Sir, – For anyone wanting to build a public hospital in the State in the future, there is a simple process that seems to work or not to work (depending on your point of view) and that doesn’t need “a comprehensive judicial inquiry” to unravel, as Alan Shatter has suggested for the National Children’s Hospital (Letters, May 31). It goes like this:
A) Do a back-of-the envelope calculation of costs, then subtract (or divide) to make it sound like a bargain; pick a year for completion, and subtract again.
B) Use terminology such as “world class”, “iconic” – and, of course, “value for money”.
C) Line up those medical experts to endorse the proposal who are most likely to benefit from a decision in their favour; exclude dissenting voices from attending presentations, news conferences, meetings with politicians, visits by the media or site assessors; criticise all other proposals; turn your nose up at the views of people from the private sector who have successfully built hospitals before and who have alternative suggestions for building a public hospital.
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D) Enlist patients and patient advocates to support the plan.
E) Do everything in your power to get a political decision in your favour to be announced, including bamboozling councillors, TDs, and Ministers with lots of medical jargon.
F) Once the political decision has been nailed down, build a toy-model of the hospital for photoshoots, then sit back, add in the essential details missing from the original design, install a nightmarish system of governance with lots of criss-crossing dotted reporting lines, pile on the costs, blame everyone you can think of for the delays and soaring costs (the design team, builders, suppliers, politicians) and things that happened after your original completion date (recessions, pandemics, wars).
G) Add in more essential details to the design because medicine is changing very quickly, and you are moving very slowly.
H) Given the obesity crisis, get a fast-food company to support some of the on-site development (maybe the tobacco, soft drinks, alcohol, and gambling industries could be targeted in the future).
I) Frustrate the public to the point where no one wants to read anything more about the project (least of all patients and patient advocates), other than the headline “Finally, it’s open!” and where few, other than lawyers, will want “a comprehensive judicial inquiry” (to add even more costs).
I hope this clears matters up. – Yours, etc,
CHRIS FITZPATRICK,
Dublin 6.