Between 2011 and 2015, we were fighting for our survival as a country. Every major project was checked and scrutinised to control costs and deliver value for the people's money. This Fine Gael Government seems to have adopted a Celtic Tiger attitude towards overspending. Just ten months after telling us that the cost of the national children's hospital on the St. James's site was to be €938 million, Fine Gael is now telling us that the final cost could be €1.73 billion or more, nearly double the previous cost. As the Minister for Health, Deputy Harris, has said, we are at the point of no return. There is a vast crater in St. James's, and having dug themselves into this hole, the Government seems to have no choice but to keep digging to try to find a way out.

However, the Government's story does not stand up. We have been told that the civil servant appointed to the National Paediatric Hospital Development Board was there in a personal capacity. That is not true. The Department of Finance Circular 12/2010 sets out in detail that civil servants appointed to non-commercial boards must inform if a matter of serious concern arises. It is a requirement for civil servants on boards to ensure that their concerns are first raised at the board, noted in the minutes and actions agreed. The circular is crystal clear:

The Minister must be notified without delay where:

(i) There are serious weakness in controls that have not been addressed despite being drawn to the attention of the board or the Chairman;

(ii) There is a significant strategic or reputational risk to the body that is not being addressed.

A Government circular overrides any confidentiality imposed by a board itself. How is it possible that this did not occur in one of the State's largest developments? How is it plausible that the Minister for Public Expenditure and Reform was unaware of cost overruns until November last, as he has asserted? The Minister for Health, Deputy Harris, has said that he was aware of some of the costs as early as last August. Did it really take another three months for the Minister, Deputy Donohoe, to be informed? Either he did not know what was going on and did nothing or else he did not know what was going on until November. It is unimaginable that the Minister for Public Expenditure and Reform was kept in complete ignorance of public expenditure.

Surely as the Minister overseeing public spending, he would have received monthly, if not weekly, updates on the progress of a project of this scale and significance. Why apparently did it take three months for the Minister for Health to inform the Minister for Public Expenditure and Reform about major cost overruns in the flagship programme of the Department of Health? How did the Government present a budget to this House at the end of last year that is already €100 million short in its capital programme?

Thanks very much for the question on the important issue of the children's hospital. It is a project about which people have been talking since the 1960s. If one goes back in the Dáil record-----

It is all backwards.

Answer the question.

-----the first time it was proposed was in 1962. There have been numerous failed attempts to deliver the project. The Government will deliver it.

So the cost is irrelevant.

It is just as well the Government is bringing-----

It is already under construction.

On the wrong site.

The satellite centre in Blanchardstown is built and will open to patients this year, followed by the centre in Tallaght next year and the main hospital in 2023. Decades of promises will actually be delivered on by the Government, something that the children of Ireland need and deserve. I appreciate that it is right and appropriate to talk about the cost and the cost overruns, but we should never forget the value of the project.

Where is the maternity hospital?

Please, Deputies. The Taoiseach needs to be allowed to answer.

There will be 380 individual rooms for children who are sick-----

Places for patients also. That is great.

-----with space for their parents to stay overnight, proper infection control which we do not have now in hospitals-----

We know all of this information.

-----a 60-bed ICU for children who are very sick or need major surgery-----

They cannot get into it.

No computers.

-----five MRI scanners and room for more-----

-----20 ultrasound scanners and 22 theatres.

I am sorry, but will Deputies show the Taoiseach the courtesy of allowing him to answer the question he has been asked?

He should answer it then.

He is not answering it.

He is falling into the hole.

Please allow the Taoiseach to answer.

He is falling into the hole again.

There will be 22 theatres where we now have 14.

He cannot get out of the hole.

There will be two cath labs, a 20% increase in inpatient capacity and a 25% increase in day capacity.

What about parking spaces?

Answer the question.

There will be a 50% increase in outpatient capacity. This is an enormous asset-----

We know.

A black hole.

-----and something that children need. I am very disturbed to hear Opposition Members suggesting the project should be suspended-----

Who said it should be?

Who said that?

-----because by suspending it-----

It should be.

Some of you have.

Please, Deputies.

By suspending it, it will be further delayed and cost even more.

I asked a question. I did not mention a suspension.

When did-----

I am very disturbed to hear those calls from some elements of the Opposition.

It is the biggest scandal in the country.

The Taoiseach is hoping the whole subject will go away.

To answer the Deputy's question-----

When did the Minister for Public Expenditure and Reform-----

A question was asked over here.

Let him answer.

Please, Deputies.

To answer the-----

Will the two Ministers be suspended?

All Government Deputies voted for it.

This is shameful.

To answer the Deputy's questions, the Minister for Health was first made aware of an issue surrounding rising costs at the national children's hospital in August. He did the right and appropriate thing.

Nothing from-----

The Taoiseach was made aware of-----

Can the Taoiseach answer reasonably?

He sought information, facts and figures before presenting the information to the Government.

Why did the Taoiseach not just say that?

When I found out about it in November, around the same time as the Minister for Public Expenditure and Reform, I responded in the same way as others in this House, first, with disbelief in struggling to believe how the price had gone up again.

Three months.

The Government was warned in advance.

Second, we did the appropriate thing which a Government should do, which was to reject it-----

You were told in August.

-----and to say, "Go back, negotiate with the companies, get the figure down, find out if we can reduce some of the specifications in the hospital to reduce the cost and find out if retendering was an option."

Why did it take three months?

The Government does not need PwC at all then.

All of those options were considered.

Three months.

Retendering would have delayed the project and probably saved nothing.

Why does the Government have PwC-----

Reducing the specifications of the project would have been a mistake because this is a 100-year project.

PwC has gone down the hole looking for it.

Negotiations were carried out with the companies to bring the figure down as much as was possible.

This is disastrous.

That is the figure that was presented to the Cabinet in December and approved by it.

More than €900 million.

Not an extra bed.

Was the Taoiseach asleep for this debate on 30 March 2017?

Please, Deputies.

We told the Government about this on 30 March.

Once upon a time Fine Gael was concerned about fiscal prudence and proper public financial management, but, clearly, no more. We all know the history and value of the project. We do not need to be lectured on it. The Taoiseach needs to address the questions put to him. He is not talking to someone who does not understand budgets. The notion that the Minister for Health was aware of a significant overrun from August and did not tell the Minister for Public Expenditure and Reform for three months-----

He should be fired.

Meanwhile, there was a "battle" going on in the national media about current expenditure overruns. An overrun of €600 million on the current side was a matter of "battles", but no one mentioned that, by the way, there was a €400 million or €500 million overrun on the capital side also. That no one even looked at this for months is not credible. The net point is that the Minister for Public Expenditure and Reform had his own man on the board with a responsibility, according to the Government's own circular, to report to him.

Did this happen, and if not, why?

It is important to clarify, once again, that the Minister for Health was first made aware of rising costs and escalating costs at the children's hospital project back in August.

In March 2017, we are told.

He kept them to himself.

He did the appropriate thing, which was to ask for all the facts and figures before going to Government with the issue.

It took him three months.

March 2017.

And after the budget was negotiated.

I have given the House an insight into the process.

Neither Minister is here.

It took several weeks - ten weeks, 12 weeks, three months or whatever it was - for that figure to be-----

Whatever it was - €100 million, €200 million.

Whatever - €600 million, €1 billion, €1.7 billion, whatever.

This is intolerable. We are supposed to show some level of mutual respect. If a Deputy asks the Taoiseach a question, at least let him give the reply. Has the Taoiseach finished?

I am happy to reply further.

Then the Taoiseach should give an answer.

As I stated earlier, the Minister for Health was informed of rising costs and escalating costs at the project back in August. He did the appropriate thing-----

He kept it to himself.

-----which was to look for facts and figures, to have it scrutinised and to drill down into it to see if the figures stacked up-----

During budget negotiations.

-----and to see if he could bring them down as much as possible and informed me and the Minister for Public Expenditure and Reform of this in November-----

After the budget was agreed.

Four months ago.

-----and the same scrutiny was then applied.

In terms of corporate governance, corporate governance has changed quite a lot since 2010. Corporate governance and corporate rules do not override Government circulars. If somebody is on a board, his or her fiduciary and legal responsibilities are to that board and the correct line of accountability is-----

Government circulars are not worth the paper they are written on.

It is not legally true.

It is not true.

-----from the chairman of that board to the line Minister, not individual board members acting on their own part.

The Ceann Comhairle said the response of the Opposition was intolerable. As somebody who sat on the Committee of Public Accounts Thursday last and listened to a complete litany of failure of governance, I find the Taoiseach's response intolerable but it is no doubt something we will return to later.

We should not need the nurses to take to the streets on strike, for only the second time in 100 years, to tell us that the health system is not safe. Prior to this strike action, which is being taken as a last resort, the nurses have repeatedly informed this Government and successive Governments, and the Minister for Health and his predecessors, including the Taoiseach, how precarious the situation was and remains given the absence of front-line staff. In August last, for example, the INMO figures showed that that month was the worst on record for overcrowding in hospitals across the country. Of course, we know the detrimental effects of this overcrowding. Dr. Fergal Hickey repeatedly tells us that, in any given year, 300 to 350 premature deaths are directly related to the time spent on a trolley. In response to these figures, the nurses took what action they could, stopping short of strike action at that point. They went out and protested. They were forced into this strike action. I give that background. Tomorrow, the GPs are going out on strike, telling us that their system is not working either.

My question is in the context of that background in Galway city where, in 2017, two theatres closed in Merlin Park. There was a high-level meeting in October following which we were told that serious action would be taken and modular theatres would be put in place. It is interesting that the two theatres were put out of action by rain. All the while, the Government is putting money into a rainy day fund, not for the health system, not for education or housing, but to bail out a financial crisis in the future.

Two theatres closed because of rain. I have a list here that I have no time to go into. This is where trust and confidence come into the system, as is the case with the children's hospital. Throughout 2018, other Deputies and I have repeatedly highlighted this. I was told in responses to questions that tender documents had gone out. I was told that contracts were to be signed. Here we are, in 2019, and the two theatres are still closed. The latest chapter in this saga is that a consultant has written to all Deputies in Galway in an unprecedented move on behalf of all his colleagues to tell us that the situation is exactly the same as it was in 2017. What has happened? When will the theatres be opened?

Almost one year ago the Taoiseach told me that he could not take a hands-on approach and that the people in charge were the Minister for Health and hospital management. One year later, there has been no progress whatsoever. It goes to the heart of the difficulty the Opposition has with the Taoiseach and his Government. There has been absolute spin and lack of trust in the answers. I want a clear answer today. What inquiries have been made by the Taoiseach or the Minister regarding the two theatres and when will they open?

The first issue the Deputy raised was the children's hospital. The terms of reference for the review by PricewaterhouseCoopers, PwC, into the escalation in costs are currently being revised.

More money for the accountants.

The review will deal with the accountability of relevant key parties, functions and roles and the prohibition on making any findings against individuals will be removed. It will establish the sequence of events in the cost increases experienced by the project, establish what was known, when and by whom, and cover the bodies, including the National Paediatric Hospital Development Board, NPHDB, its committees, the HSE and the Department of Health. The review will also be asked to identify any areas where potential cost savings or reductions, which are consistent with the applicable contractual undertakings, may be found.

Merlin Park University Hospital, MPUH, provides elective medical and surgical services, renal services and a haemodialysis unit, and two designated rehabilitation units, along with a number of specialist outpatient clinics. In September 2017, leaks developed in the roof of the building in the hospital that houses the two orthopaedic theatres. Managers temporarily suspended operations for one week to facilitate repairs. Following the deferral of elective orthopaedic procedures in 2017, the hospital facilitated the transfer of elective sessions to University Hospital Galway on a limited basis with the support of Merlin Park staff and eight orthopaedic elective beds. In addition, some minor procedures were undertaken in hospital one in Merlin Park and-----

That is not the question that was asked.

The Taoiseach must answer the question. That is a history lesson.

This is the question and the answer. In March 2018, remedial work facilitated the opening of one theatre in MPUH, which advised that it is working towards restoring the full elective orthopaedic service as quickly as possible. A tender process was recently undertaken regarding the provision of two modular theatres for orthopaedics on the MPUH site. A successful vendor was selected for the project and an enabling contract has been signed between the HSE and the modular provider. Contracts have been exchanged between both parties and are currently with the HSE national estates division. A planning application was submitted on 20 December 2018, and subject to a successful determination of that planning application, which I understand is outstanding, it is intended that the work will proceed as planned.

I wish the Taoiseach had addressed my question quicker and not given me a history lesson. I have all of the documentation here. I have raised this issue repeatedly. The Taoiseach is telling me that contract documents have been exchanged. During last year, I was told twice that they had been exchanged. We are now in receipt of a letter from the consultant orthopaedic surgeon telling us that 1,500 patients are waiting for complex joint replacements, spinal surgery, and foot, ankle and shoulder surgery, while the waiting list continues to expand exponentially. That is the situation; chronic and acute pain is being suffered by these patients, yet the Taoiseach stands there telling me that contract documents are going to be exchanged. At the very least I would have expected him to tell me what happened that they were not exchanged last February, which is when we were told they were being exchanged, and at the very least to learn from the children's hospital project and to give us the information having made the inquiries. Last year, the Taoiseach told me that he was not aware of the question and that I had not notified him. I notified him of today's question so that he would not come to the Chamber unprepared and he would have checked the situation. This is unacceptable in a city where the main hospital is creaking at the seams on a congested site, but with a 150-acre site available in Merlin Park. We are going piecemeal and piecemeal, and we cannot even provide modular theatres, which are not the answer. The answer is a new hospital. In the meantime, we would like a little bit of honesty about modular theatres.

There are a number of things to mention. An awful lot of people are waiting a very long time for orthopaedic operations and procedures, and, often, to see a specialist in the first place. It is important to acknowledge that the number of people waiting more than 12 weeks for operations and procedures, which is the Sláintecare target, is now at a four or five-year low. This includes hips and knees and other orthopaedic operations, so we are making a lot of progress in that area-----

Thanks to the people in Belfast for carrying out those operations.

-----but there is a long way to go yet in that regard.

On the MPUH issue, the Deputy will be aware that, very sadly and unfortunately, the Galway hospice planning application for Merlin Park was refused.

As such, Merlin Park as a solution for new hospital developments must be considered in the light of planning problems at the site where planning permission for the hospice has just been refused. To answer the Deputy's specific question, a vendor has been selected for the project and contracts have been exchanged between the parties.

Is it BAM?

It is with the HSE's national estates division in respect of legals. A planning application was submitted on 20 December 2018. Subject to it being successful, work will proceed as planned.