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

tara73

beauf wrote: »

The cost IS eye watering and it's not over yet.

You can't sell James as cheaper location. A lot of the higher costs have been caused by the excessive ground works due to the location. Nothing to do with facilities in the hospital. You wouldn't have those costs somewhere else. How much of James are they rebuilding. How much is left of the original hospital? 30%?

what kind of excessive groundworks, what's so difficult with the ground there? it's not even a high rise building, it's just 7 storeys at it's highest.

can't believe it's more about the presumably unsuited location than about this ridiculous costs in this thread.


the title of this thread sums it up nicely, this project is a scam, a money pit, fraud on the taxpayer of the highest order. nothing in this project justifies the mindblowing sum of 2.4 billion. there are numerous projects on this planet much, much more complex and in/with much more difficult conditions and not even close to this sum.

just to give a perspective, the burj khalifa cost 1.5 billion, this list somebody posted before is very helpful.https://en.wikipedia.org/wiki/List_of_most_expensive_buildings


I really would like to know where the money is going.

BrianBoru00

Pete_Cavan wrote: »

So you suspect one team may be able to operate just as well away from James's and just assume that applies to every team? There is far more to these hospitals than this one team that suits your angle.

I'm trying to educate myself. I'm not a medical expert. Here's another team : "The orthopaedic service in CHI at Crumlin comprises consultant surgeons, non consultant hospital doctors, anaesthesiologists, numerous practitioners in allied health disciplines, nurses, and medical administrators, as well as hospital management. We engage regularly with our colleagues in other medical disciplines as required. "
I quoted you'r post initially because it seemed a reasonable point but now that I've delved deeper into it and asked for a practical explanation you either don't have one or aren't knowledgeable enough on the subject.

It is quite simple though - Those teams are currently in Crumlin. Presumably they will move to to the NCH en masse. Its a twenty minute drive for a consultant or surgeon from St. James to go to JCM site if required.
I just want to know what those teams are going to be doing differently that they're not doing now. What specialist equipment do they need from St. James? Surely if anything the equipment will be in the NCH itself - we're going to be paying 3 billion.. A Cat scanner and an MRI together (which are two of the most expensive pieces of equipment in a hospital) cost in the region of 6 million- don't tell me that the NCH is going to do differently to Crumlin and start moving children to St. James main hospital for certain procedures.

Pete_Cavan wrote: »

Connolly Hospital doesn't have anything like the same level of specialist facilities or staff that James's has. Connolly is a Model 3 hospital, the same as Naas General or Cavan General Hospital, it is not is the same league as James's. Bringing Connolly up to James's standards would be huge and it isn't easy to relocate such services. As I said before, you cant just shut down and move these kind of facilities, particularly as you have patients receiving treatment at all times. You need to build and buy everything required new, duplicating everything, then you are left with all this incredibly expensive equipment and no use for it.

1. All of the reports suggest it should be co located with an acute hospital which JCM is. Yes St. James is obviously superior but there seems to have been too much weighting given to St. James position as the top teaching hospital when clearly JCM is an acute hospital.
2. Why can't you just move these facilities?
Like if a child is on a life support machine you're not going to be transferring them anyhow. Crumlin/Temple street aren't closing on a Friday and NCH opening on the Saturday - theres going to be several months presumably of a transfer while equipment/ departments are transferred.
You keep rehashing this argument without giving an example.

Pete_Cavan wrote: »

The NCH has expansion capacity for the 20% increase which was required under the project brief. It's ridiculous that people keep repeating these falsehoods here, proves they know nothing whatsoever about the project.

Who's repeating falsehoods? It's not rocket science. It's common sense. Google maps will show the vast differences in expansion room around both campuses.
It's irrelevant what was under the project brief as most people are suggesting the project brief was obviously flawed when it didn't provide for significant expansion as a greenfield or JCM site would have allowed for

beauf

tara73 wrote: »

what kind of excessive groundworks, what's so difficult with the ground there? it's not even a high rise building, it's just 7 storeys at it's highest. ....

I stopped following the project in detail when they decided on this location. But I heard due to lack of space they had to dig down to create parking and I assume other spaces. They also ran into major water and sewer systems that were unexpected that cost loads to resolve. I'm open to correction on this. But they were a long time getting above ground this project. Someone else might know the details. But that's not unusual on an old site. Just wouldn't be an issue on a Greenfield site.

Maybe it's been over stated in the media.

Anita Blow

BrianBoru00 wrote: »

I'm trying to educate myself. I'm not a medical expert. Here's another team : "The orthopaedic service in CHI at Crumlin comprises consultant surgeons, non consultant hospital doctors, anaesthesiologists, numerous practitioners in allied health disciplines, nurses, and medical administrators, as well as hospital management. We engage regularly with our colleagues in other medical disciplines as required. "
I quoted you'r post initially because it seemed a reasonable point but now that I've delved deeper into it and asked for a practical explanation you either don't have one or aren't knowledgeable enough on the subject.

It is quite simple though - Those teams are currently in Crumlin. Presumably they will move to to the NCH en masse. Its a twenty minute drive for a consultant or surgeon from St. James to go to JCM site if required.
I just want to know what those teams are going to be doing differently that they're not doing now. What specialist equipment do they need from St. James? Surely if anything the equipment will be in the NCH itself - we're going to be paying 3 billion.. A Cat scanner and an MRI together (which are two of the most expensive pieces of equipment in a hospital) cost in the region of 6 million- don't tell me that the NCH is going to do differently to Crumlin and start moving children to St. James main hospital for certain procedures.



1. All of the reports suggest it should be co located with an acute hospital which JCM is. Yes St. James is obviously superior but there seems to have been too much weighting given to St. James position as the top teaching hospital when clearly JCM is an acute hospital.
2. Why can't you just move these facilities?
Like if a child is on a life support machine you're not going to be transferring them anyhow. Crumlin/Temple street aren't closing on a Friday and NCH opening on the Saturday - theres going to be several months presumably of a transfer while equipment/ departments are transferred.
You keep rehashing this argument without giving an example.


Who's repeating falsehoods? It's not rocket science. It's common sense. Google maps will show the vast differences in expansion room around both campuses.
It's irrelevant what was under the project brief as most people are suggesting the project brief was obviously flawed when it didn't provide for significant expansion as a greenfield or JCM site would have allowed for

I am a paediatric doctor.

There are many instances where we require cross cover from adult doctors- cardiothoracics, orthopaedics (scoliosis surgery is provided by adult orthopaedic surgeons for example), neurosurgery, burns & plastics. Adult hospitals also house a lot of highly specialised infrastructure which we don't have in paediatrics because we don't have the numbers to justify them (SJH has the burns unit & national radiotherapy centre for head and neck cancers for example, many surgical patients from Temple St have to be sent to Beaumont which has a paediatric ward for this reason).

Kids today still of course have access to all this but separation of services means it's inefficient, untimely and impacts the quality of their care. If a child experiences a life-threatening burn they need to be taken to a Children's hospital because that's where the paediatric emergency doctors, anaesthetists, nurses are but it's not where the plastic surgeon who will operating on them is. Instead that person has to travel across the city to get there, delaying their care by critical minutes.
Many blood samples need to be sent to St James' for processing (because this is the largest and most specialised lab), which involves ordering a taxi to send the sample to SJH and unneccessarily wastes time in often urgent situations.

Some of this is due to the inefficiency in the HSE and poorly allocated resources, but some of it is also due to the fact that kids just don't get sick in the same numbers that adults do and so in a country as small as Ireland we do not have the population to justify these standalone facilities for paediatrics. This is why we rely on adult hospitals and why co-location is essential.
From a purely clinical perspective, Connolly is a complete non-runner. It is a general hospital on the level of Cavan, Naas etc (as mentioned above) and so offers zero of the specialist expertise, infrastructure and facilities that are the whole purpose of co-location in the first place. The only suitable sites for co-location are the major Dublin hospitals, all of which are plagued by awful access.

Absolutely agree with all who say that heads should roll for the cost inflation and no hospital should cost this much. I also agree that access is a major issue. But from a clinical perspective and what will actually lead to improved outcomes for sick children, the case for co-location with any of the major Dublin hospitals is indisputable.

beauf

I don't think anyone was asked co-location at a cost of 2 billion and the effect that will have on the health services other resources.

Once this project is finished. Will kids no longer be referred to Beaumont or Cappagh and similar?

As for Blanch it shortsightedly sold off if at lot of land for it's rebuild. That didn't go to plan. But end result is, that while it still has a lot of space its not as big as it once was. I assume any move to somewhere like Blanch would not have left Blanch a general hospital. It would have been upgraded.

That ship sailed a good few years ago. Too late now.

BrianBoru00

Anita Blow wrote: »

I am a paediatric doctor.

There are many instances where we require cross cover from adult doctors- cardiothoracics, orthopaedics (scoliosis surgery is provided by adult orthopaedic surgeons for example), neurosurgery, burns & plastics. Adult hospitals also house a lot of highly specialised infrastructure which we don't have in paediatrics because we don't have the numbers to justify them (SJH has the burns unit & national radiotherapy centre for head and neck cancers for example, many surgical patients from Temple St have to be sent to Beaumont which has a paediatric ward for this reason).

Kids today still of course have access to all this but separation of services means it's inefficient, untimely and impacts the quality of their care. If a child experiences a life-threatening burn they need to be taken to a Children's hospital because that's where the paediatric emergency doctors, anaesthetists, nurses are but it's not where the plastic surgeon who will operating on them is. Instead that person has to travel across the city to get there, delaying their care by critical minutes.
Many blood samples need to be sent to St James' for processing (because this is the largest and most specialised lab), which involves ordering a taxi to send the sample to SJH and unneccessarily wastes time in often urgent situations.

ome of this is due to the inefficiency in the HSE and poorly allocated resources, but some of it is also due to the fact that kids just don't get sick in the same numbers that adults do and so in a country as small as Ireland we do not have the population to justify these standalone facilities for paediatrics. This is Swhy we rely on adult hospitals and why co-location is essential.
From a purely clinical perspective, Connolly is a complete non-runner. It is a general hospital on the level of Cavan, Naas etc (as mentioned above) and so offers zero of the specialist expertise, infrastructure and facilities that are the whole purpose of co-location in the first place. The only suitable sites for co-location are the major Dublin hospitals, all of which are plagued by awful access.

Absolutely agree with all who say that heads should roll for the cost inflation and no hospital should cost this much. I also agree that access is a major issue. But from a clinical perspective and what will actually lead to improved outcomes for sick children, the case for co-location with any of the major Dublin hospitals is indisputable.

Would it not have made sense though to upgrade JCM over the course of a few years to ensure that it's where the services should be located and effectively moving St. James over the course of a few years. (I know the horse has bolted) .
Like it's not as though this hasn't been in planning for years.

Could we not for example even still move the top blood lab from St. James to JCM?

beauf

I think the plan was centralise lots of resources into a few in Dublin etc. then slowly wind down and pull all the resources out side of major cities. I know centres of excellence and all that..

A few years back before they rebuilt it looked like they might close Connolly.

Anita Blow

beauf wrote: »

I don't think anyone was asked co-location at a cost of 2 billion and the effect that will have on the health services other resources.

Once this project is finished. Will kids no longer be referred to Beaumont or Cappagh and similar?

As for Blanch it shortsightedly sold off if at lot of land for it's rebuild. That didn't go to plan. But end result is, that while it still has a lot of space its not as big as it once was. I assume any move to somewhere like Blanch would not have left Blanch a general hospital. It would have been upgraded.

That ship sailed a good few years ago. Too late now.

The cost of the NCH is unfortunately draining other healthcare resources. A lot of projects in both paeds and adult medicine have been stalled because the ever increasing cost of the NCH is vacuuming all the money.

When the hospital is finished we definitely won't be sending kids to Beaumont any longer. I'm not sure about Cappagh- Cappagh kids was recently set up so I guess it's the prerogative of the orthopaedic consultants there whether it continues or not.

BrianBoru00 wrote: »

Would it not have made sense though to upgrade JCM over the course of a few years to ensure that it's where the services should be located and effectively moving St. James over the course of a few years. (I know the horse has bolted) .
Like it's not as though this hasn't been in planning for years.

Could we not for example even still move the top blood lab from St. James to JCM?

I think in theory that would be reasonable. In practice though the cost would be prohibitive and if you were waiting to upgrade Connolly from 400 to 1600 beds and to transfer all the national infrastructure there before transferring the kid's hospitals, you would be waiting decades.
Without taking into account the inevitable cost inflation that happened with the NCH, I'd imagine the cost of rebuilding SJH would be billions. It would've been a hard sell to the general public 6/7 years ago to rebuild SJH at a cost of billions in addition to the NCH.

It wouldn't make sense to move the lab from SJH to Connolly. Every hospital requires it's own lab and the expertise and equipment in that lab will be a function of the size and expertise of it's hospital. Connolly is a general hospital with no national services so it's lab would just run standard tests like blood counts, inflammatory markers, markers of organ function. SJH is a 1200-bed national hospital with several specialist services and so it can justify an on-site lab with specialist personnel/equipment and requires on-site access to this 24/7. It wouldn't make sense to move that lab off-site away from such services and it would have a detrimental impact on care if we had to courier hundreds or thousands of blood samples every day from the main hospital in the country to a small general hospital.

AndrewJRenko

tara73 wrote: »

the title of this thread sums it up nicely, this project is a scam, a money pit, fraud on the taxpayer of the highest order. nothing in this project justifies the mindblowing sum of 2.4 billion.

Can you be specific about who is scamming who please?

BrianBoru00 wrote: »

I'm trying to educate myself. I'm not a medical expert. Here's another team : "The orthopaedic service in CHI at Crumlin comprises consultant surgeons, non consultant hospital doctors, anaesthesiologists, numerous practitioners in allied health disciplines, nurses, and medical administrators, as well as hospital management. We engage regularly with our colleagues in other medical disciplines as required. "
I quoted you'r post initially because it seemed a reasonable point but now that I've delved deeper into it and asked for a practical explanation you either don't have one or aren't knowledgeable enough on the subject.

It is quite simple though - Those teams are currently in Crumlin. Presumably they will move to to the NCH en masse. Its a twenty minute drive for a consultant or surgeon from St. James to go to JCM site if required.
I just want to know what those teams are going to be doing differently that they're not doing now. What specialist equipment do they need from St. James? Surely if anything the equipment will be in the NCH itself - we're going to be paying 3 billion.. A Cat scanner and an MRI together (which are two of the most expensive pieces of equipment in a hospital) cost in the region of 6 million- don't tell me that the NCH is going to do differently to Crumlin and start moving children to St. James main hospital for certain procedures.

1. All of the reports suggest it should be co located with an acute hospital which JCM is. Yes St. James is obviously superior but there seems to have been too much weighting given to St. James position as the top teaching hospital when clearly JCM is an acute hospital.
2. Why can't you just move these facilities?
Like if a child is on a life support machine you're not going to be transferring them anyhow. Crumlin/Temple street aren't closing on a Friday and NCH opening on the Saturday - theres going to be several months presumably of a transfer while equipment/ departments are transferred.
You keep rehashing this argument without giving an example.


Who's repeating falsehoods? It's not rocket science. It's common sense. Google maps will show the vast differences in expansion room around both campuses.
It's irrelevant what was under the project brief as most people are suggesting the project brief was obviously flawed when it didn't provide for significant expansion as a greenfield or JCM site would have allowed for

BrianBoru00 wrote: »

Would it not have made sense though to upgrade JCM over the course of a few years to ensure that it's where the services should be located and effectively moving St. James over the course of a few years. (I know the horse has bolted) .
Like it's not as though this hasn't been in planning for years.

Could we not for example even still move the top blood lab from St. James to JCM?

BrianBoru00 wrote: »

I know its one team. But the question is still relevant and you haven't actually answered it. For that one team what difference is it making to them on a day to day basis how far they are from St. James?

Again my understanding is one of the main reasons for co location is cross fertilisation of skills - that by working sometimes in paediatric care and sometimes in adult care they improve they're skill set. That can still be done easily were the hospital to be located in Blanchardstown.

The relevant equipment from everything I've read will be in the children's hospital.
The Connolly site still ticked all the boxes for co locating with an acute hospital.
It also offered plenty of space for future expansion and the construction of a national maternity hospital achieving tri-location.
It's the same distance from Castlenock train station as St. James from Heuston and most importantly its located on the main arterial route in the country.
It provides parking and expansion for parking as the site builds up. While you may be correct in stating that only a small percentage of visits each day will be by sick children - they are surely the most important people to be thinking of.

Do you think that any of the points you raise were not considered by the group of eminent experts that produced the Dolphin Report?

beauf wrote: »

It can only take the lighter helicopter afaik. The larger ones have to go elsewhere and transfer. Maybe that's changed. Coincidentally the Mater site also had some issue with helicopters. But I guess they couldn't make it a requirement otherwise as it would have ruled out these sites.

Maybe they didn't make it a requirement because it's not a requirement for a tertiary care facility?

whisky_galore wrote: »

Not a scam, just by now routine clusterfück where no one is accountable, no one loses their job so we just bumble along, fcuk good money after bad until it (eventually) gets built.

The project team is reporting to the PAC on a regular basis, along with the usual reporting to the Department. What additional accountability would you be expecting?

tara73 wrote: »

Somebody earlier in the thread wrote they were taken to the High Court? Was that a joke or is it true?

https://www.independent.ie/irish-news/courts/national-childrens-hospital-sues-contractor-in-row-over-construction-contract-39097269.html

PearseCork92 wrote: »

Give over will you.

You're trying to shut down people opining on the location of the hospital, which was extremely contentious even among people in the medical field. The owner and developer of the Blackrock Clinic even came out against James'.

You don't appear to be much in the way of an expert on this yourself, so by your own metrics, why not log off and go down the handball alley to pass your time that way yourself?

I'm not trying to shut anything down. People are welcome to opine, just as I am welcome to opine about the opines that people are opining. 95% of the stuff on this thread is nonsense - gossip, public sector bashing, vague claims with no detail.

RRand seems to know their stuff about construction. Anita seems to know her stuff about the clinical issues. Pete Cavan seems to know his stuff on some of the broader issues.

The rest is just oul lads sitting on bar stools kidding themselves that they know everything about everything, when actually, they know very, very little.

Just curious - is 'go down the handball alley' a euphemism for something?

Pete_Cavan

BrianBoru00 wrote: »

Would it not have made sense though to upgrade JCM over the course of a few years to ensure that it's where the services should be located and effectively moving St. James over the course of a few years. (I know the horse has bolted) .
Like it's not as though this hasn't been in planning for years.

Could we not for example even still move the top blood lab from St. James to JCM?

Do you honestly think that building the NCH + another hospital several times larger + replacing several national centres of excellence would be cheaper than just building the NCH and tying in with the existing centres of excellence? Think about it for a couple of minutes. Do you really think expanding the scope of the project several fold, adding years to the timeline and greatly increasing the complexity by having to coordinate the transfer of many more seriously ill people (not just children but now also adults) will reduce costs?

The logistics of moving James's would be mindblowing. As I explained before, you can't just move all these highly specialist services and equipment required from James's to a new hospital en mass overnight. You would have to leave everything running at James's to treat patients and set up all new at the new location and get it up and running. Then you have to have an orderly transfer with both centres operating for a period. This type of facilities and equipment costs an absolute fortune, things which our country can only afford one of. The cost of the duplication would be enormous and be a huge asset management challenge. The purchase and serving contracts for one piece of specialist medical equipment can cost millions. Obviously you run down one thing and replace it as it reaches end of life. It would be impossible to have everything in a hospital the size of James's approach end of life around the same time so you will inevitably be replacing equipment with years of life left it them. Any delay to the construction project could also see things having to operate longer than desired because you can't set up the replacement at the old hospital, it needs to wait until the new one is ready. The risks and potential cost and healthcare implications of any delay would dwarf the current NCH project.

beauf

Pete_Cavan wrote: »

Do you honestly think that building the NCH + another hospital several times larger + replacing several national centres of excellence would be cheaper than just building the NCH and tying in with the existing centres of excellence? ....t.

...2 billion maybe more....

I think it's exceeded most people worst fears by some margin...

jmayo

AndrewJRenko wrote: »

Which party members were involved - the party in power at the time the decision to go ahead was made? Or the party in power at the time the site was chosen? Or the party in power at the time the contract was awarded? Or the party in power at the time the decision was made to take BAM to the High Court?

How do you reckon that the corrupt party members managed to get dozens of officials to go along with the scam? How did they make sure that no other builder submitted a slightly lower tender?

A few posts in and you are in straight away to defend the new childrens hospital once again.

Mind telling us what skin you have in the game because everytime there is a thread on this there you are defend defend.

political analyst wrote: »

Isn't it the location the hospital consultants wanted? The project wouldn't have started if they had not been kept on board.

By the way, ambulances go through busy junctions all the time. I'm sure the paramedics can keep the child's condition stable until they get to the hospital.

Niner leprauchan wrote: »

Its central for a reason. No person needs to travel the entire lenght of the county and the closer to the city, the higher the population density. Possible smaller centres dotted around the outskirts could have worked but that wasnt on the table.

Its 3km from the red cow junction. where exactly would you like it placed?

You know the real funny thing, the plan is to build emergency centres in Tallaght and Connolly that emergency cases can actually get to.

So really this hospital plan is starting off admitting it is not capable of meeting most children's hospital requirements for the greater Dublin area.

This hospital is not meant to really cater for some kid with broken arm from say Blessington, Tallaght, Bray, Cellbridge, Dunboyne, Swords, Malahide, etc, etc all areas within 20km to 30km or so of Dublin city centre.
And it is siting bears that out.

It is meant to be for long term specialist treatment plans for serious illness and for serious injuries.
So a child needs cancer treatment, a child needs treatment for missing a kidney, a child has a heart condition.

But what about a child has major accident, they can't be airlifted by coast guard (and maybe even the AW139 Air Corp transport) straight to hospital.
Sure they can find a car park down the road maybe. :rolleyes:
Major drawback right from the get go.

The long term illnesses and conditions are ones that will have to go to this place regularly.

And those kids have to come from around the country, not just city centre Dublin and most definitely those along the two luas lines.

Oh and those children are the very ones that most likely won't be traveling in ambulances and definitely not on public transport.

But most sane people know this and most sane people not pushing an angle or with a vested interest in the current location would also admit the above.

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.

You mean the UK that has a great public transport system ?

Wippee a single disconnected public transport link runs along the building.
Now please tell us all how to we get to this single public transport link in the first place?

political analyst

jmayo wrote: »

But what about a child has major accident, they can't be airlifted by coast guard (and maybe even the AW139 Air Corp transport) straight to hospital.
Sure they can find a car park down the road maybe. :rolleyes:
Major drawback right from the get go.

The Garda traffic unit would clear the way for the ambulance to get to the new hospital or to the nearest A&E as soon as possible.

political analyst

political analyst wrote: »

The Garda traffic unit would clear the way for the ambulance to get to the new hospital or to the nearest A&E as soon as possible.

This works great here in Cork. Air ambulances and rescue choppers land in Bishopstown GAA pitch, the patient is brought the rest of the way by road through a housing estate and traffic...

Makes no sense to be able to land on the hospital when they can do that.

beauf

MikeOxsgreen wrote: »

This works great here in Cork. Air ambulances and rescue choppers land in Bishopstown GAA pitch, the patient is brought the rest of the way by road through a housing estate and traffic...

Makes no sense to be able to land on the hospital when they can do that.

You know I'm the same. If I have a choice avoiding traffic and going direct to somewhere or having to go through traffic and indirect route I'll always do the latter. ...

Why do I get the feeling there are a couple of posters with interests in the hospital defending this shambles in the thread.

It is literally defending the indefensible. As a Project Manager, I'm acutely aware costs spiral and budgets overrun. However,overruns on this scale, gaps in the contract and design shortcomings on what was initially agreed,it is just nothing short of criminal on the Government's part.

AndrewJRenko

jmayo wrote: »

A few posts in and you are in straight away to defend the new childrens hospital once again.

Mind telling us what skin you have in the game because everytime there is a thread on this there you are defend defend.

The only skin that I have in this game is that I'm a public servant who gets mildly irked every time we get bar stool experts pretending that they know everything about everything.

What's your skin in this game?

jmayo wrote: »

You mean the UK that has a great public transport system ?

Wippee a single disconnected public transport link runs along the building.
Now please tell us all how to we get to this single public transport link in the first place?

It's on the red Luas line, which connects directly to Connolly, Hueston, so that's pretty much all incoming trains to Dublin and Canal Dock rail stations. The red Luas line connects indirectly with the green Luas line. The red Luas line connects with a large number of bus routes.

AndrewJRenko

Nevaeh Ugly Textbook wrote: »

Why do I get the feeling there are a couple of posters with interests in the hospital defending this shambles in the thread.

It is literally defending the indefensible. As a Project Manager, I'm acutely aware costs spiral and budgets overrun. However,overruns on this scale, gaps in the contract and design shortcomings on what was initially agreed,it is just nothing short of criminal on the Government's part.

What are the gaps in the contract and the design shortcomings please?

Pete_Cavan

Nevaeh Ugly Textbook wrote: »

Why do I get the feeling there are a couple of posters with interests in the hospital defending this shambles in the thread.

It is literally defending the indefensible. As a Project Manager, I'm acutely aware costs spiral and budgets overrun. However,overruns on this scale, gaps in the contract and design shortcomings on what was initially agreed,it is just nothing short of criminal on the Government's part.

Nobody is defending the management of the project but the idea that building it somewhere else would have avoided these issues is not that simple. To build it somewhere else, you either have to accept lesser vital services on site which results in lower quality of care and you need to transport patients, or you have to move those services to the new location which multiplies the scale and complexity of the project which likely multiplies the cost and time overruns.

TheChizler

MikeOxsgreen wrote: »

This works great here in Cork. Air ambulances and rescue choppers land in Bishopstown GAA pitch, the patient is brought the rest of the way by road through a housing estate and traffic...

Makes no sense to be able to land on the hospital when they can do that.

Yes, so much traffic...

beauf

Pete_Cavan wrote: »

Nobody is defending the management of the project but the idea that building it somewhere else would have avoided these issues is not that simple. To build it somewhere else, you either have to accept lesser vital services on site which results in lower quality of care and you need to transport patients, or you have to move those services to the new location which multiplies the scale and complexity of the project which likely multiplies the cost and time overruns.

Your trying to suggest its impossible to build this cheaper or better somewhere else. Or that the problems on this site are exactly the same as any other site.

jmayo

AndrewJRenko wrote: »

The only skin that I have in this game is that I'm a public servant who gets mildly irked every time we get bar stool experts pretending that they know everything about everything.

No, am clever enough and dumb enough to know I know far from everything about anything.

But I do know when somethings can be done better and when planning in this country is never fit for purpose, doesn't even meet current requirements never mind future ones.
Wait a public servant, you wouldn't be in planning by any chance.
Nearly ever public project carried out in this country has been an expensive crock.
Oh yippe we eventually got two linked tram lines but how fooking long did it take and how more expensive than first planned did it work out.

And yes as per usual we will get the refrain about our motorways, bypasses and roads.
Then again I know some of those bypasses and new roads have some very unsual traits and sometimes not very forward thinking features that really makes you scratch your head.

BTW how many crock ups did we make before we started getting them somewhat right or should we forget about M50 and Toll bridge ?

AndrewJRenko wrote: »

What's your skin in this game?

Lets just say I know a fair bit about dealing with and supplying our hospital system.
Oh and other half works in medical system.
So I have been around the block and know how inept the whole system can be.

Also I know people that either have to sadly visit the likes of Crumlin, Temple and probably in future the James location.

Oh and I know quite amount of people that have to visit those places to carry out work.
And public transport doesn't work for them.
James site is a pain to have to visit.

Oh and I am a taxpayer and have kids who will be paying for this as well.

AndrewJRenko wrote: »

It's on the red Luas line, which connects directly to Connolly, Hueston, so that's pretty much all incoming trains to Dublin and Canal Dock rail stations. The red Luas line connects indirectly with the green Luas line. The red Luas line connects with a large number of bus routes.

Do you know how many people live along train lines in this country?
You don't work in Dept of Environment or indeed transport if you think must people travel to Dublin via train, never mind those with sick kids.

TheW1zard

AndrewJRenko wrote: »

What are the gaps in the contract and the design shortcomings please?

How about giving a company a contract to build something without telling them what to build!

Pete_Cavan

beauf wrote: »

Your trying to suggest its impossible to build this cheaper or better somewhere else. Or that the problems on this site are exactly the same as any other site.

From a healthcare perspective, to build a better hospital somewhere else, you need to relocate many one off specialist facilities from James's to this somewhere else. That will be more expensive than locating beside these existing facilities. You can choose to believe that you can build a hospital several times the size of NCH with many more complexities, logical issues and duplication of services in order to maintain treatment for less money, but that is not how it works in the real world.

beauf

Pete_Cavan wrote: »

.... You can choose to believe that you can build a hospital several times the size of NCH with many more complexities, logical issues and duplication of services in order to maintain treatment for less money, but that is not how it works in the real world.

Considering this will be the most expensive hospital ever built. Even if per bed is not an exact metric. This hospital is more expensive by something like a factor of 5. It suggests that's exactly how it works, in the real world.

This is the exact opposite of the phrase "cut your cloth to your means"

jmayo

Pete_Cavan wrote: »

From a healthcare perspective, to build a better hospital somewhere else, you need to relocate many one off specialist facilities from James's to this somewhere else. That will be more expensive than locating beside these existing facilities. You can choose to believe that you can build a hospital several times the size of NCH with many more complexities, logical issues and duplication of services in order to maintain treatment for less money, but that is not how it works in the real world.

So are we now saying that every hospital in future has to be built right beside an existing one ?

Anita Blow

jmayo wrote: »

So are we now saying that every hospital in future has to be built right beside an existing one ?

It isn't just now being said. Co-location is the international standard, particularly for countries of Ireland's size. Co-location with a tertiary hospital was a requirement from the outset of developing a new NCH.

Fewer bigger hospitals is the standard across the developed world so essentially yes. Which is why the NMH will co-locate with SVUH, Coombe with SJH and Rotunda with Connolly.

It's a different debate altogether but Dublin has far too many hospitals for its size which leads to unnecessarily fractured services.
While access & cost are obvious drawbacks, co-location of the paeds hospitals with one of the major existing hospitals is a step in the right direction for delivering cohesive healthcare.

gctest50

AndrewJRenko wrote: »

What are the gaps in the contract and the design shortcomings please?

Here's an interesting design shortcoming, the scumbag responsible should be lynched :


"The top floor of this iconic building is 29.9m high, marginally below the threshold of 30m, which prescribes an automatic requirement for life safety sprinklers," the report said. "It appears that the building has been re-engineered to deliberately avoid an essential life safety system given the fact that the top floor is just 100mm below the threshold for sprinklers."

https://m.independent.ie/news/environment/childrens-hospital-deliberately-designed-to-avoid-installing-sprinklers-claims-fire-brigade-36259501.html

beauf

Anita Blow wrote: »

It isn't just now being said. Co-location is the international standard, particularly for countries of Ireland's size. Co-location with a tertiary hospital was a requirement from the outset of developing a new NCH.

Fewer bigger hospitals is the standard across the developed world so essentially yes. Which is why the NMH will co-locate with SVUH, Coombe with SJH and Rotunda with Connolly.

It's a different debate altogether but Dublin has far too many hospitals for its size which leads to unnecessarily fractured services.
While access & cost are obvious drawbacks, co-location of the paeds hospitals with one of the major existing hospitals is a step in the right direction for delivering cohesive healthcare.

If you set the rule every new hospital has to beside an existing one and hospital like James in a location similar to James. Then you can see why we are stripping the rest of the country of services and moving them all to congested locations in the city, difficult to build in and expand, even the layout is chaotic. Hence they are expensive and will drag even more traffic from all over the country to these already gridlocked locations.

beauf

But hey it's done now. Hopefully there won't be too many more delays.

Anita Blow

beauf wrote: »

If you set the rule every new hospital has to beside an existing one and hospital like James in a location similar to James. Then you can see why we are stripping the rest of the country of services and moving them all to congested locations in the city, difficult to build in and expand, even the layout is chaotic. Hence they are expensive and will drag even more traffic from all over the country to these already gridlocked locations.

It's not an arbitrary rule, it's being done because it leads to more services, greater specialisation and better clinical outcomes. There is nothing unique about Ireland that we should reject co-location/centralisation of services when it is the standard in every developed country.

GOSH is in central London
CHOP is in central Philadelphia.
RCH is in central Melbourne.
Sick Kids is in downtown Toronto.

Access is an issue for all of these, but in all cases the need to be closer to the bulk of the population, medical research facilities and public transport trumps access by car because it leads to better quality of care.

beauf

GOSH 1852
CHOP 1855/1866
RCH 1870/1963
Sick Kids 1875

Seems like these locations are historical and without any reference to cars or modern public transport, or even any modern thinking around co-location.
Similarly none of those locations being chosen to serve the "bulk of the population" of an entire country. But once established there's not much point moving them.

To copy the pattern of these hospitals, we would not moved hospitals and services, but invested in expanding and developing an existing children's hospital.
I assume therefore the biggest one might have been chosen, Crumlin. It only 4k away only 30 mins walk from James. Since we've already established that these distances are fine, for staff, visitors and patients, and transfers using Garda to get through traffic and housing estates is no problem. As suggested a new hospital is more expensive then using an existing hospital, so it would have been cheaper aswell to expand Crumlin than build a new building at James.

Anita Blow

Building on Crumlin would not involve co-location, would be plagued by the same if not worse access issues and would necessitate a new hospital being built anyway as they existing hospital would have to remain in-use during construction.
It would offer no clinical benefits over the SJH site.
This is why the Crumlin board nominated SJH back in 2012 as the NCH site.

From a clinical perspective any alternative to SJH would require co-location with an adult tertiary hospital so that limits your options to SJH, Tallaght, Beaumont, SVUH, Mater.

beauf

Anita Blow wrote: »

Building on Crumlin would not involve co-location, would be plagued by the same if not worse access issues ..

... this implies James has access issues...also they are very close to each other. It's unlikely to have worse issues as you can easily walk between them. Unless walking is no longer an option. ...

Anita Blow wrote: »

and necessitate a new hospital being built anyway as they existing hospital would have to remain in-use during construction.
It would offer no clinical benefits over the SJH site.
This is why the Crumlin board nominated SJH back in 2012 as the NCH site...

So building a new hospital on a Greenfield site and the expense isn't the showstopper some have suggested. Now a new build is preferred. They rebuilt the Mater and kept it open. I assume those examples you have in other countries also stayed open as they grew over the years in the same site.

Anita Blow wrote: »

From a clinical perspective any alternative to SJH would require co-location with an adult tertiary hospital so that limits your options to SJH, Tallaght, Beaumont, SVUH, Mater.

...even though your examples in other countries are near other hospitals but not on the same site. Ireland is obviously a special case.

Mater is pretty much a twin of James in many regards. But it's interesting two almost identical sites with the same advantages and disadvantages, arguably the Mater is even more central. There was nothing gained changing from the Mater to James.

Well other than political maybe.

beauf

It's all old history. Pointless going over it.

Now we just have to wait and see how much money this will consume before it is finished.

Ash.J.Williams

Nevaeh Ugly Textbook wrote: »

Why do I get the feeling there are a couple of posters with interests in the hospital defending this shambles in the thread.

It is literally defending the indefensible. As a Project Manager, I'm acutely aware costs spiral and budgets overrun. However,overruns on this scale, gaps in the contract and design shortcomings on what was initially agreed,it is just nothing short of criminal on the Government's part.

I was actually looking for that post that claimed these overruns are a normal part of these projects and found yours saying what I wanted to say! Tell me this before this project what you say would be a typical budget overrun? Tens /hundreds of thousands?

Podge_irl

Muahahaha wrote: »

Connolly Hospital in Blanch was the other option where they have acres of green space for future expansions and where Coastguard helicopters could have landed which they cant do at the new Childrens Hospital in St James, there isnt the space and the helicopter pad to be installed there cannot hold the weight of them. Meaning children with severe and urgent brain injuries may not get to the hospital on time because the helicopter cannot land there. You would have thought this would be a key requirement on where to locate the hospital but no it wasnt.

At a guess, children with severe and urgent brain injuries might also go to Beaumont seeing as its the national centre for neurology and neurosurgery. The NCH is not the designated A&E for every child in the country

crazy 88 wrote: »

city/city centre...does it matter? The area is inaccessible.

It is the most accessible hospital site by public transport in the country by quite a wide margin. You can access it easily from Heuston meaning its open to public transport for a large part of the country. It has tram and bus lines literally running through it.

Yes, I am aware that not everyone going to the hospital can use public transport. GOSH has no problem advising that as many people as possible attending the hospital should use public transport and doesn't even have a car park. The expert report that decided the location came to the not unreasonable conclusion that clinical outcomes were more important than ease of parking. There is a large car park being built and if it is only used by those who actually need it then there will be sufficient space.

On top of all this, you have 70% of Dublin households which do not have a car. How are they supposed to get to this hospital off the M50?

BrianBoru00 wrote: »

- There were plenty of "distinguished people" who are/were against the location.
- Parking IS a big issue in Ireland for a national hospital given the poor transport options nationally in comparison to other countries. Best international practice should not be the be all and end all and decisions should be made with due regard for this country and our infrastructure / culture /situation
-Clinical excellence - I never got this logic. Is Great Ormonde Street Hospital co located with an adult hospital?
Surely the whole point of a children's hospital is to have excellence on a standalone basis.

St James has excellent public transport options.
GOSH is located beside the National Hospital for Neurology and Neurosurgery but its location ulimately pre-dates the research that suggests colocation is one of the most important factors in deciding location.

Deleted User wrote: »

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

SJH is one 2 luas stops away from the Cork-Dublin line terminus...

Everyone realises that not everyone using the hospital even can drive right?

crazy 88 wrote: »

Is that you Mr. Donnelly?

The central area you reference is surrounded by soul crushing gridlock all day, not just rush hour. I know as I live near St James's hospital. There's no justification for locating it where it is. And no one will be bringing a sick child on a bus or the Luas to get there.

The justification was improved clinical outcomes from co-location with an adult tertiary hospital.

Do you have a reason to dispute this conclusion?



Those suggesting the hospital location was chosen for political convenience or pressure are bordering on conspiracy theory lunacy. The factors for deciding the location were based on the Dolphin Report and it was shown that co-location was the most important factor. Thus the Mater initially and then SJH were chosen for this reason. What you are looking for is the politicians to override the expert opinion on where the hospital should have been built. you are ASKING for political interference.

beauf

Podge_irl wrote: »

At a guess, children with severe and urgent brain injuries might also go to Beaumont seeing as its the national centre for neurology and neurosurgery. The NCH is not the designated A&E for every child in the country...

There's also Cappagh.

The majority of patients do not attend A&E. But it will be the national center for a lot of treatments.

Podge_irl wrote: »

It is the most accessible hospital site by public transport in the country by quite a wide margin. You can access it easily from Heuston meaning its open to public transport for a large part of the country. It has tram and bus lines literally running through it.

Yes, I am aware that not everyone going to the hospital can use public transport. GOSH has no problem advising that as many people as possible attending the hospital should use public transport and doesn't even have a car park. The expert report that decided the location came to the not unreasonable conclusion that clinical outcomes were more important than ease of parking. There is a large car park being built and if it is only used by those who actually need it then there will be sufficient space.

On top of all this, you have 70% of Dublin households which do not have a car. How are they supposed to get to this hospital off the M50?

GOSH is historical location. It predates cars. Using GOSH as an example of an ideal location makes no sense. Its location was not planned around its current use.

So what about Dublin car ownership. Its relevant. Its about how many people use a car to get to the current children's hospitals. Also its not a Dublin hospital. Its a national hospital.

The whole point about locating it in Dublin is to have excellent public transport. If you say you can't get to the M50 using public transport. What happened to the excellent public tranport? Did it vanish? Does it only exist in the center of Dublin?

Podge_irl wrote: »

St James has excellent public transport options.
GOSH is located beside the National Hospital for Neurology and Neurosurgery but its location ulimately pre-dates the research that suggests colocation is one of the most important factors in deciding location.

I'm sure when they say "one" of most important factor. They didn't mean it had an unlimited budget, that it would effect the entire Health service budget and indeed the country.

Podge_irl wrote: »

SJH is one 2 luas stops away from the Cork-Dublin line terminus...

Everyone realises that not everyone using the hospital even can drive right?

This is bit like saying most of the people in school can't drive so we'll plan that most people will not be drive or be driven to school.

Podge_irl wrote: »

The justification was improved clinical outcomes from co-location with an adult tertiary hospital.

Do you have a reason to dispute this conclusion?

There was more than one consideration. It wasn't wasn't solely about co-location. I would wonder considering our massive wait-lists in children hospitals the wisdom of building the worlds most expensive hospital and ending up with the exact same bed capacity. Will that have a greater effect on clinical outcomes, than co-location. Considering the the majority of cases will not be effected by co-location with James.

Podge_irl wrote: »

Those suggesting the hospital location was chosen for political convenience or pressure are bordering on conspiracy theory lunacy. The factors for deciding the location were based on the Dolphin Report and it was shown that co-location was the most important factor. Thus the Mater initially and then SJH were chosen for this reason. What you are looking for is the politicians to override the expert opinion on where the hospital should have been built. you are ASKING for political interference.

I guess you give them free reign to spend as much as they like on it so. They could build it on the top of the sugar loaf and no one should question it. Spend 100 billion on it. No problem. They are experts.

The experts picked the Mater. In fact different groups picked different locations. Originally they wanted the existing hospitals upgraded and not moved. If they picked the Mater then it was found to be suitable, does that not call into doubt the process that picked the Mater in the first place.

beauf

Like I keep saying none of this matters now. Its over.

Once we've finished building the worlds most expensive hospital we should expect dramatic improvements in outcomes and throughput and a dramatic reductions in wait-lists.

Hopefully.

Anita Blow

beauf wrote: »

... this implies James has access issues...also they are very close to each other. It's unlikely to have worse issues as you can easily walk between them. Unless walking is no longer an option. ...

James' definitely has access issues.
It's well served by public transport and in my years commuting via PT I didn't have any issue, but it's a city centre location and has housing estates at the Rialto entrance so think traffic can be a bit of a nightmare at rush hour.

beauf wrote: »

So building a new hospital on a Greenfield site and the expense isn't the showstopper some have suggested. Now a new build is preferred. They rebuilt the Mater and kept it open. I assume those examples you have in other countries also stayed open as they grew over the years in the same site.

I'm not sure you could conclude that from what I said!
A greenfield site would be cheaper than city centre site, nobody would dispute that. The draw back of building a new hospital at Crumlin is that there is no available land around the hospital and so you'd have to CPO the housing estates around the hospital, build new roads etc, whereas there would be no acquisition costs of building on the SJH land.

beauf wrote: »

...even though your examples in other countries are near other hospitals but not on the same site. Ireland is obviously a special case.

Mater is pretty much a twin of James in many regards. But it's interesting two almost identical sites with the same advantages and disadvantages, arguably the Mater is even more central. There was nothing gained changing from the Mater to James.

Well other than political maybe.

The Mater would've been a great location for the NCH. The site wasn't rejected for political reasons though, An Bord Pleanala rejected it because it considered it an eye-sore visible from O'Connell St. Not sure I'd agree and it's disappointing it had to move.


For all the extremely justifiable criticism of the NCH cost, access etc. it does bring a lot of advances to children's care in Ireland so there is still positives to be excited about!

beauf

Anita Blow wrote: »

...

The Mater would've been a great location for the NCH. The site wasn't rejected for political reasons though, An Bord Pleanala rejected it because it considered it an eye-sore visible from O'Connell St. Not sure I'd agree and it's disappointing it had to move...

...and more importantly it was an over development of the site and unsustainable. One issue that caused a lot of criticism was the unsuitability of the mater for helicopters... Sound familiar.

But as say it's time to move forward to a better future.

noodler

Wanderer78 wrote: »

08 was caused by private debt, nothing to do with public debt, but the hospital shows the skullduggery between governments and major contractors, there's no fcuking way no one knew the orginal quote was gonna work

The public sector had no problem spendong the money raised by private debt.

Deleted User

Deleted User wrote: »

Northumbria Specialist Emergency Care Hospital, opened in June 2015

Cost of building, £75 million

It has 6 operating theatres for emergency and high risk surgery and a dedicated maternity theatre.

4 x-ray rooms.

2 CT scanners, two ultrasound systems, a cardiac catheter lab, an endoscopy room and an MRI scanner.

210 acute beds in seven specialty wards.

14 delivery rooms and two birthing pools in a co-located midwifery-led care unit.

20 en-suite single rooms on the maternity ward.

18 bed ICU.

36 treatment rooms in the emergency department.






Link:--> https://www.itv.com/news/tyne-tees/2015-06-16/in-numbers-how-did-it-cost-and-what-is-inside-cramlington-hospital

Bump.... for the benefit of the of the people who may have missed this post.

Choosehowevr.

[Deleted User] wrote: »

Bump.... for the benefit of the of the people who may have missed this post.

There was another big hospital in Scotland

Urban setting adult/children's hospital much bigger and a fraction of the cost here

Choosehowevr.

Problem with these jobs ime

If the design and planning isn't right or threadbare , it costs way more to fix it when the job begins

TheChizler

TheChizler wrote: »

Yes, so much traffic...

Thats Highfield


Point though..... woosh

https://en.strabag-newsroom.com/pressreleases/grand-opening-of-new-childrens-hospital-in-hamburg-2149281

States of the art children's hospital opened in Hamburg in 2017 at a cost of €69.5 million

Geuze

Deleted User wrote: »

https://en.strabag-newsroom.com/pressreleases/grand-opening-of-new-childrens-hospital-in-hamburg-2149281

States of the art children's hospital opened in Hamburg in 2017 at a cost of €69.5 million

69.5 million

18,000 m2

"The new building on the campus of the University Medical Center Hamburg-Eppendorf has a gross floor area of about 18,000 m² and comprises emergency room, outpatient centres, inpatient wards, children’s ICU and a bone marrow transplantation unit."


148 beds

Choosehowevr.

https://www.dailyrecord.co.uk/news/scottish-news/inside-scotlands-new-900million-super-hospital-5545387

1900 adult and children beds ,£900 million

beauf

noodler wrote: »

The public sector had no problem spendong the money raised by private debt.

Having no problem spending, caused the debt in the first place. Seems like the perfect partnership.