Minister for Health Simon Harris has said he will make “personnel changes” in the governance structures of the National Children’s Hospital where the final cost could now exceed €2 billion.

Mr Harris was speaking after details of the terms of reference for an independent review to be carried out by consultants PWC into the escalation of costs on the project were revealed. The Government has asked PWC to report into the overrun by March.

The terms of reference, seen by The Irish Times, state the review will “stop short of determining culpability at the individual level.”

Speaking on Friday, Mr Harris pledged there would be accountability in relation to the cost escalation of the project.

“What it says is that the purpose of the PWC review is not to assign individual liability. But let me be very clear, there will be accountability in relation to this. I was very clear on this at the health committee as recently as Tuesday. Let me even go further. There will be personnel changes in relation to some people involved in the governance structure in relation to this.”

“People will be held to account. There will be governance changes in relation to this, of that there is no doubt.”

Three choices “What I would say to people including colleagues in Dáil Eireann is if you were in my position and you were presented with three choices, halt the project, I wasn’t going to do that, retender the project when all of the expert advice suggests that it would add to the cost and add to the timelines, or build the project; which alternative decision would any of my political opponents have taken,” Mr Harris asked?

“You can imagine how frustrated I feel and that there weren’t early warning systems in terms of the governance structures that were in place.

“So, I intend to hold people to account, I intend to make changes in relation to some of the people involved in the management and governance of the project but I also intend to be led by the evidence in that regard and that’s the purpose of the external review.”

The terms of reference, seen by The Irish Times, state the review will “develop further recommendations necessary to address major residual risks, control and oversight issues and establish additional measures required to bring greater oversight of performance” and will “deal with the role and accountability of the relevant key parties” but will “stop short of determining culpability at the individual level.”

It will also “establish the sequence of events in relation to the cost increases experienced by the project and identify key areas of focus for the review.”

It will also establish what was known, when and by whom, and the reporting of relevant information from the project team to the relevant oversight and governance bodies.

Underlying causes The review will also look at the underlying causes of the cost increase and will also look ahead to potential future risks to the project and its costs.

It comes after The Irish Times reported on Friday that the Department of Public Expenditure and Reform (DPER) raised concerns nearly two years ago about governance arrangements for the development of the hospital.

The department said it had been assured by the Department of Health that there were “sufficiently robust” arrangements in place to oversee the construction of the hospital, according to official files.

Official files show that when the DPER was informed late last year that the costs had increased by €450 million or 46 per cent, it said: “Are we now looking at a project that will cost over €2 billion which would make it the most expensive hospital in the world?”

In one document sent to the Department of Health on November 20th last, an assistant secretary in the DPER said: “As you know in the past we voiced serious concerns in relation to governance of the children’s hospital project, and were assured that the arrangements in place were sufficiently robust.”

Informed sources said the DPER had contacted the Department of Health in early 2017 regarding its concerns about governance issues, particularly in relation to the roles and responsibilities of various parties including the Department of Health, the HSE, the hospital development board, and the Children’s Hospital Group.