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Will its 380 beds be enough when children’s hospital finally opens at stratospheric cost?

Facility to be among the most expensive of its kind worldwide, when Switzerland has built larger hospital in Berne for €700m

The news from Government that the new children’s hospital is to cost an additional €500 million will come as a surprise to no one.

For years now, the question has not been whether the budget for the hospital will exceed €2 billion, but by how much. That question was dodged as part of a deliberate strategy to ensure there would be no going back at the point when the bad news ultimately emerged.

The new “final” figure of €2.24 billion makes the striking building under construction at St James’s Hospital in Dublin one of the most expensive hospital builds in the world. Despite multiple assurances from Ministers on Tuesday, there is no guarantee the final cost will not be even higher.

After all, why should anyone believe anything about a project that was supposed to cost €250 million, then €450 million, then €750 million, then €1.4 billion and then €1.7 billion before reaching its current stratospheric level?

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Of more interest to the public now will be the date when the behemoth finally opens its door, given the years of delay and sliding deadlines. The latest Government statement says it “could” open in mid-2025.

That will probably be too late to impress voters going to the polls in the next general election, but at least Ministers will be able to point to a finished building on the South Circular Road that is on the point of accepting patients.

The timing could indeed be a blessing, given the inevitable teething problems that will arise, never mind the sceptical focus from the public and the media. The Republic’s population has soared since the project was first proposed more than two decades ago, so it is questionable whether the new hospital is big enough to meet demand.

With every child inpatient to be accommodated in their own room, there is no denying the hospital marks a big step-up in quality from the existing children’s hospitals it will replace. But are its 380 beds enough? In 2018, for example, there were 334 beds in the three Dublin children’s hospitals — not hugely different from what is planned.

Transferring staff successfully from Crumlin and Temple Street children’s hospital will pose a huge challenge, given the radically different cultures prevailing in the two institutions and the inevitable rivalries that exist in some areas. And while the hospital should be an attractive place in which to work, staffing it will be difficult given the ratios required to service single-occupancy rooms and the cost of renting in central Dublin.

There is talk now of learning lessons from the whole sorry process. The first cost estimate for this project seemed to be written on the back of an envelope. It failed to factor in the extra costs caused by protracted planning processes and a tight, brownfield site. The design is pleasant but perhaps over-elaborate — supposedly hyperexpensive Switzerland has just built a 532-bed, 18-storey hospital in Berne for €700 million.

Other countries have had their problems with projects of this size. In Sweden, for example, rebuilding the famous Karolinska hospital in Stockholm is costing twice what was planned.

Megaprojects tend to suck in available resources, creating their own inflation, and still they don’t come in on budget and in time — planners of future transport projects in Dublin, take note.

The new children’s hospital has swallowed a huge proportion of capital funding for health projects over the past decade, delaying the planned rebuilding of the National Maternity Hospital and many other much-needed developments.

But at least, even with the bad news around cost, there is an end in sight.

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