On Friday, July 25, 2025, writes Eamonn Coyle, I published an article in the Irish News examining the challenges involved in delivering public contracts, using the National Children’s Hospital (NCH) as a key example. The piece attracted more than 16,000 impressions on LinkedIn and prompted wide-ranging discussion among professionals both in Ireland and abroad.
One contributor from Australia shared insights into the Perth Children’s Hospital, which was delivered through a design and build model. Although this approach was intended to improve efficiency and control costs, the project ran nearly three years behind schedule and exceeded its budget by more than AUD $100m. Additional contractor claims eventually surpassed AUD $300m.
Misleading narrative
Several recent radio interviews in Ireland have cited Australian hospital projects as examples of timely and cost-effective delivery. However, closer examination and further research suggest that this narrative is misleading.
An engineer who worked directly on the Perth project explained that many of the difficulties stemmed from the design and build structure itself. This is perhaps unsurprising, given that design and delivery responsibilities had been entirely transferred to the contractor.
As a result, problems similar to those experienced on our own NCH, and other infrastructural projects, also arose – except in the Australian case, they were outsourced.
The Western Australian government had issued a clear technical brief but passed design, co-ordination, and most of the project risk to the contractor.
Crucially, the government had already gained experience through the earlier Melbourne Children’s Hospital, which helped shape its procurement strategy in Perth. The engineer concluded that, with the NCH now nearing completion, Ireland should preserve and apply the expertise it has acquired – just as Australia did.
In the article published inJuly, I suggested that achieving a fully detailed design at tender stage is more aspiration than reality. It appears that was also true in Australia, and relative to other large scale infrastructural projects. The reality is that most designers assume their design is complete, that is until something doesn’t fit on site.
Design and build: One model, many realities
Design and build (D&B) places responsibility for both design and construction with the contractor. The goal is to reduce the fragmentation often associated with traditional procurement routes.
In reality, however, most contractors still outsource the design work to the very consultants the client might have appointed under a traditional model. So if a fully detailed design was not achievable under traditional procurement, it is unlikely to be achieved through a D&B approach either.
The main appeal of D&B lies in risk transfer and contractor incentivisation. Contractors are motivated to co-ordinate and finalise designs early, knowing that any latent errors may ultimately become their liability.
D&B proved effective during the Celtic Tiger era, particularly for motorways, projects that are linear, repetitive, and relatively predictable. But a €2.2bn hospital in a congested city centre is a different proposition entirely. It brings evolving clinical requirements, rapid technological change, complex underground services, client-driven alterations, multiple subcontractors and suppliers, and intense logistical constraints.
In the 1990s, I worked on urban D&B projects in Glasgow under similarly demanding conditions. Construction often advanced ahead of updated design information. We jokingly rebranded the model as 'build and design' – a more honest reflection of how those projects unfolded.
BIM: It’s not about models, it’s about information
Building Information Modelling (BIM) is fundamentally about delivering accurate, timely project information, not just 3D geometry. It was developed to address recurring problems in construction: missing details, clashing drawings, and outdated revisions that lead to delays and costly rework.
When properly implemented, BIM creates a single source of truth, enabling live model co-ordination, clash detection, accurate metadata, and a smooth handover of asset information. However, this only works if all project stakeholders use it consistently, and, in practice, gaps remain.
In Ireland, only a limited number of main contractors operate at full BIM maturity. Many subcontractors, suppliers, and smaller consultancy firms continue to lag. Until BIM capability is standardised across the entire supply chain, its full potential will remain out of reach.
A competent BIM manager should demonstrate fluency in the following areas:
- Autodesk Construction Cloud (or equivalent) for managing the Common Data Environment;
- Revit for model design, review, and collaboration;
- Navisworks for model coordination and clash detection;
- Civil 3D for linear infrastructure projects;
- Primavera P6 for planning and scheduling integration;
- ISO 19650, the internationally recognised BIM standard.
Without these tools and processes embedded in project delivery, BIM remains underutilised.
Given the current capability gaps across the industry, widespread training and cultural change are urgently needed. We must not underestimate the importance of both industry norms and internal corporate culture, and the scale of the shift required to realise BIM’s true value.
The myth of full design at tender
The Capital Works Management Framework (CWMF) was created to ensure full design at tender and to align risk with capability, a sound principle in theory.
However, in more than 30 years of experience in procurement, site delivery, scheduling, and co-ordination, I have never seen a truly complete tender design, not even for a rural bungalow in Co Donegal.
This is not a criticism of Irish professionals, who are among the best in Europe. It is simply a structural reality. Construction takes place in the real world, where fragmented teams, unpredictable site conditions, digital inconsistencies, pressurised start dates, client-driven change orders, the impacts of climate change, and uneven information flows all collide. It is not a laboratory environment, nor is it a perfectly controlled Toyota-style production line.
Some contributors on RTÉ and Newstalk have claimed that the NCH “should have been fully designed” before going to tender. In principle, that is correct. In practice, it is rarely, if ever, achievable.
A way forward
Complexity in construction cannot be eliminated, but it can be better managed. The following principles offer a more realistic and resilient approach to major project delivery:
- Front-load planning: designers and contractors are often under intense pressure to begin work on-site prematurely, usually to satisfy political optics. But time invested upfront in detailed preconstruction planning consistently delivers better outcomes.
- Understand the project early: in a presentation I delivered in 2005, I urged project managers to fully understand their projects from the outset. One attendee jokingly replied, “We barely understand them at the end.” It raised a laugh – but it also reflected an uncomfortable truth.
- Support digital adoption: enforce ISO 19650-compliant Common Data Environments and provide robust BIM training across the wider industry to ensure consistency, quality, and accountability.
- Digital build first: use tools like Navisworks to simulate the full build sequence before any physical work begins. Weekly construction activities should be digitally rehearsed in advance, with the full site team in attendance.
- Implement a project integration plan: this must be in place from day one, clearly defining how all stakeholders will collaborate, share information, and resolve conflicts throughout the project lifecycle.
- Contract for complexity: acknowledge from the outset that full design at tender is not achievable. Build in flexible provisions and pre-costed contingencies to account for inevitable changes.
- Prioritise wider industry and corporate culture: while many Irish companies focus on corporate strategy, few give sufficient attention to organisational culture. As Peter Drucker famously observed, “culture eats strategy for breakfast”. A serious programme of change management is essential, alongside a deeper appreciation of the role culture plays in delivery success.
Finally, Ireland should commission a clear-eyed, practical 'root cause analysis' of what went wrong on the NCH and similar large-scale projects. These lessons, openly acknowledged and widely shared, must become the foundation for delivering smarter, faster, and more resilient public infrastructure in the years ahead.
Author: Eamonn Coyle, BSc (Hons), MSc, C.Eng, MCIOB, HND, CEnv, MIEI & MBA.