The children's hospital, as told by its planning file

The project's planning story begins with a refusal. In February 2012 An Bord Pleanala turned down the Mater-campus scheme in language planners still quote: a structure that 'would have a profound negative impact on the appearance and visual amenity of the city skyline.' That single paragraph moved a national hospital across the city.

Three years later at St James's, inspector Tom Rabbette addressed the ghost of that refusal directly: 'This oval-shaped ward block will provide a local architectural landmark and will be a positive contribution to the city skyscape at this location. The concerns raised by the Board in its refusal in relation to the application for the NCH at the Mater site do not pertain in this instance.' On location he was unequivocal: 'There is no other public healthcare site in the State as well served by public transport as St. James's.'

Since the 2016 grant, every design change has travelled through section 146B - the mechanism for altering the terms of a strategic-infrastructure consent. The file now holds eight decided requests: basements in 2017, the Connolly satellite in 2018, facades in 2019, Tallaght in 2020, landscaping, a moat bridge and a helipad in 2021, the family unit in 2022, and fire access and finishes in 2024. All eight were decided 'not a material alteration'. A ninth approach - a pre-application consultation lodged in March 2019, weeks after the cost controversy peaked - was withdrawn without becoming a case.

There is an irony in the very first of those cases. Assessing the basement changes in 2017, the inspector noted: 'Had the hospital been constructed, it would appear that it may have been open to the applicant to claim exempted development status for the alterations.' The paper trail exists, in part, because the building did not yet.

Set the two records side by side. The approved budget travelled from €983m in April 2017 to €1.433bn by December 2018 to €2.24bn in February 2024. The planning file over the same period recorded a floor-area change of less than one per cent in the 2019 alteration case, and a procession of landscaping, facade and layout refinements - none material. The cost story of Ireland's most expensive building happened almost entirely outside the planning system, in contract and procurement; the consented building has remained, in planning terms, the same building granted in April 2016.

One condition is worth watching in 2026: Condition 2 of the board order gave the permission a ten-year life, to April 2026. The contractor's High Court proceedings and the conciliation over hundreds of contract claims - widely reported through 2024-2026 - are contract law, not planning; no judicial review of any of the planning decisions was identified.