrote: »

The first step of a hospital is putting it somewhere to get people to work in it. ...

... you build the hospital in Dublin.

Is this the Ryanair definition of near.... I need to go to London, ok we'll fly you to manchester. You can get a bus.

beauf

AndrewJRenko wrote: »

If only there was some other way to get to the hospital other than driving a private car?

Dangerously overcrowded trains aren't most peoples idea of a optimum way of travelling to hospital.

https://www.google.com/search?q=over+crowding+on+Trains+ireland&oq=over+crowding+on+Trains+ireland&aqs=chrome..69i57.8333j0j7&sourceid=chrome&ie=UTF-8

https://www.irishexaminer.com/news/arid-30974234.html

AndrewJRenko

beauf wrote: »

Dangerously overcrowded trains aren't most peoples idea of a optimum way of travelling to hospital.

https://www.google.com/search?q=over+crowding+on+Trains+ireland&oq=over+crowding+on+Trains+ireland&aqs=chrome..69i57.8333j0j7&sourceid=chrome&ie=UTF-8

https://www.irishexaminer.com/news/arid-30974234.html

Would you like me to post some links to the 2 or 3 people killed on the road last week. And the week before that. And the week before that?

Or is it only articles about train problems that put people off?

ForestFire

beauf wrote: »

That one issue. There's also the issues specific this type of site. The complex design (and shape) of the building.

Trying to understand this....

Was the exact site not known during the Tender process?
If not, when the site was identified, did BAM raise any cost concerns then, before start of construction?

I presume they knew were the site was, before they started construction!!

But really.......Complex design and Shape!!
The plans are part of the Tender process and that's what BAM costed too....do BAM only work in Right Angles or something?

Was there any issues with the original plans that have been identified?

Remember we are going from 450million to circa 1.5/2 billion here.

beauf

At the end of the day you've got what you wanted.

Its interesting to compare...

Nya Karolinska Hospital 1,340 patient beds, 3 billion. Population 10 million.
NCH 470 beds €2.4 billion and rising. Population 5 million.

beauf

AndrewJRenko wrote: »

Would you like me to post some links to the 2 or 3 people killed on the road last week. And the week before that. And the week before that?

Or is it only articles about train problems that put people off?

If there is some other public transport system you'd prefer people to use that isn't effected by gridlocked roads, let us know.

Pete_Cavan

Nevaeh Ugly Textbook wrote: »

In pre Covid times it could take 1hr and 30 minutes to reach the Maynooth junction from Galway City. It could take another 1hr 30 mins to get as far as James with the traffic whic gets even worse past the M4/M50 turn off.

That location is appalling. James Connolly would have been better choice to serve the national interest. Surely specialist capabilities could have been transferred from James to there with an upgrade for Connolly.

Looking at the BAM tweet with the picture and having travelled that commute, the area is so compacted, it would fill you with anxiety looking at it.

Kip of a place too.

To create the same space to build the NCH at Connolly, you actually have to relocate and demolish more of it, see my post here.

Then you want to transfer the specialisms from James's to Connolly, which requires a lot more space and the cost of building another huge hospital to house it all. Transferring specialist treatments from James's would be a logistical nightmare, you would need to keep the existing operating at James's while you bring the new at Connolly online, meaning duplication of extremely expensive facilities/equipment and splitting of staff.

There is a satellite centre already open at Connolly Hospital for emergency cases and outpatient appointments. The vast majority of children who need to go to the NCH (which will only be a small fraction of total children) will be doing so as part of planned long term treatment for complex diseases.

beauf

ForestFire wrote: »

Trying to understand this....

....

Its not difficult.

Its complex site. Its a complex design. Both things increase cost substantially.

‘Difficult’ site
Now even the project team, which rejected all these arguments at the An Bord Pleanála oral hearing into the development, is conceding that the site is “difficult” and congested.

https://www.irishtimes.com/news/health/rising-cost-of-national-children-s-hospital-a-scandal-in-the-making-1.3739648

Melanchthon

Why wasn't Tallaght hospital chosen as the site though?

It satisfies the public transport criteria in terms of being on the Luas so that argument is gone.

It's got greenfields in the immediate area.

It's co-locating with an existing hospital which took over from the National Childrens Hospital

It's easier to reach by car from most parts of Dublin than James.

It's a shorter trip by car for most of those outside Dublin.

The Luas links up with Hueston and Connolly for those on public transport outside of Dublin?

Like it seems to satisfy all the requirements aside from a city center location, which shouldn't be a priority for a hospital serving the entire country while still allowing Dubliners relatively easy access by public transport.

beauf

Pete_Cavan wrote: »

To create the same space to build the NCH at Connolly, you actually have to relocate and demolish more of it, see my post here.

Then you want to transfer the specialisms from James's to Connolly, which requires a lot more space and the cost of building another huge hospital to house it all. Transferring specialist treatments from James's would be a logistical nightmare, you would need to keep the existing operating at James's while you bring the new at Connolly online, meaning duplication of extremely expensive facilities/equipment and splitting of staff.

There is a satellite centre already open at Connolly Hospital for emergency cases and outpatient appointments. The vast majority of children who need to go to the NCH (which will only be a small fraction of total children) will be doing so as part of planned long term treatment for complex diseases.

Connolly sold off a lot of its land years ago. Which kinda was self defeating. But that ship has sailed. With the exception of the main building, a lot of Connolly buildings are old anyway. No loss there.

That a satellite centre is needed, says a lot.

beauf

Melanchthon wrote: »

Why wasn't Tallaght hospital chosen as the site though?

...

IMO, the criteria was pretty much tweaked to favor the mater site. So James being so similar, fits that like a glove.

AndrewJRenko

beauf wrote: »

IMO, the criteria was pretty much tweaked to favor the mater site. So James being so similar, fits that like a glove.

Which criteria are you referring to here?

Pete_Cavan

beauf wrote: »

Connolly sold off a lot of its land years ago. Which kinda was self defeating. But that ship has sailed. With the exception of the main building, a lot of Connolly buildings are old anyway. No loss there.

That a satellite centre is needed, says a lot.

What lands were sold at Connolly, do you have a link? If you are talking about lands sold decades ago, it is irrelevant as it would be before the NCH concept.

Regardless of the age of buildings at Connolly, you still have to relocate what functions they house in new buildings, then demolish. In the case of Connolly, you'd be rebuilding practically the whole hospital, then you build the NCH at much the same size as at James's but also need new buildings to relocate significant clinical specialities from James's. You have to build a hell of a lot more hospital but also have added complications of transferring vital services which can't just be packed up. We are talking about treatments which are keeping people alive, you need to duplicate to keep treatments going to the original site while you bring the new one on stream. This would undoubtedly cost more than building at James's, where the site was previously portacabins and deplidated single storey buildings, and making use of existing specialist services without any need to transfer or duplicate.

ForestFire

beauf wrote: »

Its not difficult.

Its complex site. Its a complex design. Both things increase cost substantially.

https://www.irishtimes.com/news/health/rising-cost-of-national-children-s-hospital-a-scandal-in-the-making-1.3739648

All known at the start of the project when BAM said they could deliver the project for 450m.


Why did they not said in the tender process...
You know what...this is "complex" guys... lets say 3 billion give or take a billion or so!!

beauf

Pete_Cavan wrote: »

What lands were sold at Connolly, do you have a link? If you are talking about lands sold decades ago, it is irrelevant as it would be before the NCH concept.

Regardless of the age of buildings at Connolly, you still have to relocate what functions they house in new buildings, then demolish. In the case of Connolly, you'd be rebuilding practically the whole hospital, ...

That's why I said that ship had sailed long ago.

beauf

ForestFire wrote: »

All known at the start of the project when BAM said they could deliver the project for 450m.


Why did they not said in the tender process...
You know what...this is "complex" guys... lets say 3 billion give or take a billion or so!!

The OP started this as a discussion about issues around the tendering etc.

That's really the only issue now.

The location thing is over. people need to let it go.

Pete_Cavan

Melanchthon wrote: »

Why wasn't Tallaght hospital chosen as the site though?

It satisfies the public transport criteria in terms of being on the Luas so that argument is gone.

It's got greenfields in the immediate area.

It's co-locating with an existing hospital which took over from the National Childrens Hospital

It's easier to reach by car from most parts of Dublin than James.

It's a shorter trip by car for most of those outside Dublin.

The Luas links up with Hueston and Connolly for those on public transport outside of Dublin?

Like it seems to satisfy all the requirements aside from a city center location, which shouldn't be a priority for a hospital serving the entire country while still allowing Dubliners relatively easy access by public transport.

Not all hospitals are equal, its not a matter of just picking a hospital and saying we'll co-locate with that. Tallaght has nothing like the level of clinical services James's has. There are no green fields near Tallaght hospital, the closest field is over a km away, that is not co-locating. There is no real space on the Tallaght hospital site, again you'd have to demolish most of it to even get a the same space which is being used at James's See link to the report here. So you could build the same sized NCH at Tallaght but only after rebuilding most of the rest of Tallaght, and still be without the services it would be sharing at James's meaning an inferior NCH at higher cost or multiples more cost to move half of James's to Tallaght.

ForestFire

beauf wrote: »

The OP started this as a discussion about issues around the tendering etc.

That's really the only issue now.

The location thing is over. people need to let it go.

I am not talking about location, I am talking about how BAM tendered for a known complex project, with all the details available, for 450m and now they want 2 billion.

beauf

ForestFire wrote: »

I am not talking about location, I am talking about how BAM tendered for a known complex project, with all the details available, for 450m and now they want 2 billion.

I was agreeing with you.

beauf

Pete_Cavan wrote: »

....So you could build the same sized NCH at Tallaght but only after rebuilding most of the rest of Tallaght, and still be without the services it would be sharing at James's meaning an inferior NCH at higher cost or multiples more cost to move half of James's to Tallaght.

I can't see how building at any other site could cost multiples, 4 billion, 6 billion etc.

Pete_Cavan

ForestFire wrote: »

All known at the start of the project when BAM said they could deliver the project for 450m.


Why did they not said in the tender process...
You know what...this is "complex" guys... lets say 3 billion give or take a billion or so!!

BAM never said they could deliver the project for €450m. That figure is from years ago and has no relevance to what is being built now.

https://merrionstreet.ie/merrionstreet/en/news-room/releases/20190409_nch_report.pdf

Budget and Cost Escalation

In 2013 the original budget for the NPH Project was defined as €790m.

In April 2017, the Definitive Business Case (DBC) identified a total cost of €983m to cover the construction and equipping of the NCH and the two
satellite centres.

By December 2018 the estimated cost of building the NCH and satellite centres had increased by €450m to €1.43bn as set out in the diagram below

Melanchthon

Pete_Cavan wrote: »

There are no green fields near Tallaght hospital, the closest field is over a km away, that is not co-locating. .

That's not true though, take a look at Google satellite view, get rid of the Musgrave's warehouse by CPOing it (CPOing a warehouse isn't politically sensitive like houses and wouldn't be a huge cost), there is additional free space across the road as well.

Edit: your link doesn't go anywhere, you can run tunnels under roads and the cost of the children's hospital as it stands means saying it would cost more is literally insane.

PhilOssophy

Pete_Cavan wrote: »

Not all hospitals are equal, its not a matter of just picking a hospital and saying we'll co-locate with that. Tallaght has nothing like the level of clinical services James's has. There are no green fields near Tallaght hospital, the closest field is over a km away, that is not co-locating. There is no real space on the Tallaght hospital site, again you'd have to demolish most of it to even get a the same space which is being used at James's See link to the report here. So you could build the same sized NCH at Tallaght but only after rebuilding most of the rest of Tallaght, and still be without the services it would be sharing at James's meaning an inferior NCH at higher cost or multiples more cost to move half of James's to Tallaght.

100% agree.

People here don't seem to realise that building a hospital involves much more than just plonking it in a green field site in the middle of nowhere to suit car owners.

There's a tonne of logistical constraints, and number 1 being resourcing, which beauf and others seem to think aren't a problem in spite of that being the number 1 problem. There is no point having a super hospital in the middle of nowhere and it being inaccessible for anybody who doesn't have a car, and where doctors etc will just say "eh no thanks, I am not going there".

I know some people who work in Crumlin have refused to move to James's - either retired, or moved to other roles, etc. So to trivialise the HR issue associated with moving a hospital out to the middle of nowhere is extremely naïve.

Pete_Cavan

beauf wrote: »

I can't see how building at any other site could cost multiples, 4 billion, 6 billion etc.

Well you have to do as much or more decanting and demolition at either Connolly or Tallaght just to get the same sized site as at James's, so at least the same if not more cost. With the same sized site, you are building the same height/mass of building to get the required floor area, so about the same construction cost.

Once built, you have the same NCH building but lacking access to many of the specialist services at James's. You either accept an inferior hospital at similar cost but having to do lots of patient transfers. To bring up to the level of services of James's, Connolly or Tallaght would then need further new buildings to house such services, basically building a new most specialised hospital in the country which will obviously cost billions. As everything has to stay live treating patients at James's, you have these services replicated across two sites at extra cost for a period and buy everything new for the new hospital and write off investments already made at James's. So yeah, another site would cost multiples.

tom1ie

ForestFire wrote: »

All known at the start of the project when BAM said they could deliver the project for 450m.


Why did they not said in the tender process...
You know what...this is "complex" guys... lets say 3 billion give or take a billion or so!!

Are we blaming BAM here?
Projects go marginally over cost at the best of times due to unforeseen things that weren’t captured at design stage.

This project didn’t even have a design.

The blame lays squarely with the project management (including the design team).

BAM are only doing what any other contractor would do.

PhilOssophy

Pete_Cavan wrote: »

Well you have to do as much or more decanting and demolition at either Connolly or Tallaght just to get the same sized site as at James's, so at least the same if not more cost. With the same sized site, you are building the same height/mass of building to get the required floor area, so about the same construction cost.

Once built, you have the same NCH building but lacking access to many of the specialist services at James's. You either accept an inferior hospital at similar cost but having to do lots of patient transfers. To bring up to the level of services of James's, Connolly or Tallaght would then need further new buildings to house such services, basically building a new most specialised hospital in the country which will obviously cost billions. As everything has to stay live treating patients at James's, you have these services replicated across two sites at extra cost for a period and buy everything new for the new hospital and write off investments already made at James's. So yeah, another site would cost multiples.

I think the sad thing about Irish people is they don't see the hidden cost or the importance of making the place accessible for patients and recruitment. Once they could drive to the door and there's a 3 acre parking lot, that's good enough for them.

What has gone on in this instance is a disgrace regarding BAM and the costs, etc but I think people don't see how quickly Opex costs run up and how quickly they are amplified once re-locating people is involved.

The mistakes which were made were all due to giving BAM the job in the first place.