What caused the explosion in construction costs such as the James children's hospital project?


General Mayhem

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So you are saying all consultants in every discipline deal with emergency situations?
Ha, now you’re getting into what ardillaun referred to earlier. The ones that do, need designated parking near the hospital.

Also they are always on call and never work regular shifts where they arrive as normal with no emergency situation. Interesting.
When not at work, many consultants are on call, even when they have on call cover. Some patients cannot be handed over to another on call consultant.

Will the " disabled children" walk in themselves after being dropped at the door by their parents? Maybe they'll fill in some forms while their parents are looking for a spot? Will they explain their medication to some inadequately vetted junior doctor while their parent is circling the neighborhood?
At ER, there are people on hand to assist arriving emergencies. If both parents need to be in the car to park it, the children may not be disabled at all.

Would you employ a doctor in the car park to determine whether a patient is enough of an emergency to be allowed park next to the consultants and hospital managers?
No, I would allow that non disabled people understand that reserved parking is not reserved for them.

We certainly have:

We have lost sight of who the children’s hospital is being built for

Although we forgot a long time ago who our health service is for.
Ah now. We were talking about parking spaces :petunia:
 

ruman

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Ha, now you’re getting into what ardillaun referred to earlier. The ones that do, need designated parking near the hospital.



When not at work, many consultants are on call, even when they have on call cover. Some patients cannot be handed over to another on call consultant.



At ER, there are people on hand to assist arriving emergencies. If both parents need to be in the car to park it, the children may not be disabled at all.



No, I would allow that non disabled people understand that reserved parking is not reserved for them.



Ah now. We were talking about parking spaces :petunia:
You're seriously suggesting a parent hand their child over to some random hospital worker ? Alternatively both parents have to come to the hospital and if they have other kids they can stay at home on their own.

Non disabled people ? You mean like doctors and nurses. Personally i'd rather the parents of a sick child have a parking spot. Not all doctors are on call, not all doctors deal with emergency situation. A limited supply rotated between those that do at a particular time in order to provide more to parents could work.

Lovely lady, credit to the medical profession !

- Doctor prepared to go to jail for parking in disabled spot - Independent.ie
 

Patslatt1

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So you are saying all consultants in every discipline deal with emergency situations? Also they are always on call and never work regular shifts where they arrive as normal with no emergency situation. Interesting.

Will the " disabled children" walk in themselves after being dropped at the door by their parents? Maybe they'll fill in some forms while their parents are looking for a spot? Will they explain their medication to some inadequately vetted junior doctor while their parent is circling the neighborhood?

Would you employ a doctor in the car park to determine whether a patient is enough of an emergency to be allowed park next to the consultants and hospital managers?

We certainly have:

We have lost sight of who the children’s hospital is being built for

Although we forgot a long time ago who our health service is for.
The minister of health should bear the ultimate responsibility for cost overruns and managing vested interests in the hospital's location. Too many medical cooks spoil the broth.
 

Schuhart

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She could have taken a 145 bus; 17 minute journey, departs every 10 minutes. I'd love to see the "heavy equipment" she says she was carrying.

That said, we all need a mental shift on car usage. The lack of any guaranteed carparking for anyone (even people with children in intensive care) at Great Ormond Street does highlight the distance we have to go to change unrealistic expectations.
 

ruman

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The minister of health should bear the ultimate responsibility for cost overruns and managing vested interests in the hospital's location. Too many medical cooks spoil the broth.
Oh absolutely but Varadkar was completely beholden to the consultants. It was inevitable given the location that James would run significantly over budget , the people who wanted it there had to lowball in order to get it chosen.
 

ruman

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She could have taken a 145 bus; 17 minute journey, departs every 10 minutes. I'd love to see the "heavy equipment" she says she was carrying.

That said, we all need a mental shift on car usage. The lack of any guaranteed carparking for anyone (even people with children in intensive care) at Great Ormond Street does highlight the distance we have to go to change unrealistic expectations.
I'd estimate the expectation of car parking is far more prevalent in the public sector. Taking free car parking from TD's would force them to use public transport and give them an incentive to improve it. Likewise banning them from using private healthcare.
 

Massey

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Oh absolutely but Varadkar was completely beholden to the consultants. It was inevitable given the location that James would run significantly over budget , the people who wanted it there had to lowball in order to get it chosen.
Really, its the consultants fault?
Andwas it Varadkars decision to move it to St James , even though he was minister for transport at the time?

Nutty, "chip on your shoulder" stuff.
 
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ruman

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Really, its the consultants fault?
And it was Varadkars decision to move it to St James , even though he was minister for transport at the time?

Nutty, "chip on your shoulder" stuff.
Varadkars capitulation to lobbying fron consultants on mandatory disclosure is well documented at this stage.
The decision on James was taken prior to leo as you are aware and the takedown of the more viable connolly option by
Vested interest groups is also documented.
 

Patslatt1

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Varadkars capitulation to lobbying fron consultants on mandatory disclosure is well documented at this stage.
The decision on James was taken prior to leo as you are aware and the takedown of the more viable connolly option by
Vested interest groups is also documented.
Well documented where?
 

ruman

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Ardillaun

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She could have taken a 145 bus; 17 minute journey, departs every 10 minutes. I'd love to see the "heavy equipment" she says she was carrying.

That said, we all need a mental shift on car usage. The lack of any guaranteed carparking for anyone (even people with children in intensive care) at Great Ormond Street does highlight the distance we have to go to change unrealistic expectations.
Or she could get a taxi. Some people do tend to lose the run of themselves when it comes to parking.

I had to attend a meeting at another hospital, parked in what I thought was wasteland and got a ticket for my crime. When I rang the parking police to see if I could appeal, they told me the judge had a particular dislike of doctors who did that and was quite liable to increase the fine substantially. I decided not to test the veracity of their story.
 

ruman

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Or she could get a taxi. Some people do tend to lose the run of themselves when it comes to parking.

I had to attend a meeting at another hospital, parked in what I thought was wasteland and got a ticket for my crime. When I rang the parking police to see if I could appeal, they told me the judge had a particular dislike of doctors who did that and was quite liable to increase the fine substantially. I decided not to test the veracity of their story.
Well it took a judge to highlight the HSE's inadequate vetting of doctors while they have also repeatedly flagged the need for reform of the disgusting treatment of mothers who suffer negligence at birth.
Its a shame senior management in the health service dont share this concern for patients.
 

Cnoc a Leassa

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Having some experience of large complex projects, I commented on the project back in Feb 2017 to effect that
“having good estimates for actual total project costs and time scale to operational status are crucial factors in estimating large projects. The most difficult part of novel and complex projects is risk assessment. For more experienced people, the combination of complexity, uncertainty and irreversible decisions emphasises the importance for risk averse behaviour and a precautionary approach.

Listening to the Board spokesperson - lets focus on the benefits and the needs and the great project we will have when its all finished – is a classical presentation approach for a project that is already doomed to failure. Reminded me of a Trump sales pitch for a new casino. This is not a personal criticism of the spokesperson herself; she was doing her best with an impossible situation in my view.

The St James Children’s Hospital is a complete and total financial disaster that is unfolding before our eyes. The Government must restart the whole project again. Sorry to be so pessimistic, but this project just screams financial disaster to me.” Ends

The damage was done by the previous government. The political imperative was to get the project approved at St. James and lots of decision short cuts and under-estimations were deliberately taken in my view. The present government had option to stall and review, but did not have the political courage to do so.

Seems to me the present cost justification is an exercise for now; sufficient to keep the project moving along to the next crisis phase. The idea that the final cost of the project is now settled is a fallacy.
 

Patslatt1

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Having some experience of large complex projects, I commented on the project back in Feb 2017 to effect that
“having good estimates for actual total project costs and time scale to operational status are crucial factors in estimating large projects. The most difficult part of novel and complex projects is risk assessment. For more experienced people, the combination of complexity, uncertainty and irreversible decisions emphasises the importance for risk averse behaviour and a precautionary approach.

Listening to the Board spokesperson - lets focus on the benefits and the needs and the great project we will have when its all finished – is a classical presentation approach for a project that is already doomed to failure. Reminded me of a Trump sales pitch for a new casino. This is not a personal criticism of the spokesperson herself; she was doing her best with an impossible situation in my view.

The St James Children’s Hospital is a complete and total financial disaster that is unfolding before our eyes. The Government must restart the whole project again. Sorry to be so pessimistic, but this project just screams financial disaster to me.” Ends

The damage was done by the previous government. The political imperative was to get the project approved at St. James and lots of decision short cuts and under-estimations were deliberately taken in my view. The present government had option to stall and review, but did not have the political courage to do so.

Seems to me the present cost justification is an exercise for now; sufficient to keep the project moving along to the next crisis phase. The idea that the final cost of the project is now settled is a fallacy.
In view of the hearing at the Oireachtas health committee, would you change the above criticism? Costello testified that the contract was awarded based on a preliminary design in which the materials required were recognised but their costs were completely underestimated due to complexity.
 

wombat

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Costello testified that the contract was awarded based on a preliminary design in which the materials required were recognised but their costs were completely underestimated due to complexity.
Its obvious they went to tender before the scope had been developed sufficiently. Perhaps some of our IT experts can comment on increased cabling costs - what is it needed for? If the footprint of the hospital has not changed, why is extra cabling needed?Surely doctors will use wireless devices like tablets for communication? It looks like the TDs are more interested in grandstanding than digging into details of cost increases.
 

clearmurk

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Its obvious they went to tender before the scope had been developed sufficiently. Perhaps some of our IT experts can comment on increased cabling costs - what is it needed for? If the footprint of the hospital has not changed, why is extra cabling needed?Surely doctors will use wireless devices like tablets for communication? It looks like the TDs are more interested in grandstanding than digging into details of cost increases.
How many "consultants" are involved?
 

Cnoc a Leassa

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In view of the hearing at the Oireachtas health committee, would you change the above criticism? Costello testified that the contract was awarded based on a preliminary design in which the materials required were recognised but their costs were completely underestimated due to complexity.
Like intangibles in value judgements, retrospective complexity is the last shelter for either incompetence or a deliberate rush to get the project approved.
 
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clearmurk

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Irrelevant, the claim is that quantities have changed, the question is why?
The proposal before the house is that the cost of a project increases directly in proportion to the number of consultancies involved.

More consultants = more likelihood of Rolls Royce solutions being pursued.

And why not? The state will fork the bill, nobody pays the price, except the citizens of course. Wonderful thing, the capacity to levy taxes. Whether to line your personal bank account, or to provide the best for the best.
 
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