5 lessons from National Children's Hospital for future projects in Ireland

RTÉ News​

29-05-2025

The National Children's Hospital (NCH) project stands as one of Ireland's most significant infrastructure undertakings - and one of its most instructive failures. Originally conceived as a state-of-the-art facility to consolidate paediatric services across Dublin, the project has instead become emblematic of systemic challenges plaguing Irish public infrastructure development.
With costs spiralling beyond €2.2 billion and completion dates repeatedly deferred, the NCH offers invaluable lessons for future major infrastructure initiatives. This is even more relevant as the sector embarks on the development of the National Maternity Hospital and other critical public works.
From RTÉ Radio 1's Today with Claire Byrne, Dr Paul Davis from DCU assesses the latest delays to the Children's Hospital project
These lessons extend far beyond mere cost overruns or construction delays. They illuminate fundamental weaknesses in how Ireland approaches large-scale public infrastructure, from initial conception through final delivery. Understanding these failures is crucial not only for avoiding repetition but for establishing a more robust framework for future development.
Governance failures are the starting point for dysfunctional projects
The most profound lesson from the NCH concerns governance architecture. Despite establishing multiple specialised committees and oversight bodies, the project suffered from fragmented decision-making structures that operated in relative isolation. This created what organisational theorists term "accountability gaps". These spaces where responsibility becomes diffused across multiple entities, resulted in effective accountability residing nowhere.
The absence of a unified command structure proved particularly damaging. Various stakeholders - for example, the Health Service Executive, the Department of Health, construction contractors and clinical staff - operated with competing priorities and insufficient coordination mechanisms. This fragmentation manifested in delayed responses to emerging challenges and led to inconsistent strategic direction throughout the project lifecycle.
From RTÉ Radio 1's Morning Ireland, health economist Dr Brian Turner on the ongoing delays to the NCH project
I believe that future infrastructure projects require centralised governance frameworks with clearly delineated authority structures. This means establishing single points of accountability for major decisions while maintaining appropriate checks and balances. The governance model must also ensure that oversight bodies possess both the expertise and authority to challenge assumptions and redirect project trajectories when necessary.
Traditional management tools are not good enough
The NCH project initially relied on conventional project management tools. These tools, primarily Microsoft PowerPoint presentations and Excel spreadsheets, proved fundamentally inadequate for managing the complex, multi-billion-euro infrastructure development. The subsequent integration of Building Information Modelling (BIM) demonstrated the transformative potential of advanced project management technologies, enabling more accurate cost estimation, enhanced design collaboration and sophisticated risk assessment capabilities.
But technological adoption alone proves insufficient without corresponding organisational capacity. The effective utilisation of advanced project management systems requires comprehensive training programs, cultural adaptation within organisations and integration with existing operational frameworks. Future projects must prioritise technological infrastructure from initial planning phases rather than retrofitting solutions after problems emerge.
From RTE Radio 1's Today with Claire Byrne, why is so expensive to construct medical facilities in Ireland?
Real-time data analytics and integrated project delivery methods offer additional advantages, including enhanced stakeholder coordination, reduced operational redundancies, and streamlined workflow management. These technologies enable more responsive project management, allowing teams to identify and address challenges before they escalate into major disruptions. It became evident through multiple appearances at the Public Accounts Committee that this data was not begin collected nor used properly.
Changing the script around procurement value and risk
The NCH's initial procurement approach prioritised lowest-bid submissions. This reflected a narrow understanding of value that failed to account for broader project implications. This strategy systematically underestimated total project costs while overlooking significant risk factors that subsequently materialised as major challenges.
Contemporary procurement theory emphasises value-based selection criteria that integrate price considerations with quality assessments, delivery capabilities, and risk management competencies. This approach recognises that apparent cost savings during procurement often translate into substantial expenses during implementation phases.
From RTÉ Radio 1's Today with Claire Byrne, is Ireland's public infrastructure lagging behind?
Effective procurement strategies also foster collaborative relationships between public sector clients and private sector contractors. Rather than adversarial dynamics focused solely on cost minimisation, successful projects develop partnership frameworks that encourage innovation, shared risk management, and mutual investment in project success. This collaborative approach enables more creative problem-solving and adaptive responses to emerging challenges.
Communicating what you're doing to the general public
The NCH project's communication failures contributed significantly to eroding public confidence in Irish infrastructure development capabilities. Inconsistent messaging, delayed disclosure of cost overruns and limited stakeholder engagement created an information vacuum that fostered speculation and distrust.
Transparent communication strategies serve multiple functions beyond mere public relations. They enable early identification of potential problems through stakeholder feedback. They create mechanisms for community input that can improve project outcomes. More importantly still, they establish accountability frameworks that encourage responsible decision-making throughout project lifecycles.
From RTÉ Radio 1's Late Debate, when will patients eventually be treated in the new and overdue Children's Hospital?
Future projects must establish regular communication protocols that provide consistent updates to stakeholders, including the general public. This includes proactive disclosure of challenges and setbacks rather than reactive responses to external pressure.
The importance of comprehensive risk management
I think that fundamentally, the NCH project failed to integrate comprehensive risk management into its planning and execution phases. Risk assessment was treated as a secondary consideration rather than a core component of project architecture. This reactive approach to risk management resulted in expensive crisis responses rather than proactive mitigation strategies.
Effective risk management requires systematic identification of potential challenges during initial planning phases. It also requires the development of corresponding mitigation strategies, as well as continuous monitoring throughout project implementation. This includes financial risks, technical challenges, regulatory changes, and stakeholder dynamics that could affect project trajectories.
From RTÉ Radio 1's Morning Ireland, Dr. Paul Davis examines the findings of an external audit into the infamous Leinster House bike shelter
Risk management must also incorporate scenario planning. These scenarios should consider multiple potential outcomes and develop adaptive strategies for each possibility. This approach enables projects to maintain momentum despite encountering unforeseen challenges while minimising disruption to overall objectives.
What all of this means for future infrastructure development
These lessons have direct relevance for Ireland's upcoming infrastructure initiatives, particularly the National Maternity Hospital and other major public works. Implementing these insights requires systematic changes to how Ireland approaches large-scale infrastructure development, from initial conceptualisation through final delivery.
Success requires integrating governance reform, technological advancement, procurement innovation, communication enhancement, and risk management improvement into comprehensive project frameworks. This holistic approach recognises that infrastructure development challenges are inherently systemic rather than isolated technical problems.
Ireland's future infrastructure success depends on delivering major public works efficiently, transparently and in accordance with public expectations
The NCH experience demonstrates that effective infrastructure development requires more than engineering expertise or construction capabilities. It demands sophisticated organisational frameworks. These framework must have the capability and capacity to coordinate complex stakeholder relationships, manage evolving requirements, and maintain public trust throughout extended implementation periods.
Ireland's future infrastructure success depends on internalising these lessons and developing institutional capabilities that can deliver major public works efficiently, transparently, and in accordance with public expectations. The stakes are too high, and the public resources too valuable, to repeat the mistakes that have characterised the National Children's Hospital project.