Finance rejected plan for five-storey extension of Rotunda hospital

Officials said falling birth rates must mean existing facilities were ‘underused’

The Department of Finance rejected a plan for a five-storey extension of the Rotunda maternity hospital in Dublin because the number of live births in the region was "falling significantly". This meant the facilities of maternity hospitals in the region must "presumably as a result be underused".

On February 13th, 1987, the Department of Health wrote to the secretary of the Department of Finance seeking approval to go to tender for the proposal. Contractor John Sisk & Son had been the lowest tender of six received, coming in at just over £3 million plus VAT.

Health officials said the development was “essential to provide accommodation of an acceptable standard for the delivery of a modern obstetric service”.

“The new accommodation will replace existing sub-standard and antiquated facilities. This proposed development will not result in the provision of any extra beds,” wrote principal officer S Benton.


The extension would include a 24-bed unit, administration area and a new main entrance on the ground floor of the then 230-year-old Rotunda building, as well as a delivery suite and an operating theatre suite.

Finance officials wrote back in March seeking further information, including the birth rate projections on which the provision of the beds was based.

In June, the Department of Health indicated the total outlay up to 1990 would be £4.25 million, including £258,000 paid to the end of 1986.

They said the birth rate in the then Eastern Health Board area, which mainly represented the Rotunda’s catchment area, had declined from 22.1 per 1,000 of population in 1980 to 17.5 in 1985, similar to the national average decline.

“This downward trend is expected to be less steep in future years. There has been a gradual increase in the number of live births at the Rotunda since 1984. The reasons for this are not easily ascertained but could be due to such factors as patient preferences, widening of the catchment area or higher catchment area birth rates relative to those for other hospitals.”

The Department of Finance eventually responded on July 28th querying the case for new facilities at the Rotunda.

“The number of live births is falling significantly in the EHB region as a whole and the facilities of the maternity hospitals in the region presumably must as a result be underused. In the circumstances sanction for the project would not be warranted and must therefore be refused.”

Finance said the minister was concerned that new facilities involving extra current expenditure “should be kept to a minimum at a time of limited financial resources”.