Dáil Éireann Debate, Wednesday - 5 December 2018
36. Deputy Bríd Smith asked the Minister for Health the way in which he will ensure that women have access to healthcare, including the right to abortion services, at the proposed maternity hospital on the grounds of St. Vincent’s Hospital in view of concerns in relation to the possible influence of a religious ethos on the provision of these services; and if he will make a statement on the matter. [50770/18]
Amharc ar fhreagraThis question concerns the urgency with which we need to find out what is happening with the national maternity hospital in terms of the ethos being applied to it. Is the plan to have the building go ahead as soon as possible on track and, if not, what is the reason for that? According to newspaper reports, there is some kind of cold war under way between the Department and the boards of the national maternity hospital and St. Vincent's Healthcare Group. Does the Minister believe that the step to ensure the St. Vincent's Healthcare Group is set up as a charitable status must be taken? If this step has not been taken, when will it be taken? Is the Minister fully satisfied that the hospital will be protected from being dominated by a Catholic ethos in a newly secular Ireland?
I welcome this question because it provides me with an opportunity to debunk a few myths. I am not giving any hospital to the nuns. With regard to people handing out flyers stating that I am giving the hospital to the nuns, let us debate facts in politics and not try to demonise each other. I am a strong advocate for the separation of church and State and respecting the role of each while not allowing the role of either to cross over and interfere with that of the other. I saw a newspaper headline at the weekend quoting an anonymous source in some hospital which stated that I was meddling in the development of the new hospital. The definition of the word "meddling" is to interfere in something that does not concern one.
I want to be very clear. The people of this country think it is right and proper that their Minister for Health should be concerned with the development of any new national maternity hospital and should want to know that the hospital will have robust governance, will be able to operate independently and that the State will have a seat at the table when decisions are made by the board. I am very confident that we can reach an agreement that ensures such robust clinical governance. It is important to point out that, notwithstanding Deputy Smith's view or my view on how the world should be, both St. Vincent's Hospital and the National Maternity Hospital, Holles Street, are voluntary hospitals. However, the State is the funder of the capital project and the staff and the custodian of health policies with responsibility for their development.
I assure the Deputy that the hospital will operate with full clinical independence. I note the excellent letter from Dr. Rhona Mahony, the outgoing master of Holles Street, and Dr. Shane Higgins, the incoming master, in The Irish Times this week in which both of them, being strong advocates for women's health with impressive track records, stated:
The new NMH will operate in accordance with the law of the land, not canon law - just as it does now. It will have no religious ethos. As the outgoing and incoming Masters of the NMH, we would not countenance supporting anything other than the continued clinical independence of the NMH.
There will be no religious ethos in the new hospital. I agree with Deputy Smith that there must be absolute certainty about the charitable status. I am aware that St. Vincent's Hospital and the nuns have given commitments in that regard. We need to build this new hospital as quickly as possible, but we need to get it right.
I do not believe people are accusing the Minister of not delivering the goods. What I think is going on is that nobody knows what is happening. That is the reason I am asking the Minister straight questions. Why has the St. Vincent's Healthcare Group not yet registered as a charitable organisation? We have been talking about this for 18 months or more and it still has not been done. People suspect that some kind of meddling is going on and that there is, at the heart of this, a cold war between the Minister and the two organisations concerned. If that is not the case, I want the Minister to use this opportunity to explain to us what is happening with the negotiations. When can we expect this group to register as a charitable organisation? I remind everybody that almost €400 million of public money will be spent on this project. Apart from the financial aspect, this is a step forward not just regarding women's reproductive health but in how we see ourselves as a society. We have moved on and become secular. We are a different kind of country and it is important for everyone that we leave behind the advocates of Mother Mary Aikenhead.
The National Maternity Hospital, Holles Street, is an excellent institution providing wonderful care for women in this country. The current facility is not fit for purpose. The idea of having stand-alone maternity hospitals is not in compliance with our national maternity strategy or best international norms. It makes sense to co-locate maternity hospitals with adult acute hospitals for the times when, sadly, things go wrong during pregnancy.
There are three issues that need to be addressed. The Deputy is right that the charitable status of St. Vincent's Healthcare Group must be sorted out, giving effect to the fact that the nuns have said they are leaving. I cannot comment on where that is at, but the matter needs to be resolved. The second issue is making sure there is a robust and modern governance system in place that sees the State having a seat at the table. The third issue is public ownership. We need to know who owns the building to ensure there are safeguards in place because, frankly, they are not in place today. In that way, if the Minister of the day or any future Minister has any concerns, and I am not envisaging they would, they can say to the taxpayer and, more important, to the women of Ireland who are also taxpayers, that they have the powers and leverage that people would expect them to have in a 21st century republic.
I believe this matter can be resolved and we can reach agreement in the coming weeks. However, I will not be backed into a corner by anybody who suggests that I should ask for anything less for the State or women, particularly after all that has happened in this country in the past year.
I am delighted to hear the Minister say he will not be backed into a corner by anybody but we are still not getting answers. That is very concerning. Groups are forming and they will protest at 2 p.m. this Saturday at the Spire, not because they cannot stand the sight of the Minister but because they are genuinely concerned about what is happening. Why has charitable status not been registered? The Minister spoke about public ownership and proper safeguards not being in place. Why has he not secured those safeguards? This has been going on for a long time. The Minister says he cannot comment. Why not? This is public money and involves the public interest and a public hospital. We need answers. I would like the Minister to explain what he means by the State having its feet under the table.
A seat at the table.
What does that mean in terms of the State's influence? Does it mean the Minister will get a golden seat and will have the absolute say in terms of what goes at the board? There is no clarity on that.
The Minister should not be surprised that people are protesting and giving out leaflets. We are concerned, having fought long enough to make changes in this country. While I acknowledge the Minister's role in that regard, we need more answers. We need the truth. This is, after all, a public issue which involve public money. Is someone messing about and delaying this project because there are rumours in the newspapers that it has to be signed off on by the end of the December? Will the Minister clarify what exactly is the problem?
The issue is very straightforward. The Mulvey agreement was negotiated between St. Vincent's University Hospital and Holles Street Hospital. Many people, in particular women, made their views very clearly known to me, loudly and articulately, that they were not satisfied that it was robust enough on the issues of governance and ownership. In effect, they asked me to revert to seek more assurances and protections and that is what I have been doing. I have had my senior officials engage with both hospitals. It is a statement of fact that they are voluntary hospitals with their own governance structures. It is like the road from County Kerry, of which it is said, "I would not start from here." I disagree, however, with the assertion that we are gifting hospitals to nuns, which I have heard put about at protests. It is very important that we get this right. There will be no gifting of any hospital to nuns. No one is blocking this, but I want agreement. I have made very clear to both hospitals what I expect on the ownership of the building and the governance model. I expect that we can make progress in the coming days. The ministerial representatives on the board of Holles Street Hospital were appointed by Barry Desmond who was Minister for Health a long time ago. The Archbishop of Dublin nominally chairs the board, on which the parish priest sits. We need to change that structure to provide for modern, fit-for-purpose governance of our national maternity hospital. That is what I am going to deliver.
