Children’s hospital and spiralling costs


Sir, – Three weeks ago, our daughter had cause to be admitted to the American Children’s Hospital here in Madison, Wisconsin, within one hour of attending her primary care clinic. She had a lovely en-suite room to herself with a bed couch for either my husband or I to sleep on. Her care and how we were looked after as a family were outstanding on all levels.

Wisconsin is twice the land-mass of Ireland and with the same population. The American Children’s hospital is ranked top in the US for six paediatric specialities as well as offering full surgical and transplant services to a population larger than Ireland’s here in America’s mid-west. The cost of building it in 2007 was just over $75 million (€65 million), which even allowing for 50 per cent ,inflation would be around $120 million (€104 million) in today’s money. Aesthetically it is a pleasing building. It is eight storeys high, with exactly the same bed capacity as the new children’s hospital in Ireland. It will not win any architecture awards but it gets the job done.

There is a certain air of disbelief when one reads that the children’s hospital costs have escalated to €1.4 billion. How and why? Do the children of Ireland need an amazing avant-garde architecturally designed building? Maybe it is what goes on inside the hospital that matters?

The largest children’s hospital here in the US is in Houston, Texas. They added an extension last year – 25 storeys for approximately $500 million (€435 million).

Maybe it is time to go back to the drawing board quickly and to deliver a cost-efficient design that gets the job done. – Yours, etc,




United States.

Sir, – Prof John FitzGerald’s interesting article regarding cost overruns on major capital projects is very timely in the context of our new children’s hospital. He rightly notes the propensity for large public projects to exceed or substantially exceed their initial budget (“Cost of capital projects often rockets due to lofty notions”, Business Opinion, January 11th).

I would like to raise a question as to the commitment of the promoters of such projects to fully identify all costs at the outset. I suggest that when such projects are being initially promoted, by political or private interest groups, there is a real risk that the project may not be allowed to proceed if the real costs are identified. So there is an incentive to take an overly optimistic view of the overall cost and then, when the project has gained some traction, to drip-feed the additional costs into the mix. All of these costs can be identified at the outset and controlled during the project if there is the will and discipline to do so. Prof FitzGerald identified the Luas north city project in this regard. Unfortunately, it seems that the political will to do so on many public projects is missing.

Regarding the new children’s hospital, one has to continue to question the process and criteria used to select a site which was located within an already very congested and busy existing hospital complex, with significant access restraints, when a greenfield site at the Blanchardstown hospital was available. This selection is already contributing significantly to the construction costs of the hospital, not to mention its questionable location for parents and children who will need to access its services in the future. – Yours, etc,


Sandyford, Dublin 18.