The exorbitant cost of the national children's hospital is going to have a serious impact on the delivery and progression of other projects over the next number of years, and that much has been confirmed by the Minister for Health and the Department. Despite the massive implications, nobody involved in the process appears to want to take any responsibility. It seems the Government has set its face against any statutory review by either the Comptroller and Auditor General, as was hinted at by one of the Tánaiste's ministerial colleagues recently, or any other State organ. The Secretary General of the Department of Public Expenditure and Reform, whose job it is to supervise procurement and public expenditure, is still refusing to appear before the Joint Committee on Health to account for his Department's role in the process. The Minister for Health, for his part, and the Department are hiding behind the review of the process being conducted by PricewaterhouseCoopers at a cost of €450,000 in taxpayer's money, to add insult to injury.

At a meeting of the Joint Committee on Health on 16 January, Mr. Tom Costello, chair of the board of the national children's hospital, said: "If we were to start again on a project of this scale and complexity we would adopt [exactly] the same procurement approach." That seems to be a head-in-the-sand approach.

No lessons have been learnt. Nothing is going to change and the taxpayer simply has to get on with it. What we need to know is what projects will be affected. At the Committee of Public Accounts this morning I put it to the Secretary General of the Department of Health, Mr. Jim Breslin, whether a number of projects, including the second cath lab for Waterford, are under consideration. That funding was promised to Waterford Oireachtas Members and regional Oireachtas Members. There is a raft of capital projects which we now understand are under consideration. We were told that money was guaranteed and yet today at the Committee of Public Accounts the Secretary General of the Department of Health said it had not been signed off on and it is under review. It is one of a number of capital projects that is under review by the Department. Other projects affected are the new MRI scanner at Midland Regional Hospital, Mullingar; the upgrade to wards in Cavan hospital; the national radiation oncology programme in the Tánaiste's county of Cork; and the second cath lab in Waterford. We need straight answers. Only a few minutes ago the Minister of State, Deputy John Halligan, said in my ear that the Minister had said the project was safe. Which is it? We had the Secretary General at the Committee of Public Accounts telling us it was under consideration and a local Minister of State saying the funding is secure. There will be victims and casualties as a result of the massive overrun. Services will be cut, capital projects may not go ahead and the Tánaiste must spell out very clearly to people across the State, either in Mullingar, Cork, Waterford or wherever else, which capital projects are under consideration and not signed off on and which are not.

The Minister for Health has made it very clear that he is committed to the second cath lab in Waterford. It is part of the service plan for 2019. The Taoiseach has said very clearly that the funding challenges in relation to the national children's hospital will not result in the cancellation of any commitments that have been made. In the nature of capital expenditure, as others in this House who have been involved in significant capital expenditure management linked to Government are aware, there may well be delays and space to ensure that the extra €100 million or so - half of which is in the Department of Health - that is linked to the increased cost of the national children's hospital this year, can be found by delays that may happen in relation to other big capital expenditure projects. We are spending billions of euro this year on capital expenditure. Capital expenditure is up by 25% on last year. I reassure people that we are not going to cancel other projects that have capital commitment, but the scheduling of payments for some of those projects that may be affected by means of enforced delays through planning or permitting systems or other delays will be looked at in order to create the space and the funding to facilitate the increased cost of the national children's hospital.

In relation to the PwC review, the Government is committed to doing an independent and thorough investigation into the process and how the estimated expenditure of delivering the hospital increased as it did, so that we can learn lessons from that to make sure that when we spend a committed €116 billion of capital expenditure over the next ten years we ensure that projects are kept within budget and that we do it in a way that is transparent and open. When PwC finalises its report it will be published so that we learn lessons from it. Many public projects are coming in on time and within budget. The national children's hospital is a project that we need to learn lessons from and that is the whole point of getting an independent piece of professional work done, which I accept costs money, but in the context of the overall cost of this project and the potential savings from lessons learnt, we hope that it will be money well spent.

I cannot accept the responses to the questions I put. The sum of €50 million alone will come from the capital expenditure in health this year as a consequence of the overrun. The Tánaiste is missing the point that we were informed - Deputy Howlin and other Oireachtas Members in the south east - that the money was already committed to and was there. Now we are being told that the project could be delayed and it is mixed up with a range of other health projects which may not be delivered on time.

Nobody told the Deputies it would be delayed. The Deputy should not mislead the House.

It is being reviewed.

I did not mislead the House. I put the question myself to the Secretary General of the Department at the Committee of Public Accounts.

The Deputy said there would be a delay.

The Tánaiste will get a chance to come back. He is saying one thing and the head of the Department of Health is saying something else. History teaches me that I do not know who to believe on this issue. We have been fighting for the second cath lab for so long.

In relation to the overspend, here is what we also learnt at the Committee of Public Accounts today.

I thank the Deputy. His time is up.

On top of the €1.4 billion there will now be an additional €75 million in ICT costs, an additional €52 million for electronic records, an additional €86 million for children's health integration, and an additional €40 million for the Mater campus. The entire project is based on the potential of getting €150 million from the private sector from philanthropy, which is not secure. We do not know yet what the overall cost will be.

The Deputy should please conclude. His time is up.

What we know is that some capital projects are under review and the Tánaiste and the Minister for Health are not being entirely clear with people as to which projects they are and what projects will be delayed or scrapped. The Tánaiste needs to be very clear with people, not just in the south east but across the State.

Could I be very clear? The Deputy's time is up.

Nobody is trying to hide anything. I am looking at my speaking note on the national children's hospital, which has not changed in a week, and it talks about the costs of investment in ICT, the roll-out of electronic health recording through new ICT capital programmes, the kind of thing Deputy Cullinane is now supposedly revealing as some new piece of data that we do not have. This is information that has been in the public domain.

The issue is around the scheduling of capital expenditure to take account of the increased costs of the national children's hospital, to ensure that projects that have been committed to are followed through on. The Minister for Health's commitment to the second cath lab as part of the 2019 service plan is there. I was not at the meeting this morning but what I suspect is that Deputy Cullinane was not told that the second cath lab in Waterford is going to be delayed. He was told that the funding is in a process of review.

It is not secure.

A process of review.

I was not at the meeting. All I can say is that the Government is committed to the second cath lab. Many people in this House and elsewhere have worked hard on that, from the Minister of State, Deputy Halligan, to Senator Coffey, Deputy Cullinane and others.

The Tánaiste’s time is up.

They have raised this issue repeatedly. The Government's commitment to it is firm.

But it is being reviewed.

It is not secure.