Tuesday, 12 July 2016

Questions (13)

Mick Barry


13. Deputy Mick Barry asked the Minister for Health his views on the continuing depth of involvement of religious organisations in providing State-funded health care, on the separation of church and State, and if he will make a statement on the matter. [21000/16]

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Oral answers (8 contributions) (Question to Health)

Does that mean that Deputy Connolly will get an opportunity to speak after me?

Yes. There will be time for her question if we adhere rigidly to the time allocated.

I will do that and I appreciate this. My question is to ask the Minister for Health for his views on the continuing depth of involvement of religious organisations in providing State-funded health care, on the separation of church and State and if he will make a statement on the matter.

I thank Deputy Barry for his question. Voluntary and non-statutory service providers, including religious orders, have a long history of providing health and personal social services in Ireland and of receiving State funding to provide such services. I would like to acknowledge the significant contribution of all such providers to the delivery of these essential services. I remarked earlier in this House that were it not for some of those voluntary service providers, one wonders how many of our people would have been cared for throughout the years in this country in terms of disability services, mental health services and other services.

The HSE, however, has a statutory responsibility - one cannot delegate that - for the management and delivery of health and personal social services. As well as providing services directly, the HSE enters into service agreements or arrangements with service providers to provide such services on its behalf. As Minister for Health, my priority is ensuring that all of the resources available to the HSE are used in the most beneficial, effective and efficient manner to improve, promote and protect the health and welfare of the Irish public. To that end, the HSE has a formal national governance framework which governs grant funding to all service providers under sections 38 and 39 of the Health Act 2004. This framework seeks to make sure that governance systems are sufficiently robust and effective to ensure that both the HSE and the grant-funded agencies, be they religious orders, irrespective of denomination, or other voluntary or non-statutory service providers, meet their respective obligations. The most critical issue for me, regardless of whether the service provider is a religious organisation, is whether the service is being provided for which we the taxpayer, through our health service, are paying.

I do not have an ideological position on the involvement of religious organisations in the delivery of health care. I believe there is scope for diversity in the range of service providers delivering health care - that has always been the way in this country - but that service must be delivered and, let me be clear on this, in line with Government health policy, legislation and the responsibilities attaching to the use of public funding. Once an organisation is complying with our health policy, the Government's policy, the legislation passed by this House and the responsibilities attaching to the use of the public money, the matter of whether the service provider is a religious or non-religious organisation is not something that keeps me awake at night.

The Minister is right in saying there is a long history of provision of health care by such service providers but we are now in the 21st century. The Minister said the key issue is the whether the service is being provided, so let us get down to the nitty-gritty on that. I refer to an article in The Sunday Business Post of 9 May. The headline stated: "Catholic ethos restricting St. Vincent's Hospital from procedures." The article stated that doctors working at St. Vincent's Healthcare Group in Dublin are being restricted from carrying out procedures that are contrary to Catholic ethos. It stated that gynaecologists and urologists said they were not allowed to perform procedures such as vasectomies and tubal ligations for patients who want to permanently prevent pregnancy. It further stated that the doctors contradicted assurances given by management which had insisted there were no restrictions stopping its doctors from performing these procedures. Doctors at the Mater Misericordiae University Hospital in Dublin city centre said they faced the same restrictions. It also states that the Mater hospital and St. Vincent's hospital receive €450 million in State funding between them each year. Mr. John Thornhill, the President of the Irish Society of Urology said vasectomies were "not allowed in hospitals in the public sector with a Catholic ethos". Would the Minister care to comment on that?

As I said very clearly already, my responsibility as Minister for Health is to make sure that we are delivering the services that the Irish public require in terms of their health and well-being. My responsibility is to ensure that the funding this House approves for me to expend on the health service is disbursed by the HSE, either spent by it or disbursed to voluntary organisations, and that we get value for money and get the services that we pay for and require.

I set health policy on behalf of the Government; nobody else and no religious order sets health policy. Therefore, I feel very strongly, and I share Deputy Barry's view on this, that where the HSE or the taxpayer is funding the service, it is this House and this Government that set the policy and not any other house or any other type of governing body.

There is obviously an issue of conscientious objection and that may be the issue to which the Deputy is referring. That could potentially arise in the context of the provision of treatment and services in health care facilities run by religious organisations. The European Court of Justice has outlined that this conscientious objection remains a limited right derived from religious freedom that cannot lead to the restriction of the rights and freedoms of another person. However, a health care professional's conscientious objection absolutely does not absolve his or her duty of care to the patient. Therefore, he or she could not abandon the patient or cause the patient's care to suffer in situations where such a transfer would not be possible. This is in line with the approach outlined in the Medical Council's guide to professional conduct and ethics which facilitates the transfer of a patient from one doctor to another.

A dedicated State-funded service with the specific remit of catering to homeless pregnant women has been provided by a so-called pro-life organisation, Life Pregnancy Care, which recently branded itself as Anew, and now claims to be multidenominational. According to its audited financial statements for 2014 provided to the Companies Office in November 2015, its directors include Lorcan Price, who is also a director of the Pro Life Campaign. In 2014, the HSE gave Anew, formerly Life Pregnancy Care, nearly €0.5 million in funding, 83% of Anew's total budget. Would the Minister care to comment on that?

I will have a look at the information the Deputy has made available to me and I will revert to him directly on it. I recently met people involved in the Termination for Medical Reasons, TFMR, group, and we had a discussion on a number of issues regarding ensuring consistency in terms of access, particularly to bereavement counselling and procedures. I have undertaken in regard to bereavement standards to make sure that phrases such as "fatal foetal abnormality" feature as opposed to just phrases such as "life-limiting conditions". I am very clear on this view. I do not care too much, to be quite frank, once the service provider provides the service but I do not want any patient in this country not to be able to access a service that is in line with my policy as Minister for Health and the policy of this House and of the Government.