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

Amirani

Skyfloater wrote: »

https://upload.wikimedia.org/wikipedia/en/thumb/9/93/Burj_Khalifa.jpg/1200px-Burj_Khalifa.jpg

So, at €2.4billion we could have built not one, but two of these!

I think a National Children's Hospital is a far better use of money than a half empty vanity skyscraper.

We also don't have enough slave labour available in order to build 2 Burj Khalifa's for that price. Not such a problem in the UAE.

Whatever the merits of the NCH, price comparisons of anything with the Burj Khalifa are the most moronic things going.

RandRuns

Amirani wrote: »

I think a National Children's Hospital is a far better use of money than a half empty vanity skyscraper.

We also don't have enough slave labour available in order to build 2 Burj Khalifa's for that price. Not such a problem in the UAE.

Whatever the merits of the NCH, price comparisons of anything with the Burj Khalifa are the most moronic things going.

Comparision with hospitals (rather than skyscrapers, hotels, etc.) in the Arabian Peninsula are interesting - the Arabian Peninsula is consistently the most expensive place in the world to build a hospital, just after the USA, due to many factors (little local expertise, corruption, oil wealth driving up prices, difficult construction challenges etc.).
Yet, from what I can see, no hospital ever built there comes anywhere close to the cost per bed as the NCH, in fact none have even come in at one third the cost per bed.

The best little country in the world to win a healthcare construction project.

blackbox

Why do we need a children's hospital?

Would it not be much more efficient to have children's wards in regular hospitals.

Then there would be no issues with co-location and there would be savings in administration.

Amirani

RandRuns wrote: »

Comparision with hospitals (rather than skyscrapers, hotels, etc.) in the Arabian Peninsula are interesting - the Arabian Peninsula is consistently the most expensive place in the world to build a hospital, just after the USA, due to many factors (little local expertise, corruption, oil wealth driving up prices, difficult construction challenges etc.).
Yet, from what I can see, no hospital ever built there comes anywhere close to the cost per bed as the NCH, in fact none have even come in at one third the cost per bed.

The best little country in the world to win a healthcare construction project.

Construction in the UAE (and many parts of the Arabian peninsula) is done with lots of slave labour from South Asia. When you don't pay construction workers, don't provide them safety equipment and don't pay compensation when they are injured/die then it lowers construction costs significantly.

Kingkong

Until we start treating the ripping of the taxpayer as mandatory prison time it will happen again and again. We are far too soft of spending billions yet cribe about not getting a fiver extra on childrens allowance.

RandRuns

Amirani wrote: »

Construction in the UAE (and many parts of the Arabian peninsula) is done with lots of slave labour from South Asia. When you don't pay construction workers, don't provide them safety equipment and don't pay compensation when they are injured/die then it lowers construction costs significantly.

Not disputing that at all. Read my post again.

The Arabian Peninsula is consistenly the most expensive place in the world to build a hospital.

Yet Dublin is somehow multiples more expensive than even there.

James Brown

ExMachina1000 wrote: »

From experience with tenders I can tell you that it's not uncommon for one party to be given the details of the other tenders as they come in. All done as a favour of course with a reward if the contract is awarded.
That's common enough.
Not saying that's what happened here obviously but it definitely goes on. Cronyism built this country my friend.

That's what Varadkar did with the union negotiation.
We are still awaiting the findings of the Siteserv investigation where Siteserv was sold at a loss and then awarded a state contract to the buyer. Theres even suspicion the contract was awarded before the company was bought but we'll need see the findings.
Then we'd the communications minister getting free lunches off a bidder on the broadband contract. Then we'd the 'preferred bidder' status given to a FG chum with previous crony attachment.
It's not hard to imagine info being passed to a crony. If that's the least that happened I'd be suprised.
We do not do accountability. We had the then finance and health ministers wringing their hands like they didn't like it but it was nothing to do with them.

AndrewJRenko

RandRuns wrote: »

The expertise that grossly underestimated the cost initially, and now issue quarterly increases?

The onsite "project team expertise" is expertise on maximising the amount of money this project will cost.
The procurement "project team expertise" was such that the initial costs, design, timeline, and contract were grossly inadequete.

If you have, as you seem to admit, no knowledge of construction, quantity surveying, or anything else related to this subject, it might be best not to tell those that do, that they are wrong, without at least providing some basis for that opinion.

I have negligible knowledge of construction, and no knowledge of quantity surveying.

I do know a very little bit about Design and Build contracts, and how they are a fairly standard approach with projects of this nature all over the world, with the result that the client is NOT entering a fixed price contract to build their facility at the outset.

You did know that yourself, right?

RandRuns wrote: »

I'm not sure who that was directed at, but I can assure you that I am far from a "barstool expert" on this subject.

I was referring primarily to the barstool experts on this thread who seem to think that they know more about hospital location issues than the eminent professionals who have worked their whole lives on this issue.

Here's another great example.

LuasSimon wrote: »

Some Builders are going to become extremely well off people out of the Childrens Hospital, many of these are sizeable donors to Fine Gael coffers.

How sizable, given the laws on political donations restrict them at quite low levels?
https://en.wikipedia.org/wiki/Political_funding_in_Ireland#Regulation

Have you seen many such donations reported?

RandRuns

AndrewJRenko wrote: »

I have negligible knowledge of construction, and no knowledge of quantity surveying.

I do know a very little bit about Design and Build contracts, and how they are a fairly standard approach with projects of this nature all over the world, with the result that the client is NOT entering a fixed price contract to build their facility at the outset.

You did know that yourself, right?

I don't know you, so I'm not aware of your expertise or otherwise, but I'd be willing to bet I've a lot more experience with large construction projects, esp. medical projects, than you have. And that goes from design, through tendering and procurement, to construction and completion.

Snide remarks aside, I am very familiar with design & build contracts. I'm also familiar with how, in this case, it was neither a D&B, nor a fixed price from the off, which is why we find ourselves where we are.

I've worked on many large hospital projects, and have worked on some of the largest contracts ever completed in Ireland.
None of them went the way this one has. It was set up to fail from the beginning.

AndrewJRenko

AndrewJRenko wrote: »

You do know that not everyone drives or has access to a car, right? We need a hospital with great public transport connectivity, as is standard in UK and around the world. The Luas literally runs beside this building.

Sure grand, we'll get the Luas up from Cork. No problem.

Pete_Cavan

Pete_Cavan wrote: »

Most of the medical staff will be transferring from the existing children's hospitals so the majority are likely Dublin based already. Most will be switching from Crumlin which is not far away.

Could have easily moved it out past the Red Cow which would have suited the Crumlin staff too much better.

I guess it had to be convenient for the D4 types.

Though this may sound silly, if the hospital has to be so close to St James, could they not have just built onto St James? Or reinforce the foundations and add a couple of storeys to it? (unsure how plausible this is).


I still think, an easier-to-access green site off the M50 with space and a plan to build there again in future would have made more sense. In 20 years St James will be outdated and the increasing population will need another hospital to replace/add to that one. This could be then built beside the NCH if it was on a green site with some long term thinking.

BailMeOut

blackbox wrote: »

Why do we need a children's hospital?

Would it not be much more efficient to have children's wards in regular hospitals.

Then there would be no issues with co-location and there would be savings in administration.

Anyone who ever experienced having a child treated for some serious illness at Crumlin would understand. Health care requirements for kids is very different than for adults and the culture, care (and love) of the entire facility is as important to the medical care being given. Crumlin is a national treasure and I really hope they can seamlessly transfer their ethos how they operate to the new facility.

jimmycrackcorm

LuasSimon wrote: »

Some Builders are going to become extremely well off people out of the Childrens Hospital, many of these are sizeable donors to Fine Gael coffers.

I think you are referring to the wrong party when it comes to dodgy builders

Pete_Cavan wrote: »

James’s is Ireland’s largest adult teaching and research-intensive hospital with 39 clinical specialities and numerous national facilities. Some of these have highly specialised staff and equipment. For a population as small as ours, you can only provide this in one location, having them in two locations means buying twice as much incredibly expensive equipment and having twice as much staff each doing half the work. If the NCH isn't located where this is, you have to bring the patients to it and back which is not efficient. No patients or teams will have to be transferred now, thats the point. Not everything is different between adults and children, the person turning 18 means nothing to a serious disease.

How is that working currently when it comes to the existing setup? I would have thought it more advisable to build on a greenfield site for the vast majority of cases and have small specialized satellite units in the likes of James. Even after it's built, won't serious neurological cases still mean using Beaumont?

At the end of the day though, while there is a huge spend on this hospital, it's still going to be used in 100 years time.

RandRuns

If the contract for the new hospital had been awarded on a fixed contract at a comparable cost to similar projects in other Western European countries, rather than arguing whether it should be on the St. James' site or not, we could have built an entire new St. James' AND the new NCH on a greenfield site for the same cost as the new hospital alone will cost.

Pete_Cavan

jimmycrackcorm wrote: »

How is that working currently when it comes to the existing setup? I would have thought it more advisable to build on a greenfield site for the vast majority of cases and have small specialized satellite units in the likes of James. Even after it's built, won't serious neurological cases still mean using Beaumont?

At the end of the day though, while there is a huge spend on this hospital, it's still going to be used in 100 years time.

What you suggest is literally the opposite of how health care is provided. The whole point is that NCH will be for the specialist cases which can't be done on a small scale in multiple locations. You are duplicating equipment and staff, none of which would be operating at the level required. The vast majority of cases go to the various other hospitals around the country, not one massive general hospital. Specialist needs to be provided centrally in one location to achieve the necessary scale, general care is provided in many locations.

Pete_Cavan

RandRuns wrote: »

If the contract for the new hospital had been awarded on a fixed contract at a comparable cost to similar projects in other Western European countries, rather than arguing whether it should be on the St. James' site or not, we could have built an entire new St. James' AND the new NCH on a greenfield site for the same cost as the new hospital alone will cost.

No chance you could build building a children's hospital and also a new largest adult hospital in the country for less than just building a new childrens hospital and integrating with the existing largest adult hospital. You obviously need to buy everything new as you can't just transport and set up specialist medical equipment, as well as patients, overnight and continuing to provide care the next morning. You have to duplicate everything for a period and what do you do with it all after?

RandRuns

Pete_Cavan wrote: »

No chance you could build building a children's hospital and also a new largest adult hospital in the country for less than just building a new childrens hospital and integrating with the existing largest adult hospital. You obviously need to buy everything new as you can't just transport and set up specialist medical equipment, as well as patients, overnight and continuing to provide care the next morning. You have to duplicate everything for a period and what do you do with it all after?

The standard benchmark cost for a new hospital build in the Western world at present is between €750,000 and €1.5m per bed.

Taking the higher figure gives us a cost of €1.5 billion to build a new St. James and €705 million for the NCH. Together, less than what the NCH alone is projected to cost.

Skyfloater

Amirani wrote: »

I think a National Children's Hospital is a far better use of money than a half empty vanity skyscraper.

We also don't have enough slave labour available in order to build 2 Burj Khalifa's for that price. Not such a problem in the UAE.

Whatever the merits of the NCH, price comparisons of anything with the Burj Khalifa are the most moronic things going.

I would thought the exclamation mark adequately reflected the seriousness of the comparison. Apparently not.

AndrewJRenko

Deleted User wrote: »

Could have easily moved it out past the Red Cow which would have suited the Crumlin staff too much better.

I guess it had to be convenient for the D4 types.

What assumptions are you making about the geography of the Crumlin staff? How many of them are Filipino or Indian immigrants based around the city centre?

Deleted User wrote: »

Sure grand, we'll get the Luas up from Cork. No problem.

Strangely enough, there is a train from Cork which stops at Hueston, which is the next Luas stop to St James.

AndrewJRenko

Deleted User wrote: »

Though this may sound silly, if the hospital has to be so close to St James, could they not have just built onto St James? Or reinforce the foundations and add a couple of storeys to it? (unsure how plausible this is).

Do you know St James at all? There is no one building, it is a sprawl of generally lo-rise buildings. What they've done by building on the current site is effectively 'building onto St James'.

AFAIK, adding storeys to existing buildings is a bit of an engineering nightmare.

Deleted User wrote: »

I still think, an easier-to-access green site off the M50 with space and a plan to build there again in future would have made more sense. In 20 years St James will be outdated and the increasing population will need another hospital to replace/add to that one. This could be then built beside the NCH if it was on a green site with some long term thinking.

Is there any particular reason that you reckon that your view on this matter should be given equal or more consideration than the eminent industry experts?

AndrewJRenko

RandRuns wrote: »

The standard benchmark cost for a new hospital build in the Western world at present is between €750,000 and €1.5m per bed.

How well do construction standard benchmarks in the Western world apply to Ireland for, say road building or say, residential developments? Would it be fair to say that construction costs in Ireland is generally significantly ahead of Western world benchmarks?

Pete_Cavan

RandRuns wrote: »

The standard benchmark cost for a new hospital build in the Western world at present is between €750,000 and €1.5m per bed.

Taking the higher figure gives us a cost of €1.5 billion to build a new St. James and €705 million for the NCH. Together, less than what the NCH alone is projected to cost.

Per bed is too crude a metric here. All the rooms in the NCH are single occupant with en suite and larger than normal to allow a family member stay the night, that is very unusual as most public hospitals would generally be based around multiple occupancy wards. It also has another family accommodation unit, a school for the kids there, educational facilities for staff and a research centre. The NCH has 22 operating theatres, more than it itself needs as it is also sized for the needs of a future maternity hospital to replace the Coombe. It also provides new facilities to also service the entire James's campus including Central Sterile Services Department, Catering Department, Deliveries receive and distribution, Waste Management Facilities, space for a future St James’s and Maternity energy centre, tunnel link to James’s for FM. I don't know what level of parking would be included in that rate but unlikely includes for three times as many parking spaces as beds, as is the case with the NCH. The NCH project also includes two other >5,000m2 satellite centres which include urgent care and general paediatric facilities. All of this hugely distorts a simple per bed rate.

I doubt those rates are applicable for a new hospital to replace James's either given the high level of clinical specialism and acute services there which is well above a standard hospital. It also has numerous national services including our National Blood Centre. The MISA building only opened there a few years ago which would be a €40m facility written off if abandoning the James's.

AndrewJRenko

RandRuns wrote: »

I don't know you, so I'm not aware of your expertise or otherwise, but I'd be willing to bet I've a lot more experience with large construction projects, esp. medical projects, than you have. And that goes from design, through tendering and procurement, to construction and completion.

Snide remarks aside, I am very familiar with design & build contracts. I'm also familiar with how, in this case, it was neither a D&B, nor a fixed price from the off, which is why we find ourselves where we are.

I've worked on many large hospital projects, and have worked on some of the largest contracts ever completed in Ireland.
None of them went the way this one has. It was set up to fail from the beginning.

Yes, you certainly know more than me about construction, by the sounds of it - so let's talk about the construction issues.

Let's not pretend you or I are hospital planning experts or health strategy experts. Let's not pretend that we know about what scams happened, though we have no actual detail when challenged.

So what are the construction/contract issues here? Are you saying this could have been done as a fixed price contract? How long would it have taken to complete the design work to the stage that a fixed price contract was feasible - every power outlet, every network point, light fitting, every water connection and drain?

jelem

being built where it is just so the government can continue to allow private health gain profit and
no intention of employing FULL staff as it intends sharing staff between the hospitals.
this another cheap gimmick (professionals nearby) whilst politicians have gained 2 pay rises in last year
or was it more.
it should have been built sort of midlands between the N7 and N6 and as near same distance from all points in ireland for access.
it would be dublin city\county issue to deal with clear acces to hospital for dublin residents not cork\donegal patients\residents
whom have to travel to dublin. again corruption by FG and FF

AndrewJRenko

jelem wrote: »

being built where it is just so the government can continue to allow private health gain profit and
no intention of employing FULL staff as it intends sharing staff between the hospitals.
this another cheap gimmick (professionals nearby) whilst politicians have gained 2 pay rises in last year
or was it more.
it should have been built sort of midlands between the N7 and N6 and as near same distance from all points in ireland for access.
it would be dublin city\county issue to deal with clear acces to hospital for dublin residents not cork\donegal patients\residents
whom have to travel to dublin. again corruption by FG and FF

Is there any particular reason that you reckon that your view on this matter should be given equal or more consideration than the eminent industry experts?

What 'corruption' are you talking about here? Who was corrupt and what did they gain from it?

jelem

AndrewJRenko wrote: »

Is there any particular reason that you reckon that your view on this matter should be given equal or more consideration than the eminent industry experts?

What 'corruption' are you talking about here? Who was corrupt and what did they gain from it?

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Any more off topic spam like that and you will be threadbanned

Muahahaha

Skyfloater wrote: »

https://upload.wikimedia.org/wikipedia/en/thumb/9/93/Burj_Khalifa.jpg/1200px-Burj_Khalifa.jpg

So, at €2.4billion we could have built not one, but two of these!

NCH currently ranked at the 21st most expensive building in the world and is expected to climb higher as costs rise further
https://en.wikipedia.org/wiki/List_of_most_expensive_buildings

RandRuns wrote: »

Comparision with hospitals (rather than skyscrapers, hotels, etc.) in the Arabian Peninsula are interesting - the Arabian Peninsula is consistently the most expensive place in the world to build a hospital, just after the USA, due to many factors (little local expertise, corruption, oil wealth driving up prices, difficult construction challenges etc.).
Yet, from what I can see, no hospital ever built there comes anywhere close to the cost per bed as the NCH, in fact none have even come in at one third the cost per bed.

The best little country in the world to win a healthcare construction project.

Whatever about Arabia closer to home is Sweden who built the Karolinska Hospital in Stockholm, it came in under the price of the NCH AND delivered three times the beds as Stephen Donnelly was saying in his time in opposition in 2019

Fianna Fail’s Health spokesman, Stephen Donnelly, said the most expensive hospital in the world was the Royal Adelaide Hospital in Australia.

And the most expensive hospital building project was the new Karolinska University Hospital in Stockholm, Sweden - the current cost stands at almost €2.1bn.

“But they are getting three times more hospital beds,” said Mr Donnelly.

If Sweden can build that in a climate where it goes below -10c for large parts of the winter and end up with three times the beds for cheaper then we are getting royally ripped off here with the NCH.

PearseCork92

AndrewJRenko wrote: »

Is there any particular reason that you reckon that your view on this matter should be given equal or more consideration than the eminent industry experts?

We may as well shut down boards altogether then. Any topic we touch on will have experts that you can defer to and outsource all your thinking to - and we can all go to bed at night happy in the knowledge that said experts get it right all the time and it's a waste of time probing what they commit to a report.

Curiously enough, you were quick to question a procurement expert from DCU. Go figure.

Northernlily

I don't think it's a scam. I think senior civil servants are as incompetent as they seem for letting BAM get such a contract like this in place.

Governance and accountiblity has failed. Heads need to roll.