I suggest there really is something surreal about the way the Minister for Housing, Planning and Local Government is trying to explain away what can best be described as an existential crisis across the public health service. Those in Fine Gael pride themselves on their management skills, efficiency and financial prudence, yet they are trying to justify what has been, in the period Fine Gael has been in office with three different Ministers for Health, namely, James Reilly, Leo Varadkar and Simon Harris, an absolutely extraordinary tale of failure and crisis.

GPs are protesting outside Leinster House as we speak over the crisis in general practice. There is a national nurses' strike and an ambulance strike. There is a persistent and unprecedented trolley crisis and there are hundreds of thousands of people on hospital waiting lists. There is a crisis in our mental health service where the child and adolescent mental health service, CAMHS, is 50% understaffed, there has been the scandal around CervicalCheck, and there are persistent overruns in the health budget running to hundreds of millions of euro. The cherry on top of all of this is the absolute disaster of the national children's hospital. When it was first touted, the national children's hospital was going to cost just over €400 million, but now the bill has reached €1.4 billion or €1.7 billion all in. Even by the Government's estimate, it is a €1 billion increase in the cost of the national children's hospital. Are we seriously supposed to believe the Government when it says that this is not really its fault and it will get to the bottom of the matter, that it is in charge of things?

To add insult to injury, much of this is being batted off to PwC to find answers. This is PwC which worked for BAM, the contractor at the centre of this controversy, auditing its accounts for nine years, for which BAM paid it at least €34 million. BAM is a contractor with a history of massive overruns in Holland, Britain and Ireland. Now the company which audited them are apparently the people who will get to the bottom of the scandal of the national children's hospital. It beggars belief.

Why does the Minister try to explain away this €1 billion cost overrun, that is, €1 billion which will go into the hands of building contractors, but the Government digs in its heels against the nurses and says the nurses will not get a cent? The Government says it is okay, that it can explain away an extra €1 billion to building contractors but it cannot pay the nurses, the people who hold together what is left of the health service. It digs in its heels and refuses to engage with them seriously. The Government has made a mess of the health service under three successive Ministers. Why does the Government not just give it up and accept that it failed?

I thank the Deputy for the question. Of course we have challenges in health, but that is why we are spending more money in health than we ever have.

It is not being spent on health. It is going on the hospital.

Each year we have sought to increase the budget for health, both current and capital funding, and where additional resources have been made available, health has been prioritised. I have been part of the negotiations where we have discussed increases in budgets. The cost overrun here is €450 million above what was profiled in the initial outline in 2017. About €320 million of that is for construction and €50 million is towards VAT. The rest is for equipment leasing, design teams and those types of things. That money must be spent to deliver this hospital.

It is wrong to conflate this with the issue of the nurses for several reasons. It is not true to say that nurses are not getting pay increases under the public service pay agreement. Changes are happening as a result of last year's review into issues around recruitment and retention. The challenges in the public sector go beyond nurses. The public service pay agreement is in place across the unions to ensure that we can restore losses in salary that were inflicted as a result of the crisis in a way that we do not step back into another crisis and have to cut salaries again. We must do everything in a sustainable way.

Let me be clear about the importance of the delivery of this hospital. That will cost money. We will get to the root of how these costs went from the initial outline for phase 2 announced in 2017-----

There are no landing pads. There is no access.

-----and the figures that were brought to the Minister in November and then to the Cabinet for decision in December, and what exactly happened in that process. PwC will work in tandem with the Government in doing that. I say in tandem because the Minister for Health, Deputy Harris, has been at the joint committee all morning answering questions on this. The Minister for Public Expenditure and Reform, Deputy Donohoe, has also taken questions on the matter, as has the Taoiseach in the Dáil. Officials were before joint committees last week where they took questions. A process is in place where questions about what happened are being answered, but we also have to do a deeper dive, and PwC will do that.

A deeper dive.

Members will have seen the terms of reference of what it has been asked to deliver, which we will have by March, and we will go on from there. It is very important that we get to the facts of the matter. It is very important that we all understand that we need to build this children's hospital-----

It is in the wrong place.

-----and that we are going ahead with this because of the important improvement it will bring to the health system, which needs those improvements in facilities to ensure that when parents have sick children, they are given the most appropriate care possible in the right environment. That is what the children's hospital is about. It will stand there for more than 100 years. It is incredibly important that we get it delivered now and that, in delivering it, using PwC's work, we find cost controls and savings where we can as we go to completion in 2022.

It is a deeper dive down the hole the Government has dug itself.

Who holds the public health service together? It is the nurses and the midwives, the ambulance drivers, and the GPs. The Government will not speak to the INMO about the issues that have brought its members out on strike, it will not recognise the National Association of General Practitioners, NAGP, the representative group of the general practitioners, and it refused to talk to the National Ambulance Service Representative Association, NASRA, branch of the Psychiatric Nurses Association which is involved in an industrial dispute in the ambulance service. It will not speak to them. It will not give a cent to the people who hold the health service together but it will pay €1 billion over and above the original estimate announced by the then Minister, Deputy Reilly, at St. James's which was €485 million. It is now €1.4 billion under this Government's watch, and we will fork it out, and it will probably go higher.

According to a meme I saw recently, the tallest building in the world cost €1.7 billion, which is about the cost of the national children's hospital. It is shocking, but while the Government is willing to give money to these builders, it will not even talk to the people who hold the health service together, the nurses and midwives, GPs and ambulance drivers. It is shocking double standards, typical of Fine Gael. Its last little claim for credibility, that it could manage things in a prudent financial way, has now been exposed. It has made an absolute dog's dinner of this key infrastructural project and no apologising or explaining can justify it.

I thank the Deputy for his supplementary question. There are nurses at work today. I know that the nurses who will strike tomorrow do not take that action lightly, given their commitment to and care for the patients they look after. However, we as a Government must bear in mind the potential consequences were we not to stick to the public service pay agreement. Within that agreement, there will be changes and improvements in conditions and increases in salaries for people in the health sector. Additional increases will kick in from 1 March. It is not true that things are not being done to help improve the position of public sector workers, because they are. That is why we are seeing an increase in the number of people working in the public sector in recent years.

The Deputy referred to figures from six years ago when we first started speaking of this children's hospital. That it was six years speaks to the delay which has taken place and why we do not want to delay further. The economy has radically transformed in the past six years, no thanks to Deputy Boyd Barrett, of course, or any position that he has taken on any budgetary decision that this Government had to make to restore the public finances. In relation to the public service pay agreement we are trying to keep public finances on a sustainable footing, not least because of potential dangers relating to Brexit. In this significant cost overrun, it is important that we get to the actual facts of the matter. The €1 billion overrun is not a fact. The Deputy can jump up and down about it but we need to get to the actual facts, then understand what lessons are to be learned and what decisions the Government can take on accountability and the additional cost savings that can be found between now and the completion of the hospital in 2022.