Dáil Éireann Debate, Monday - 9 September 2024
1706. Deputy Catherine Murphy asked the Minister for Health for an update in respect of the development of a new national maternity hospital; the amount expended on the project to date; if he has engaged consultancy firms on the development of the project; and, if so, the amount expended to date on same. [34385/24]
Amharc ar fhreagraI set out a project update below.
In July 2023 Cabinet gave its approval for the new National Maternity Hospital (NMH) at Elm Park, co-located with St Vincent’s University Hospital (SVUH), to proceed to tender for a main contractor to construct the new hospital in line with EU and national requirements.
The main tender process, which began in September 2023, is programmed to run over a period of c.18 months. The steps in this process include:
Contractor pre-qualification process which started in September 2023
• Tender issue to the pre-qualified contractors which started in April 2024
• Receipt of tender responses. These responses are scheduled for return in Q4 2024
• Evaluation of returned tenders in line with the award criteria
• Updating of the final business case to incorporate market responses
• Government consent to proceed to sign contracts
The budget for the main construction works is subject to the outcome of this tender process and the subsequent updating of the final business case.
In parallel to the tender and procurement process, in order to construct the proposed NMH development as a single-phase development and to de-risk the future site as much as possible, a number of buildings are required to be completed in advance of the commencement of the main NMH works. This will enable the decant of existing facilities away from the NMH footprint and improve SVUH campus wide resilience in terms of mechanical and electrical energy. Clancy Construction commenced these works in December 2023. It is expected that these enabling works and the tender process will both be completed in tandem by mid-2025.
Construction Costs to date
To date, and outside of the works currently underway at the SVUH campus, a series of works were carried out campus to de-risk the campus in advance of the construction works for the new hospital and as part of the ongoing investment our legacy health estate infrastructure to address the risks on acute hospital campuses. These works included:
• Aspergillus prevention works
• Enabling works, including site preparations works
• Infrastructure resilience, energy centre, and upgrade works
• Decant of existing services to clear the main development site
• Pharmacy facility and extension to the existing multi storey carpark, and
• Statutory / planning cost, and Local Authority fees and charges.
The early programme delivery of the additional car-parking spaces and junction upgrades was a specific requirement of the Strategic Infrastructure Development planning permission, required to reduce the impact of the NMH construction works both on the operation of the campus and on the surrounding residential area.
The original SVUH pharmacy was located on the proposed site for the new NMH and needed to be relocated, commissioned, and operationalised prior to the commencement of construction of the new NMH. As well as being necessary to allow the NMH development to proceed, the requirement to replace the outdated pharmacy had been recognised for some time as part of the wider SVUH Campus Development Plan and was a necessary campus project in its own right. Both the carpark and associated works and the new pharmacy were competed in 2021.
The overall cost of these works to date is c. €67M including VAT/RCT.
Consultancy
Since 2014, a significant amount of work has been undertaken through the various Capital Works Management Framework (CWMF) project stages, as well as guiding the project through the External Assurance Process (EAP) and the Major Project Advisory Group (MPAG) review in compliance with the Public Spending Code ((PSC) now Infrastructure Guidelines), and multiple design validation processes.
The Department of Public Expenditure, National Development Plan Delivery and Reform's (D/PENDR’s) Infrastructure Guidelines note that, to avoid unnecessary, unpredictable and uncontrolled changes in costs, it is imperative for Sponsoring Agencies that output requirements for infrastructural investment proposals are accurately, precisely, and comprehensively specified at the start or as early as possible in the investment proposal delivery process – this is the primary purpose of Design and Planning. Without this diligent investment proposal preparation at earlier phases of a project lifecycle, projects may require amendment after project design or construction has begun. Such changes inevitably give rise to delays or additional costs.
As outlined in the Analysis of Cost Forecasting in Major Capital Projects & Programmes paper produced by the National Investment Office, D/PENDR, December 2023 www.gov.ie/pdf/?file=https://assets.gov.ie/279389/53c65e5d-87d6-4cb1-a4af-edf487d2b3bf.pdf#page=null, “prior to beginning construction on a capital project, it is essential that significant planning in the project development phase and consideration into project risks is taken. One of the most common approaches to major capital projects is racing forward to “start digging” or “get the shovels in the ground” and amongst scholars this is seen as one of the primary causes of significant delays and cost overruns in projects (Flyvbjerg & Gardner, How Big Things Get Done, 2023)”.
The process of patiently and extensively planning projects at the early stages of project development before construction begins can help to reduce cost and schedule risk in major projects and programmes. However, there is a cost associated with this in order to mitigate the risks of greater costs later in the project development lifecycle.
Since 2014, the NMH Contracting Authority has engaged various consultants to support with the delivery of the significant programme of work associated with preparing for the relocation of the NMH to SVUH. The consultancy services include the Design Team, which is responsible for the design, procurement, and tendering requirements associated with the series of enabling and advanced works to de-risk and prepare the main development site, as well as preparation and tendering of the main works, and the reserved specialists. The Design Team has also supported in the preparation of the documentation required to achieve PSC/ Infrastructure Guidelines Decision Gate 2 approval i.e. to proceed to tender. The spend to date for this critical input into the project is ca. €36M including VAT.
Similarly, the NMH Contracting Authority has engaged professional consultants to comply with the project assurance and risk management procedures as defined under the Infrastructure Guidelines, the development of the various Operational Readiness policies, the preparation of the Draft Final Business Cases for both capital build and the ICT infrastructure, and to support progressing the programme through Decision Gates 1 and 2 of the PSC/ Infrastructure Guidelines. This work included the implementation of the various recommendations of the EAP, MPAG review, independent third-party review of the technical documentation prior to the issuing of the tender package, and folding in the various lessons learned from other major healthcare programmes into the NMH to SVUH programme as required by the value for money principles set out in the Infrastructure Guidelines. The spend to date for this work is ca. €6M.
For the External Assurance Programme (EAP) review, introduced in an update to the then PSC in 2021, D/PENDR established a single lot, multi-supplier framework from which funding Departments can source the independent reviewers to conduct the reviews. In mid-2022, a 'Supplementary Request for Tenders' from this established framework was published on the eTenders platform by my Department.
Following a tender evaluation process, the Most Economically Advantageous Tender was selected to perform the EAP review on the business case documentation for the relocation of the NMH . The value of this contract was €98,338.50.
