Dáil Éireann Debate, Thursday - 29 January 2026
449. Deputy Carol Nolan asked the Minister for Health the actions implemented following the audit findings on capital project overruns, particularly regarding major infrastructure developments; and if she will make a statement on the matter. [7266/26]
View answerThis response is to the following clarified Parliamentary Question: To ask the Minister for Health what actions are implemented by her department or the HSE in instances where the Comptroller and Auditor General identifies capital project overruns in the HSE, particularly regarding major infrastructure developments; and if she will make a statement on the matter.
My Department is not aware of any specific findings or commentary issued by the Comptroller and Auditor General (C&AG) in relation to the HSE Annual Financial Statements or associated C&AG audit reports that directly addresses budget or schedule overruns on HSE capital projects.
Nevertheless, the Department and the HSE are acutely aware of the increased and appropriate focus on ensuring value for money for taxpayers in the delivery of capital projects. The HSE delivers hundreds of capital projects on time and within budget every year, with projects ranging from several hundred thousand euros to tens of millions of euros.
As with all publicly funded bodies, the HSE adheres to strict National and EU public procurement procedures governed by EC Directive 2014/24/EU and the National Guidelines “Public Procurement Guidelines – Competitive Process” when undertaking any capital build works. In addition, the HSE complies with the Department of Public Expenditure, Infrastructure, Public Service Reform and Digitalisation’s Capital Works Management Framework (CWMF). This CWMF is an integrated set of contract forms, guidance and standards that are available for the delivery of capital build public works.
Under the Capital Works Management Framework, the Contract figure is a not fixed price; provision is made in the contract for claims where there may be scope changes to the project, service delivery, legislative or socioeconomic issues which may impact on the delivery timelines and the outturn cost of the project, such as inflation, poor weather events, etc.
Given the above, the HSE accounts for variation in individual contract costs using programme-level contingency to support project budgets. Contingency allows for appropriate contract cost increases and ensures projects remain within approved budgets. The HSE’s capital programme has delivered within the vote allocated capital budget each year.
In recent years the impact of unprecedented construction inflation will have affected some capital projects, but this is not unique to the health sector. Similarly, some older projects were significantly impacted by Britain’s exit from the European Union (Brexit) and the onset of the global Covid-19 pandemic in March 2020 and the subsequent impacts on supply chains and site closures.
Lessons are learned from every capital development and some of the main learnings the HSE has applied include:
• the use of separate enabling works contracts ahead of the main construction works to de-risk the main works;
• enhanced site presence throughout the construction period to mitigate risks and provide project assurance;
• greater application of optimism bias in line with the requirements of the Infrastructure Guidelines to provide an external viewpoint to cost and budget development and to ensure that estimated values of costs are realistic and reliable.
The Department and the HSE also recognise the importance of the application of lessons learned on the National Children’s Hospital Ireland project being delivered by the National Paediatric Hospital Development Board. The NPHDB has applied the recommendations from the 2019 PwC Independent Review of the NCH cost escalation, and these have also been considered by the HSE in its capital developments.
As the Department of Health and the HSE continue to work collaboratively to deliver the National Development Plan for Health (2026–2030) to modernise Ireland’s health infrastructure and improve service delivery, there will be a continued focus on ensuring the delivery of capital projects within budget in as expedient a manner as possible, leveraging the lessons learned on previous projects.
While the HSE has expanded capacity and put in place multi-supplier frameworks to support the delivery of additional health infrastructure, I and my Department have emphasised the importance of ensuring that any reforms or flexibilities introduced to accelerate infrastructure delivery apply equally to the health sector, for the benefit of patients and taxpayers.
