Minutes show mounting fears over soaring children's hospital price tag

Children’s Hospital Project and Programme Steering Group minutes show growing concerns over escalating costs of New Children’s Hospital. An average of three to four Department of Health officials attended each steering group meeting, along with representatives from the HSE and Children’s Hospital Ireland (CHI) group representatives, writes Health Correspondent Catherine Shanahan

May 26, 2017

Greg Dempsey, Assistant Secretary Finance, DOH; Tracey Conroy, Assistant Secretary Acute Hospitals Policy, DOH; Fionnuala Duffy, Principal Officer, Acute Hospitals Policy, DOH

Milestones and timelines of the project and programme will be key discussion items at all future meetings.

It was considered preferable to meet monthly for the forthcoming months and then move to every six weeks.

August 29, 2017

Tracey Conroy, Assistant Secretary Acute Hospitals Policy, DOH; Greg Dempsey, Assistant Secretary Finance, DOH; Muiris O’Connor, Assistant Secretary R&D and Health Analytics, DOH; Siobhan Keenan, Acute Hospitals Policy, DOH

It was noted that there is a funding deficit of €3m to year-end in relation to the Children’s Hospital Integration Programme.

HSE requested an update at every meeting regarding the expected Vs current programme of the construction project.

Tom Costello, chair of the NPHDB requested a report of slippages since April ahead of the Governance Board meeting on September 14.

The minutes say: “The NCH construction programme project has been benchmarked against similar projects in the UK and compares favourably (month/1,000 sq.m).”

John Pollack, NPHDB project manager raised a concern regarding costs – it was noted that there is an aligned programme issue between mechanical/electrical work and main contractor as well as fire certificate/sprinklers additional requirements – to be reported to the group on a regular basis. Guaranteed Maximum Price (GMP) to be agreed with BAM at the end of the GMP process and will be known within the next 7-9 months.

The minutes also note that a philanthropy campaign is required, and that no funding has been acquired for the Research Building.

Oct 20, 2017

Fionnuala Duffy, Principal Officer, Acute Hospitals Policy, DOH;Greg Dempsey, Assistant Secretary Finance, DOH; Muiris O’Connor Assistant Secretary R&D and Health Analytics, DOH

John Pollack, Project Director “noted some emerging challenges, with estimated capital cost currently exceeding funding available”.

“JP noted this is a working estimate; it will be January-March 2018 before there is certainty.”

JP “confirmed there will be reasonable certainty about the size of the funding deficit by end March 2018”.

JP added that the agreed Guaranteed Maximum Price (GMP) will require Government / HSE approval by early July 2018.

Discussed four possible options for addressing capital cost funding deficit including:

i) Descoping capital project:

ii) Reallocating capital from wider HSE Capital Plan — difficulty due to contract constraints.

iii) Mitigating deficit through philanthropic funding.

iv) Engaging with DPER for additional funding.

It was agreed John Pollack and Eilish Hardiman would prepare a short report for CHP&P Board “that describes the emerging risks and commits to looking at immediate ways to mitigate the deficit and, in parallel, exploring backstop/contingency options in the event a sizeable deficit cannot be reasonably avoided.”

November 22, 2017

Fionnuala Duffy, DOH; Greg Dempsey, DOH; Muiris O’Connor, DOH; Tracey Conroy DOH

Update on the Capital Build: John Pollack raised risk around capital programme funding for 2018; €120m is being made available, which is €40m lower than expected.

Among the actions listed are: “Finalise paper on projected capital deficit for CHP&P Board” and brief John Connaghan, deputy director general, HSE.

January 25, 2018

Tracey Conroy, DOH; Fionnuala Duffy, DOH; Muiris O’Connor, DOH

Standing Update on Capital Funding: John Pollack noted backstop plan No 1 was rejected by all stakeholders and presented backstop plan No 2.

John Connaghan queried process for the €47m capital funding from commercial sources for the basement carpark.

John Pollack confirmed, as set out in the Business Case, this requires HSE to cashflow the basement construction, until NPH can raise commercial capital funding from carpark operators/funders on opening of the hospital.

JP noted €13m shortfall in NPH capital funding for 2018.

February 26, 2018

Tracey Conroy, DOH; Fionnuala Duffy, DOH; Muiris O’Connor, DOH; Colm Desmond, Director of Finance, DOH

John Pollack confirmed capital budget overrun currently projected at €35m (after €20m additional funding for sprinklers, €6m additional savings relating to equipment, and before use of €20m contingency reserve).

John Connaghan requested paper by April, to resolve before Memo to Government in May 2018. JGC requested update for CHP&P Board meeting on March 14.

General agreement monthly CHP&P Steering Group meetings are appropriately frequent.

General agreement that more frequent and targeted sub-meetings would be beneficial.

March 26, 2018

Tracey Conroy, DOH; Colm Desmond, DOH; Fionnuala Duffy, DOH; Muiris O’Connor, DOH

John Pollack presented capital backstop plan No 3. JP explained the current estimated budget shortfall is €35m — €20m to be offset by NPH contingency, on instruction from CHP&P Board, against advice from JP; €9m to be offset by once-off funds raised from dissolution of existing hospital foundations; €6m to be offset by philanthropic funding.

John Pollack explained the intention, as discussed at CHP&P Board, in assigning the NPH contingency to known costs at such an early stage in the capital project is for it to be re-filled as other funding sources are received. JP noted this involves significant risk as some funding sources may fall short of expectations and the holder of this risk would need to be confirmed. John Connaghan “flagged considerable risk associated with relying on philanthropic funding”, particularly when it is due towards the late stages of the capital project.

John Pollack “noted potential shortfalls of €60m in 2019 and €50m in 2020”.

John Connaghan “asked if the expected gaps could change”.

John Pollack confirmed they may decrease or potentially increase, depending on Guaranteed Maximum Price agreement with the contractors. He agreed to prepare a briefing paper on the current anticipated cashflow gap. He agreed to review the paper with NPH Board the following week and share with relevant Steering Group members following this.

Mr Pollack confirmed June 2018 as current expected timeline for GMP agreement with contractor (original target May 2018). He noted GMP agreements with main contractor “are currently unsatisfactory and this issue has been escalated”.

Tom Costello noted the timeline for the memo to government “is dependent on readiness of GMP agreement”.

The minutes’ record: “If GMP approval slips further, there is a risk the memo to government could be delayed until after government summer recess, which would likely have implications for the overall new children’s hospital timelines.” John Connaghan suggested, given the scale and importance of the project, someone should be assigned to document it as a case study.

April 23, 2018

Tracey Conroy (TC), DOH; Colm Desmond (CD), DOH; Fionnuala Duffy (FD) Principal Officer, Acute Hospitals Policy, DOH; Muiris O’Connor (MO’C) Assistant Secretary R & D and Health Analytics, DOH

Discussed CHP&P Steering Group governance review, presented at CHP&P Steering Group in March.

It noted the scope of the governance review was limited to the CHP&P Steering Group, not the CHG or NPH Boards.

TC flagged concern about attendance of CHP&P Steering Group members.

Standing Update on Capital Funding Guaranteed Maximum Price (GMP) Approval: JP noted GMP approval by end June is significantly at risk. JP flagged pricing discrepancies between NPH quantity surveyors and BAM/M&E Contractors. JP explained that pricing discrepancies that cannot be agreed will go to the agreed independent expert to adjudicate, which will take time. JP confirmed that BAM agree that the overall programme completion date is still achievable, provided some critical path activities in Phase B contract are brought into Phase A contract to continue work on site without delays. TC recognised need to invest time in concluding the process of GMP approval to ensure best value for money, however raised concern about the potential impact on the overall programme completion date. TC asked at what point would slippage in GMP approval impact on the overall completion date. JP explained this is difficult to assess without an integrated programme being agreed with BAM/M&E Contractors, but tentatively suggested autumn this year.

JGC asked about the financial risk involved. JP explained it is too early to estimate at this point. JP agreed to provide clarity about the timeline and financial risk by June.

Action: TC noted the slippage in the GMP approval will delay the memo for Phase B construction decision to government and suggested the possibility of an interim memo for information to government in summer to provide an update on overall progress.

Cashflow Analysis: JP described cashflow gaps presented in letter (April 11) responding to Jim Curran (limited circulation). SM noted efforts to manage cashflow will need to be within the programme; HSE does not have sufficient cash available. JGC asked if capital spend could be reprofiled towards later years when surplus cashflow is available. JP explained this would prolong programme duration, delay programme completion date and increase overall programme costs. SM suggested possibility of securing supplementary funding – e.g. €47m for carpark, €20m for sprinklers – earlier than planned and using to offset anticipated cashflow gaps. CD noted this degree of cashflow differences between HSE and NPH is unexpected. CD agreed to convene sub-committee to resolve before next CHP&P Steering Group meeting, consisting of CD, TC, JP, SM (optional) and Jim Curran.

May 31, 2018

Tracey Conroy (TC) Assistant Secretary Acute Hospitals Policy, DOH; Colm Desmond (CD) Assistant Secretary, Finance & Evaluation, DOH; Fionnuala Duffy (FD) Principal Officer, Acute Hospitals Policy, DOH; Muiris O’Connor (MO’C) Assistant Secretary R&D and Health Analytics, DOH

Standing Update on Capital Funding: JP reported progress in relation to the Guaranteed Maximum Price (GMP) programme. All design packages issued by QS to contractors for final measure of quantities and pricing. An independent expert will deliver binding decision on disputed construction costs. Deadline end-June will not be met for concluding GMP process. End of June NPH will have a strong sense of where we stand in overall terms for Capital Construction Cost. July and August to work through identified issues, make any changes to contract documents and firm up on GMP. September NPH QS to produce a Final GMP Report. NPHDB Board will then meet to approve and to allow Dept to bring a memo to government in October for decision.

TC advised to go to government for decision before the 2019 Estimates process, September would be better than October.

SM requested an approximate figure be adjudicated on by mid-July (before estimates process closed) to allow DPER and Government to maximise position.

June 25, 2018

Colm Desmond (CD) Assistant Secretary, Finance & Evaluation, DOH; Fionnuala Duffy (FD) Principal Officer, Acute Hospitals Policy, DOH; Muiris O’Connor (MO’C) Assistant Secretary R & D and Health Analytics DOH

Standing Update on Capital Funding: JP reported work on the Guaranteed Maximum Price (GMP) report. Clarity will be obtained within the next two weeks and will be reported to NPHDB in July.

Action: JP to provide an update on the completion of GMP report at the next CHP&P steering group meeting.

Action: Noted action arising from CHP&P Board meeting is that EH is to draft a business case for a philanthropy director by week ending Friday 13, July.

Government funding decision/approval for phase B contract due end Oct. Chair queried what on the critical path is affected if instruction re Phase B is delayed. JP awaiting BAM response on implications of delay.

An update on the completion of GMP report is to be provided at the next CHP&P steering group meeting.

August 27, 2018

JP advised that the main build at the St James’s site is approximately three months behind schedule; however the contractor is optimistic about making up the time as the project progresses.

The GMP process is not yet complete. The contractor submitted new estimates on Aug 24 and these now need to be reviewed. The timeline for completion of GMP will be more clear during w/b Sept 3. It is likely that the final GMP will be significantly greater than originally anticipated.

The paper submitted in relation to bringing forward elements of Phase B works to Phase A was not considered at the meeting. JP requested that the request to the Steering Group for approval to bring forward the works is put on hold. This will be discussed at a future meeting.

Sept 24, 2018

Fionnuala Duffy (FD) Principal Officer, Acute Hospitals Policy, DOH

Standing Update on Capital Funding and Capital Project: PD informed the group that work at the Tallaght site is likely to overrun by three months. The Connolly site is currently running approximately one week behind schedule however is on track to open in mid- 2019 with handover to the Children’s Hospital Group in spring 2019.

October 22, 2018

Colm Desmond (CD), Assistant Secretary, Finance & Evaluation, DOH; Fionnuala Duffy (FD), Principal Officer, Acute Hospitals Policy, DOH; Muiris O’Connor (MO’C), Assistant Secretary R&D and Health Analytics, DOH

The Chair requested that items for discussion at the CHP&P Steering Group should be limited to issues that cannot be appropriately resolved outside of the Steering Group structure.

The funding required for integration (originally €85m) is to be re-profiled to be in line with the current programme. The investment case is to be updated and implementation workstreams reprofiled to align with the current programme and submitted to the CHP&P Steering Group for approval. The updated Integration Programme is required as soon as possible as there will be a need to refer to the current programme in the next children’s hospital project memo to government.

Action: Integration costs (ref €85m) are to be re-profiled to be aligned to the current programme. The Integration Programme text is to be updated and submitted to the November CHP&P Steering Group for approval.

PD reported that the GMP process has not yet concluded. A report in relation to the GMP process will be submitted to DS as chair of the CHP&P Steering Group in advance of the next CHP&P Board meeting (16/11/18). It was agreed that an additional meeting of the CHP&P Steering Group will be required to review the report and inform the CHP&P SG Chair’s report to the CHP&P Board. It was noted that there is likely to be a delay in submitting the report from NPHDB to the Chair of the CHP&P SG.

Actions: NPHDB to advise DS of any delay in submitting the GMP report and an additional meeting is to be arranged of the CHP&P SG in advance of the CHP&P Board.

Dec 10, 2018

Tracey Conroy (TC) Assistant Secretary, Acute Hospitals Policy Unit, DOH; Fionnuala Duffy (FD) Principal Officer, Acute Hospitals Policy Unit, DOH; Muiris O’Connor (MO’C) Assistant Secretary R&D and Health Analytics, DOH

Capital Project: JP reported that the Guaranteed Maximum Price (GMP) process concluded in November. The NPHDB has recommended continuing with the current contractor. The matter is currently under consideration by Government.

A decision is awaited from DPER regarding equipment procurement.

Memos to the minister

Memo September 13, 2017

To: Health Minister Simon Harris

From: Fionnuala Duffy, Principal Officer, Acute Hospitals Policy, Department of Health (DoH), and member of Children’s Hospital Project and Programme Steering Group (CHP&PSG)

Purpose: To update minister on capital cost estimates in relation to construction of new children’s hospital.

This memo revealed that the NPHDB “has now advised the Department [of Health] of anticipated additional projected final capital costs following signing of the contracts with additional costs of €61m emerging from extended duration of the project and fire certificate requirements”.

The extended timeline meant the timeframe for moving services to Connolly Hospital outpatient care centre — one of two satellite centres that are part of the new hospital project — was pushed out from Q3 (third quarter) 2018 to April 2019. In relation to the second satellite, Tallaght, the dates changed from February 2010 to June 2020 and in relation to the main hospital on the St James’s campus, the timeline changed from Q1 2022 to Q3 2022.

The delay in building commencement and extended project duration “has resulted in additional capital cost”, the memo says.

It also says “these additional costs and requirement for additional exchequer funding will be discussed further at the Children’s Hospital Project and programme Board (CHP&PB) on September 14”. Department of Health secretary general Jim Breslin chairs the board.

Memo August 27, 2018

Marked: Urgent — New Children’s Hospital — Capital Cost Update

To: Minister Harris

From: Tracey Conroy, Assistant Secretary Acute Hospitals Policy, DoH, and member of CHP&PSG.

Ms Conroy outlines how the minister was advised of “potential additional costs of €61m” and that through the “CHP&P governance structures, this issue is being closely and carefully monitored through a risk minimisation strategy”.

Ms Conroy highlights how it has also “not been possible” to complete a report on Guarantee Maximum Price (GMP) by June 2018, as per the contracts, to allow Phase B (over ground works) to be awarded by the end of August 2018 “to avoid incurring possible programme delay and associated costs”.

Ms Conroy makes reference to a meeting the previous Friday, where the NPHDB advised the DoH that the GMP process was nearing conclusion “and it is apparent that the construction budget is trending very significantly over budget” — €191m over the value notified to government in April 2017. She points out this increase does not include, inter alia, Vat and hyperinflation.

She says it should also be noted that the main contractor (BAM) is also seeking a programme extension, due to increased scope, beyond the contracted 52 months.

Significantly, she also refers to correspondence from BAM the previous Friday where it submitted additional costs claims as part of the GMP process “to a value of €200m over and above” what was included in the €191m additional costs.

Memo September 7, 2018

To: Minister Harris

From: Tracey Conroy, Assistant Secretary Acute Hospitals Policy, DoH, and member of CHP&PSG.

Ms Conroy raises the BAM claim again and expresses concern at the contractor’s performance saying they will be notified that they have delayed the overall project. She refers to a further three-month period to complete the GMP process.

A separate briefing note from NPHDB project director John Pollack refers to a September 5 meeting where the design team and executive briefed the NPHDB on overall capital costs, including the late claim.

The note says: “The situation is one of grave concern to the board.”

It also says it would be “premature” of the board to provide a revised project cost update given the current “volatile” situation in relation to determining the GMP. Mr Pollack writes that “the NPH is available to brief the minister and others at the end of the process and also as it proceeds”.

Memo October 10, 2018

To: Minister Harris

From: Fionnuala Duffy, Principal Officer, Acute Hospitals Policy, Department of Health (DoH), and member of Children’s Hospital Project and Programme Steering Group (CHP&PSG)

Again refers to concerns that construction costs are trending very significantly over budget — “estimated to be €191m over the value notified to government in April 2017”. It also mentions BAM’s additional €200m cost claims.

The memo says the NPHDB “shares the concerns of the CHP&P Board and is seeking further clarity and certainty on the additional cost component breakdown to report to the CHP&P Board.”

It says the NPHDB is to conduct an audit “to identify the key elements that have impacted on the change in costs”, and that the HSE and DoH will engage with the NPHDB on this.

In relation to the €191m, Ms Duffy says the NPHDB will provide a report to the CHP&P Board “by mid-October [2018] at the latest”.

She also says Jim Breslin, DoH secretary general, has written to the chair of the NCHDB, Tom Costello, requesting a report on the GMP process “to better understand how the current situation has arisen”.

Memo November 9, 2018

From: Fionnuala Duffy, Principal Officer, Acute Hospitals Policy, Department of Health (DoH), and member of Children’s Hospital Project and Programme Steering Group (CHP&PSG)

To: Minister Harris

Ms Duffy says GMP negotiations have concluded and the NPHDB “has arrived at a robust cost position”, with an overview presented by both Dean Sullivan, HSE deputy director general earlier in the week and the NPHDB meeting on November 7.

She sets out an overview of costs to the DoH where she says the cost is now projected a €1.433bn “an overall project increase of €450m”. A key component driving the increase includes €94m on “design development”.

The memo says the programme timeline “is extended by over four months “to practical completion in August 2022”.

It warns that there will be “further cost implications” estimated at €138m if BAM is not instructed on “Phase B” of the project by early December — “as contractors will no longer stand over 2016 tendered rates”.

The memo says the current cost of the main hospital is €6,500 per sq m. It outlines three options for completing the project, namely, sticking with BAM, retendering which is says would introduce cost and time delays or opt for a management contractor to tender out the remaining packages which will also add cost and time delays.

The memo says the “overall conclusion of the NPHDB” is that “the current process, despite very significant additional costs, will deliver best value for money”.

It says the DoH secretary general, Jim Breslin, is writing to Dean Sullivan to ask him to arrange an external review of the NPHDB report on the GMP process to be presented to the CHP&P Board on November 16.

Correspondence between the relevant departments

Correspondence from the Department of Health (DoH) to the Department of Public Expenditure and Reform (DPER) vis-à-vis the New Children’s Hospital.

Spectre of €2bn hospital raised.

17 Oct 2018

To: Barry O’Brien, Principal Officer in charge of Health Expenditure, DPER

From: Fionnuala Duffy, Principal Officer, Acute Hospitals Policy, Department of Health (DoH), and member of Children’s Hospital Project and Programme Steering Group (CHP&PSG)

“We spoke briefly a couple of weeks ago when I said we want to brief you on the current position in relation to the new children’s hospital capital project. I know you have been occupied with Estimates work recently but would appreciate if you could suggest a couple of possible slots when you are available to meet next week.

“We want to brief you on the current position and potential cost issues emerging relating to GMP.”

n 23 Oct

To: Fionnuala Duffy, DoH and Barry O’Brien, DPER.

From: Jessica Lawless, DPER

“Could you send me on the briefing note you have and then we can set a date to meet you soon?”

24 Oct

To: Jessica Lawless, Barry O’Brien, DPER

From: Fionnuala Duffy, DoH

“As per original request we need to meet with you to brief you on the emerging position. I would be happy to give you an advance briefing verbally.

“Would appreciate if we could get a meeting scheduled for early next week if this week is not possible for you.”

15 November

To: Barry O’Brien, DPER

From: Fionnuala Duffy, DoH

“Barry — just following up again on our request for some weeks not to meet with you to brief you on the emerging position re NCH construction project.”

19 Nov

To: David Moloney, Assistant Secretary, DPER

From: Fionnuala Duffy, DoH

“Dear David, I understand that you are aware of issues emerging in relation to the children’s hospital capital cost.

“Tracey Conroy and I wish to arrange to brief DPER officials this week on the detail relation to the Guaranteed Maximum Price and capital cost position.

“I would appreciate if you could advise us of your availability this week.”

20 Nov

To: David Moloney, DPER

From: Tracey Conroy, Assistant Secretary Acute Hospitals Policy, DoH, and member of CHP&PSG.

“David we have been seeking to meet your division on this issue since the end of September— Fionnuala’s discussions with Barry O’Brien on September 27 and follow up voicemails and emails requesting a meeting on October 17, October 24 and November 15.

“I’d appreciate if you could revert with a time this week to meet to brief you in detail on the current position in advance of the minister making a submission to government.

“We have arranged to brief the Department of the Taoiseach in this regard tomorrow.”

20 Nov

To: Tracey Conroy, DoH

From: David Moloney, DPER

“While Jim Breslin (DoH secretary general) signalled that some work was being undertaken on this during the Budget discussions in early October, this is the first material we have received in relation to a very significant budgetary overrun.

“As you know in the past we voiced serious concerns in relation to governance of the Children’s Hospital project and were assured that the arrangements were sufficiently robust.

“We will review the material provided and come back to you asap.”

21 Nov

To: Tracey Conroy, DoH

From: Barry O’Brien, DPER “As you have previously highlighted in the memo to Government, the accounting officer [jim Breslin] at Department of Health is responsible for the overall governance of the project. Yet we received nothing from DoH that considers total costs — where the overall project now stands. The build costs submitted to government 18 months ago have increased by €450m or 46%.

“Are we now looking at a project that will cost over €2B which would make it the most expensive hospital in the world?” “Obviously given the temporary nature of the NPHDB, the DoH is required to robustly assess [its] documents. Where is the DoH assessment?”

22 Nov

From: Tracey Conroy, DoH

To: David Moloney, Barry O’Brien, DPER

“Thanks for the opportunity to brief you in detail on all of these issues at our 11.30 meeting tomorrow.

In relation to total costs, Ms Conroy points out that a report on the GMP process was sent to them by Fionnuala Duffy on November 20.

She says an external review has been commissioned to examine the project at the request of the CHP&P Board and that the NPHDB is undertaking an audit, also at a request of CHP&P Board.

Ms Conroy says as part of the drafting of the memo to government “consideration is being given to cost containment”.

24 Nov

From: Fionnuala Duffy, DoH

To: Jessica Lawless, Barry O’Brien, DPER

“As per original request, we need to meet with you to brief you on the emerging position.

I would be happy to give you and advance briefing verbally.

“Would appreciate if we could get a meeting scheduled for early next week if this week is not possible.”

    The New Children’s Hospital governance framework: Who’s who

  • The National Paediatric Development Board (NPHDB) is the body with over-arching responsibility for designing, building and equipping the new children’s hospital. It has a 12-member board, appointed by the minister. Three members represent the public interest, one of whom is Paul Quinn, chief procurement officer at the Department of Public Expenditure and Reform, and head of the Office of Government Procurement (OGP). The incoming chair is Fred Barry, former chair of the National Roads Authority. He replaces Tom Costello who resigned last weekend. Project director is John Pollack.
  • The Children’s Hospital Project and Programme Board (CHP&PB) is chaired by Department of Health Secretary General Jim Breslin. The responsibility of the Programme Board is to oversee progress of the project and programme to ensure it delivered against the agreed parameters in relation to timeline, scope and funding.
  • The Children’s Hospital Project and Programme Steering Group (CHP&PSG) is chaired by HSE deputy director General Dean Sullivan. The responsibility of the Steering Group is to direct the overall programme of work within agreed parameters and to ensure an integrated approach is taken across all programme elements. It considers monthly progress reports in relation to the capital project, the integration of the three existing hospitals, workforce, ICT and other relevant issues. Monthly Steering Group reports form the basis for updates to the Programme Board. The steering group reports to the Programme Board which reports to the Health Minister. Both the Programme Board and Steering Group include director-level representatives from the Department of Health and the HSE.
  • Children’s Health Ireland (CHI), formerly the Children’s Hospital Group CHI, was established by law on December 4, 2018. Headed by a 12-member board appointed by Health Minister Simon Harris, it takes over responsibility for services currently provided by Dublin’s three children’s hospitals — Crumlin, Temple St and Tallaght. It will run the new children’s hospital and outpatient and urgent care centres when they open. The first board meeting of CHI was held on December 14, 2018 and the three Dublin hospitals transferred into this single public body from January 1, 2019. The HSE is the sanctioning body for the new children’s hospital and OPD Urgent Care Centre programme and principle capital funder. The HSE provides funding for the programme based on approved plans submitted by the NPHDB and approved by the Minister.

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