Everybody in this House wants to see the national children's hospital completed on time and within budget. As we know, the project has gone through many trials and tribulations. The Mater site did not get planning permission and then the site at St. James' Hospital site was identified by the then Minister for Health, Senator James Reilly. When that was announced the cost was estimated at around €485 million. In 2016, after planning permission had been sanctioned, the cost was estimated at about €650 million. We are now told that the projected cost is €1.4 billion. This is despite the fact that on 27 September, and the week before that in reply to a parliamentary question asked by Deputy Cowen, the Minister for Health, Deputy Harris, said it would be about €983 million. In the space of about six weeks it has apparently gone from less than €1 billion to €1.4 billion, which is extraordinary stuff.

The management of major capital projects is critically important. We have a Minister for Health, we have a Cabinet committee on health, and yet the recently projected cost of €1.4 billion seems to have caught everybody by surprise, including the Taoiseach. It has an impact on other projects within the health service and indeed across the public service in general. The Secretary General of the Department of Health has met the hospital group with a view to reining in costs. At an event in recent days, the Taoiseach himself said that the cost has gone beyond all expectations and beyond what anybody anticipated, and that it would mean other projects or services would be scratched or certainly delayed. We have recently seen a report from the Health Information and Quality Authority, HIQA, which comments very critically on clapped-out equipment in hospitals throughout the country. It refers to 12 year old equipment at the Mercy University Hospital in Cork. It mentions St. Michael's Hospital, Dún Laoghaire.

Breast cancer equipment in Cork University Hospital, which is a centre of excellence, is out of date. The ballooning costs of the children's hospital and the nature of how this has come into the public domain suggests that many of these requirements of hospitals throughout the country will not now be met because of the impact of the soaring cost of the children's hospital and the lack of any controls put in place.

Why the absence of transparency on this? Deputy Cowen has been pursuing this for quite some time, as indeed have many journalists such as Mr. Paul Cullen. Will the Taoiseach confirm that the up-to-date projected cost, including IT and fit-out costs, is €1.4 billion? Is that the upper limit of the cost of the hospital? How did this overrun occur? Were there deficiencies at tender stage? Will the Taoiseach outline to the House what other projects will be delayed or cancelled as a result of the overrun on the children's hospital, and will he specify that in terms of Health and other Departments? Will the Government stop stonewalling on this and provide a detailed and transparent presentation on this entire issue because the public is entitled to know?

I think we all agree that the country's new children's hospital is a project that we all support. We all want to see it built, if not on time and maybe even not ahead of schedule-----

It is still in the wrong place.

-----and open to the children of Ireland to receive the best quality paediatric healthcare in the world, which is what I believe they deserve. This project is the biggest single investment in healthcare in our history and it allows three rather old hospitals at Crumlin, Temple Street and Tallaght to be replaced by a new state-of-the-art hospital. It will be a hospital with all the best equipment: five MRI machines, ten theatres for children who need operations, outpatient departments, and single rooms for every child to reduce the risk of infection, give them the privacy they deserve, and ensure that their parents can stay with them at night if need be. This is going from antiquated infrastructure that is not up to standard to what will be, I believe, one of the best children's hospitals in the world when it opens.

We are getting there. Deputy Micheál Martin is right to say that this project has a long history. The fact that planning permission was not secured at the Mater caused cost and delays. We now have planning permission secured for the site beside St. James's.

The children's hospital itself comes into existence on 1 January 2019. The three hospitals will be merged under a single governance structure, which is getting right the hospitals' merger across the three sites before they come together in the one building.

We know all this.

The satellite centre at Connolly Hospital is almost finished. I visited it yesterday. It will be open to patients next summer. Tallaght is very well advanced. The enabling works, the site works and the phase A works are now close to completion at the St. James's site.

It has a dedicated board, a paediatric hospital development board, which was set up with the express purpose of making sure that this project was driven by expertise, people who knew how to do big projects. The board is made up of people who have experience in this area and has a CEO who is experienced in this area.

This morning, Cabinet met and discussed the issue of the escalating costs. We agreed to accept the new overall cost, which is €1.433 billion. That represents a €450 million increase on what we had projected in April 2017. Of that, €319 million is made up of increased constructions, €50 million is VAT and the remainder relates to staff planning, design teams, risk contingency and the management equipment service to make sure that the hospital is properly equipped.

There will be further investigations as to how these costs escalated by so much since April last year, and the National Paediatric Hospital Development Board will be available to brief members of the Committee of Public Accounts and of the Oireachtas joint committee to give them any information that they want about this project and about the reasons behind the escalating costs.

The Taoiseach's confirmation is incredible. On 27 September, with great gusto, the Minister stated, "We are making a massive €1 billion investment in children's health, which is right and proper". Today is 18 December.

The cost of the hospital has increased by approximately €400 million in the space of weeks. Did anybody tell the Minister, Deputy Harris, on or around 30 September that the figure he gave to the House could be €400 million out? It is beyond comprehension. Who is reporting to the Minister, the Cabinet committee on health and the Minister for Public Expenditure and Reform, Deputy Donohoe, on this matter? The Minister, Deputy Harris, is quite stoic about this. I have to admire his poker face. However, there must have been some behind the scenes engagement on the increase. The Taoiseach stated that the matter would be investigated. Who is responsible for this and who is accountable to whom? Ultimately, the Minister is accountable to the committee and should appear before it, along with the hospital board. It is extraordinary that in the space of six weeks the estimated cost has gone from less than €1 billion to €1.433 billion.

Deputy Martin has overshot the runway.

Was there confidence among the members of the Cabinet during its deliberations this morning that the figure of €1.433 billion is the upper limit? Does it include the costs of an information technology system and the fit-out of the hospital?

The board is responsible for the project and accountable to the Minister. Of course, the Minister and the Government are accountable to the Oireachtas. As I stated earlier, the board is happy to receive a delegation from or meet the Oireachtas Joint Committee on Health and the Committee of Public Accounts to give further information on the reason for the cost escalation. I repeat that this is the biggest ever single investment in the health of our children.

Some €400 million is a lot of money.

It may turn out to be one of the most expensive children's hospitals in the world but it will also be one of the best. Its first elements, such as the satellite centre in Blanchardstown, will open to patients next year, while the centre in Tallaght will open the year after and the main campus will open in 2022. Work is very much under way. This project is real. The hospitals will be under a single governance structure as early as January 2019.

Is the Cabinet confident this figure is the upper limit?

The cost of €1.433 billion is-----

A cost of €1.4 billion to start with.

-----the gross or agreed maximum price, which contains assumptions on tender price indexes and the cost of inflation which may cause the cost to increase. I will not pretend otherwise.

Has the Cabinet been so advised?

Yes.

The Cabinet has been advised that that is not the upper limit.

It may be the upper limit but it is based on certain contingencies.

The Taoiseach is indicating the final cost could be higher and the Cabinet has been advised of that.

It is possible.