Official Report: Minutes of Evidence

The Chairperson (Mr McGuigan): I welcome Jennifer Welsh, chief executive of Belfast Health and Social Care Trust; and Mr David Porter, director of strategic development in the Belfast Trust. Thank you very much for coming. We have some helpful papers from you, but I now hand over to you, Jennifer, to make some opening remarks, and then I will take questions from members.

Ms Jennifer Welsh (Belfast Health and Social Care Trust): Thank you, Chair. Good afternoon, everybody. Thank you for the opportunity to return to Committee to give you an update on some of the progress that has been made on our major capital projects, along with some of the challenges and issues of concern that we continue to address.

First, as the Committee will be aware, construction commenced on the new building for the children's hospital in March 2025, with a programmed completion date of March 2030. As has been reported to the Committee, the works on-site continue to progress well. The excavation works and the removals from the site have largely been completed, and the construction of the substructures and service tunnels is progressing. Extensive work was undertaken by the trust in advance of the main contract commencing to clear the site of any below-ground infrastructure. That work has been hugely beneficial in mitigating a substantial programme risk and in allowing the contractor to proceed through the excavation phase without delay. Works on the primary drainage system are also now complete. You can see three tower cranes on the site that also mark the visible signs of progress. The trust's engagement with the contractor continues in the management of the works on site and in the ongoing review of the technical submissions. Considerable work has already been undertaken in the review of the technical submissions in collaboration with trust representatives, Department of Health Health Estates, as our professional and technical advisers, and the consultant design team. The trust will continue to monitor the impact of the construction traffic on the site throughout the duration of the contract.

The Committee will also be aware that the trust has carried out an extensive review of the design of the water systems in the new children's hospital. That review was undertaken in response to previous design reviews, the lessons learned from the maternity hospital project and the latest NHS guidance. In October/November, we confirmed to Health Estates the 25 changes to be instructed to the design team, and DOH Health Estates have since been working with the consultant design team to expedite the implementation of the changes to the design. The latest update provided by Health Estates indicated that the design changes would be completed by the end of May 2026. Therefore, further liaison and review with the contractor will be required subsequently before the final cost and the programme impacts are confirmed to the trust.

In relation to the maternity hospital, Belfast Trust, through DOH Health Estates, has appointed the consultant design team for the remediation works to the water systems in the new maternity hospital. The design team is managed by DOH Health Estates on behalf of the trust. The team commenced work on the design of the new domestic water system in the neonatal unit in October 2025. In addition to the provision of a new domestic water system in the neonatal intensive care unit, the proposed remediation works involve localised remediation works to the water systems throughout the remainder of the building. Belfast Trust has recently received a draft of a stage 1 design report from the consultant design team. The report is being reviewed by the trust and DOH Health Estates. A number of areas of clarification have been requested, including requests for clarification on the updated cost estimates and the detailed programme showing the phasing of the remediation works. Following feedback from DOH Health Estates and the trust, the report is due to be completed within the next two weeks. A summary paper will be shared with the Health Committee once that report has been accepted by our trust board.

It has been a complex and challenging programme of work to get us to this point. However, it is good that I can say that remediation works will shortly commence on-site. The initial phases of the remediation work, including the isolation of the existing neonatal water system and the strip-out work for the remediation, is due to commence in the next two to three weeks. Once again, it should be noted that proceeding with localised remediation works throughout the remainder of the building is not a final decision, as you all know. In the event that Belfast Trust is not assured that the localised remediation works are delivering a safe and robust water distribution system, the trust may need to review the extent to which the domestic water systems need to be replaced in other areas of the building. While that has always been the case, we can confirm, for assurance, that the trust continues to monitor all emerging information through the governance of our project water safety group. The trust's four responsible persons for water also met separately in January 2026 to review the latest information. They concluded that, while areas of concern remain, the evidence and opinion received did not cross the threshold of challenging the decision to proceed with option 2: to replace the neonatal water system and provide localised remediation in other areas of the building.

Some members have requested more detailed information about the handover process for the maternity hospital building and the trust's acceptance of the new building. It is helpful to note that those matters are defined in construction projects in the terms of the main contract. When the maternity hospital contract was awarded, the contractor was granted a limited contractual right to possess and occupy the site for construction purposes from the commencement date of 13 November 2017. At the time of practical completion, the possession of the site and the building was returned to the trust in accordance with the terms of the contract. While the trust and DOH Health Estates work with the contractor and the consultant design team throughout the construction phase and during the handover process, the assessment of whether practical completion has been achieved is the contractual responsibility of the consultant design team. The design team lead has responsibility to sign off certification of completion. It should be noted that there is no protocol or legal process through which the trust can refuse acceptance of the building once the completion certificate has been signed. That being the case, the trust's acceptance of the building thereafter is largely a formality. The signing of the completion certificate legally transfers possession of the building and the site back to the trust. Belfast Trust accepted handover and took possession of the new maternity hospital on 29 March 2024. I can also confirm to the Committee that the trust is currently commissioning an independent management investigation into arrangements surrounding the handover of the maternity building. To ensure that any investigators have the necessary freedom to investigate and identify all lessons to be learned, I cannot comment on the details of that investigation while it remains ongoing.

I am also aware that Members have requested clarification on the current quality of the water in the maternity hospital building. I note again that the building has never been fully commissioned and has at no stage been in operation. Thus it effectively remains within what is deemed the construction phase of the programme until the remediation works are complete. I referred to a meeting of the trust's four responsible persons for water in January 2026: at that meeting, the responsible persons agreed, as a precautionary measure, that the trust would continue to advise all staff in the building to consider the water not to be safe for drinking. Signs remain in place throughout the building, advising staff and any operatives of that status. That is a wholly precautionary measure, because the building is not in service operation.

I turn now to the acute mental health inpatient centre (AMHIC). The Committee will be aware of the programme of work for the remediation works to the AMHIC on the Belfast City Hospital site. As has been reported previously, the trust will decant the psychiatry of old age ward from the AMHIC building to the Mahee ward on the Knockbracken site. An essential part of that work is preparing the Mahee ward to ensure that it is a suitable environment for acute mental health patients. We are conscious that we are moving patients and staff from a specialist environment, and we need to ensure that we move them to a facility that is of equivalent safety and where staff will be able to continue to deliver a high standard of care. The consultant design team for the remediation works to the Mahee ward on the Knockbracken site has been appointed, and the work remains on-programme. Tender packages have been issued to the trust for assessment, and works on the Mahee ward are due to start on-site next month. The work is due to complete in December 2026, which will allow the decant of the psychiatry of old age ward from the AMHIC building in January 2027. Following the decant to Mahee, the remediation works to AMHIC will proceed on a phased ward-by-ward basis. The overall programme is as follows: completion of the Mahee design development April 2026; the Mahee refurbishment works from May 2026 to December 2026; the Mahee commissioning and decant from December 2026 to January 2027; and the AMHIC ward refurbishments from January 2027 to February 2029. It is estimated that the cost of the works will be approximately £6 million. However, those are high-level costs, and they will be subject to refinement and variation as the work progresses on-site.

Finally, I am pleased to report that the regional haematology project received outline business case (OBC) approval in December 2025. The project is progressing to stage 2, including concept design development and enabling activities. The much-needed facility will provide 32 single en-suite rooms, of which 12 will be isolation rooms, and will permanently transfer the specialist haematology inpatient service, which will avail itself of all 32 rooms. The trust is working with Health Estates to finalise the appointment of the consultant design team. Completion of the project is due in the second quarter of 2030. The estimated capital cost of the scheme is approximately £18·8 million. Some £3·3 million of the capital cost will be funded from charitable donations; £4·5 million will come from the trust's general capital fund; and the remainder will come from the Department of Health. I again place on record our sincere thanks for the generous charitable donations that will allow the project to proceed.

We are happy to take any questions that members have. Thanks, Chair.

The Chairperson (Mr McGuigan): OK. Thank you, Jennifer, for providing that.

I will start with the maternity hospital and then move to the children's hospital and will explore some of the issues that you have raised in a bit more detail. It is probably years since the Committee visited the maternity hospital. It is a modern facility with lots of space, but it is a shell: there is no equipment, no staff and no patients. Up to this point, the project has cost £100 million of public money. It is not operational. It is three and a half years late. As you said, it was handed over in March 2024, and there is still no end goal or no end in sight for when we will see patients being treated at the maternity hospital. As someone who is tasked with the job of scrutinising, on behalf of the public, the use of public money and public projects, I cannot help but feel — I am going to ask whether you agree with my assessment — that, to this point, that is a public scandal.

Ms Welsh: We are as frustrated as you are about everything that has occurred. We very much want to get the building open and in service for the people who need it and for our staff, who have worked incredibly hard and hoped that they would have been delivering babies in the unit at this stage.

I will ask David to comment.

Mr David Porter (Belfast Health and Social Care Trust): As Jennifer said, we understand and share so much of the concern that Committee members have about the time that it has taken. When I came into post, after the pseudomonas was first uncovered and after it had escalated post-handover and so on, it was clear to me that the first thing we had to do was take immediate action to stabilise the water system and so on. We reported previously to the Committee how we had undertaken actions on the dead legs in the system, the suitable flushing and so on. That phase and the testing that was done thereafter allowed us to define the route forward that we have now —.

The Chairperson (Mr McGuigan): I am sorry to interrupt you, David.

Mr Porter: You are OK.

The Chairperson (Mr McGuigan): I have a number of questions, and I want to get through them, so I will start at the beginning.

Jennifer, you talked about the handover and explained some of the reasons for that, but we and the public are confused about the handover. Why was the facility handed over? There were 16 extensions at the request of the contractor at a cost of £17 million throughout that project, so there were a number of extensions and the project was not on time. It is a fairly fair question to ask. Given that there was concern about the water, why was the hospital handed over?

Mr Porter: We understand those concerns. As Jennifer mentioned in the opening statement, we have commissioned a management investigation in the trust of some of the matters around the time of handover.

The Chairperson (Mr McGuigan): I do not want that to be the stock answer to hide from us getting answers today. It is a long time. I am pretty sure that there are questions that you can answer for us and therefore for the public in relation to the handover. I do not want to be hard on you, but I do not want you to come back to our legitimate questions with, "There is going to be an investigation". We have a job to shine a light on this. As I said, it is a public scandal. There is a lot of money. It is public money. The public deserve to know the answers. If concerns about water were raised in advance of the handover, it is a fairly legitimate question to ask why it was handed over.

Mr Porter: Absolutely. My point, really, is that we want to be cautious that we say nothing that will prejudice that investigation. I appreciate that we have been on record in the Committee here outlining some of the details of what took place around water criteria and so on that had to be set prior to handover and the fact that, at the time of handover, those conditions were considered to have been met. I understand that we have gone into some of that previously with the Committee, but I do not want to do anything that would prejudice that investigation.

The Chairperson (Mr McGuigan): Fair enough. Were there consenting voices in senior management about handover? Were concerns raised? Were there consenting voices that senior management, at any point, considered not accepting handover?

Ms Welsh: If I may reiterate one of the things that I said in the opening statement on the process around that, there is no protocol or legal process by which the trust can refuse acceptance of the building once the completion certificate has been signed, and the trust does not sign the completion certificate. Those are some of the things that we want to explore in that investigation.

The Chairperson (Mr McGuigan): OK. I come back to my question: were there dissenting voices? Did senior management have to decide between accepting handover or not accepting it, given, as I have said, that there were delays throughout the contract? To ask for a delay because of a problem that people were aware of seems reasonable to me, sitting here now, a number of years on. We have had a previous engagement, as we meet every week with people who are under pressure because of lack of resources. The public will be concerned about not just this project but a number of projects in Belfast Trust that have gone way beyond what they were spending. There is public money, and we need to be cautious. I am asking basic, legitimate questions to try to throw a bit of transparency on it. I would like to know if, when the decision was made, it was unanimous, whether people were concerned about the decision and whether the trust had considered making a different decision. I would actually like to go further than that: I would like to know whether the Department had any role. For example, was there a rush from the Department to get the project handed over? Was any pressure applied by the Department? Those are things that we should have some answers to.

Mr Porter: I appreciate that. We are not for a second saying that those are not valid questions. We understand that. We are absolutely committed to finding out all of the facts that we can to establish the facts around all of that. We are not here to defer that in any way, but, as I said, we do not want to prejudice that investigation.

You asked about the number of people who were involved. As Jennifer mentioned, these are contractual matters. A number of people are involved in the delivery of the project. We in the trust have a capital planning and redevelopment team that leads on major projects in the trust. Other representatives of the trust, such as the estates teams or clinical teams, are part of the projects, and we engage with them as well. Then there are representatives of the Department of Health and of Health Estates, and we have our consultant design teams. There are a huge number of people involved in all of this, Chair. We need to ensure that they all have a voice in the investigation where required and that we establish all the facts around it.

The Chairperson (Mr McGuigan): That is true, and I would expect that, but I do not know why you cannot answer the question that I asked. Was it a unanimous decision? Was thought given to not accepting handover? If a project is taking place that costs an awful lot of money and is important to the public in the North and somebody raises a concern about water quality and says, "I have a big concern about this", that should cause questions to be asked. I am looking for assurances here that, if concerns were raised, they were investigated properly and the proper decision-making process took place to allow — I was going to say "to allow progress to be made", but, with hindsight, we can see that progress has not been made. I am trying to figure out whether, if a different decision had been made a number of years ago, we would be further down the line towards getting the hospital that we want and our people deserve.

Mr Porter: I understand the question. The issue is that the terms of the contract meant that, at the time of handover, those were contractual decisions. They are contractual matters that we work within. As I said, a large number of people were involved in the project at the time.

You are asking whether there were concerns. Again, we previously reported that the pseudomonas was uncovered before handover and that we were aware of it. We cannot say that there were no concerns; of course we were aware of them, and we reported them previously, Chair. However, as I said, we need to go into that in full detail in the investigation, including some of the questions that you have asked, to establish the answers to all of that.

The Chairperson (Mr McGuigan): The obvious question is why the investigation did not happen two years ago. Why are we asking questions two years on? You are telling us, in essence, that we will probably have to wait. I do not know how long the investigation will take, but I do not think that it will be quick. Is it a case of the trust kicking scrutiny and transparency down the road?

Ms Welsh: Absolutely not. Those are the types of questions that I have been asking since I came into my role. Obviously, David is still relatively new in his role. We have been asking those questions. We want the answers as well.

The Chairperson (Mr McGuigan): Have you not got answers to them to date?

Ms Welsh: It is important that we go through the investigation process.

The Chairperson (Mr McGuigan): We are at odds here. I am not blaming you, because both of you are new, and you are probably asking the questions that I would expect, but, for public representatives who are trying to scrutinise a public body for the public, it is wholly unsatisfactory that the answers are not in the public domain and that we are discussing other options. How can we have any confidence in what is being proposed as a remedial solution, given that we do not even know what the decision-making process was in the first instance? If you do not mind my saying so, the public will have low confidence in the Belfast Trust's capital projects. Damage has been done. This is just one project, but there are others. How can we convey trust that option 2 will work, will not cost much more than £6 million and will not add years to what is already an extremely delayed project?

Ms Welsh: There are a number of things there. I will start and ask David to come in. I absolutely understand and share everybody's frustration. It is important that we do a thorough investigation. The trust is not the only party involved in all of this, as we have said, and we need to make sure that we do the detail. I then want to make as much of that public as I can. That is the right thing to do. You are public representatives asking for that, and we are spending public money. You are talking as well about the public not having confidence. That is a natural and understandable question and is probably a thought that I had even before I came into this role. There are a number of projects, and we will go through them. Since I have come into the role, though, it has been easy to see that there are different things in the different projects. It is not as if there is a recurring theme. There are specific identifiable issues with each project.

The other thing I will say — I will maybe ask David to comment on this — is that trusts never work alone in this. We have our capital development team, supported by the estates team, but we work closely with the Health Estates directorate in the Department of Health. Design teams and contractors are appointed, and other advisers are brought in. Every trust works in the same way, and we are not the only trust to have run into difficulty on major projects. It is maybe worth reflecting on some of the things that have happened across the UK.

Mr Porter: Regrettably, the issues with water safety are not unique to the Belfast Trust. I think we mentioned before that there have been incidents in other trusts in the UK. I think of the issues that occurred at Royal Papworth Hospital and of the Scottish hospitals inquiry, where there have been water safety issues, buildings have been occupied and there have been tragic consequences. We share the concern around some of those issues. We regret what has occurred. We are committed to putting it right, but the trust has always prioritised the safety of patients in this and will continue to do so. We will not open the building until we are assured that it is safe.

I will come back, Chair, if I may, to a couple of the other questions that you raised about assurances around what we are doing moving forward. I can speak to a good degree on that, having had much more personal involvement in that. We established a multidisciplinary team to have an open review. We had a number of sessions with representatives from estates and the clinical side, so various disciplines across the piece came together to look at all the evidence that we brought together on the building, what had happened in the past and the latest testing that we had done. We have records of those discussions, the options that were appraised and why that was done. All of that has gone for scrutiny. The Minister called for an independent review, and we fully support that and understand why that was done. Our decision-making and the route forward with the option 2 that we referred to were reviewed, and the independent review by the Minister highlighted no concerns around the governance of that. It even stated that it appeared to be the correct decision on the basis of the information available.

With regard to what we are doing moving forward, we can speak with confidence to the governance of what has been done, the records of that and the decision-making. We are by no means saying that this is an absolute, and we cannot give cast-iron guarantees of perfection, but we have worked to balance the patient safety issues that we were acutely aware of with the impact on the public purse in the decision-making around all of that.

The Chairperson (Mr McGuigan): OK. I could probe this for half an hour, but I will not do that because it would not be fair on everyone else. In fairness, I am a bit disappointed that we are maybe not getting the answers to some of the questions. I understand the need for investigating the decisions, but I think that we could have been given more answers about that today.

Moving to the children's hospital, you outlined some positive news, Jennifer, on the work. It is proposed that the new hospital will cost about £670 million, with £389 million for construction and £280 million for equipment. It is due to be constructed and handed over by 2030. Is there anything that the Committee needs to know today about that cost or that timeline for construction? Are both on target?

Mr Porter: Jennifer said in her introduction that the works are progressing well on-site. We are pleased to report that. We have reported as well that we have made a number of changes to the design of the water system. They were proposed under the governance of the project water safety group that we established.

We reviewed all those proposed changes to determine which were essential in order to provide a safe water system for the children's hospital. As Jennifer mentioned, DOH Health Estates instructed the design team on 25 of the changes. We therefore anticipate that the design changes will be completed in May. They will have to go to the contractor. That will have an impact on the cost and the programme, but the trust has not yet received that information from the contractor. We appreciate that that will have an impact, but we cannot confirm what it will be.

The Chairperson (Mr McGuigan): Are the numbers that we are talking about small or big?

Mr Porter: I cannot give you that information today, I am afraid, because we have not yet received it from the contractor.

The Chairperson (Mr McGuigan): OK. Will that cause a delay to the project?

Mr Porter: We know that it will have an impact on the cost and the programme.

The Chairperson (Mr McGuigan): Are we talking about days, weeks, months or years?

Mr Porter: Again, it would be speculative of us to give figures at this stage.

The Chairperson (Mr McGuigan): That is frustrating. We are talking about a project that is of vast importance to the population and to health outcomes and that will cost £670 million. We are asking legitimate questions, yet we cannot get answers.

Ms Welsh: I assure you, Chair, that, when we have the answer to that question, we will be able to share it with you. We hope that, by the end of May, we will have the report on the impact on the cost and the programme, and we will be happy to share that report with you then.

The Chairperson (Mr McGuigan): I look forward to that.

Mrs Dodds: The Chair said that he is frustrated. Like many people listening in, I am a bit angry that we are in this situation two full years post the handover of the maternity hospital and having spent hundreds of thousands of pounds on flushing the systems in that hospital. You have come here today with almost a clever ruse, which is that there is an independent management investigation of the handover, in order not to answer questions. That is inappropriate and is disrespectful to the Committee. I seldom say such things to anybody who presents to the Committee. People will be gobsmacked that, after two years, we have no further answers and that you have said that you cannot guarantee that what you propose at the maternity hospital will work, which means, I presume, that you may end up stripping out all the pipework in the hospital if the flushing does not do what it is supposed to do.

My first question is this: what makes you think that flushing the system for another two years will get rid of the pseudomonas — in the main maternity hospital, not the neonatal part — when it has not done so in the past two years?

Ms Welsh: I will start with your comments about being inappropriate and disrespectful. I assure you that there is absolutely no intention to be inappropriate or to be disrespectful to the Committee. I take seriously my role as the organisation's accounting officer, and, when I am able to share that information with you, I will do so. For the reasons that I have already given, however, it is hugely important that we take forward the management investigation, which concerns the arrangements surrounding the handover. Doing that will be important.

On your point about not being able to guarantee that option 2 will work — David will want to comment more on this, and I referred to it in my opening statement — the information that we have at the moment indicates that option 2 is the right course of action to take. I take reassurance from the meeting in January of our four responsible persons for water safety. They concurred that that was the correct way forward. I cannot give you an absolute guarantee — in saying that, I am taking a precautionary approach — but, on the basis of the information that has been given to me, I am fairly confident that option 2 will work and that we will not be in the position of having to proceed with option 3.

Out of an abundance of caution, I say that it remains an option, but everything points to option 2 being the correct course of action. David will probably want to provide more detail on that.

Mr Porter: You mentioned flushing. It has been a key point of our management of the building to ensure that the water is turning over, but we are doing more than that as part of the remediation works for the remainder of the building. We are removing any of the outlets that have tested positive for pseudomonas. We are also replacing some of the valves that were considered to be a risk. More work than flushing is therefore involved as part of the remediation works.

The advice that we are getting from our experts is that, following the remediation works and the mitigation work, the system should be able to deliver potable water in the building. We caution that we cannot give that as an absolute guarantee, as I mentioned, but we have a level of confidence in what we are doing moving forward.

As I said earlier, the independent review that the Minister had called of the decision-making process and the decision to proceed with option 2 also indicated that, given the information that was available to the review team at the time, the selection of option 2 appeared to be the correct decision.

Mrs Dodds: I understand that Building Services Research and Intelligence Association (BSRIA) engineering consultants were asked to do an audit of the handover of the building, and I know that you have the information on that audit trail. I also understand that the engineering consultants found that a significant number of reports on the handover were missing. Do you want to tell the Committee what the outcome of the audit was, how many reports were missing and why they were missing? Was the handover completed without all the relevant information being considered?

Mr Porter: If I may, as a point of clarification, the BSRIA audit was just of the documentation that was handed over as part of the handover process; it was not of the entirety of the handover itself. The audit did not look at its governance or decision-making.

Mrs Dodds: I accept that entirely.

Mr Porter: OK. It was purely of the handover information that the trust had received. There were certainly issues with some of the documentation that was received.

Mrs Dodds: Can you tell us how much of the information was missing?

Mr Porter: I cannot give you a percentage. I will need to check. I am not sure that we have that.

Mrs Dodds: I understand that almost half the information was missing.

Mr Porter: I am not sure that I concur with that, Diane. I do not have a figure to hand that states how much was missing or inaccurate.

Mrs Dodds: Will you provide the Committee with the exact figure? It is important that the public understand the process. I have been asking questions about this for two years, and, every time I ask questions, more arise. If we had a process in which some of the information was not available or had gone AWOL, questions would have to be asked about the governance of the handover.

I understand from the answers to all the questions that I have asked that pseudomonas was present at the time of the handover but was deemed to be within an acceptable limit: is that right?

Mr Porter: It met the criteria in the contract. I do not think that the trust has ever referred to an acceptable limit of pseudomonas.

Mrs Dodds: Pseudomonas was present; the level met the criteria in the contract; and samples from outlets were tested. How many outlets were tested?

Mr Porter: I will need to check the exact figure. My recollection is that it was around 100 in the neonatal area, but I will need to clarify that and get back to you.

Mrs Dodds: How many outlets are there in the whole of the new maternity hospital?

Mr Porter: The figure is considerably more than 100. Those 100 were a selection of outlets in the neonatal area only. I will need to get you the exact figure for the total number of outlets, Diane.

Mrs Dodds: From the information that I have been given, it seems that very few outlets were tested. Probably in excess of 200 were not tested. I do not know what the information was on which the handover of the building was accepted if a number of outlets were not tested. I am just trying to probe you, as I have no idea, because I am not a water expert.

We know that pseudomonas is lethal. There have been tragedies in the Royal Group of Hospitals because of pseudomonas. I would therefore have thought that there would have been an overabundance of caution when it came to testing outlets before accepting them for the handover.

May I also —?

Ms Welsh: I —.

Mrs Dodds: Sorry. I want to say this before I lose my train of thought. You have indicated for the first time — I wrote this down — that the handover is the contractual responsibility of the design team: am I correct?

Mr Porter: Signing the completion certificate is a matter that is handled by the design team, yes.

Mrs Dodds: On the basis of what information?

Mr Porter: Many meetings take place in the lead-up to that, Diane. It is the responsibility of the design team lead to liaise with all their team and other parties involved to make the decision to sign-off.

Mrs Dodds: Is the design team part of the Belfast Trust estates, the Department of Health or an outside body?

Mr Porter: The team is made up of external consultants.

Mrs Dodds: It was signed off by external consultants, and you say that you have no right to refuse. Have I picked that up right, or am I completely wrong?

Mr Porter: The trust and Health Estates work with the consultant design team throughout the construction process, Diane, as we are doing with the children's hospital project. We are simply stating today that those are contractual matters, and, once that completion certificate is signed, that is what transfers ownership. Sorry, I should not say "ownership": when the completion certificate is signed, possession is transferred back to the trust.

Ms Welsh: Such things are always a partnership and a collaboration between the teams in the trust, including the capital development team and the estates team. As David said, there are others involved from the relevant services. Clinical people will be involved, including from microbiology and other areas. A number of the DOH Health Estates team are included in that, and then the design team and the lead for that team are appointed.

Mrs Dodds: I am interested in the process, Jennifer, and that is the first time, I think, that I have heard that said in the Committee.

I have to be honest and say that I do not know the answer to the question of what form your independent management review will take. My party and I are of the opinion that we will not be satisfied that there will be complete transparency until there is a full public inquiry into what happened along the lines of the Scottish inquiry. We have witnessed a stalling process here today, and I cannot see how that will help us get to the bottom of what happened.

The other thing that is absent today is accountability. Who on the design team takes responsibility for the new water outlets and systems in the children's hospital?

Mr Porter: That is a contractual responsibility of the consultant design team, Diane. As we have mentioned before, in light of some of the lessons learned, we have changed the structure of project delivery and established safety groups to improve oversight, diligence and the delivery of some of the specialist systems. Water is certainly one responsibility, and you will understand why. We are establishing project safety groups for fire, electrical and ventilation systems.

There are therefore a number of other areas in which, we feel, specialist oversight is required to ensure that systems are delivered as safely as possible.

Ms Welsh: May I also respond? Diane, you talked about holding a public inquiry and said that it has been a stalling process today. There is no intention for this to be a stalling process: absolutely not. We all agree that, be it through our management investigation or some other form of inquiry, we need to know the answers. I assure you that David and I are taking the situation seriously, as is our trust board. I assure the Committee of that. As soon as we are able to share any of the information, I will be happy to come back to the Committee and do so.

David will probably provide a little more detail, but it is worth mentioning that pseudomonas is opportunistic and is prevalent in many places. You are right, Diane: that is why, because of the vulnerability of neonates, testing should be done diligently. Pseudomonas's almost ubiquitousness means that it is a difficult thing to manage. That is where flushing and so on becomes important. Individuals coming into the building can also bring pseudomonas in with them. We could all be carrying it.

Mrs Dodds: May I ask a final question? If there is pseudomonas in water, which there probably is in lots of places, and the water is perfectly potable, what has been found in the water in the maternity hospital that makes it unsafe to drink?

Mr Porter: In our recent testing for pseudomonas, we have also tested for legionella and other bugs. That is our primary concern, Diane. We are fully aware that there can be many other bacteria in the system that are dangerous. Water safety is therefore not simply a pseudomonas issue. We are currently testing outlets, and we will test before commissioning to ensure that the building is safe for handover.

Mrs Dodds: Would it be possible for you to let us know what the results of some of those tests are? They might be incomprehensible to me. I might need someone to translate, but that would be a useful exercise.

I tabled a question for written answer about the issue, and I will quote the answer that I got from the Minister:

In what other new hospital buildings in Northern Ireland could we not drink the mains water? I do not remember there being an issue in the Ulster Hospital or anywhere else.

Mr Porter: Part of our process, Diane, is to ensure the safety of the systems. We would not allow operatives to use the systems for drinking water or even for en suites. That is partly because, as Jennifer mentioned, healthy individuals can carry many bugs and not be aware that they are doing so. In order to avoid contamination of the systems, for their safety, we have not permitted operatives to use some of the outlets during the construction phase, not simply for the safety of operatives but to avoid contamination of outlets and so on. We do not want operatives on-site using the outlets until the time of handover.

Ms Welsh: Technically, the building has never been fully commissioned, as everybody knows. At no stage has it been in operation. The remediation works mean that it technically remains in what is deemed to be the construction phase.

Mrs Dodds: It is the property of the trust, however.

Ms Welsh: It is in the possession of the trust, yes.

Mrs Dodds: That is the issue.

Finally, there is something entirely wrong with the way in which the Belfast Trust and DOH Health Estates approach capital build projects. The overspends mean that people in my constituency will not get a new hospital in Craigavon. People in the Northern Trust will not get the new mental health unit that is so badly required. The Belfast Trust is soaking up money as a result of mistakes, overruns and delayed projects. That is not acceptable, and the public need to know the answers, which they will get only through a public inquiry.

Mr Donnelly: A lot of my questions have already been asked, but I want to dig a bit more deeply. It is clear that there is a pattern of capital projects going way over budget and way over time, with a lot of public money — millions and millions of pounds — being wasted. There is also a pattern of scandals. There have been multiple scandals in the Belfast Trust. I agree with Diane and the Chair about that.

I will ask you for a prediction first. We visited the maternity hospital a year ago. It is a beautiful new hospital — absolutely lovely — but it is sitting there completely empty and completely unusable, and that will be the case for the foreseeable future. There are still huge amounts of work to be done, and millions of pounds more will be spent on it to get it up and running. We also have the children's hospital, which, as far as we are aware, will cost us £671 million, although there is a report coming in May that will tell us what the additional cost will be. Which hospital will be open first?

Mr Porter: As Jennifer said, we will provide the Committee with that information. We have a stage 1 report from the design team, which we are reviewing with the team to finalise it. That report will go to the trust board, and we will provide the Committee with a summary of it as soon as we can thereafter. Part of what we are looking at at the minute is whether there can be early occupation of some parts of the maternity building. The localised remediation work will be undertaken in advance of fully stripping out and replacing the neonatal system. We are therefore looking at whether some areas of the building can be brought into occupation in advance.

Mr Donnelly: What is the timeline for that looking like?

Mr Porter: We will confirm that as part of the report to the Committee. As I said, we are reviewing the report with the design team at the minute, and we will close that out in the next couple of weeks. We are actively looking at how we can do that. Of course, in previous correspondence with the Committee, we highlighted the fact that doing that will be subject to suitable testing. We are also going through the models of care with the clinical teams to ensure that we have safe models of care and suitable staffing. Those staff will be working slightly remotely.

Mr Donnelly: Is it your answer that the maternity hospital will hopefully be open first, almost —

Mr Porter: The maternity hospital —.

Mr Donnelly: — 10 years behind schedule and after costing £100 million?

Mr Porter: We will present the programme to the Committee shortly. As I said, within the next two weeks, we will close out the report with the design team. The report will, we trust, be ratified by the trust board, and it will be shared with the Committee thereafter.

Mr Donnelly: We look forward to receiving it.

Your submission states that the review of the lessons learned from the maternity hospital identified 35 required changes, subsequently reduced to 25 required changes, to the water system in the children's hospital. Why were those required changes not in the original plan? Was the original plan unsafe?

Mr Porter: There are a number of areas in which we have learnt lessons from the maternity hospital. There is also updated NHS guidance that was published in 2024. A number of factors have contributed to the lessons learned and to the review of the design of the children's hospital. I cannot give you a single reason that led to that, but we feel that the 25 changes that we have instructed are essential. We are proceeding with those changes.

Mr Donnelly: Without those lessons learned, you could have built a children's hospital that would be completely unusable for years and would require millions and millions of pounds' worth more work to be done.

Mr Porter: We felt that there were risks that needed to be addressed, and we have made the changes to address those risks.

Mr Donnelly: At the minute, the children's hospital will cost £671 million. Jennifer told us earlier that you will bring a report to us by the end of May that will —.

Ms Welsh: It will come to us by the end of May.

Mr Donnelly: Will you be able to share that report with the Committee?

Ms Welsh: Once it has gone through our trust board, yes.

Mr Porter: I will clarify. The design changes will be complete by the end of May. The contractor will need then to assess the changes and their impact on the cost and the programme. There will be work for the contractor to do before we are informed of the impact on the cost and the programme. May is the date by which the design changes will go to the contractor. There will be further work thereafter to allow the contractor to assess the impact.

Mr Donnelly: It sounds as if there will be significant changes made, possibly costing a significant amount of money. Is that fair to say?

Mr Porter: The changes are important, and quite a bit of work has been done. It has taken the design team a few months to do its report, so there will be a bit of work for the contractor to assess all of that.

Mr Donnelly: OK. You mentioned an investigation. That was the first time that we had heard of that investigation. I was as shocked as Diane when it was mentioned. You have referred to it a couple of times, in that you have been unable to answer questions because of that independent investigation. How can we be assured of its independence? Is the trust doing the investigation, or have you brought in somebody else?

Ms Welsh: We have not yet appointed people. They will be completely external to the trust.

Mr Donnelly: Completely external?

Ms Welsh: Yes.

Mr Donnelly: OK. Will their report be released to the public and the Committee?

Ms Welsh: The intention is for the report to go to our trust board, and, if there are elements that I can release to the Committee or the public, I am more than happy to do that.

Mr Donnelly: Why might you not be able to release that to the Committee?

Ms Welsh: Unless there is anything in the report that is a contractual issue, my intention is that it will be made public.

Mr Donnelly: OK. I hope that it will be made as public as possible, because, as we said, these are huge financial scandals.

Ms Welsh: I absolutely agree.

Mr Donnelly: We need full transparency, and the more you can tell us about what went wrong and what is going on, the more we can be assured and can have confidence. The Chair referred to public confidence. The public have little confidence in the Belfast Trust at the moment: it is just scandal after scandal. We do not want to see that. We have reached more than £671 million for the children's hospital, and, as Diane mentioned, other trusts have facilities and projects that we will not get because of that increase. People across Northern Ireland will suffer because of those ongoing changes in projects. Do you commit to making that report public?

Ms Welsh: That is certainly the intention.

Mr Donnelly: OK. How long will it take? Do you have a timescale for the report?

Ms Welsh: I do not have one yet. It is early days.

Mr Donnelly: OK. My final question is about something that I have a personal interest in, which are the Changing Places facilities on your sites. I want to get some answers on those facilities. There are no Changing Places facilities across Belfast Trust facilities at the moment, but you had plans to have a facility installed in the Royal Victoria Hospital.

Ms Welsh: That is correct.

Mr Donnelly: Can you give us a timescale for that?

Mr Porter: I will need to get back to you on that, Danny.

Ms Welsh: We are also looking at one for the children's hospital. That is much more difficult, and a group has been established to look at that. We have nominated people to that group. I do not have the detail on it, but we are looking at it.

Mr Donnelly: Are there Changing Places facilities in the plans for the children's hospital?

Ms Welsh: Yes. I am talking about the situation currently rather than the new build.

Mr Donnelly: Rather than when they build the children's hospital?

Ms Welsh: Yes.

Mr Donnelly: OK. Got you. You cannot give us a timescale for even starting —.

Ms Welsh: We are happy to come back on that.

Mr Porter: As Jennifer said, a group is taking that forward. I do not have that information at the moment, but we will certainly get it for you as quickly as we can.

Mr Donnelly: It is important.

Mr Porter: I appreciate that.

Mr Donnelly: I have heard from people who have had to change children on toilet floors and places like that. It is absolutely heartbreaking; that should never happen. Changing Places facilities should be available in all our trust facilities.

Mr Porter: I understand. We will get you that information.

Mr Donnelly: I look forward to seeing those reports as soon as possible. I encourage you to share as much of them with us as you can. The Committee has taken a great interest in those matters, and a huge amount of public money is involved.

Ms Welsh: I absolutely agree.

Mr Donnelly: Thank you.

The Chairperson (Mr McGuigan): Before we move on, I will pick up on Danny's point. Jennifer, you have not appointed anyone, and I note the timescale. I think that the Committee is urging urgency on that so that it is not seen as a delaying tactic.

Ms Welsh: I absolutely understand that. We will relay that to the members of the investigation team once they are appointed. We want something to take place as quickly as possible.

The Chairperson (Mr McGuigan): Will you give a commitment that, when the investigation completes, you will return and speak to the Committee?

Ms Welsh: Yes.

The Chairperson (Mr McGuigan): OK. Thank you.

Miss McAllister: Thank you very much for the presentation. My questions will have a slightly different focus, but, first, I also want to reflect on the questions from other members and the answers from the two of you on the maternity hospital. The reason why we are asking so many questions to try to get to the bottom of that is to ensure that it does not happen again. So that we have public confidence and, ultimately, a first-class health service with not just new buildings but all the new equipment that comes with those, it is important that such a situation does not happen again. We also must have the workforce's participation in that, and we look forward to hearing more details about the investigation.

I have a question about the last item in your presentation, which was the haematology cancer unit. You said that it has passed stage 2 and is going into the design phase. Will you go back over the timeline of that for us? We are now in 2026, and I believe that it was scheduled for 2030. Is there any indication of whether it could be before then? Over the years, many patients have lobbied and worked with others to get that moved forward.

Ms Welsh: Thanks, Nuala. I will ask David to give you the detail. I completely agree: that project is close to my heart. Before returning as chief executive, I was the director responsible for cancer services in Belfast. The project to refurbish and expand our haematology services has been much needed for a very long time, so I am delighted that we are at the stage that we are.

David can give the detail.

Mr Porter: The programme for that work is driven by a couple of factors. First, there are staff on A floor of the City Hospital tower, which is where it is proposed that the ward will be, and we need to provide decant facilities to move them out. There is also quite a bit of design work to be done to develop the scheme, and the scheme itself is complex and challenging to deliver in the existing hospital tower. It consists of 35 single bedrooms for patients, 12 of which are what we refer to as "isolation rooms". Those have the ventilation lobby that will provide the greatest possible protection to those patients. As members know, haematology patients are among our most vulnerable patients, so we are providing 12 isolation rooms in that facility. That requires the installation of a huge amount of equipment and the engineering systems to provide that ventilation. That is part of the challenge of delivering the scheme.

We will absolutely go back and ask whether the programme can be expedited, but I just wanted to say that the programme, as it sits, has been driven by some of the challenges of working in the existing City Hospital tower and moving out existing staff, as well as the complexity of the services to be provided in it. They are specialist services that, as you know, are to meet the needs of a vulnerable group of patients.

Miss McAllister: I completely understand that. Everything has to be done properly, but another four years seems quite long when it is a new complex but not a brand-new building — it is within an existing building structure. Four years before handover seems like a long time, and it could even be beyond that.

Mr Porter: We have challenged that programme already. The sequence of works is part of the challenge, as is their complexity. That is what has driven the programme.

Miss McAllister: Thank you. My other question is on respite. It is about the capital side of that, rather than service delivery or resource. Have the leadership team and the capital projects side had much contact about or many requests for new builds or for the refurbishment of existing buildings in the Belfast Trust to enhance respite or long-term residential provision for children under the age of 18?

Mr Porter: We are looking at our accommodation for that group, Nuala. We appreciate the need that is there and have been looking at potential projects and areas to try to improve the accommodation for that patient group. Forgive me, because the full details of that are not available to me at the minute, but quite a bit of work has been done on that.

Miss McAllister: You say that you have been "looking at" it, but what exactly, does that mean, is being done by the team? I will put it in context: in my constituency of North Belfast, a site in Willow Lodge, which is in the Belfast Trust area, has been refurbished. I have lodged a question for written answer to the Minister that has hopefully made its way to you on Chestnut Grove. That was previously an older persons' residential care home. It has been refurbished, but I do not understand why, given that it was earmarked for closure long ago and has been closed for some time. That is just beside Willow Lodge and is housing two long-term placements. Is Chestnut Grove one of the accommodation facilities that is being looked at? What does it mean that it is being "looked at"? Is it feasible? I just do not understand what that means. Since the £13 million was announced, every time I ask — I had taken an interest in the matter before the 'Spotlight' programme — all that I am told is that things are being looked at, but no one will say what that means or tell me why there has not been any more progress.

Mr Porter: As you know, Nuala, on-site work is under way at Chestnut Grove. I will have to come back to you on the details of the areas that we have looked at in that regard. I apologise for not having those details with me at present.

Miss McAllister: OK. It would be good to get information on what capital works have taken place, outside of the existing respite provision provided by the Belfast Trust or in conjunction with the South Eastern Trust, so that we know what additional places there are.

I would also like information on whether any capital projects are under way or whether you have been asked to undertake any work for capital projects for post-18 provision for long-term residential stays outside of the provision that is already being offered on the Innisfree ward. People are moving back into those wards for the right reasons. However, there are others who are either aged 17 or are being moved out of Muckamore and need to be placed in supported, specialised accommodation. Rather than having to rely on the private sector or the voluntary sector, I would like to have some detail on what the trust has done on the capital side.

Mr Porter: I will get that for you, Nuala. I do not have that to hand today.

Miss McAllister: OK. Chair, I have no more questions.

The Chairperson (Mr McGuigan): Thank you, Nuala.

Mr McGrath: Thank you, David and Jennifer. I will say something that will probably shock you: I think that we have received reasonable information from you today. I have a sense that you know what you are looking for and that you are putting the procedures in place to find that. I sense the frustration among the rest of the Committee. At the time, we were frustrated with some of the personnel, but the personnel have changed. We were frustrated by the processes, and you are investigating the processes to find out what happened and why, and you are trying to rectify that. It is reasonable that there is frustration at the time that the overall project is taking. However, it is not necessarily fair to direct that at you, because you two are new to this role and are picking up something that has been kicking about for years.

We have an Executive who build things all the time. You are building in the trust on behalf of the Health side of that. Are the procedures that you have to follow unique and bespoke to the trusts, as part of the Department of Health, or is there a wider, Executive-wide book whose procedures you need to follow? Is there a chance that some of the frustrations that we see are around the fact that governance procedures need to be reviewed? It may come to light that those processes have enabled certain operators to work in a way that has delivered us to where we are. If we tighten up those procedures, we may not return there in the future. Had they been tighter previously, we might not be where we are now.

Ms Welsh: I will ask David to comment on that, given his knowledge.

Mr Porter: As you know, I worked in the Health Estates directorate of the Department and know the system there reasonably well. I now work in the trust. It is probably worth noting that we are bound by the same legislation across the piece, which is 'Managing Public Money Northern Ireland' and so on. A specific governance framework for our projects was established by the Department of Health. That includes the role of Health Estates as our professional and technical advisers, and there are responsibilities that lie with the trust, be that with me as the senior responsible officer (SRO) or the other members of the delivery teams. Yes, those are bespoke arrangements for the delivery of our capital projects in Health.

Mr McGrath: Who develops those? Who sets down those arrangements?

Mr Porter: The governance framework for that is established by Health Estates in the Department.

Mr McGrath: How long has that document been in existence, or is it a new document?

Mr Porter: The arrangements have been in place for some time. They have been reviewed at times in the past, but, broadly speaking, the arrangements have been in place for some time. I cannot give you specifics on that, Colin, but I know that they have been there for some time.

Mr McGrath: More than five years?

Mr Porter: The overall governance framework as it sits, as well as the relationship between Health Estates and the trust, is largely similar from beyond that period.

Mr McGrath: Ministers from a number of backgrounds from a number of parties have been in charge of that governance document: is that correct?

Mr Porter: The Department has been responsible for and has defined that for some time.

Mr McGrath: What is that document called again?

Mr Porter: There is a governance framework.

Mr McGrath: Maybe we could write to the Department to ask what that document is, how long it has been about and how often it has been reviewed. That is the document that governs what you, as a trust, do when you deliver those projects.

Mr Porter: That is correct. The Department undertook a review of it recently. I understand that that will be shared with the trusts in the near future. I do not have a timescale for that, Colin, but I know that it was reviewed internally in the Department recently and that that is due to be discussed with the trusts and the other arm's-length bodies.

Mr McGrath: Has the Department interacted with you about your review of the management of that to say, "We would like to work with you on that" or, "We'd like to find out what the outcomes of that are, because there may be lessons to be learned from that"? Is pseudomonas unique to hospital buildings, or could there be pseudomonas if you are building a school, an agricultural building or a water treatment plant? I presume that pseudomonas can appear in any building that you build, so the lessons that you learn about the management process will need to go back to the Department and into the Executive. I presume that there is an estates department in each Department.

Mr Porter: I refer to some of the testimony given to the Committee by Dr Alison Walker. I believe that she referred to pseudomonas as "an opportunistic bug". I could have it today and not realise. The risk lies with immunosuppressed patients, so it is a particular concern in Health. It could be in other areas and not be noticed and never really be an issue. The risks involved are particular to Health.

Mr McGrath: People are sick when they are in hospital, and, therefore, they may be more susceptible to the dangers that go with it.

Mr Porter: Yes.

Ms Welsh: Colin, we have spoken to the Department about its involvement in the review or investigation. It is important that it be involved.

Mr McGrath: I know that it is maybe my being kind and cuddly in a sense, but that is not what I mean by that. One of the greatest frustrations that I have had about all of the processes is that it felt that we, as a Committee, had to dig to get the information. That was desperately frustrating from the point of view of trying to hold people to account. We received a reasonable amount of information. I understand that we cannot ask you to investigate people in your employment and then tell us live on television exactly what you are doing and what the outcomes will be. That would not be fair to the people being investigated. However, my plea is that you be as open and transparent as possible when answering the questions that we ask, because it is critical that we do this role properly and in partnership. We should not feel that information is being hidden or kept away from us. The fact that you are new to the role gives you an opportunity: although you have no skin in the game when it comes to what happened six months ago, a year ago or five years ago, you can make sure that we have no such issues in the future and that we get these things delivered for people. I hope that we can maintain that open communication and receive information, while appreciating that you cannot give all of the information all of the time because of particular processes.

Mr Robinson: I echo what Danny said about the Changing Places facilities. There is a public interest in that, as we know. That is another battle that the SEN sector has on its hands. It is a shame that it has to fight for everything. I have a provisional meeting with the Minister and some families. We look forward to that; hopefully, there will be some progress on that.

I have only one question, and it is about the acute mental health inpatient centre. It was our understanding some time ago that there was an ant infestation in the building: has that been resolved? Secondly, is there now a woodlice infestation? If so, how serious and widespread is it?

Mr Porter: I can answer on the ant infestation. You will recall that we had two pilot rooms, as we refer to them, that we stripped out to determine the extent of the problem. One of the pilot rooms involved in that was the room where there had been ants. There was —.

Mr Robinson: Ants or woodlice?

Mr Porter: Ants, at that time. In all honesty, nothing has been escalated to me about woodlice. I have seen the question for written answer. That is with our team that answers the questions. As far as I am aware, nothing has been escalated to me. We are certainly asking questions, and we will get back to you on that, Alan.

Mr Robinson: Has the ant infestation been dealt with?

Mr Porter: The ant infestation was, as I said, in one of those pilot rooms. That was stripped out, and the infestation was dealt with as part of the refurbishment of the two pilot rooms.

Ms Welsh: It was not an infestation of the building.

Mr Porter: No, no. It was specific to an area that was a part of those —.

Mr Robinson: It was localised.

Mr Porter: — two rooms that were refurbished as part of the pilot. With regard to woodlice, I will need to —.

Ms Welsh: We do not know.

Mr Porter: Nothing has been escalated to me on that. I saw the question for written answer coming in just last night. That is with our team, who will provide a response.

Mr Chambers: I echo what Colin said. You have come along today and have been open with us. I do not think that you have tried to cover up anything. We are all frustrated with the situation, and we all recognise that it is hard to defend what has happened up to now. It did not happen on your watch, and you are trying to do something about it. I respect that. I think that the frustration that you are expressing is absolutely genuine and is just as genuine as the frustration that we have. I do not want you to come here and give false timelines, such as, "Oh, we'll get it open in such and such". I do not want you to take shortcuts or cut corners to get it open. I want to see it opening and being 100% safe for patients and the babies who will be born in that facility. I think that you share that aspiration: you want to see it open, but you will not open it until it is 100% safe. I appreciate what you are trying to do to achieve that.

The Chairperson (Mr McGuigan): OK. Thanks. I have just one point. I quoted a figure of £389 million as the construction cost for the children's hospital when the project was announced. Since then, the Strategic Investment Board's activity reports over the summer have added another £50 million to that. It suggested that it would cost between £350 million and £400 million, and the latest figures are that it will cost between £400 million and £450 million. That is probably in advance of the changes to the water design. Is that just because construction costs are going up?

Ms Welsh: Largely, yes. David will give the detail of that. It is because of inflationary costs as time moves on.

The Chairperson (Mr McGuigan): So, it will potentially cost an additional £50 million in advance of the design report. If there are any further delays, you would expect that that will continue to increase.

Mr Porter: There are mechanisms in the contract. Where there is inflation uplift, there is a pain-gain share for the first five years, so inflation is shared by the contractor and the trust under the terms of the contract.

Ms Welsh: We try to capture in business cases projections of where, we think, inflation will go. Those projections are then profiled by the Department of Health and Health Estates around the money that is needed at particular times. It is fairly technical.

The Chairperson (Mr McGuigan): OK. Thank you both very much for coming along. We look forward to seeing the report in May. We will have you back up when the investigation has been completed.