Alan O’Reilly is a political activist based in London.
When it comes to infrastructure, many countries often struggle to successfully implement projects on time and on budget; indeed, international research on the issue shows that nine out of ten projects with a value of over $1bn go over budget or over deadline around the world.
Ireland is no different. Earlier this spring it emerged the Government had been warned of another delay to its flagship infrastructure project: the construction of a new National Children hospital.
In 2016 Leo Varadkar TD, the current Taoiseach and then Minister for Health, announced the construction of a new state-of-the-art children’s hospital that would centralise and enhance healthcare services for children.
At the time, the project cost was estimated to be approximately €650m. When complete, it will boast a total of 6,150 rooms in total (comparable to Great Ormond Street Children’s Hospital) including nearly 400 individual inpatient rooms, each with an en suite and a bed for a parent to sleep on.
More importantly, when it came to timelines, Varadkar said the children’s hospital would be completed by 2020, “short of an asteroid hitting the planet”.
Fast forward to 2023 and it is still under construction. The latest estimates from the National Paediatric Hospital Development Board (NPHDB) – the body charged with delivering the project – suggests that construction will be substantially complete by May 2024. Follow-on works are then required to get it ready for use.
All of which means that it is looking increasingly unlikely it will be open before March 2025 – the deadline for the next election.
Costs of the project have also sky-rocketed; from an initial estimate of €650m it is now expected to cost upwards of €1.5bn to €2bn (depending on estimates). This would give it the dubious honour of being one of the most expensive hospitals in the world.
But at least there has been actual physical progress. Unlike, say, the long running saga of the MetroLink project.
As far back as 2000, ministers announced a metro project to connect the north of Dublin to the centre. It was also proposed to provide a link to Dublin Airport, which currently has no train or tram connection.
Twenty three years later, construction on any form of a line has not started. Even worse, according to a report to the Oireachtas in March this year, about €300 million has now been spent on the project without any works actually commencing.
Under current plans, construction is forecast to begin in early 2025, with services set to start in the early 2030s, although hard pressed Dublin commuters probably won’t be holding their breath in expectation.
The obvious question is: does this represent good value for money?
As noted above, research shows almost all state-sponsored infrastructure projects either run over time or over budget (often both). This is often due to multitude of factors including initial under-estimation of cost, failure to account for contingencies, scope creep, and local opposition.
But if the costs are underestimated, it can often be the case that the full scale of the gains of a project are not fully considered either. There are often significant benefits, accrued over time, which may not have been envisioned in the initial project.
For example, in the late Nineties and early Noughties Ireland undertook an extensive motorway expansion programme. The programme, initially forecast to cost €5.6bn, ended up coming in at €16bn.
But the construction of these motorways created new links across the country, significantly cutting journey times. They helped open up the West of the country for economic development and allowed for greater connectivity.
The same could well be true of the hospital; merging three children’s hospitals into one will mean all the paediatric specialists working under one roof. This means children who are very sick, in particular those who have complicated health issues, can be treated without having to go to different hospitals.
But the public are tired of seeing projects started with no end in sight. The challenge for the Government is ensuring they can see past the costs and overruns to the eventual benefits – when they finally arrive.