Financial Statements 2024: Children's Health Ireland and the National Paediatric Hospital Development Board
Committee scrutiny focused on the 2024 accounts of Children’s Health Ireland and the National Paediatric Hospital Development Board, alongside the continuing delay in completing the new children’s hospital. CHI reported an €8 million deficit, acknowledged weak controls and reputational damage, and defended its handling of the €30,000 Christmas party contribution while disputing Aramark’s later explanation. The development board said the hospital remains close to completion but BAM has missed its latest deadline, with major outstanding defects, rework and no confirmed substantial completion date. Members pressed both bodies on escalating costs, commissioning plans and whether the hospital will realistically open in 2027.
This morning, we will engage with Children's Health Ireland to examine its financial statements for 2024 and with the National Paediatric Hospital Development Board to examine its financial statements for 2024.
On behalf of the committee, I welcome the officials from Children's Health Ireland: Professor Lucy Nugent, chief executive officer, Ms Paula Kelly, clinical director, Ms Julia Lewis, transformation director, Ms Sharon Gaffney, chief financial officer, and Mr. Adrian Carroll, programme director.
From the National Paediatric Hospital Development Board we have: Mr. David Gunning, chief officer, and Mr. Phelim Devine, project director.
We are also joined by officials from the Department of Health who are: Ms Tracey Conroy, assistant secretary, and Mr. Eamonn Quinn, principal officer.
From the Health Service Executive we have: Mr. Patrick Lynch, national director of planning and performance, and Mr. Trevor O'Callaghan, integrated healthcare area manager for Dublin south city and west, who are attending in a representative capacity.
Finally, we are joined by officials from the Office of the Comptroller and Auditor General: Mr. Ciaran Kellett, audit manager, and Mr. Seamus McCarthy, Comptroller and Auditor General, who is a permanent witness to the committee. Everyone is very welcome.
Before I begin I will read a note on privilege. I will explain some limitations to parliamentary privilege and the practice of the Houses as regards references witnesses may make to other persons in their evidence. The evidence of witnesses physically present or who give evidence from within the parliamentary precincts is protected, pursuant both to the Constitution and statute, by absolute privilege.
This means they have an absolute defence against any defamation action for anything they say at the meeting. Witnesses are, however, expected not to abuse this privilege and it is my duty as Cathaoirleach to ensure that this privilege is not abused. Therefore, if witnesses' statements are potentially defamatory in relation to an identifiable person or entity, they will be directed to discontinue their remarks. It is imperative that they comply with any such direction.
Witnesses are also reminded of the long-standing parliamentary practice that they should not criticise or make charges against any person or entity by name or in such a way as to make him, her or it identifiable, or otherwise engage in speech that might be regarded as damaging to the good name of the person or entity.
I call on the Comptroller and Auditor General to make his opening statement.
Comment on this
Children’s Health Ireland was established as a statutory public body on 1 January 2019 through an amalgamation of the existing children’s hospitals located at Crumlin, Temple Street and Tallaght. It operates as one of the section 38 agencies supported by grant funding from the HSE.
CHI’s financial statements for 2024 recognise income totalling just over €676 million. Within this, HSE recurrent and capital grant funding amounted to €633 million, representing a year-on-year increase of 17% or €91 million. Retained staff pension-related contributions amounted to a further €20.6 million. Income from patient charges amounted to €11.9 million, down from €14.4 million in 2023. Other income, including donations and fundraising, totalled €11.3 million. Recurrent expenditure in 2024 was €664 million, an increase of 14% year-on-year, or €83 million. This comprised €462 million spent on pay and pensions, and €202 million on non-pay categories of spending. After transfers of a net €20 million to capital reserves, the financial statements indicate there was a deficit for the year of €8 million.
The 2024 financial statements were certified by me on 4 December 2025. My opinion on the financial statements was qualified on the basis that, in complying with the direction of the Minister for Health, Children's Health Ireland accounts for pensions only as they become payable. This is a standard accounting direction for many health sector bodies. Otherwise, in my view, the financial statements present a true and fair view in accordance with financial reporting standard 102.
In presenting my opinion, I drew attention to disclosures made about the governance of the hospital. These included the turnover of board membership in 2024 and 2025, which resulted in an almost completely new board, and the commissioning of formal independent reviews of certain clinical matters. I also drew attention to a disclosure in the statement on internal control about CHI's acceptance in 2022 of a financial contribution of €30,000 from a concession holder. The contribution was not recognised as income in the 2022 financial statements and the expense was not disclosed in the governance statement as staff hospitality, as it should have been. When the deferred income of €30,000 was queried during the 2024 audit, CHI decided to repay the full amount to the concession holder.
CHI continued in 2024 to incur a material level of non-compliant procurement. The value of the non-compliant procurement identified was of the order of €4.2 million. Finally, I drew attention to claims to the value of €200,000 which were submitted to private insurers which were not collectable because the hospital had not finalised the claims within the required timeframe.
As members are aware, the National Paediatric Hospital Development Board, NPHDB, is responsible for the planning, design, construction and fit-out of the new national children's hospital facilities. In addition to the main hospital at the St. James’s campus in Dublin, where construction is ongoing, two satellite paediatric outpatient and urgent care centres located at Tallaght and Connolly Hospitals have been completed and are now functioning under the management of Children’s Health Ireland. Parallel programmes, outside the remit of the development board, are required to integrate and transfer staff, equipment and services into the new hospital, to bring it into operation. These are being progressed by Children's Health Ireland, which will manage and deliver care in the new hospital into the future.
The development board is funded by Oireachtas grants, provided via the HSE. In 2024, the grant funding amounted to €131 million. This matched the expenditure incurred by the board in 2024, and so the financial statements record a break-even situation. As outlined in Note 2, total accumulated capital development costs incurred by the board to the end of 2024 amounted to €1.527 billion. These costs included payments to the main contractor, as well as the board’s own costs in respect of administration, project design and project oversight. Note 8 indicates that the value of the board’s capital commitments outstanding at the end of 2024 stood at €139.5 million. Combined with the costs incurred to the reporting date, this indicates a projected overall development cost of a minimum of €1.67 billion.
The board’s governance statement discloses that the aggregate value of contractor claims where supporting information has been provided was €856 million. Most of the claims are low value, and some have been settled. The board disputes the validity of many of the claims, including a small number of high-value claims. Notes 3 and 6 disclose a number of bonded payments totalling €164.7 million related to four high-value claims. These are payments the board was obliged to make arising from court proceedings taken by the contractor. On the basis that these were not certified payments against the contract, they have not been treated as operational expenditure. Funding was provided to the board by the HSE to allow it to make the payments, and any amounts not ultimately certified for payment that are recouped will be repayable to the HSE. Note 11 explains that, in February 2024, the approved budget available to the board was €1.88 billion.
The 2024 financial statements were certified by me on 18 August 2025. As in the case of CHI, my opinion was qualified on the basis that, compliant with the directions of the Minister for Health, the board’s financial statements account for pensions only as they become payable. Otherwise, I am satisfied that they present a true and fair view of the board’s affairs in accordance with financial reporting standard 102.
Comment on this
I thank the Comptroller and Auditor General. I now ask Ms Nugent, the chief executive, to deliver the opening statement on behalf of Children's Health Ireland, CHI. As set out in the letter of invitation, Ms Nugent has five minutes to make her opening statement.
Comment on this
I thank the committee for the opportunity to appear before it today. CHI exists to provide safe, high-quality and compassionate care to children and young people, and their families, across Ireland. Each year, our services across 40 specialties support hundreds of thousands of patient interactions. Behind every one of these interactions are a child and a family, and a team of professionals working to achieve the best possible outcome. We are a team of over 4,600 staff and each one of us cares deeply about the children and young people we care for.
There is a significant body of clinical integration and commissioning work happening to ensure we are ready to move to the new hospital, in parallel with the delivery of day-to-day operations across our four clinical sites. Since December, CHI has progressively taken phased early access to clinical and operational areas of the hospital, allowing teams to accelerate preparation work ahead of full handover. So far, level 6 is now fully fitted out, with all planned equipment installed. This floor, consisting of four wards, is completely finished and ready to accommodate patients. This floor also temporarily holds equipment being prepared for other levels as access is phased.
In February, CHI received early access to the lower ground floor, which includes laboratories, kitchen areas, health technology management spaces and key support infrastructure.
In March, early access was extended to areas on the ground floor, home to some of the hospital’s largest and most complex clinical areas, including the emergency department and radiology imaging. Significant progress has been made on equipment installation across the building. Some 15% of medical equipment is now installed and 14% of non-medical equipment is in place. Some 21% of laboratory equipment has been deployed and 16% of ICT infrastructure has been installed.
Commissioning extends beyond fitting out physical spaces. CHI continues to finalise plans for crucial commissioning activities, such as staff training, trial runs, loading consumables and patient migration. This progress reflects the sustained effort of multidisciplinary teams across all of CHI. Each month brings visible and meaningful progress as we move closer to welcoming patients, families and staff. CHI is ready to do our part in making the building a functioning and welcoming hospital, and as previously stated, this commissioning period will take approximately seven months following handover of the completed building at substantial completion.
Turning to our 2024 financial statements, CHI returned a deficit of just over €8 million for statutory reporting purposes. The deficits are a combination of pay and income loss against our final budget allocation. We saw a significant increase in our pay spend due to the growth of our headcount. In 2023, the HSE issued a memo pausing recruitment. CHI adhered strictly to this pause up to mid-2024. In 2024, CHI had to fill critical clinical posts based on patient safety requirements, which did increase our pay spend. Non-pay spending saw a significant increase in 2024 versus 2023, but with the additional supplementary funding received at the end of 2024 our non-pay spending came in on budget. The additional supplementary funding related to international outsourcing for spinal surgery and drug spend. In 2024, we saw a significant drop in income, mainly due to the introduction of the public-only consultant contract. However, over recent years private patient income has reduced, year on year.
There are a number of areas in the accounts that I want to be transparent about. These include the continued reliance on State funding to meet operational costs, the presence of a year-end deficit and the need for improved controls and consistency in some areas. We also recognise the challenges posed by legacy systems following the integration of multiple hospitals. These are not issues we shy away from. They are clearly identified and we are actively addressing them.
We share the committee's concerns about issues raised within our financial statements. We provided a briefing, as requested, which we hope was helpful, and we will endeavour to alleviate any remaining concerns in relation to all matters identified in our financial statements and to provide context and assurances that all matters are being proactively managed. We have put in additional controls in relation to private insurance claims, which has seen our loss decrease from 201,000 in 2024 to 123,000 in 2025. We are focused on working with our clinical teams to reduce this further. We are continuing to build a more unified organisation with consistent systems and ways of working. These changes are already improving how we manage risk, resources and performance. They will continue to be a priority, but ultimately, we need our new hospital to align all systems.
It is important to acknowledge that challenges and public scrutiny in recent years have impacted trust in CHI. We recognise that trust must be earned and re-earned through transparency, accountability and consistent delivery. We are committed to that work. We are being open about our shortcomings and proactively addressing them by strengthening how we operate and by continuing to focus on what matters most, that is, the children and young people in our care. We have many examples of excellence across our services, with innovation ever present in our work. For example, our dental colleagues have developed new phototherapy treatments that significantly improve the experience of children undergoing cancer care, reducing the pain and impact of treatment-related mouth ulcers which previously made simply eating extremely challenging.
We recognise that our communication with children, young people and their families has not always met the standard of care they deserve, and it is an area we are actively working to improve. This work is being shaped directly by the voices of families through our family advisory network and our youth advisory council, ensuring that improvements are informed by lived experience and focus on what matters most to patients and their families.
While we recognise the challenges we face, we are confident in the direction of travel. We are building a stronger, more accountable organisation and remain focused on delivering the highest standard of care for children and families across the island of Ireland. I thank the committee. We are happy to answer any questions members may have.
Comment on this
I thank the committee for inviting the NPHDB to discuss the 2024 financial statements and provide an update on the construction of the national children’s hospital Ireland, NCHI. I am chief officer at the NPHDB and I am accompanied by my colleague, Mr. Phelim Devine. The NPHDB was appointed by the Minister for Health in 2013 to design, build and equip the NCHI. Planning permission was granted in 2016 to build the hospital on the 12-acre site of the campus shared with St. James’s Hospital in Dublin 8, a paediatric outpatient and urgent care centre at Connolly Hospital Blanchardstown and a paediatric outpatient and emergency care centre at Tallaght University Hospital. The latter two facilities were handed over to CHI in 2019 and 2021, respectively, and are fully operational. Also within the remit of the NPHDB is the construction of the new Ronald McDonald House family accommodation unit. Construction commenced in February 2024 and the completed building was handed over to the HSE and Ronald McDonald House Charities Ireland in December 2025. The unit is located directly across from the main entrance. It provides accommodation for 52 families each night, which is more than double the accommodation available at the current Ronald McDonald House in Crumlin.
The NPHDB's 2024 accounts have been audited and approved by the Comptroller and Auditor General. The expenditure as of 31 December 2024 for that year was €131 million, including accruals and VAT. The Comptroller and Auditor General is due to commence the audit of 2025 accounts in the second quarter of this year. The opening statement submitted to the committee contains a table of the expenditure, for the benefit of the committee members.
The original construction contract value is €910 million, excluding VAT, which was part of an overall capital budget of €1.433 billion for the design, build and equipping of the three buildings. In February 2024, the Government approved enhanced capital and current budget sanctions, bringing the total approved capital budget to €1.88 billion. To date, the total cost incurred by the NPHDB, as of end of March 2026, is €1.64 billion, including VAT.
The Government-approved budget increase included provisions to address areas not originally included in the 2018 budget, a number of which were clearly set out in the independent review carried out by PwC in 2019. The PwC report, which noted that the NCHI was unique in scope, scale and complexity, also noted the number of project risks that had the potential to place further cost pressures on the approved capital budget. These risks included legitimate contractor entitlements under the contract, the outturn of provisional sums, recovery of construction inflation above 4% and the contractor's right to claim for additional costs in line with public works contract provisions.
The report also noted the need for additional capacity and capability within the NPHDB executive team. The size of the NPHDB inspectorate team had to be significantly increased in order to provide the necessary oversight and assurance. Ordinarily, compliance inspections usually check circa 10% of rooms in detail, using sampling for repeat spaces and expanding only if issues are found. On this project, 100% of the rooms are being inspected to ensure the right clinical and regulatory standards, which is more time- and resource-intensive, but necessary to protect both CHI and the State's interests.
Since late 2019, the NPHDB has been reporting to our key stakeholders through the established governance structures, with membership from the Department of Health, the HSE and CHI, that the project is behind schedule. Updates on these timeline challenges and the associated impact on cost have been shared with all key stakeholders.
The new Ronald McDonald House is complete. This project was delivered on time and on budget with our construction partners, Clancy Construction. Construction of the NCHI is now in its final stages, with significant progress achieved across all areas. As outlined in Appendix A, BAM has already granted early access to level 6, level 0, and the lower ground floor, enabling further fit-out and operational readiness. Planned installation of medical, non-medical and ICT equipment is fully complete on level 6, the lower ground floor and level 0. The works completed on these three levels by the NPHDB comprise the delivery of circa 12,500 pieces of medical and non-medical equipment, of which circa 7,500 have been installed, commissioned and asset tagged.
The overall procurement of the equipment is close to completion, with only a small number of items intentionally deferred to ensure access to the most up-to-date and innovative technologies.
All specialist in-built equipment, including MRIs, CT scanners, X-ray units, C-arms and dental suites, has been successfully installed. The automated guided vehicles system is also fully installed, with final testing and simulation phases scheduled to commence following substantial completion. The warranties on the equipment already procured commence at the point of first patient use.
Technical commissioning and snagging activities are nearing completion, with remaining works focused on final system commissioning, including ventilation, cause-and-effect testing and system integration, all of which are progressing towards achieving stable environmental conditions in full accordance with the contract. In addition, public realm works and external landscaping have been completed to a high standard.
On 24 March 2026, BAM Ireland confirmed to the NPHDB that it would not deliver on its commitment to reach substantial completion of the NCHI by today, which is approximately 40 months later than the revised contract date of 2 December 2022. Instead, it said it would complete a large majority of the building, but crucially not all of it. This will be the 19th time BAM has changed its own substantial completion date; this is set out in Appendix B. The employer's representative, ER, the independent third party responsible for administering the contract, wrote to BAM on 27 March 2026 to formally request an updated contract programme. At the point in time when we provided this opening statement to the committee, this programme update had not been provided by BAM Ireland to the ER.
In the meantime, the NPHDB's focus is on continuing to seek opportunities for early access to the areas that BAM committed to offer, once they have reached the completion standard. NPHDB and CHI are primarily focused on an area within the building known in hospital planning and design terms as the hot block. The hot block includes the emergency department, imaging and diagnostics, laboratories, clinical engineering at levels LG and 0, and the critical care and operating theatres at levels 1 and 2. While we were advised to expect levels 1 and 2 in early March, we now expect BAM to hand over level 1 and level 2 in the coming weeks. Once these areas are in place, the NPHDB and CHI can continue progressing with additional fit-out and equipping activities. These areas are close to completion standard, but the contractor is continuing to resolve commissioning issues and rework areas that were not correct the first time. One of the main issues is dust in the ventilation ducts. I think members will all appreciate that we cannot accept critical areas such as theatres where the contractor has not removed the dust and dirt in these ducts.
The NPHDB is exercising all rights and remedies available under the contract to compel BAM to achieve substantial completion. The NPHDB has, on multiple occasions, withheld 15% of payments due to BAM when BAM's programme was deemed non-compliant by the ER.
As the ER has not certified that the works have reached substantial completion on the contractual date, the NPHDB has previously issued an employer's claim under the contract to deduct liquidated damages. Based on BAM's previous forecasted completion date of 30 April 2026, the NPHDB estimated potential liquidated damages for the works to be approximately €40 million. In addition, the NPHDB has pursued alternative dispute resolution options outside the contractual framework, including a moratorium on disputes, during which the parties actively engaged with the objective of achieving programme and cost certainty.
In March and April 2026, the Minister for Health, the HSE, the Department of Health and the NPHDB met with senior representatives of the Royal BAM Group, including the CEO and chairman of the executive board, Mr. Ruud Joosten, to receive assurance that BAM Ireland will meet its committed substantial completion date of 30 April. One focus of the meeting was securing the balance of early access to the NCHI's levels 1 and 2, comprising critical care rooms and operating theatres, and ensuring all clinical rooms and patient areas are completed to the required standard. During the meeting, BAM committed to provide a resource-loaded close-out plan to achieve substantial completion by 30 April 2026. As I mentioned, on 24 March, BAM reported it would not achieve this date.
BAM has missed its stated substantial completion dates. This is primarily due to its failure to deploy sufficient skilled labour and competent management resources to properly supervise the site and maintain effective quality assurance processes. As a result, there has been no consistent right-first-time approach to delivery. BAM has also failed to properly programme, co-ordinate and sequence the works in a logical and efficient manner. This has led directly to disruptions, inefficiencies and significant on-site rework. In addition, appropriate prioritisation has not been applied and performance has not been aligned with critical milestones or the overall programme for project completion. Finally, BAM has failed to adequately assess the scope of the works, resource requirements and the level of effort required to achieve completion of the NCHI in full compliance with the contract standard and its stated programmes.
To date, 4,313 of 5,728 rooms have been offered at the completion standard, of which 3,159 have been validated by the design team. BAM's room offer rate declined in recent months, with a current four-week average of 117. There are currently 12,414 defects remaining, of which 4,463 have been offered to the design team for validation. The overall defect close-out rate has slowed as the remaining defects become more complex and increasingly time-consuming to resolve.
The ER and the NPHDB will not accept the NCHI if it is not in compliance with statutory regulations and standards. Over the past 15 months, significant rework has impacted BAM’s progress. The design team has raised and BAM has closed an unprecedented 106,500 defects in the 5,728 rooms. The NPHDB and CHI have undertaken due diligence studies and considered lessons learned from other large international and complex hospitals. These reviews have evidenced that unresolved compliance issues can cause operational disruptions and safety risks to patients. Acceptance by the ER of substantial completion is dependent on all statutory and contractual requirements being fully satisfied.
The NPHDB also remains focused on achieving NCHI's overall substantial completion, which is the key enabler for day one opening. Once substantial completion is achieved, the NCHI will be handed over to CHI for operational commissioning before the hospital can be opened.
This is a landmark project for Ireland and a world-class hospital for the children of Ireland. The NPHDB is committed to doing everything in its power to compel BAM to conclude its work and fulfil its contractual responsibilities, so that the NCHI is completed to the standard set out in the contract as soon as possible and handed over to CHI for operational commissioning.
Comment on this
I might ask Mr. Gunning one question to give him adequate time to respond and so that it does not eat into members' question time. The last time he appeared, he indicated that BAM had informed him of a substantial completion date of today, 30 April. I understand from his opening statement that he has no updated completion date from BAM. The question that this committee has and that the children who want to use this hospital have is when he expects the hospital to reach substantial completion.
Comment on this
I cannot answer that question, but I can let the Chairman know that I have become aware that BAM has indicated to the employer's representative that it intends to provide a programme tomorrow, 1 May, to the employer's representative. Once we see that programme and once it is reviewed for compliance and assessed - we have had to do this every time we have got a programme - we will be in a position, assuming it is compliant, to provide an update to the committee in relation to the date of substantial completion. That is the information.
Comment on this
Speaking on behalf of the committee, I think it is deeply unsatisfactory that that programme will only be provided to Mr. Gunning tomorrow, after today's meeting.
As I do not want to eat into members' time, I will proceed to call our first speaker, Deputy James Geoghegan, who has 15 minutes. All subsequent speakers will have ten minutes.
Comment on this
I thank all the witnesses for being here. My first question is for Ms Nugent. In the letter she sent to the committee about the Christmas party in CHI Crumlin, she stated that funding of €30,000 was received from a concession holder in CHI Crumlin in respect of the 2022 Children's Health Ireland Christmas party. That obviously predated her time as CEO. How did she discover that the purpose of that money was for a Christmas party?
Comment on this
The C and AG highlighted this amount of money was in deferred income in our accounts. To put it into context, in 2022 this Christmas party was for all CHI sites, not just for Crumlin. The idea-----
Comment on this
I am just interested. This obviously predated Ms Nugent. Was there a document? Who did she talk to? Did she talk to the concession holder?
Comment on this
The new chief financial officer, Ms Gaffney, and I conducted an internal review. We established that CHI asked for this donation in an attempt to keep the ticket price reduced for our staff. It was wrong. CHI asked for it and that was wrong.
Comment on this
CHI asked the concession holder for moneys for the Christmas party.
Comment on this
Is that documented in emails? How is it documented?
Comment on this
I will let Ms Gaffney speak on how it was reported and so on. We also spoke to people who were involved at the time and they advised that they had asked for it.
Comment on this
Was it the then CFO of CHI Crumlin that Ms Nugent and Ms Gaffney spoke to?
Comment on this
The then CFO of CHI orally communicated that to Ms Nugent and Ms Gaffney and they relied on what was said to them in that regard.
Comment on this
We also looked through the accounts. I might hand over to Ms Gaffney to explain.
Comment on this
I am only interested in the documents that exist that evidence or support what the former CFO said. Are there such documents?
Comment on this
There are limited emails but those emails clearly state that sponsorship would be asked for in respect of a Christmas party in CHI.
Comment on this
Will the witnesses provide a copy of those emails to this committee?
Comment on this
While it is not the witnesses' fault and I do not know if they are aware of it, Aramark, the concession holder, issued a statement last night that was published in The Irish Times literally as the witnesses sat down at this committee. I will read it to them. It says:
Aramark held a concession for the running of a retail outlet in CHI. Retail revenues fell due to visitor restrictions during Covid. The payment was made as final reconciliation of concessions which was required arising from service interruptions caused by Covid restrictions
Comment on this
We met with the CEO of Aramark earlier this week. We are unaware of that statement. This is the first we have heard about it. However, I can categorically say, regrettably, that CHI asked for that donation.
Comment on this
While I acknowledge that this is the first time both Ms Nugent and Ms Gaffney have heard this statement, do they accept that what Aramark is now saying contradicts what they told the Comptroller and Auditor General?
Comment on this
Absolutely. As I said, when we met with the CEO of Aramark, we established that the fault is with CHI. We own and accept that. That is why we returned the money when we became aware of the ask.
Comment on this
Aramark's position in the statement it issued to The Irish Times is that it was for a different purpose. It is making clear that it related to revenues that fell, and that it was essentially moneys that were owed to CHI. That is what Aramark is saying. When the witnesses met him earlier this week, did the CEO of Aramark contradict what they had told the Comptroller and Auditor General as to the purpose of the money?
Comment on this
We need to look at what Aramark is saying. We can review our own invoices to validate or otherwise what it is purporting to say.
Comment on this
It seems pretty clear that Aramark is not accepting that the moneys were for a Christmas party, yet Ms Nugent has an email that says they were for a Christmas party and the former CFO told her that was the case.
Comment on this
We have a very significant contradiction here. At the time CHI was being audited by the Comptroller and Auditor General, did Ms Nugent verify with the concession holder, Aramark, what she was saying to the Comptroller and Auditor General as to the purposes of the moneys? Did she double-check with it?
Comment on this
My understanding is that attempts were made to contact Aramark. However, as I said, Ms Gaffney was not there at the time and the previous interim CFO is no longer with us.
Comment on this
When CHI told its auditor that it was for a Christmas party, had Ms Nugent talked with Aramark about that? She had no discussions with the concession holder.
Comment on this
When CHI paid the concession holder the €30,000 back, was there any communication with Aramark? Was the money literally just sent back by way of bank transfer or were there discussions at the time?
Comment on this
Even at that moment, there was another person-----
Comment on this
Yes. However, I can say that a credit note was raised. It was not a bank transfer.
Comment on this
Either way, the moneys went back. I would have assumed there was some engagement at that point in time. Does it come as a big surprise this morning that Aramark has issued this statement flatly contradicting what the witnesses told their auditor, especially given that they met with the CEO earlier this week?
Comment on this
As I said, we have evidence that, regrettably, we asked for it.
Comment on this
I have a question for Mr. Gunning. The hospital was supposed to be handed over today. You could rinse and repeat his statements to this committee and previous committees. I am the parent of three young children myself. In the case of one of my children, I spent more time in Crumlin and Temple Street than I would care to remember. Ultimately, the children and parents of Ireland just want to know when the contractor is going to hand this building over to the people of Ireland. What can we say to them?
Comment on this
It is important to know that we are very close to the completion of this project. Members will have seen the "Prime Time" programme. It was an excellent piece. You could see just how close we are to completion. It is really important to understand that we are nearly there. Our job now is to make sure that, as the Minister said on "Prime Time", when this hospital is completed, we will not accept anything that is not at the appropriate clinical standard.
Comment on this
Yet, the board is still saying that the contractor does not have enough boots on the ground in the hospital after all of this and after the years this has gone on. Mr. Gunning says we are very close but the board is still not satisfied that the contractor has enough staff on site. What is wrong with this contractor? Has the State ever had an engagement of such a hostile nature with a contractor? Mr. Gunning has been around a long time. I certainly cannot think of a comparable situation.
Comment on this
I have never experienced anything to this extent. I want to talk about what is delaying completion right now and what the issues are. There are a number of completion-of-works items. We mentioned acoustic issues with the ventilation system in our statement. There is also the reworking of items. We have a number of issues with doors, including manual doors and sliding doors. We also have a number of issues with floors. These were discussed again on Monday night. We have had issues with floors in the past. We have 15 operating theatre floors that need to be replaced. We have issues with leaks, both water coming in from the outside and leaks within the building from some of the plumbing and other systems. An issue with duct cleaning has also developed over the last number of weeks. These are all issues that rest entirely with the contractor. These delays and this programme are an issue. We are waiting for the programme. However, with regard to early access, it is important to say that CHI and the NPHDB have made tremendous positive use of early access.
Comment on this
We are ready. When the contractor is finished, we are ready to deploy this hospital.
Comment on this
I will illustrate some of the points Mr. Gunning is making. Am I right in saying there was a minor fire - I do not know when it was-----
Comment on this
There was a fire a week ago in the hospital that caused a level of damage. The cause of that fire was obviously unintentional. It was an accident of some form or another. In major construction projects, things go wrong. We all recognise that. When that fire happened, it caused damage. How quickly is the damage repaired when an incident like that happens?
Comment on this
I will ask Mr. Devine to deal with that question.
Comment on this
Following that particular incident, BAM sought to repair the damage immediately. Even though it was unfortunate that we had a fire within the operating theatre corridor - it was not in a theatre but in a corridor - the positive is that the fire alarm and sprinklers activated straight away. It was a good test of the quality of the systems in the hospital.
Comment on this
I am not trying to draw this out but what caused the fire? I just want to illustrate the point.
Comment on this
It was an accident. An operative was repairing a piece of flooring in the corridor with a heat gun and the heat gun came into contact with an aerosol can, which exploded and went on fire.
Comment on this
Again, I am not trying to pin this on anybody but that is obviously not something that should happen in a construction project. Presumably there are supervisors that should be----
Comment on this
There are supervisors, hot work permits, and health and safety requirements but this was just a freak accident. Perhaps more health and safety training or supervision would have helped prevent it.
The good thing about that, while it has happened, is that it is not going to cause any delay. It is the other issues that Mr. Gunning talked about that are causing the delays.
Comment on this
In that example, there was a fire and BAM came in and fixed the stuff quickly. That is what Mr. Devine is saying.
Comment on this
It is still in progress. They dried all the water up. They took the ceiling away because the ceiling was damaged. They have taken part of the wall away. It will be replaced. We have to do a due diligence survey to make sure there is no smoke in the ducts.
Comment on this
If an incident like that happens, BAM has boots on the ground. We throw everybody in and solve the problem. With regard to all the other outstanding issues in the hospital, why can BAM not fan the flames of those metaphorical fires and throw people at the solution to deliver the hospital? Why can BAM not replicate its rapid response to a fire incident to all of the other things that are outstanding?
Comment on this
We have maintained many times in these that insufficient resources are being deployed by the contractor to deliver to the timeline it is committing to. Some 18 or 19 changes in the substantial completion date is all the evidence the Deputy needs to prove that. It just has not happened. A fire like that will mean that resources are coming from other important work areas to deal with that rather than progressing the issues I have mentioned, namely, the doors, floors, leaks and other things that should be being progressed in order to get to substantial completion. In our view, this is primarily a lack of resources and a lack of supervision of those resources to get proper progress in relation to them.
Comment on this
As Mr. Gunning knows, the contractor is not here, but what it keeps saying is that it is none of that, it is all of the design changes that the NPHDB is demanding of it. Where is the grey? Where is the middle in this? Are these drawing changes? What are the things that BAM says the board is imposing on them versus what BAM says it is doing?
Comment on this
What is stopping us getting to substantial completion? There are no design issues between us and substantial completion. This is all about rework of doors and floors that need to be reworked, leaks that need to be addressed and issues like the cleaning of the ducts. It is not a design issue to clean ducts; it is a work issue. It is an allocation of resources to do it. On the design change, Mr. Devine will briefly comment on that.
Comment on this
I would like to dispel this statement by BAM that there are design changes. There has not been one design change on this project in 2026. Over the past nine months, that is the first time that BAM actually offered a clinical room at the right standard. It was signed off and validated by the design team nine months ago. In that nine-month period, changes were identified in 58 rooms out of 5,728 rooms. In that same period, BAM has closed 60,000 defects and snags in the building. There were 58 issues - I will tell the committee what they were - versus 60,000 defects. I do not think you need to be a brain surgeon to understand what is causing the delay in this project. It is rework and closing out defects. On the defects, with our team in place, BAM is closing these defects to the correct standard. It is taking more time than it should. It should not be there in the first place.
Comment on this
I raise the pace of handover. There was a consistent pace in how many rooms were being provided to NPHDB. That pace has declined in the past week or so. What is going on there?
Comment on this
It is like anything else when you get to the last 5% of any project. If you build a house extension, for example, the final bit of snagging is the most difficult. It has dropped off from about 160 rooms per week to about 117. That is the latest four-week average.
Comment on this
The curtain is going to be opened when the new date, the 19th date that BAM gives to this independent group. What does Mr. Gunning think? In some respects, who cares, because it has no credibility? For our benefit, what date is going to be in that document based on what he sees?
Comment on this
We have made a practice of not putting dates out that could be overruled or disagreed with by BAM. We will wait until we get that. In the Minister's letter to Royal BAM recently, it was that we needs absolute certainty, assurance and complete confidence in this programme. This has got to be the one that they deliver. We cannot have another cycle around or a 20th missed date. We do not have any tolerance for that. They have to deliver. This has to happen. We are close. That is the point. It is months we are talking about.
Comment on this
I thank everyone for being here today. Did anyone receive external training in advance of today's visit?
Comment on this
Yes, we did. We have a company that acts as our PR adviser. Part of that contract is preparation for committees such as this. We want to be able to-----
Comment on this
How much was paid for this visit?
Comment on this
No, it is part of that contract and part of a monthly fee.
Comment on this
CHI pays a PR company a monthly fee.
Comment on this
We use the same company, but we would have tendered from this service a number of years ago from the same company CHI uses. We have an annual arrangement. There is no additional cost to this, but it is included in the broad set of services that they provide, namely, press, public relations and community outreach. We have a local residents monitoring committee. A whole range of different activities are comprehended in this scheme that we tendered for.
Comment on this
Mr. Devine noted a contradiction in yesterday's statement from BAM with regard to designs where it has said the design of the hospital is still not fully finalised. Mr. Devine has contradicted that in some way, shape or form. In the entirety of this project, how many redesigns have there been in total right down to the minutiae? How many redesigns have there been?
Comment on this
I said it at the previous committee meeting. There has been no material change to the design and functionality of this building since 2019. We are no different from the public works contract. Under the public works contract and EU directives, design teams cannot specify products or materials. Basically, you put in specifications and the contractor then comes back with its products and systems, which are going to be slightly different. They all have to be brought together. That is called co-ordination and the contractor is responsible for that.
Comment on this
How many redesigns have there been over the duration of this project?
Comment on this
I do not have the exact total. I can tell the Deputy how many drawings have been reissued. Since 2009, there have been 23,500 reissues of drawings. There are 6,000 drawings on the project, so they have gone through a cycle of revisions, but they have done that because of inputs from the contractor. There has been some design change. We have that in our statement. The contractor has been paid 6.5% of the contract sum in the design change to date-----
Comment on this
What is the monetary value?
Comment on this
A total of €53 million determined, a total of €60 million including adjudications and conciliations.
Comment on this
A total of €60 million of the overall-----
Comment on this
A total of €60 million of the €910 million has been paid in addition to the contractor to date, which is 6.5%. Broken down, half goes to an increase in provisional sums and about half in extra money for measured in the billable quantities.
Comment on this
Does Mr. Gunning expect there to be any further revisions from his side of things?
Comment on this
There will be some as we continue to go toward the end, but it tapers off because we are pretty much done. Members will have the claims table, but the determination process that this typifies, and this is giving to the Deputy as the end of March, that lags somewhat what is happening on the ground. We would expect these numbers to increase somewhat but we are still in the €59 million or €60 million territory here. We are not close to the €1 billion that the contractor is claiming.
Comment on this
Would Mr. Devine suggest then that the statement from BAM yesterday is misrepresentative of the current situation?
Comment on this
As I said, this is factual information. I am here as a witness. There has been no design change this year that has impacted any physical works on-site. If you go back nine months, it is 58 issues in 58 rooms. If you go back 18 months, I think it is 200 issues in about 200 rooms. I will give the Deputy an idea of what they are.
Comment on this
I am sorry, but I am running out of time. If Mr. Devine could forward them to the committee, that would be great.
Comment on this
I know, but they are very simple issues. It is moving a socket in a room or adding an emergency light. We have a massive hospital with lots of cameras, escape signs in the ceilings and that. Sometimes you need a minimum of five looks over a break-glass unit or something like that so you get shadowing. We have put in additional lights. They are basically plug and play. You drill a hole, put the light in and a cable 5 m long is plugged into the modular wiring system.
That is the majority of the changes in the last 18 months. Design is not delaying this project. It is rework and closing out defects.
Comment on this
That is very clear. On 8 April the Minister wrote to Royal BAM, as Mr. Gunning said, seeking an update on when early access to the hot block would be provided. In response to my parliamentary question last week the Minister said she still had not received a response. Has anyone from the Department seen that response and is it possible to furnish this committee with the letter the Minister sent and the response received from BAM?
Comment on this
We will of course share that letter with the committee. As of last night a response was furnished to the Minister, which is typical of this contractor in terms of submitting material at the last minute in order to egg up the situation from the PAC today. We will review that letter in time but what I can say is that it mirrors a lot of the accusations that have been suggested in the press as of late. It is in direct response to the Minister's interview on "Prime Time". We are going to review that letter and will share that with the committee as appropriate.
Comment on this
Has Mr. Gunning seen that letter?
Comment on this
It is as Mr. Quinn summarised. I do not see anything I have not heard before, if I was to put it that way. There was no new information that I in any sense feel I need to go off and do a major bunch of research on. We understand. The BAM narrative is very clear. It is all about change and that the cost of these extensions of time is all the employer's fault. We rebut that in its entirety.
Comment on this
In the letter BAM essentially says, "We are very good at delivering projects; look at the projects we have delivered." To me, that is like the schoolchild saying they did not do their homework today but look at all the other homework they have done. We are concerned about the tangible project in front of us today. We are not getting any traction on that.
Comment on this
To Ms Nugent, if go back to the €30,000, we now see a complete difference of opinion from Aramark regarding that. I am conscious that Ms Nugent and Ms Gaffney were not in position at the time. What was the attempt to reduce ticket prices for the Christmas party? Can Ms Nugent give me the context for what that was?
Comment on this
There was a Christmas party to be held for all sites to come together as part of integrating the three entities.
Comment on this
Where was that going to be?
Comment on this
In the Guinness Storehouse. Staff pay for their own tickets but at the time there was an attempt to reduce the cost for staff and the donation was to offset against the cost of the event.
Comment on this
According to the subsequent enquiries, why was not one cent of that €30,000 put towards that Christmas party?
Comment on this
The money was received into the bank in January 2023, and because the expenses had not been received in full for the Christmas party and the funds regarding the contribution from staff had not been received, it was put into a deferred income account, which is not a bank account but a general ledger account in our management accounts. It sat there until all moneys and all expenses were received. It should have been reconciled in 2023.
Comment on this
No, it was not and, unfortunately, it carried forward into 2024. It was during the 2024 audit that the C and AG pointed it out.
Comment on this
Did staff end up getting a discount on their Christmas party tickets?
Comment on this
Was this event sponsored by Aramark? Is that what was sought? It was sponsorship?
Comment on this
Ms Nugent mentioned sponsorship in her previous contribution.
Comment on this
It was not publicised that-----
Comment on this
No, it was a donation toward the cost. It was not as if the company's name was over the entrance to the event or anything like that, which sponsorship normally is. If I used the wrong language before-----
Comment on this
That is fine. If CHI did not use the €30,000, I am going to assume that CHI found money elsewhere to cover the difference between what staff paid and what Aramark did not pay. Is that correct? How did that manifest or crystalise in the accounts? Where did that come from?
Comment on this
Obviously, we have different income sources. It would have come from one of those income sources we have that are not related to day-to-day activities.
Comment on this
In the opening statement Ms Nugent said there are no other cases where this was happening, where vendors were approached asking for a donation. However, I imagine the foundation would quite often seek donations. Why does Ms Nugent think that €30,000 would have been resting in a CHI account as opposed to encouraging Aramark to donate this to the Children's Health Foundation, where this would have had a much greater impact than sitting in an account for an endless period of time?
Comment on this
I cannot speak for what happened in 2022 or 2023; it predates me. However, the Children's Health Foundation, which is a separate legal entity to CHI, raises money for the purposes of children, not for staff parties.
Comment on this
Deputy Farrelly might have got away with one extra question. Deputy Bennett might continue in the vein.
Comment on this
I am going to get back to the nitty-gritty. At the start, Mr. Gunning mentioned €1.64 billion that has been spent so far on the national children's hospital. Is that correct?
Comment on this
Then why, in 2024, was €2.24 billion the figure pushed around? Did that figure include something else?
Comment on this
That is the overall cost, which is both the NPHDB and CHI costs. If I just-----
Comment on this
What was the additional cost then in between the build and the-----
Comment on this
My purview is the €1.88 billion, which is the current budget for the NPHDB cost. That is the cost of the design, build, equip, commission and handover. It is our intention and we are confident we will deliver the project within that. What has been spent to date is €1.648 billion.
Comment on this
Mr. Gunning is saying €1.88 billion will be the total cost-----
Comment on this
I am saying €1.88 billion is the NPHDB element of it. CHI has other elements and its representatives can speak to those.
Comment on this
Maybe Ms Nugent can explain to me the additional money.
Comment on this
It relates largely to our electronic healthcare record, EHR. I will hand it over to our transformation director to explain it in more detail.
Comment on this
We have an approved budget for commissioning which includes the EHR and the commissioning of the hospital of €361.6 million.
Comment on this
It still does not add up, does it? What is the total Ms Lewis said?
Comment on this
It was €361.6 million, of which, €41 million is sitting in contingency.
Comment on this
That is for commissioning the hospital and putting in the electronic healthcare records. We also are responsible for the ICT equipment and the laboratory equipment.
Comment on this
CHI is saying that will all be commissioned within nine months, is that correct? How long before we will have-----
Comment on this
Seven months from the date of substantial completion.
Comment on this
When we get a substantial completion date, it will be seven months after that.
Comment on this
At this stage then we will be into 2027.
Comment on this
Similar to Mr. Gunning, I do not want to speculate on a date because I am very conscious of disappointing-----
Comment on this
We were told last year it was definitely going to happen in 2026 but it is not going to happen in 2026 now.
Comment on this
It is going to be 2027. However, CHI is confident of the activation period. It previously said nine months but now is saying seven months.
Comment on this
Our commission team has worked extremely hard to reduce that time.
Comment on this
How was that time reduced to seven months?
Comment on this
It was originally one year within the definitive business case and it came down to nine months. We then moved it down to seven months. We have done that because of early access. The early access period, when we talk about floor 6, the lower ground floor, ground floor, floor 1 and floor 2, allows us access into the building before substantial completion and to be able to put in a significant amount of equipment. That helps us take off and get us down to seven months. We will not be able to go down further than seven months because if we were doing an electronic healthcare record by itself, that is a six-month programme, and we actually have to load the building before we start that.
Comment on this
Is there staff already employed in the hospital?
Comment on this
For the new hospital we have commenced the day 1 numbers recruitment. The first tranche are due to start on 1 July. Even with the prolongation, those staff will be put to good use.
Comment on this
Part of that staffing is actually to address safer staffing for existing sites. There is a tool which says how many nurses you should have across your entities, depending on the acuity. CHI was the last hospital to use the safer staffing tool because the national safer staffing tool does not apply to paediatrics because the ratios are different. The majority of those staff will correct the safer staffing issue in the first instance.
Comment on this
Okay. There will be 117 staff from July and a wage bill every month. How much will that cost every month, going forward until people are actually in the hospital? How much will we have to pay monthly for staffing?
Comment on this
I do not have that broken down but we can supply it to the committee.
Comment on this
Could I be given it before the end of the meeting? There will be 117 staff from the start of July but there will not actually be any patients on site, is that right?
Comment on this
As I say, part of it is for safer staffing-----
Comment on this
I am just thinking of the additional money it is costing.
Comment on this
However, those staff will allow our existing staff, who, first of all, have to be trained in the building and the electronic healthcare record, etc., to be trained-----
Comment on this
Where are the existing staff at the moment? Are they in the other hospitals?
Comment on this
There will be 117 additional staff.
Comment on this
That is for phase 0. In total, we are getting 576.6 additional staff. That is for safer staffing and the additionality of the building. For example, we are going from 15 theatres to 22 theatres, eventually. We are increasing our critical care path capacity-----
Comment on this
Could I get a cost estimate of how much it will cost for staff while there are no patients in the hospital? In terms of claims and disputes between the board that have been adjudicated and resolved, how many claims have been adjudicated and resolved to date?
Comment on this
In terms of adjudications, I will open my adjudications table.
Comment on this
Adjudications happen in parallel to the contract under the Construction Contracts Act. There have been 16 adjudications to date carried out.
Comment on this
Were they resolved? They are all done?
Comment on this
It is a process with a beginning and end. These are done.
Comment on this
I will give some details. I will not go through them but in aggregate terms, BAM sought an amount through adjudication of €72.8 million. In terms of what was awarded at the end, the value of the adjudications decision was €4.9 million. It is approximately 7% and very similar to the number Mr. Devine mentioned earlier about what the ER has awarded. It is a similar percentage of 7% of what has been sought.
Comment on this
BAM looked for €72.8 million but it got €4.9 million. That is on top of the money it has been paid as well. Somebody just asked me in relation to abortive fees for professional services. Has the board paid out anything for those services? No? No professional services have been aborted while on the project?
Comment on this
No, that is okay. I got the total value from the witnesses. How does Mr. Gunning feel about BAM? Does he regret that BAM was the project contractor on site?
Comment on this
This is a facts-based committee rather than a feelings committee. We are beyond frustrated. A month ago, the contractor informed us it would not hit today's date for substantial completion. A month before that, it was giving us assurance it would hit the target of 30 April 2026. We meet regularly with BAM and, as the Deputy has said, the Minister has been involved in these meetings. BAM has come to our board and given assurance time and again at these large set pieces of when we are going to get things. It has not happened. Our view is that this is entirely a resourcing problem. BAM just is not resourcing it sufficiently to deliver to the timeline. It is not managing its resources on the ground sufficiently to get the return it needs. This is leading to delay after delay on top of the rework. It is all very well to do something, but what about if you have to go back and do it again? It is a cost for BAM but for the children of Ireland, it is a delay. It is unacceptable.
Comment on this
It is a cost to the taxpayer is what it is.
Comment on this
Well, it is a cost but it is a delay in treatment for the children of Ireland. Obviously, that is a significant issue.
Comment on this
Earlier, Mr. Gunning said there were four High Court claims worth €164.7 million, is that correct?
Comment on this
That includes the taxation element. The number we work with is if you take the VAT or RCT from that, it is €145 million. That is the number the development board under the contract has paid in bonded payments to the contractor. Just to be clear on what this is, through the conciliation process, if the conciliator makes a recommendation, and we have issued a notice of dissatisfaction on those, under the contract, we are still required to pay over that money. That money has been paid over to BAM but it is bonded. The C and AG mentioned it is a bonded payment. We have a bond and it is an on-demand bond we can call if we want to get that money back in certain circumstances.
Comment on this
Very good. What worries me is the State continues to use BAM as a contractor after all of this. Have we not learned from our mistakes? I want to put that on the record. Could I get an answer on that?
Comment on this
We are bound by public procurement rules for public procurement-----
Comment on this
Obviously, the public procurement rules are not working because BAM came in at a set price on this and the price of this hospital has gone from €650 million initially up to €1.64 billion now. Where does procurement come into that? How can somebody go in with a procurement price and, at the end of the package, it costs €1.88 billion? I do not think the procurement rules are working too well.
Comment on this
To be fair, they are the public procurement rules. It is not my-----
Comment on this
I agree with some of the context there. We have very clearly set that out in terms of the Department of public expenditure's review of Accelerating Infrastructure. In the Department's submission to that, we are very clear that we are concerned about the European procurement rules and the high bar that is set for us to try to disallow future contractors for past performance. Under public procurement rules, and they are there for good reason, we are not allowed to take account of poor behaviour on a past project. We are not allowed to take that on board.
BAM is not the only poor contractor the State has suffered from, I am sure, but I will also call out the fact that we have many good contractors around this country. There are indigenous contractors in tier 1, tier 2 and tier 3.
Comment on this
Are they contractors that come with an initial price that ends up three times the price? I would not call that good value for money.
Comment on this
If we could get further information on it, I imagine it would be valuable to the committee. In some ways, there are two stories being covered here. There was the very small amount of money of €30,000 and a very large amount of money of €1.6 billion. I want to keep those two things in context as I ask about both of them. My concern about the €30,000 was its impact in terms of procurement and good practice for procurement. I will ask a number of questions about the process of the €30,000. Ms Nugent said CHI asked for the money. Does she have an email that shows CHI asked that?
Comment on this
Okay. It was not made on behalf of a staff representative or anything like that. This is somebody at a very senior level in the hospital. Was it somebody within procurement or who had responsibility for procurement?
Comment on this
They were not in the procurement department but that would have sat in their sphere of responsibility. I am very conscious of individuals and not-----
Comment on this
I am very conscious of that, too. That is why I have not asked Ms Nugent for the name. What policies were in place to ensure people who have responsibility for procurement are aware that a payment of this nature may be a breach of a procurement policy?
Comment on this
There are policies in place. The intent was to try to support staff, but as I have said, it was wrong. It falls below the standards of an organisation, which is why we returned it when we became aware of it.
Comment on this
To clarify, the contract which was tendered for and which Aramark won was before this period. The only other new contract since then would have been for the new hospital, which it was not successful in winning. To be fair, I do not think it compromised any of those processes.
Comment on this
As I say, I was not there, and neither was Ms Gaffney. In that respect-----
Comment on this
Staff used Eventbrite to pay for their tickets, so all the costs have not been reconciled yet. It was put in the deferred income account.
Comment on this
So the moneys paid by staff were paid into an Eventbrite account, which was transferred to-----
Comment on this
So that was transferred into a CHI account, but not the same location as the €30,000 from the sponsor, for want of a better word.
Comment on this
It would have gone to the same location, but not until 2023. The invoice was raised in 2022 and paid in January 2023. The Eventbrite money was not received until later on.
Comment on this
The staff contribution and the sponsorship amount were both deposited together, but a reconciliation was never done.
Comment on this
Had the Comptroller and Auditor General not pointed out his concern regarding the payments, that €27,000 would still be a loss for CHI because the payment should never have been received in the first place. How can Ms Gaffney stand over the finances of a staff party on the basis of a payment that she now knows to be incorrect? Does she see the point I am making? At some stage, the budget for an event had to be signed off on. The €30,000 was included in that budget, but Ms Gaffney said it was wrong. I think anybody on this committee would have been concerned that somebody engaged in procurement would give an amount of money of that magnitude. It could compromise any future procurement, or that pressure could be contained. How could somebody sign off on a budget which contained that payment?
Comment on this
Unfortunately, and I am not being evasive, we were not there, so we cannot explain the thinking at the time. To reassure the committee, we did not use any public funds in respect of that €27,000 payment. That came out of alternative income.
Comment on this
We have not contacted contractors, but we have done an internal audit and review and have not found any payments since then.
Comment on this
I appreciate that. At a previous meeting, Ms Nugent gave evidence about the review of surgeries that may have been unnecessary. I corresponded with her office about a particular constituent in February. I would appreciate if I could get a response on that matter.
Comment on this
Absolutely. If the Leas-Chathaoirleach gives me the details, I would be happy to follow up on it this week.
Comment on this
That is fine. I do not have time to go into it, but I think it is an important issue.
I want to talk to Mr. Gunning about the claimed bonds. My understanding is that, as a result of High Court proceedings, these bonds were required as opposed to the other increased cost claims. Is that correct?
Comment on this
The bond claims I have before me include a frame claim bond, a level 7 steel claim bond, a critical delay claim bond, an inflation bond and a bond relating to VAT. Will Mr. Gunning take us through each of those claims and tell us what they are for?
Comment on this
I will ask my engineer to go through it, but, if I may, I will outline what the process is. When the conciliator makes a recommendation, either party can disagree with it and issue a notice of dissatisfaction. We have disagreed with some, BAM has disagreed with some, and both have disagreed with others. When that happens, if BAM refers the dispute to the High Court and issues proceedings, then there is a responsibility on the development board to pay the money, but BAM has to provide a bond.
Comment on this
With interest. At the moment, the interest on that would be-----
Comment on this
These are primarily technical and there is the steel issue.
Comment on this
BAM put in a claim for the first year or two of building the framed structure of the building. It went through new work determination, and BAM was not awarded anything by the employer's representative, ER. The matter was referred to conciliation. I think it claimed for 90 days.
Comment on this
No. It was all about the cost of the delay. No additional steel was required. That was done as part of the remeasure of the contract. This was just for BAM's establishment on site, its tower cranes and its people. That is what it calls-----
Comment on this
That is a delay claim. Some additional steel was built, but there was a provisional sum for special steel to hang all the mechanical and electrical services. We agreed with BAM that we would redesign the primary steel to incorporate that, even though that was a BAM responsibility to design with the mechanical and electrical subcontractor, then we got a huge claim for delays.
Comment on this
That was BAM taking a number of claims together and applying, over a period of two years, for 730 working days, for myriad issues. It said this was the critical path and the longest-----
Comment on this
It is associated with the global claim in that it said it should get inflation of top of what it claimed.
Comment on this
I refer to one other thing that I noted. There was talk of €360 million for commissioning from CHI. There is also talk of a similar fund, in the amount of €360 million, for fit-out and commissioning by the National Paediatric Hospital Development Board. Is that the same figure or are they two different figures?
Comment on this
We are responsible for technical commissioning. We need to make sure the heat works, the light works, and all that. We then hand over to CHI, which is responsible for operational commissioning, turning a working building into a hospital, which is a significant responsibility. That is CHI's responsibility. It is very different, but we will be supporting CHI through that process.
Comment on this
We call ours technical commissioning. BAM, the contractor with its specialists, is responsible for technical commissioning of all the building systems in the contract. That is witnessed by our design team.
Comment on this
I thank everybody for being here. Apologies if I engage in some repetition. I missed some of the hearing earlier. To get my bearings, we know that the substantive date of 30 April will not be achieved. We have no indication of another date at this time. Is that the position?
Comment on this
Deputy McGrath may have missed it, but the contractor has informed the employer's representative that the contractor intends to submit an updated programme tomorrow. We may get it and we may not. If we get it, we have to review all that.
Comment on this
Is it months or weeks? We have no indication.
Comment on this
We do not. We will have to wait and see it, review it, and assess where we are.
Comment on this
We are in the dark on that at this point in time.
Comment on this
Today is 40 months later than the original estimated completion date. Is that correct?
Comment on this
It will effectively be the 19th delay that the contractor has sought. Are we entering the 20th today?
Comment on this
Commissioning is now down to seven months for CHI. We are obviously waiting for the handover date. When we get it, how soon will patients be seen in the hospital?
Comment on this
Will that be a phased opening? It will not be fully open in seven months.
Comment on this
We will migrate our patients over the course of between one and three days. We are still deciding on the timeframe.
Comment on this
So the entire new hospital will be operational seven months after the handover date.
Comment on this
In the past, it has been stated additional staff were required. I think the number of 500. Where are we with recruitment at present?
Comment on this
We have 576.6 staff approved thanks to the support of the Department and the HSE. This is broken down into phases. Phase 0 will see our staff starting to join us from 1 July onwards. This is primarily for safer staffing. This was always something where there was a deficit in our current staffing levels. Phase 1 will commence from 1 January 2027 and phase 2 will be from 2028 onwards. A phased staffing recruitment is probably prudent because it would be challenging to get the full number of staff on day one. In addition, the capacity of the building is future-proofed for the next number of years-----
Comment on this
There is no staffing issue, as such. There is a pipeline and a plan.
Comment on this
Yes. We have 50% of staff in phase 0 who have almost completed their recruitment process and will be given a date. The other 50% of staff will be next.
Comment on this
Seven months after the substantial handover date, whenever that will be, the hospital will be fully operational and fully staffed.
Comment on this
We will have phase 0 and phase 1 of our staffing in place.
Comment on this
Realistically, it will be 2027 at this stage.
Comment on this
The budget allocated to the board is €1.88 billion. Is the board confident that it is going to come in on budget?
Comment on this
In addition, there is money that CHI has to spend. The amount in that regard was stated as €361 million. That brings us to an overall budget of €2.25 billion. Would that be accurate?
Comment on this
It currently stands at a total of €2.25 billion. Where do the claims sit in that context? What assumptions are being made in relation to claims when we land at the figure of €2.25 billion?
Comment on this
The claims are outside that amount. The claims are not liabilities relating to the project. If the contractor feels it has an entitlement, it submits a claim. That can be for a delay or some kind of quantum such as, for example, if there has been an extra piece of steel or has-----
Comment on this
It is likely that some of those claims-----
Comment on this
The contractor can submit all of these claims.
Comment on this
We think that a large number of them are exaggerated, and we do not-----
Comment on this
There have been findings in favour of the contractor in relation to this.
Comment on this
Yes, and there are scores on the board if we look at what the employer’s representative has delivered. It is about 6% of what-----
Comment on this
I looked at the appendix. In fairness, there is a great deal of information in the appendix. My point is that there is a probability that some of those claims will fall out in favour of the contractor on the basis of the fact that previous claims have fallen its way.
Comment on this
Regarding the number of claims, 3,165 have been determined by the employer’s representative. Her award in that context nets out completely to €52 million, where BAM has claimed €819 million. That is an important piece of information.
Comment on this
When we look at that €819 million, we are back to the 41 or 42 months. That €819 million is equivalent to 11 years of time extension and not 42 months.
Comment on this
This means that there has been significant over-claiming of the time. In the dispute settlement, when this is resolved, if BAM is entitled to money for a delay, it can only get paid once for that delay. It cannot get paid multiple times for the same days.
Comment on this
Will Mr. Gunning clarify the figure for me? Out of all the claims amounting to €819 million in value, the actual findings in favour were for about €52 million.
Comment on this
On those 3,165 claims determined by the employer’s representative, BAM has claimed for €819 million. The net amount, the net change to the contract sum, as a result of those claims is €52.369 million, which is 7% of the claimed amount.
Comment on this
What is outstanding that has not been settled?
Comment on this
Quite a number of claims have not yet gone through the process.
Comment on this
The employer’s representative has seen many of these claims. They then go to the next phase of dispute resolution, which is conciliation. Not much is happening in that area at the moment. Separately, we have a number of claims in the High Court.
Comment on this
How does this compare to the €819 million? Are we talking about similar figures again?
Comment on this
Yes. It is a similar type, but conciliation is a very different process compared to the employer’s representative role in the contract. If she determines that an amount of money is due, the NPHDB has to pay it. Conciliation, however, is a separate process involving a conciliator. Either party can say that the other party can take it or leave it. A notice of dissatisfaction can be issued, which we have done.
Comment on this
The likelihood is that there will be further claims in favour of the contractor. What I am getting at is that the €2.25 billion budget is likely to increase.
Comment on this
We think we will deliver this project for under the €1.8 billion.
Comment on this
In addition, then, there is the CHI funding. What total amount are we going to land at overall in terms of the budget?
Comment on this
There will be litigation, but we are confident. Do we think these claims have real value? We think they are significantly exaggerated and we do not think there is a significant entitlement. We do not think that the contractor has demonstrated the entitlement.
Comment on this
Is the total likely to go above €2.25 billion?
Comment on this
I ask the Deputy to forgive me, but I am looking at the €1.88 billion, which is our piece.
Comment on this
Is Mr. Gunning confident on that front?
Comment on this
Is CHI confident regarding its estimated figure of €361 million?
Comment on this
This figure was based on a substantial completion date that was earlier. It was envisaged that substantial completion would be done by June or July 2025 and that we would open in April 2026. We have worked really hard to ensure that our funds are well used. On the original budget, we will move into the contingency, which is €41 million of that €361 million, at the beginning of 2027. It will then depend on getting the building.
Comment on this
So, that €361 million may increase.
Comment on this
There is a question mark over that amount.
Comment on this
How much has been spent on legal fees to date in relation to all these claims and settlements? The witnesses can come back to me on that.
Comment on this
I have that figure and I can get it for the Deputy. We have it here.
Comment on this
Does CHI have a figure for this element or is this just purely within the remit of the development board?
Comment on this
We are not party to the payments, but we would have legal fees in relation to the tenders we have done. For example, in 2025, we did 17 tenders worth €44 million for the new children’s hospital. There will be legal fees associated with that undertaking but nothing in relation to claims.
Comment on this
It is not in terms of disputes or claims.
Comment on this
While Mr. Gunning is finding the answer to my last question, I might ask another question, or perhaps he has now?
Comment on this
Yes. The cumulative bill for our general legal fees from 2014 to February 2026 is €5.3 million.
Comment on this
That is the amount for legal fees.
Comment on this
That is since the start of the organisation. Obviously, in the accounts for 2024, we have the amounts for that year. I can give the Deputy a bit more detail on that, but perhaps we can provide that information separately.
Comment on this
Settling or adjudicating claims to date has cost €5.3 million.
Comment on this
It includes defending as well. Defending €1 billion worth of claims is a-----
Comment on this
Over €5 million in legal fees has been expended by the development board.
Comment on this
Mr. Gunning mentioned earlier that, in his view, the delays were because the contractor is not resourcing the project adequately. Why does Mr. Gunning think it is not adequately resourcing the project?
Comment on this
The contractor maintains that it is, but the evidence of 19 or 20 missed deadlines tells us it is not happening. We look at the performance, we hear the contractor telling us it has sufficient resources and we then look at our key performance indicators. These include the number of rooms being handed over and the progress made on the commissioning activities, and, consistently, the contractor has been behind the programme on each and every one of these key performance indicators. Typically, it is progressing at about 60% to 65% of its committed rate to hit the deadline. If this is being done consistently, it is crystal clear to us that there is a resourcing problem here.
Comment on this
Mr. Gunning thinks there is clear evidence that the project is not being resourced sufficiently. That is his view.
Comment on this
In relation to the contract, it was mentioned that all avenues open to the board were being used in terms of the original contract. How would Mr. Gunning describe that contract in terms of its suitability for a project of this nature?
Comment on this
I try to focus on what we have to do. We have to work within the contract. We try to make it work as best we can. In terms of future changes, that is really a policy matter the Department of public expenditure-----
Comment on this
As someone who is working within the contract, though, Mr. Gunning can clearly see the flaws within it.
Comment on this
I would have lots of comments. We have provided some of our key learnings. It is not just about the contract, but also about the organisation, how it is set up and how it deals with and engages with the contractor. There are issues here that have to be captured, and I think they have been captured. We have had discussions with the Department of Health, which, in turn, has had discussions with the Department of public expenditure and others in relation to this matter.
Comment on this
Is it fair to say that the contract, as it was originally written, did not give the board sufficient tools to deal with the ongoing delays and disputes?
Comment on this
Again, we are working with what we have. You could draw those conclusions but you have to also remember that if you put too much on the other side into a contract, the appetite for people to bid for this business could be affected. There is a complex issue to be discussed here-----
Comment on this
-----at a national level. There is no single quick fix to any of these issues.
Comment on this
I understand, but what the public will want to hear is that we will not find ourselves in this position again as regards a massive budget overrun and a massive time delay. That is what the public want to hear in terms of assurance.
Comment on this
As we move into the break - we will take our sos beag at 12 o'clock - I just want to clarify and to remind both members and our witnesses that the committee is not in a position to make findings in relation to contractual matters in relation to witnesses or between witnesses and other parties. Our focus is on value for money expended by CHI and the National Paediatric Hospital Development Board. I refer all witnesses and members back to the initial note I read out with regard to parliamentary privilege and ask them to take note of it. My intention is to move into the break. The first speaker back should be Deputy Ardagh.
Comment on this
I was wondering if it might be possible during the break for Ms Nugent and her colleagues to identify the email they were referring to, without identifying the persons in the email, in order that when they come back after the break at least what was said could be read out, given what has broken this morning. Ms Nugent said the email confirms that they were looking for a donation for a Christmas party. If the witnesses could have that email when we come back, that would be great.
Comment on this
I have a similar request for Mr. Quinn. If we could be furnished with the response from BAM to the Minister over the break, that might just help in terms of questioning in the piece after-----
Comment on this
I will not commit to that because, to be fair, we just got it after hours last night and we need to read-----
Comment on this
I will leave those two requests with the witnesses and we will let them respond after the break. I ask witnesses to keep it to about ten minutes, to be back in the room for 12.15 p.m.
Comment on this
Before the break, there were two requests put to the witnesses with regard to documentation. Mr. Quinn, I might ask you to respond to the one that was put forward by Deputy Farrelly.
Comment on this
I thank Deputy Farrelly for the question. As I said before, that letter landed into our inbox at 6.23 p.m. last night. We have not had an opportunity to review it in full but we will be happy to share it once we have had an opportunity to review-----
Comment on this
At 6.23 p.m. last night into the Minister's inbox - the private secretary's inbox - so it was after hours. I was preparing for this meeting and then I reviewed it, but I need more time.
Comment on this
The emails relate to a member of staff who is no longer working in CHI, and the only people who have authorised access are myself and Ms Gaffney. We could ask a member of staff but we feel that would be compromising the data protection rules in relation to that. We are happy to provide it after the committee meeting.
Comment on this
I was looking only for the substance of what was in the email.
Comment on this
But, obviously, it is now a dormant email account. For someone else to access it, because it relates to an ex-member of staff, it would be limited to the appropriate personnel. I am very happy to provide the wording after this session.
Comment on this
That is a commitment to provide the committee with those two documents after the committee meeting. Is that correct?
Comment on this
Sorry, I had a question for the meeting as well about the staff. How much is that going to cost?
Comment on this
Yes. I can answer that now. In relation to the 117 whole-time equivalents, which will start to come on board from July, that is, they will not all be there on day 1, it will be a cost of €1.018 million per month.
Comment on this
Every month it is going to cost that until the hospital opens.
Comment on this
When they are all in place, but they will not all be in place from 1 July, obviously.
Comment on this
I am going to go back and discuss the €30,000 Aramark concession payment.
I know it is a small payment in the broader scheme of things, but it speaks to governance at the hospital. CHI has told the committee that it was for a Christmas party but in The Irish Times today, Aramark said it was to settle accounts. What version is true?
Comment on this
We have evidence to show that we requested the donation. It was wrong. This is why we returned the donation, so in that regard, we are happy to provide the-----
Comment on this
Does CHI have written correspondence showing that-----
Comment on this
To show the emails and we also spoke to the ex-member of staff.
Comment on this
Does CHI have any emails or documentation from Aramark confirming that it was in relation to a Christmas party?
Comment on this
We do not any documentation to suggest it-----
Comment on this
Does CHI have replies to emails?
Comment on this
-----or to suggest that it was a rebate of lease money.
Comment on this
Is Ms Nugent saying that CHI has information from Aramark that states it was for a Christmas party?
Comment on this
We have information internally from ourselves that we requested it and how it was to be recorded.
Comment on this
Does CHI have any information from Aramark acceding to that request?
Comment on this
No. We , we met with the COO of Aramark and obviously they have a different understanding of it, but we have evidence. The reason we gave it back was because we knew it was unacceptable.
Comment on this
Does CHI have an email? Someone obviously requested the moneys and there would then have had to have been some sort of discussion in relation to how that was transferred back over. I understand it was by way of a credit note, but there would have had to have been some sort of instruction by Aramark to say go ahead and proceed that way. I do not think CHI would have unilaterally issued a-----
Comment on this
I understand that it was recorded. Does CHI have documentary evidence to show that Aramark understood that it was for a Christmas party?
Comment on this
I do not have any emails from Aramark that said it was from a Christmas party. I have internal emails that document what it is and I have internal emails to ask for the invoice to be raised for Aramark with regard to the €30,000.
Comment on this
Does CHI have the emails from the head of finance to the person in Aramark and them coming back saying, "Yes, we agree with that and here is the money"?
Comment on this
We understand that it was a verbal transaction.
Comment on this
But we are confident that we requested it, which was wrong and is why we returned it.
Comment on this
Did CHI have written policies in place at the time in relation to the acceptance of payments from concession holders?
Comment on this
Was this in breach? You are saying it was a verbal request for funding. It would be realistic to presume that it was in breach of CHI's-----
Comment on this
It was wrong. Regarding the person who breached the policies in respect of governance and the acceptance of payments from concession holders, were there any disciplinary procedures brought against the individual?
Comment on this
As I said previously to the Chair, I am reluctant to name any individuals. All I can say is that they are no longer in the employment of CHI. Neither Ms Gaffney nor I were in the hospital at the time, so we cannot comment.
Comment on this
At the time that this came to light - it is important to say that the Comptroller and Auditor and General brought the payment to light and then it was returned - was there anyone internally who had discovered this payment? If they did, why did they not return it? Was this payment hidden from other members of the-----
Comment on this
It was in deferred income, but it was the Comptroller and Auditor General who brought it to our attention.
Comment on this
No one came across it bar the Comptroller and Auditor General.
Comment on this
No. Just to confirm, it was not hidden, but it was not called out as staff hospitality. It was when the Comptroller and Auditor General picked up the value and picked a sample of the deferred income account that it came to light.
Comment on this
I presume that large tenders like that go before the board.
Comment on this
Absolutely. There is a threshold for contracts. I have the delegated authority to approve up to €500,000, but anything after that, or anything of significant strategic importance, has to go to the board.
Comment on this
Did the finance director at the time sit on the board?
Comment on this
Did the finance director report to the board?
Comment on this
I am in attendance at the board - I am not a member of the board - and members of the executive management team attend the board to provide specific reports and information. At the time in 2022, I understand that there was a wider representation of the executive management team in attendance at the board.
Comment on this
Around the time that it was discovered, was there any delay or decision to defer the retendering of any catering-type tenders that Aramark would have gone for?
Comment on this
Are there any written board notes in relation to the delaying of a tender or deferring the awarding of a tender?
Comment on this
No, because they were already in place under a contract.
Comment on this
Obviously, there is a huge attrition or turnover rate among board members of the hospital in terms of resignations. Does Ms Nugent have any idea of the reasons so many of them resign?
Comment on this
Does Ms Nugent know if there was a full quorum at these meetings?
Comment on this
Was there a full quorum at all of these meetings of the board?
Comment on this
Yes. I think there was one vacancy for a period time of the 12-member board, bringing it to 11.
Comment on this
What is the full complement of the board now?
Comment on this
Is it a working board and meeting regularly?
Comment on this
Absolutely, and very supportive of the executive management team.
Comment on this
What is the status of the recommendations in relation to the clinical audit of hip surgeries?
Comment on this
I will hand over to my clinical colleague in a moment, but the audit made a number of recommendations that have been implemented already, such as a cross-city multidisciplinary team. There was a further recommendation to do the multidisciplinary team clinical review - that has now been completed - and to ensure that there is consistency in the follow up of these patients to skeletal maturity.
Comment on this
One of the recommendations that we have implemented has been the standing up of a multidisciplinary team, MDT, discussion. Any child who is considered for surgical treatment is discussed. They are obviously seen in the clinic and then they are discussed at a group of a number of consultant orthopaedic surgeons, radiology, physiotherapy, nursing and an external orthopaedic surgeon as well. Initially, there were two - one from Boston and one from the UK. We have now stood down the Boston surgeon and the UK surgeon still attends those MDT discussions. Any decision being made on a child having pelvic surgery goes through that MDT and that is fed back to the family.
Comment on this
Regarding the results of the independent clinical review, we understand that 93% of the recommendations have been followed through. There are still 7% that have not been followed through. What progress has been made in relation to the implementation of the 7%?
Comment on this
Is the Deputy talking about the HIQA report?
Comment on this
The non-medical grade hip implants.
Comment on this
Sorry. I am talking about the independent clinical review concerning non-medical grade implants and the independent clinical audit of hip surgeries in children.
Comment on this
The last element of this is the external expert panel review, which is a process that has been commissioned by the HSE to establish, as far as possible, if the threshold for surgery was appropriate. A team of 14 international experts have convened. There is a chair in place and that review has commenced.
Comment on this
Sorry, but it was my understanding that review was completed and that 93% of the recommendations in relation to non-medical grade implants had been implemented.
Comment on this
We are actually at 98.5% completion of the recommendations. The remainder relate to ongoing work on culture which will continue indefinitely.
Comment on this
I apologise. I thought that was in relation to hip surgeries. Have all of the families been advised about what the next steps are?
Comment on this
It is in relation to the audit on hip surgeries. I am on hips.
Comment on this
Yes. We worked very closely with the hip dysplasia advocacy group. I would like to acknowledge that the group was extremely helpful in relation to how we communicated with the families, the content of the letters that we wrote to people and making sure that the information on our website was understandable.
Comment on this
Are there any families still waiting for information or is Ms Nugent satisfied that all families are very happy with how they have been communicated with?
Comment on this
I think all families are waiting to know if their child had necessary surgery or not.
Comment on this
Have all of the families been informed?
Comment on this
The point of the clinical review, which has been completed, was to establish the current status of the child's hip, and then the second part is the external expert panel review, which will look at the threshold and whether the surgery was appropriate.
Comment on this
When does Ms Nugent think that will be completed?
Comment on this
I will defer to my HSE colleague in that regard.
Comment on this
On the external expert panel review, we are working with CHI and Cappagh around finalising the numbers and putting those up on a suitable database for the international experts to review. That is due to start in the coming months. It is likely that it will take approximately a year, given the numbers involved, but there will be continuous communication.
Comment on this
What numbers are we looking at?
Comment on this
Have any sample cases been done? Is there a percentage?
Comment on this
No. The clinical reviews are what has been completed and then the expert panel review will commence.
Comment on this
The likelihood is there will be a lot of families down the line who will get bad news that their child has had unnecessary surgery.
Comment on this
We do not know but we will continually communicate with families and the advocacy groups on this. It is a very challenging time for families and we are very conscious of that.
Comment on this
I thank Deputy Ardagh. Ms Gaffney mentioned an invoice being raised against Aramark. Will she provide a copy of that invoice to the committee and particularly the description that was included on that? Is she aware what the description said?
Comment on this
The description was "additional services".
Comment on this
I thank the witnesses for their presentations and the information. I will start on the issue of idiopathic scoliosis procedures taking place in Blackrock Clinic. I have replies to parliamentary questions from CHI illustrating that quite a number of procedures are taking place in Blackrock. In 2023 it was 39, in 2024 it was 48 and by the end of November 2025 it was 67. Why are these procedures - I presume they are fusion procedures - taking place in Blackrock as opposed to Cappagh?
Comment on this
It is a capacity issue. Idiopathic scoliosis, by its nature, is normally an unknown cause, commonly in otherwise normal, healthy children. Therefore they are suitable for surgery in a third-party private hospital as opposed to the additional supports that more complex surgery requires. Our aim in the longer term is to repatriate all spinal surgery to CHI and Cappagh.
Comment on this
If the procedure is done in Blackrock as opposed to Cappagh, is there a difference in how much the surgeon will get paid?
Comment on this
The Blackrock patients are done under the unique authorisation number, UAN, process, which is under the HSE access to care programme. The surgeons do not get paid by the HSE or CHI. They are paid by Blackrock so we do not have access to what they are paid. We pay for the package, as such.
Comment on this
Okay. If they do it in Cappagh it is included as part of their salary, presumably, and they are not getting an extra fee. If they do it in Blackrock-----
Comment on this
It is outside of their normal contractual hours so it is additional work.
Comment on this
Is it possible they are getting €10,000 per procedure?
Comment on this
Do the surgeons have an influence on whether the operations take place in Blackrock or in Cappagh?
Comment on this
Each child is allocated based on clinical grounds. The surgeons do not influence where the surgery is to take place except if it is clinically appropriate.
Comment on this
The surgeon will decide if it is clinically appropriate to go to Blackrock, as an example, but after that if the child can be treated in Blackrock then it is chronological scheduling with the wider team of nursing operations and the surgical team.
Comment on this
The surgeon says this child would be appropriate to do in Blackrock.
Comment on this
Surgery along with anaesthesia and nursing. It is a multidisciplinary decision. The surgeons who do surgery in Blackrock is well outside their core clinical activities. They all have a contractual commitment to provide 37 hours – 30 hours of clinical care and seven non-clinical – so it is all outside their clinical commitment. It is additional work.
Comment on this
Surgeons are not using their contracted HSE time to perform these operations.
Comment on this
Would Ms Kelly accept that if, for example, they are getting €10,000 per procedure in Blackrock that there is a material incentive for them to suggest that the child would be done in Blackrock as opposed to in Cappagh?
Comment on this
Knowing all the surgeons, to be honest, the drive for all the surgeons is to get quality care and to get our waiting lists under control so I do not believe for a moment that there is any monetary incentive to do that surgery.
Comment on this
Ms Kelly is saying the reason it is not currently happening in Cappagh is because there is not enough capacity.
Comment on this
There is capacity in Cappagh. Cappagh traditionally had done a lot of idiopathic scoliosis. That was stood down at a time when we were looking closer at governance. There was an additional need. Blackrock Clinic has in-house anaesthesia and in-house paediatricians. Cappagh did not have that at the time. The clinical director at Cappagh had to make sure that all the safety measures were in place to provide spinal surgery in Cappagh.
Comment on this
There was an appointment of two additional paediatricians recently in Cappagh.
Comment on this
Two additional paediatricians have been appointed so that could be stood back up.
Comment on this
From now on, there should not be any idiopathic scoliosis procedures taking place in Blackrock and they should all happen in Cappagh.
Comment on this
Particularly some of the Crumlin surgeons would feel that they will do their complex surgery in Crumlin and then their adolescent idiopathic surgery in Blackrock, if appropriate, but not to go into a third site. What we are trying to do is optimise capacity, use our less complex surgery – so non-spinal surgery – to move out to Cappagh to utilise that capacity so that we can do our complex spinal surgery in the one site.
Comment on this
In addition to that, with the support of the HSE and the Department, we have been able to get more equipment for an additional theatre in Crumlin to be converted into a spinal theatre and the caseload in that theatre are moving out to Cappagh.
Comment on this
CHI is not paying the surgeons for the procedures in Blackrock but presumably, ultimately, the public is paying. Blackrock is not paying them from its own money.
Comment on this
I had a reply to another parliamentary question which suggested that something like 60 cases, not necessarily of idiopathic scoliosis, were done in the Mater Private over the course of five years or something from CHI. That confused me. Does Mater Private normally do children’s operations?
Comment on this
It would depend on the timeframe. Maybe that is a historical arrangement. I am not familiar with it.
Comment on this
An answer back from Caitriona McDonald on 12 March 2026 said that CHI could advise that between January 2021 and January 2026 a total of 60 procedures for patients on the CHI inpatient and day case waiting list were carried out in the Mater Private Hospital.
Comment on this
That is fine. I am not suggesting they were.
Comment on this
Sorry, yes. There would be a number of initiatives for orthopaedics. The likes of the Mater Private would have done spinal and general orthopaedic cases in the past under the NTPF.
Comment on this
I will go back to all the procedures, for example, idiopathic scoliosis procedures, that are happening outside HSE-contracted time. I understand some surgeons would operate two theatre lists in Blackrock. How is that happening within the time one has in a week? How do they have enough time?
Comment on this
When the Deputy says two theatre lists does he mean two lists?
Comment on this
Two lists in a week in Blackrock Clinic in addition, presumably, to their contracted HSE hours.
Comment on this
The work plan for each surgeon is two days of operating, ideally, with access. We have one spinal list every Wednesday in Blackrock so they will do one spinal case in Blackrock. That will be in addition to their two days in CHI.
Comment on this
Okay. In relation to the surgeon who is referred to the Medical Council in relation to the insertion of non-medical grade springs - springs that had nothing to do with medicine whatsoever - and is also involved in the unnecessary hip dysplasia operations-----
Comment on this
I am going to caution members that we are not in a position to findings of fact against individuals. That is just to caution members.
Comment on this
No problem. Is that surgeon still being paid?
Comment on this
I do not wish to appear evasive but I am very conscious there is an ongoing HR process and I do not wish to jeopardise that.
Comment on this
It is a simple enough question whether they are still being paid.
Comment on this
Thank you very much. Basically, will they continue to get paid up until a point, if the Medical Council were to find against them?
Comment on this
With respect, I do not wish to comment further.
Comment on this
Let us say, a hypothetical situation, of a receptionist who works in CHI and steals from CHI. I presume someone like that would be fired and would not be paid any more. Is that a fair assumption?
Comment on this
They would be taken through a disciplinary process.
Comment on this
At the end of that disciplinary process, presumably, if there were serious disciplinary issues it would result in someone being fired and they would not get paid any more.
Comment on this
Does Ms Nugent see a problem in the fact that a surgeon can have very serious allegations against them and yet continue to get paid for a long period of time?
Comment on this
As with all members of staff who are going through a disciplinary process, there is a process to be followed according to their contract.
Comment on this
Are his legal fees being paid by the CHI?
Comment on this
In relation to the other surgeons who were found to have done unnecessary hip dysplasia surgeries, in the first look at that, all of those other surgeons, with one other exception, as far as I understand, are still operating on children. This includes doing some hip dysplasia operations.
Comment on this
Correct, and all cases of hip dysplasia go through the cross-site multidisciplinary team where there are agreed criteria for the threshold for surgery.
Comment on this
This is an overarching question. The basic issue here is that if there had been oversight, let us say a comparison of Crumlin and Temple Street, something would have been flagged that there was some reason a lot more surgeries were being done in one place over the other. Has that governance issue been addressed into the future where there is someone looking at these?
Comment on this
Yes. We have made significant progress on our governance structures. We look at the RCSI clinical governance framework, which looks at ensuring that we have morbidity and mortality conferences, M and Ms, multidisciplinary teams , MDTs, clinical audit and research. For example, our clinical audit activity has increased from 86 audits in 2024 to 100 last year. We are very focused on ensuring we provide safe care. We have now made changes in our structures. We also have clinical speciality leads now in place. That was one of the recommendations from the HIQA report. That is moving from a traditional department head role to one of managerial leadership, with certain responsibilities. We are the first hospital in the country to have all of our clinical speciality leads in place, so yes, I am confident that governance has been improved in CHI.
Comment on this
I want to pick up on some comments by Mr. Devine about the small fire that occurred in the hospital last week. He seemed fairly emphatic that this would not cause any further delays and that BAM sought to repair the damage immediately. This is for my own understanding. Obviously, if a ceiling is damaged to the extent that it has to be taken away, that will inevitably cause some sort of a delay, whether it is a minor delay or not, but it is additional work on top of all the defects that need to be reworked and closed off. I would suggest that there will be some sort of a delay. What I want to tease out a little bit is the comment about the investigation of smoke in the ducts. What does that entail?
Comment on this
I will start with the first point, if that is okay. The reason it is not a delay is because it is not on a critical path. It will take probably less than a week to repair that section of the corridor. There are other aspects where we talked of rework across the project, which will take a lot more than a week. Yes, as Mr. Gunning said, it does take resources away from other work but it will not be the last thing that is required to be done on the job, so it is not a critical delay to the job but it does disrupt other work.
Comment on this
I presume that is covered by BAM's insurance?
Comment on this
There is an owner-controlled insurance policy including BAM that covers for that and BAM has indicated that to the insurance company.
In terms of the investigation, the fire happened below the ceiling-----
Comment on this
-----but there was some smoke damage. As a proper due diligence, whether it be dust in ducts or smoke damage or staining in ducts, if it is found under investigation that there is, then they will be thoroughly cleaned.
Comment on this
On that point, in Mr. Gunning's opening statement there is the alarming aspect of the dust in the air ducts. We all know that accumulation in HVAC systems can cause fires, so it is a related topic. When dust builds up it restricts airflow, thereby forcing the system to work harder and to overheat. The excess heat, combined with electrical sparks from motors or wiring or whatever it may be, can ignite a flame, leading to fires. We have seen this in houses everywhere, right across the board. Has the risk of fire in the air ducts been explored and remediated? Is that a consideration?
Comment on this
Our primary focus on the ducts at the moment is that, as Mr. Devine told me, they have been cleaned twice already. Because of what we would regard as not good practice, the rework that has gone on around has allowed other dust to go in to the types of vents that are above our heads here in the committee room. That is what we are talking about. It is a requirement on the contract and our priority is that the ducts are clean and that there is no dust in them when this hospital is handed over to us. We, in turn, can hand over to CHI a hospital where, in the operating theatres, there is not a pile of dust being blown around. It is critically important that this happens. As I said, the issue we have is that this has been done before but now it needs to be done again. This kind of rework gives rise to delay, which unfortunately, is delaying the time when Irish children can be treated in this hospital.
Comment on this
I would imagine a bit of common sense here would be that this is probably the last thing to be done if there is work ongoing at every stage, but-----
Comment on this
I totally agree that there is a sequencing on this and that it is not right but we are not the contractor.
Comment on this
The last line of that section of Mr. Gunning's statement says I think you "will all appreciate that we cannot accept critical areas such as theatres where the contractor has not removed the dust". In reference to the main issue of dust in the ventilation, was Mr. Gunning talking about any level in particular or was he talking about the hospital as a whole?
Comment on this
The critical areas are the very important ones such as the ICUs and the operating theatres and all that stuff. There is 75 km of ductwork in this hospital. As of last week when the subcontractor finished the assessment, 40% of that requires additional cleaning. We are talking about a significant effort and it is not just in one place; the 75 km is all over the hospital. Mr. Devine might have more detail on where and which areas are affected.
Comment on this
I am just curious which levels are of concern.
Comment on this
As Mr. Gunning says, it is throughout the hospital. I do not have the exact detail of which is worse. The two levels that they are working on at the moment contain critical care and operating theatres, for which we are awaiting early access. The critical care floor was not that bad and there are set international levels for the amount of dust particles in ductwork. It differs between supply ducts and extract ducts. Extract is obviously more than supply. Supply is the key one because that is the one that might impact the patients.
Comment on this
As for where I am trying to go with this, there is early access for fit-out already on level 6, lower ground and level 0. From what I can make out in that part of the hot block statement, lower ground and level 0 contains the clinical engineering, labs and diagnostics. Am I right? That would suggest to me that a significant amount of equipment might perhaps already have been placed in these rooms that will be affected by the dust. In my view, not just the ventilation system but the equipment itself would need to be removed, cleaned, autoclaved and sanitised before it can be returned in a sterile, fit-for-purpose state. If all that effort has to be gone to of taking it out, cleaning it, sanitising it and putting it back in, will that whole process have to be rinsed and repeated if it has to be gone through again? I am conscious there is a line in Mr. Gunning's statement about the warranty only kicking in on the first use of patients. I would imagine - and I am open to clarification on this - if equipment has to be taken out of a hospital to sterilise and clean it that could perhaps be affecting the warranty before it is even in place. There is a vicious circle of events here that could potentially have further ramifications and add additional costs that I do not believe are being considered at this point.
Comment on this
I assure the Deputy that ducts in hospital are routinely cleaned on a rotating basis. There are very experienced people in the CHI team and in our own joint team on the equipping of the building. Clinical engineers will remove that equipment. If someone is going up to access a duct to clean it, the equipment will be temporarily taken out of that room. It will be stored and then put back in. They do this routinely all the time across the hospitals. We will work with the contractor to ensure that the fantastic equipment we have procured for the building will not be impacted in any way.
Comment on this
That is good to hear because the fact that the ventilation system and the ducts are referenced in the opening statement means that it is obviously a cause for concern for the board or it would not be referencing it. It is important to tease out where the equipment fits into this. How far back was this issue with the ducts and the dust flagged?
Comment on this
This time around it was flagged before Christmas by our mechanical and electrical consultants who are responsible for signing off on the ductwork.
As part of their inspections on site they saw some of the ducts were recontaminated.
Comment on this
This is recent enough. This is not going back to the major generic faults highlighted by the expert who installed the ventilation system and has since left the project.
Comment on this
As the Deputy said herself, the additional dust is a result of the sequencing of the work, number one and, number two, all that rework that we talked about - all the 100,000 defects over the past 15 or 18 months - has recontaminated the ducts. The ducts were cleaned about the middle of last year. The second round of cleaning happened in the second or third quarter of last year. This additional contamination has happened between that time and now. It has been flagged. It was flagged earlier. That is why the executive requested BAM to carry out a full vacuum test to determine the extent of the dust in the ductwork. It was requested for the whole building, which it has now completed.
Comment on this
That is crucially important because the last thing we want is to finally get a substantial completion date and for another fire or something to occur and undermine everything and everybody's patience and investment in this.
I intended to come to Ms Nugent earlier. I apologise for that. I am really tight on time. In relation to the €8 million deficit in the 2024 accounts, I note the Comptroller and Auditor General is moving on to the next set of accounts from the middle of this year. Does she anticipate a further deficit?
Comment on this
Yes, we are. I might hand over to my colleague. In 2025 we effectively broke even. We have now moved on to 2026 from an operational perspective.
Comment on this
I am out of time so I might come back to that later.
Comment on this
Some of our witnesses might have to leave at 1.30 p.m. so we will be going into a second round of questions. Is that correct or is Ms Nugent okay in terms of time?
Comment on this
I thank all the witnesses. I will try to close out this concession issue as much as I possibly can. Ms Nugent met with the CEO. Why did she meet the CEO?
Comment on this
He asked to meet you. Was he trying to get his story straight about the concession before she came to this committee? Was that the purpose of the meeting?
Comment on this
I am consistent and have been consistent about the fact that we, wrongly, asked for it. We paid it once we became aware of it.
Comment on this
I know Ms Nugent's reason but-----
Comment on this
Was that the premise of the meeting?
Comment on this
I think there was concern, understandably, that there was some insinuation that it was some sort of a backhander, which it was not. We asked for it. To be fair to the company, it is on us in that respect.
Comment on this
I presume Ms Nugent has had a chance to read the statement. I presume she has had a chance to read it and she heard what I said on the statement. Is she surprised with the content of their statement following that meeting?
Comment on this
Yes I am, because I clearly said we asked for it and we take responsibility for it.
Comment on this
Did they deny, not deny or acknowledge during the course of that meeting that it was a donation for a Christmas party?
Comment on this
Again, I am conscious of putting words inappropriately into a third party. Certainly there was a discussion about Covid and how the process has changed but we said that was not the issue here; the issue here is that we asked for it and we received it.
Comment on this
What did they say when Ms Nugent said that?
Comment on this
CHI, along with a lot of other entities during Covid worked with all its vendors and partners to make sure that there was a realistic approach to things like rent but this did not form part of that. This was a donation that we asked for.
Comment on this
Personally, I find it really strange that a CFO of a public hospital would call one of the concession holders and say: "Any chance you would give us 30 grand for the Christmas party?" Does Ms Nugent find that strange?
Comment on this
It is not something that I would be used to.
Comment on this
Has she ever come across anything like this before?
Comment on this
I will move to Ms Gaffney. I misunderstood her. I thought she said there were emails between the hospital and Aramark which evidenced an affirmation by the hospital that this was a donation for a Christmas party but she is now saying all of the emails were internal.
Comment on this
So there is no documentary evidence between either side.
Comment on this
I have not found any emails between Aramark and CHI.
Comment on this
So it is essentially a case of "he said, she said" right now, although last week, when there was a meeting in advance of this committee there was no dispute. Then last night Aramark issued a statement that seems to have turned all of this on its head all over again, which I do not particularly understand.
Comment on this
Neither do I. I will be taking it up with the CEO of Aramark.
Comment on this
That is fair enough. Aramark is not here. The internal email that Ms Gaffney saw is presumably from the former CFO to whoever – an accounting person or something in the organisation saying-----
Comment on this
They are internal emails. I do not want to paraphrase because obviously I had to run through a lot of emails. I will get those emails and I will send them on to the committee.
Comment on this
It said something like "this is for a Christmas party".
Comment on this
"This is a donation for a Christmas party."
Comment on this
How did it get from a donation for a Christmas party to being an invoice for services rendered? Where is the chain of documents dealing with that point?
Comment on this
How did it go to an invoice which says "additional services"?
Comment on this
The emails that I have seen are after the invoice was raised.
Comment on this
So the invoice was raised for additional services and this is a retrospective explanation for what that invoice was for.
Comment on this
Would Ms Nugent agree with me that if Aramark is right, she should not have given the €30,000 back?
Comment on this
Okay. I have only got 20 seconds left. I have a question for the HSE and the Department of Health. I am not sure who is here from the HSE. A total of €145 million of bonded payments have been provided for the disputed claims. That is real money. Who is here from the HSE? Is it Mr. Lynch?
Comment on this
Perhaps the Department of Health can help me here too. That money is real money in the sense that it came from the Department of Health, presumably through its Vote. Is that how it would have worked?
Comment on this
That is documented in the Vote that the Department of Health provided €145 million.
Comment on this
As part of the overall capital allocation.
Comment on this
It was part of the overall capital allocation. Would that have come in the budget at that time-----
Comment on this
Not as a Supplementary Estimate or anything like that?
Comment on this
The Department of Health has committed €145 million of additional moneys. It gave it to the HSE. It is not accounted for in the HSE's 2024 accounts but reference is made to what it is. It does not form part of the HSE's accounts at all. Is that the point? Does it wash through its accounts?
Comment on this
It is not that it washes through, the allocation came from the capital plan but because it is a bonded payment, similar to the development board, it was not money that was drawn or taken as drawn from the capital plan.
Comment on this
It is real money from a taxpayer perspective.
Comment on this
It is moneys that have been allocated to the Department of Health in the budget. The sum of €145 million is a lot of money. We could build primary healthcare centres with that money. Ultimately, that has had real world consequences. Even if that money comes back, there is a consequence for budgetary considerations. Is that correct?
Comment on this
Ms Gaffney has the internal emails regarding the Christmas party. What was the process for deciding that it would be in the Storehouse?
Comment on this
I honestly cannot answer that. I was not there at the time but the emails do not say why or how the decision was made.
Comment on this
They do not mention the choice of location.
Comment on this
Aramark has been the lead supplier of catering at the Guinness Storehouse since 2000. Is there a potential here for a significant conflict of interest at play with regard to this whole process?
Comment on this
Again, I honestly cannot answer because I am not sure how the decision came about to go to the Guinness Storehouse. That is being honest with Deputy Farrelly.
Comment on this
In the emails the witnesses have seen, there is nothing external that contradicts Aramark's statement about what it believes the purpose of that was. Is that true?
Comment on this
I have not yet seen any emails that were sent or received from Aramark.
Comment on this
The invoice it would have received did not outline CHI's belief in what the purpose of that payment would have been. Is that correct?
Comment on this
It purely stated it was for additional services.
Comment on this
How can we be confident that it is wrong and CHI is right?
Comment on this
An email outlined that the staff event was to be invoiced as additional services.
Comment on this
That is an internal piece of correspondence.
Comment on this
It is internal, but it is how it was to be recorded, and for what purpose.
Comment on this
Did Aramark ever confirm that to CHI? Is there proof that it has ever confirmed that?
Comment on this
We do not have any written confirmation as to the purpose of that payment from an Aramark perspective.
Comment on this
It was a verbal conversation, or that is our understanding.
Comment on this
That is no good to anybody. Do we have anything in writing?
Comment on this
We have emails that confirm it was for the staff event.
Comment on this
Which is no good to this conversation in terms of Aramark's perspective.
Comment on this
I suppose the converse is also true. There is nothing from Aramark to say that it was for Covid.
Comment on this
This was not discussed at the CHI meeting on Monday.
Comment on this
There was a conversation about Covid. We said that we know this was not for Covid, and that we asked Aramark for this money. To be fair to Aramark, we are taking responsibility for this. This was wrong of us to do. Whether it is Aramark or another vendor, this was wrong of CHI and that is why we returned it.
Comment on this
Do we have any further information as to why it was never put to its purpose? I know we said there was a delay in it, but why was it never used once it was finalised?
Comment on this
It was not taken back in. It was left in the deferred income account, and it was not reconciled.
Comment on this
There were multiple mistakes.
Comment on this
We are not trying to be evasive but, unfortunately, we were not there at the time.
Comment on this
I accept that, but this is going to play out even further now.
Comment on this
I am intrigued by the witnesses' perspective, given they have no proof to contradict what Aramark is saying.
Comment on this
I suppose there is the word of people who were involved in asking for it at the time.
Comment on this
I have a question for Mr. Gunning. Has the board ever considered any other legal avenues to compel BAM to increase its workforce on-site?
Comment on this
The plain answer is that under the contract, there is no lever we can apply.
Comment on this
In the contract. What about outside the contract?
Comment on this
We have done many things. We have been in an alternative-----
Comment on this
It is a specific question. Has the board considered-----
Comment on this
Has it sought legal action?
Comment on this
I will tell the Deputy exactly what we did. I think it was in 2021 or 2022. BAM approached us for some cash flow funding, which is in addition to the normal. We provided, I think, some €20 million on the condition that BAM would increase its resources over a particular period of time. Once we came to the end of that period, BAM had not increased its resources, and we backed out of that particular piece of cash flow funding. We have done a number of initiatives to try to advance this particular issue, but they have not worked.
Comment on this
I asked a direct question. Has the board sought other external legal avenues to compel-----
Comment on this
I do not believe there is a legal basis for us to do this. That is my point. Within the contract, we do not think there is a legal basis for us to do this.
Comment on this
That cash flow request from BAM to the board-----
Comment on this
It was a without prejudice, separate item under a different-----
Comment on this
Was it part of the contract?
Comment on this
No, it was not. It was outside the contract.
Comment on this
Why would the board go outside the contract?
Comment on this
BAM approached us. We said that we could provide some funding, but it would be done on the basis that it needed to deliver on these aspects.
Comment on this
How much of that €20 million was paid?
Comment on this
It was funding that was provided, and when BAM did not deliver on its commitment, it was withdrawn.
Comment on this
That is fine. From the perspective of the Department, have there been any conversations between Mr. Quinn and the Minister or anybody else at senior level with regard to considering further legal avenues to compel BAM to increase its workforce on-site?
Comment on this
The Minister and all of the officials in the Department are hugely frustrated, as are Mr. Gunning and the development board members. In relation to that, the Minister and the Department are not a party to the contract. The development board is the aegis body responsible for that, so there is no legal mechanism for the Minister to insert herself into that contract.
Comment on this
No conversations have happened.
Comment on this
On what grounds? Similar to what Mr. Gunning said, the Minister does not have a contract with BAM, so there are no grounds for her to take any case to BAM. I am not sure, and there are plenty of other people with legal degrees who might have an opinion, but we are not aware of any legal mechanisms in this regard.
Comment on this
I want to go back to Aramark. In relation to the €30,000, we went through it, and went over and back. Have any other random companies given CHI donations like Aramark did?
Comment on this
There is nothing in emails and nobody has been speaking about it.
Comment on this
Definitely not. It is very unusual. I have never heard before that a company would ask somebody for €30,000. Is Aramark employed in the hospital?
Comment on this
It has a contract to provide restaurant concession services in Crumlin.
Comment on this
Does it have anything in the new CHI hospital?
Comment on this
No, it did not win the tender for the new hospital.
Comment on this
How long has it had the contract in Crumlin?
Comment on this
To go back to the deficit that my colleague, Deputy Joanna Byrne, asked about, it was €8 million in 2024 and a similar amount in 2023. What was the exact amount of the deficit in 2023?
Comment on this
Deputy Byrne discussed the situation in 2025. What was the deficit for 2025?
Comment on this
We have not finalised our financial statements for 2025, but it looks like a break-even.
Comment on this
CHI will not have a deficit in 2025.
Comment on this
But it will have one again in 2026.
Comment on this
If CHI does not get enough in the budget, it will have a deficit.
Comment on this
I want to ask about the equipment. Am I correct that all the hospitals that CHI is over at the moment will be amalgamating and going into the new hospital?
Comment on this
What happens to all of the old equipment?
Comment on this
We are bringing a small amount of equipment with us. Some of it is end-of-life, which will be disposed of, some will be sold and some will be donated to charity.
Comment on this
I read an article recently about radiography. Is there something wrong with the machines? Is it correct that 80% of them are beyond their lifespan?
Comment on this
That is for radiotherapy within CHI. St. Luke's Hospital provides radiotherapy for children if they require it. We are not aware of that. St. Luke's has not escalated any issues to us to date regarding issues with equipment. Once we move, we will continue to provide radiotherapy at St. Luke's with our clinical, nursing and anaesthetic staff, and with the oncology team to support that. We are not aware of that.
Comment on this
I understand there are plans to close ten Child and Adolescent Mental Health Service beds later this year at St. Vincent's Hospital in Fairview, and plans to open ten CAMHS beds in Linn Dara, as well as ten beds in the National Children's Hospital. If this is the case, we will have fewer CAMHS beds available in Dublin at the end of this year. Is that correct?
Comment on this
CAMHS services are under the HSE, so I will defer to my colleague.
Comment on this
Given the Government's mental health strategy that there would be 100 beds, and we are currently only at 50, is it counterproductive that the HSE is going to close beds?
Comment on this
The plan for the Dublin and midlands region is to reopen the 11 beds that are currently closed in Linn Dara, which is a purpose-built unit. On top of that, there are 20 beds in the new children's hospital that will be opened.
Comment on this
Twenty beds are being opened in the children's hospital.
Comment on this
That is on a phased basis. Initially, it will be seven beds, and we will then phase it in based on the recruitment process. Regarding the beds in Fairview, a decision has been taken by the Dublin north-east area to close those, but there is a plan that this would work in tandem with the reopening of the beds in Linn Dara. There would still be an increase in the number of beds, by one initially, and by an increased number of beds coming through.
Comment on this
One bed is not much of an increase.
Comment on this
There will be, once we get into the new children's hospital.
Comment on this
There was a call in the strategy for 100 beds. The Government is saying it is going to increase by 100.
Comment on this
Yes, and that is something that has been worked on through the system, but-----
Comment on this
However, it will come in on a phased basis. Staffing is a major challenge as part of that, but there are beds that will open as we go along.
Comment on this
Okay. I will go back to the Comptroller and Auditor General, please. In terms of efficiency of expenditure and safeguarding our public purse and ensuring we do get value for money, does the Comptroller and Auditor General have an opinion on the Irish procurement law that would benefit from being able to take into account past poor performance of those who have tendered for contracts, as in BAM?
Comment on this
First and foremost, it is a legal issue. It is secondarily a policy issue, and I cannot comment-----
Comment on this
Yes, but I cannot comment on policy per se.
Comment on this
In fairness to BAM, it has had a significant number of projects from across Government Departments and there are very many projects where it delivers on time and on budget. If you like, in the round, we would have to look at its performance. The other matter is that a contractor supplying a Government Department or public body is entitled to avail of the provisions of the contract and is entitled to make claims if it is due them. It has to be able to make them stand up, of course. The matter is not resolved, therefore, either for or against BAM in all of those cases.
Comment on this
Does the State not have a say in relation to the timeframe it has taken for BAM to build the hospital? Was there no timeframe put in place whenever BAM took on the contract that it would have-----
Comment on this
There certainly was a timeframe envisaged.
Comment on this
Was the State not able to hold a court case against BAM because it has not built the building in the timeframe that was allocated?
Comment on this
The contract completion date was originally August 2022. Due to Covid and other things, the contract completion date was then December 2022. As I said earlier, that is 41 months ago. The remedy in the contract for the State is liquidated damages. The liquidated damages in terms of what the State would be entitled to seek to enforce against the contractor would be of the order of €40 million for that delay.
Comment on this
That is something that will happen when we get to the end and the final account and all these matters come to light at that particular time.
Comment on this
Therefore, the State is entitled to get €40 million back from BAM?
Comment on this
My opinion will be that it should be very much intending to enforce or seek to enforce that remedy and entitlement against the contractor.
Comment on this
I have two questions, the first of which is in relation to the Christmas party. What was the final figure for the Christmas party?
Comment on this
In terms of staffing of the new CHI hospital - I do not know if it is the CHI or the Department of Health - are the witnesses confident that it will have adequate staffing to ensure that, once we are fully in occupation, it is staffed to as high a standard as possible? Do the witnesses envisage difficulty in staffing?
Comment on this
I will recruit every staff member that I am given approval for, just to reassure the committee. In relation to phase 0, 50% have already gone through the end of the recruitment process and are at the point of being given their dates and the remaining 50% are in train. It is always dependent on supply. We do know there are people waiting to come home to work in the new children's hospital. We are doing a lot of work through our own networks to attract people back to this amazing building, which will bring all of the paediatric expertise under one roof.
Comment on this
I thank Ms Nugent very much. That concludes our meeting. I thank the chief executive and her officials from Children's Hospital Ireland for attending today. I also thank the officials from the National Paediatric Hospital Development Board, the Department of Health and the HSE, and the Comptroller and Auditor General, as always, and his staff for their attendance once again. Is it agreed that the clerk will seek any follow-up information and carry out any agreed actions arising from the meeting? Agreed.
The committee will meet next Thursday, 7 May with the National Oil Reserves Agency to discuss its financial statements 2024. The meeting stands adjourned.