I must now deal with a postponed division on the motion on national maternity services. Yesterday, when the question: "That the motion be agreed to", was put, the Ceann Comhairle declared the question rite. A division was claimed and that division must now be taken.
National Maternity Services: Motion (Resumed) [Private Members]
The following motion was moved by Deputy David Cullinane on Tuesday, 17 May 2022:
That Dáil Éireann:
notes that:
- in its report entitled "Report of the unannounced monitoring assessment at the National Maternity Hospital, Holles Street, Dublin", the Health Information and Quality Authority (HIQA) noted that "the infrastructure of the hospital, despite numerous and ongoing renovations and refurbishments, was not in line with recommended guidelines for maternity care facilities";
- in the report entitled "Overview report of HIQA's monitoring programme against the National Standards for Safer Better Maternity Services, with a focus on obstetric emergencies", HIQA noted that:
- 15 of the 19 units or hospitals inspected had an outdated physical infrastructure that did not meet the recommended design standards and specifications for modern maternity services;
- only four maternity units and hospitals were compliant with the national standard relating to physical environment; and
- therefore, staff in these 15 maternity units and hospitals were providing services and care in substandard physical environments that were in need of significant upgrading and refurbishment;
- gynaecology waiting lists have increased by 45 per cent since March 2015, from 24,825 patients on active waiting lists to 36,027 in March 2022; and
- the number of people waiting longer than 12 months on gynaecology waiting lists has increased by 67 per cent since March 2015, from 4,127 patients to 6,889 in March 2022;
further notes that:
- the Minister for Health has brought forward a proposal for the relocation of the National Maternity Hospital (NMH) at Holles Street to the Elm Park Campus of St Vincent's Healthcare Group (SVHG);
- on 22nd April, 2022, the divestment of the Religious Sisters of Charity (RSC) from SVHG was completed;
- the proposal for relocation is in the form of a 299-year lease of the site, and any buildings erected thereon will be owned, in freehold title, by SVHG, at the end of this lease whether in 299 years or at a sooner date due to the forfeiture or termination of the lease;
- leasehold interest does not confer the comfort, control, or unencumbered rights which are inherent to freehold ownership;
- the permitted use of the site under the proposed leasehold agreement is subject to the undefined and ambiguous "clinical appropriateness" test, which many clinicians, legal professionals and women have raised concern over due to its ambiguity and the potential for Court action by the landlord or by a third party which may disagree with the Health Service Executive (HSE) or NMH's interpretation at some point in the duration of the 299-year lease; and
- all activities at the new NMH at Elm Park are subject to a convoluted governance arrangement, involving Directors appointed by SVHG, the NMH Chartered Trust, and the Minister for Health, three separate companies with three separate constitutions, Boards and sets of Directors;
furthermore, notes that:
- two eminent members of the HSE Board, Professor Deirdre Madden, a Professor of Law specialising in Medical Law and Ethics and Deputy Chairperson of the HSE Board, and Dr Sarah McLoughlin, the Patient Advocate on the Board, have expressed a concern that "in the interests of public trust and confidence in this new project there should be absolute clarity of the separation of Church and State. This would be better achieved if the State owned the land on which the hospital was built, in line with the recommendations of the Day Report (2018),";
- Professor Madden and Dr McLoughlin further expressed that "the statement from SVHG that they must retain ownership for the delivery of integrated patient care is unsatisfactory" and further, that "the advantages of co-location could be achieved by contractual terms … without any detriment to patient care";
- the Taoiseach, in March 2021, stated in the Dáil that "I am of the view that hospitals which are predominantly or overwhelmingly funded by the State should be in State ownership. That is my view. The State now essentially supports these hospitals in all manner and means through current and capital funding … With regard to the National Maternity Hospital, my view is the ownership, control and ethos of it has to be informed by State and Government policy";
- the Tánaiste, in 2019, stated in the Dáil that "It is our policy that the hospital will be publicly owned and that the land it is on will be in public control"; and
- the Leader of the Green Party, in 2017, stated in the Dáil that the new NMH "should involve not the creation of a lease arrangement but rather the transfer of ownership of the site to the State so that there is no uncertainty or lack of clarity on the ownership";
recognises that:
- in 2020, €338.8 million, or 67 per cent, of SVHG's revenue came from the HSE for the provision of public healthcare;
- in 2020, €72.8 million, or 86 per cent, of NMH's revenue came from the HSE for the provision of public healthcare; and
- the State, via the HSE, will pay for the construction of the new NMH building; and
calls on the Government to:
- pursue the full realisation of the promise that was made by the RSC to gift the land to the people of Ireland;
- engage, at the highest level, with the new ownership group behind SVHG, St Vincent's Holdings CLG, to secure full public ownership of the site and new building, with all necessary safeguards, wayleaves, and guarantees to ensure the integrity, integration and highest quality of care on the site;
- resource the National Maternity Strategy and increase capital funding, for the upgrading and refurbishment of maternity hospitals and units which are in dire need of works to meet clinical and safety standards for patient care; and
- ensure the full provision of the range of legally available sexual and reproductive health services across all relevant HSE facilities, and the advancement of accessible community-based services in this field.
Question put:
The Dáil divided: Tá, 56; Níl, 10; Staon, 69.
Tá
- Andrews, Chris.
- Bacik, Ivana.
- Barry, Mick.
- Boyd Barrett, Richard.
- Browne, Martin.
- Buckley, Pat.
- Cairns, Holly.
- Carthy, Matt.
- Clarke, Sorca.
- Collins, Joan.
- Conway-Walsh, Rose.
- Costello, Patrick.
- Cronin, Réada.
- Crowe, Seán.
- Cullinane, David.
- Daly, Pa.
- Doherty, Pearse.
- Donnelly, Paul.
- Ellis, Dessie.
- Farrell, Mairéad.
- Fitzmaurice, Michael.
- Funchion, Kathleen.
- Gannon, Gary.
- Gould, Thomas.
- Guirke, Johnny.
- Harkin, Marian.
- Hourigan, Neasa.
- Kenny, Gino.
- Kenny, Martin.
- Kerrane, Claire.
- Mac Lochlainn, Pádraig.
- McDonald, Mary Lou.
- Mitchell, Denise.
- Munster, Imelda.
- Murphy, Catherine.
- Murphy, Paul.
- Murphy, Verona.
- Nash, Ged.
- O'Callaghan, Cian.
- O'Reilly, Louise.
- O'Rourke, Darren.
- Ó Broin, Eoin.
- Ó Laoghaire, Donnchadh.
- Ó Murchú, Ruairí.
- Ó Ríordáin, Aodhán.
- Ó Snodaigh, Aengus.
- Pringle, Thomas.
- Quinlivan, Maurice.
- Ryan, Patricia.
- Sherlock, Sean.
- Shortall, Róisín.
- Smith, Bríd.
- Smith, Duncan.
- Stanley, Brian.
- Ward, Mark.
- Whitmore, Jennifer.
Níl
- Canney, Seán.
- Collins, Michael.
- Fitzpatrick, Peter.
- Healy-Rae, Danny.
- Healy-Rae, Michael.
- Lowry, Michael.
- McGrath, Mattie.
- Nolan, Carol.
- O'Donoghue, Richard.
- Tóibín, Peadar.
Staon
- Bruton, Richard.
- Burke, Colm.
- Burke, Peter.
- Butler, Mary.
- Byrne, Thomas.
- Cahill, Jackie.
- Calleary, Dara.
- Cannon, Ciarán.
- Carey, Joe.
- Carroll MacNeill, Jennifer.
- Chambers, Jack.
- Collins, Niall.
- Coveney, Simon.
- Cowen, Barry.
- Creed, Michael.
- Crowe, Cathal.
- Devlin, Cormac.
- Dillon, Alan.
- Donnelly, Stephen.
- Duffy, Francis Noel.
- Durkan, Bernard J.
- English, Damien.
- Feighan, Frankie.
- Flaherty, Joe.
- Fleming, Sean.
- Foley, Norma.
- Griffin, Brendan.
- Harris, Simon.
- Haughey, Seán.
- Heydon, Martin.
- Higgins, Emer.
- Humphreys, Heather.
- Kehoe, Paul.
- Lahart, John.
- Lawless, James.
- Leddin, Brian.
- Madigan, Josepha.
- Matthews, Steven.
- McAuliffe, Paul.
- McConalogue, Charlie.
- McEntee, Helen.
- McGrath, Michael.
- McHugh, Joe.
- Moynihan, Aindrias.
- Moynihan, Michael.
- Murnane O'Connor, Jennifer.
- Naughten, Denis.
- Noonan, Malcolm.
- O'Brien, Darragh.
- O'Brien, Joe.
- O'Callaghan, Jim.
- O'Connor, James.
- O'Dea, Willie.
- O'Donnell, Kieran.
- O'Donovan, Patrick.
- O'Dowd, Fergus.
- O'Gorman, Roderic.
- O'Sullivan, Christopher.
- O'Sullivan, Pádraig.
- Ó Cathasaigh, Marc.
- Ó Cuív, Éamon.
- Rabbitte, Anne.
- Ring, Michael.
- Ryan, Eamon.
- Smith, Brendan.
- Smyth, Niamh.
- Smyth, Ossian.
- Stanton, David.
- Varadkar, Leo.
Tellers: Tá, Deputies Pádraig Mac Lochlainn and Denise Mitchell; Níl, Deputies Mattie McGrath and Michael Collins.
Question declared carried.