Tuesday, 11 December 2018

Ceisteanna (1, 2, 3, 4)

Michael Moynihan


1. Deputy Michael Moynihan asked the Taoiseach if he has met church leaders recently. [49133/18]

Amharc ar fhreagra

Mary Lou McDonald


2. Deputy Mary Lou McDonald asked the Taoiseach if he has held recent meetings with representatives of churches and faith communities as part of the church-State structured dialogue process. [50346/18]

Amharc ar fhreagra

Richard Boyd Barrett


3. Deputy Richard Boyd Barrett asked the Taoiseach if he has recently met church leaders. [50390/18]

Amharc ar fhreagra

Brendan Howlin


4. Deputy Brendan Howlin asked the Taoiseach if he will report on his recent meetings with church leaders. [51852/18]

Amharc ar fhreagra

Freagraí ó Béal (37 píosaí cainte) (Ceist ar Taoiseach)

I propose to take Questions Nos. 1 to 4, inclusive, together.

On 25 August, I met with Pope Francis during his visit to Dublin Castle. The meeting provided an opportunity for us to discuss several issues, although, regrettably, not in any depth because it was of short duration.

On 22 January 2018, I met with representatives of the Church of Ireland, Presbyterian and Methodist Churches in a formal meeting under the structured dialogue process between the church and State. We discussed important social and economic issues facing Irish society as well as international issues. This was the second in a series of meetings that I will be holding with dialogue partners.

On 31 August 2017, I held a formal meeting under the structured dialogue process with representatives of the Catholic Church, led by Archbishop Eamon Martin.

Some of the issues we discussed at these meetings were challenging. They are issues on which people have deeply held views and which are matters of conscience. Our discussions were valuable, not just because they dealt with important issues, but particularly because they were conducted in an atmosphere of respect for the views of others, where everyone sought to be constructive.

Like public representatives generally, I meet church leaders informally from time to time in the course of attending official or public events, including visits to the Jewish and Muslim communities. In particular, with the recent presidential inauguration and the visit of Pope Francis, I attended several events that were also attended by representatives from various religious groups, which enabled me to engage with them.

I thank the Taoiseach for his reply. I reiterate that in the past few days the issue of the impact of historical ownership models within the health sector has come to light in the context of Holles Street. For the sake of moving forward with critical improvements to women's healthcare in Dublin in particular, but also throughout the country, I hope this will definitely be resolved immediately. I put this forward not from an ideological perspective but from a governance and capacity perspective. It points to a failure in recent years to have a more structured and comprehensive approach to patronage and ownership in an era where religious groups no longer have the capacity to effectively manage institutions. Years were wasted on an adversarial approach where arbitrary targets were announced. Progress basically dried up as we know, particularly in education. We had all the talk of divestment and nothing happened as a result. Has the Taoiseach proposed any new systematic engagement with the churches about their roles within education and health and the wider social services?

As we talk about constructing new hospitals, where existing sites are sold, the funding should only go to new hospitals. We are in danger of losing many positive contributions if we do not have a more systematic approach. Furthermore, the churches, to be fair, were pillars of the peace process and were able to maintain a dialogue with the men and women of violence even when they were at their destructive and sectarian worst. Nothing could have been achieved without brave members of religious communities who worked night and day for peace. In this context, it has to be a deep concern that many religious leaders today are very worried about the direction of events in Northern Ireland. They believe that the political deadlock imposed by the DUP and Sinn Féin is dramatically escalating tensions and that a dangerous atmosphere is developing. Has the Taoiseach had any recent meetings with religious leaders about their concerns about Northern Ireland? Has he sought their co-operation to try to find a pathway forward to the restoration of democratic politics and a more energised civic dialogue within Northern Ireland, which has been suppressed for far too long?

The new National Maternity Hospital to be housed at St. Vincent's has been mired in controversy. Public opinion is clear that it must be owned and operated by the State. Some 19 months have passed since the Sisters of Charity announced that they were to end their involvement in the St. Vincent's Healthcare Group. Last week, the Minister for Health confirmed that the withdrawal of the order from St. Vincent's had yet to be finalised. Alarmingly, the Minister acknowledged that he has yet to ensure that the hospital will remain in public ownership or that its board will include a public interest director. Over the weekend, as the Taoiseach may know, hundreds of women gathered in Dublin to voice their concerns about the ownership and ethos of our new maternity hospital. Hours later, Archbishop Diarmuid Martin stated that citizens do not have to obey laws that are contrary to their Catholic faith, an assertion which I, as a Catholic, found alarming and extraordinary. The Taoiseach can understand the heightened concerns that women and their families have regarding their healthcare. It is clear that the January deadline, as committed to, for the provision of abortion services will not be met and we have the Archbishop of Dublin publicly encouraging a revolt by anti-choice medical professionals with regard to the referral provisions in the Health (Regulation of Termination of Pregnancy) Bill. Dr. Rhona Mahony, as she ends her term as master of Holles Street, is concerned that the new maternity hospital project is in danger of falling apart. Will the new maternity hospital be owned in full by the State? Will the Taoiseach reassure women and their families that there will be no involvement at board, management or ownership level by the Sisters of Charity or any other religious order?

I am asking this question on behalf of Deputy Boyd Barrett. Last Wednesday morning, I had the opportunity to ask the Minister for Health the same question about ownership of the new National Maternity Hospital and I got no answer. I do not think it is good enough that the public, especially women, are, until the 11th hour, when the deal was supposed to be signed on Friday, not being given information. Some 25 months ago, discussions commenced on the ownership of the hospital and we still do not have accurate information. I was one of the people at the protest on O'Connell Street. I was not there for the fun of it. It was a cold, wet day but I was there because the answers being given here by the Minister for Health are not acceptable. They are not answers. Women are genuinely concerned about the future of maternity care for many reasons, not least the legacy reasons of the role of the church in healthcare. The Taoiseach has said on many occasions, as has the Minister, Deputy Harris, that he wants to see the full separation of church and State in health and education. Now is an opportunity for him to ensure that happens. Will he guarantee here today that what will probably cost the State at least €350 million, not an untidy figure, will belong to the people and will be governed and run in a purely secular manner that can guarantee women in the post-repeal era 21st century maternity care? Can we see details of the deal? When will this new company be incorporated and the separation made?

I agree with the questions which have been posed so far about the new National Maternity Hospital. The Taoiseach talked about the visit of the Pope. There was an interaction during that visit when the Minister for Children and Youth Affairs presented the Pope with a letter. I understand there was follow-on communication. Was there ever a response from the Vatican to that correspondence, has it been discussed by Government and what is its nature?

Is there a structure for the Government's interaction with various religious groups and organisations in the State? There has been much recent controversy about the Church of Scientology and its expansion plans, particularly a Narconon centre in Ballivor in County Meath, which is apparently to be a rehabilitation and drug treatment centre. I understand that while planning permission is needed, there is no regulation or inspection of residential treatments for rehabilitation. Is this a matter that the Taoiseach has had any interactions with the Church of Scientology about? Have there been any interactions between the Taoiseach, the Department and the Church of Scientology?

Will the Taoiseach clarify where his Government stands with regard to the National Maternity Hospital in Holles Street? It has a long tradition of care. As somebody who had a baby in Holles Street, I can personally testify to that. When we were in government, there was a strong understanding between the Labour Party and the Taoiseach's party, as the bigger party in that coalition, that this would be a fully independent maternity hospital whose ends and objectives would relate to women and babies irrespective of any kind of clerical or church control or influence. The Taoiseach and Minister for Health have consistently refused to come out completely clearly and show how that will be done by the State. The nuns have announced that they have stood back but none of us is clear as to whether or not the commitments they have given are adequate. The Taoiseach must have taken advice from the Attorney General. We know that the hospital project has to proceed. What is delaying the Government, the Taoiseach and the Minister for Health in being clear about this?

There are quite a few things happening with regard to patronage and ownership. Many new schools are being built around the country. Many are community national schools, Educate Together schools or are under education and training boards, ETBs. Some are under relatively new religious patronage bodies such as Le Chéile or Edmund Rice Schools Trust. These new builds on new sites are publicly owned by the Department of Education and Skills. There is a divestment programme, which is slow but it is happening. That relates to a number of locations around the country where the parents of preschool children are being surveyed and polled about what type of patronage they would like to have for their local school. In time, that will lead to quite a number of diocesan national schools being transferred to the patronage of the local ETB.

In healthcare, a former chief civil servant in the European Commission, Catherine Day, has prepared a report on patronage and voluntarism in our health service. I do not think many people in this House will dispute, with regard to voluntarism in the health service, that many hospitals around the country, including the Mater, St. Vincent's or the National Children's Hospital, formerly on Harcourt Street, or the Mercy in Cork, were founded by religious bodies or charities, often being paid for, built and staffed by them and they did the country a lot of service. We should not throw the proverbial baby out with the bathwater.

We need to modernise, but I do not believe that should involve abandoning or expelling voluntarism from our health services. The same would apply to Our Lady's Hospice and to St. Francis' Hospice as well. It is a case of making sure we have modern structures and governance in place, but that does not necessarily mean complete and absolute secularisation.

I am not saying that.

People who have had the experience of those hospices and so on will agree with that.

Does that apply to governance?

In terms of Holles Street specifically, as I understand it, it is intended that the site and building will be sold and that the proceeds will be used as a contribution towards the new hospital. It will be gifted to the State.

It is not going to be gifted.

On the national maternity hospital, it is important that we develop a practical solution in this instance. This is not a greenfield site or the establishment of a hospital de novo. Rather, it is the movement of a hospital that has been around for hundreds of years onto the site of another hospital that has been around for a long time, both of which are currently not in the ownership of the State. The Minister for Health is bringing together two existing hospitals on the same site. These are hospitals with their own legal personalities, boards and staff and, in some case, their own debts and various other liabilities. It is important to get the governance and ownership right. It is intended that the hospital will be owned by the Government and that any procedure or service that is legal in this State, including tubal ligation, abortion, IVF, will be available in that hospital, the law of the land will apply, and the ethical principles that will apply are those of the Medical Council and medical ethics not any other ethics. The hospital will also have its own board and governance separate from St. Vincent's Hospital but the hospitals will require a degree of integration. The purpose of co-location is to ensure that a woman who is pregnant and has a heart condition can avail of the cardiology services in St. Vincent's Hospital. Similarly, a woman who is pregnant and suffering from epilepsy will have access to the full suite of neurology services available in that hospital. These are the matters we need to get right.

The time for this group of questions has expired. We must move on.

The reason for the delay in providing clarity around this issue is that it has not yet been finalised or formally agreed. Once it is, clarity will be provided.

Will it be clarified by Friday?

I do not know.

May I ask a brief supplementary question?

The time for this group of questions is expired. If Members wish to ask further supplementaries, the time will have to be taken from later questions.

I would appreciate it if we could do that.

I also have not finished my answers.

Do members wish to continue on this group of questions?

I have a lot more supplementary answers.

We will need only a few minutes to deal with the final question, so we could take some of the time allocated to it.

Let us take ten minutes and first allow the Taoiseach to continue his answers. Is that agreed? Agreed.

I was asked about the interaction between the Minister for Children and Youth Affairs and the Pope during his visit. As members will be aware, they spoke briefly in Arás an Uachtaráin about Tuam and the Minister followed up that conversation with a letter. The Pope has provided a written response, although it is more of an acknowledgement than a substantive response. The Minister has engaged with the religious order that operated and owned the Tuam home and it has agreed to make a financial contribution towards the excavation and to work with her on helping the commission get to the facts of what happened in that particular mother and baby home.

On church-State dialogue, it is not a formal structure in the sense that it does not have a secretariat and there is no member of staff whose job it is to manage that dialogue, but it is structured in the sense that it occurs at least once a year. Everybody knows when it is going to happen, an agenda is prepared and delegations are put together, usually comprised of myself and a number of Ministers and representatives of the religious orders. Defined times are set aside to deal with each of the issues and during the year these are followed up by the line Ministers.

The Church of Scientology is not part of the church-State dialogue and I have not had any interactions with it.

I will allow brief supplementary questions as distinct from statements.

I am not talking about voluntarism in respect of St. Vincent's Hospital and Mercy hospital. These are systemic hospitals. They are big concerns in which there has been significant investment by the State. To all intents and purposes, they are tertiary hospitals and will remain so into the future. The religious orders have exited the governance of the hospitals. The danger with a lay trusteeship is that private concerns can enter into the realm over time. The State needs to be guarded in protecting the taxpayer and the citizen in terms of what have been identified as tertiary centres where acute care has to happen. As I said, I am not talking about fuzzy voluntarism; rather, I am talking about a fundamental aspect of capacity and governance in our health services into the future. As the new maternity hospital is being co-located on the site of St. Vincent's Hospital, which is a tertiary hospital, the former has to have a State-oriented future one way or the other.

Nobody is gainsaying the contribution of voluntarism in the past but we are now at a point where massive public investment is envisaged in a national maternity facility and people need clarity and certainty. The Taoiseach said that he cannot give that certainty because the matter has not yet been resolved. It was to have been resolved at this stage, but it still is not. When will it be resolved and when will we have the certainty we desire?

According to the media, construction of the national maternity hospital is due to commence on 14 December. We still do not know when a company, which 18 months ago we were promised would be established, will be incorporated. This company was to be established for the expressed purpose of separating the new national maternity hospital from the St. Vincent's Hospital Group. Until such time as this has been done and we have assurances in that regard, the doubt, concern and protests will continue. We need to see the colour of the Government's money, in particular of the Taoiseach and the Minister for Health, because our money is being used to build a hospital with no guarantees for the future of women's healthcare. There is ambiguity in the Taoiseach's response.

I remember well my visit to Holles Street hospital as Minister for Public Expenditure and Reform, following which I had discussions on the new national maternity hospital with the then Minister for Health, James Reilly, because I allocated the money for it. There was an understanding between us that the hospital would be a national maternity hospital built on a co-located site but totally independent. We need to have this clearly expressed now and doubly so in the context of the utterances of a senior church person during the week which urged Catholics to break the law or, at least, to not comply with laws that run contrary to church teaching. This is a worrying development in the context of a new national maternity hospital. I ask the Taoiseach to state that the intention of the Government, and of this House, is that the national maternity hospital will fully comply with every aspect of the law, its governance will be secular, and whatever legal means are required to achieve that will be pursued.

The Taoiseach cited examples of women in either hospital and what might happen to them. If a pregnant woman in St. Vincent's Hospital is in danger of dying due to a heart attack, will she be moved to the maternity hospital for a termination if that is what will save her life or could staff with conscientious objections on the general hospital side simply not offer her what should be available to her and her family by way of choice? It is important that the Taoiseach publishes draft governance arrangements such that we can work through the type of examples he set out earlier.

They are challenging examples so can the Taoiseach assist the Dáil in that way?

Hospitals such as St. Vincent's, the Mater and the Adelaide and Meath Hospital incorporating the National Children's Hospital in Tallaght are tertiary hospitals. They are also voluntary hospitals. There is nothing fuzzy about voluntarism.

There is no volunteerism in them at present.

It is serious. It is a particular model of governance, and it is certainly not unique to Ireland. The Mater Hospital in Belfast, for example, which has been part of the NHS since its foundation, has autonomy and an arrangement with the NHS. Many of the hospitals in Germany are owned by voluntary bodies or charities, some of which have religious foundations as well. However, Deputy Micheál Martin's point is valid. There is a difference. As religious orders diminish in number they are transferring patronage of schools and hospitals to lay people, who may or may not have religious views. We must bear in mind that a change is happening in that regard.

I was again asked about when the issue relating to the National Maternity Hospital will be resolved. I do not know. I cannot put a date on it because the Government is not the only party involved. It involves the Department of Health and the HSE, St. Vincent's and the National Maternity Hospital. When three parties are involved in a negotiation no single party can say when it will be resolved. It would be similar to me asking Deputy McDonald when an executive will be up and running in the North. It is not in the gift of any single actor in this-----

One would not think that normally given the commentary.

-----so it will be resolved when it is resolved. I will repeat what I said earlier, lest there be any doubt. The Government will be investing hundreds of millions of taxpayers' money in this new hospital and it will not be gifted to anybody. The entire investment will be protected by the State. The hospital will be independent of St. Vincent's and will have its own governance, board and staff, but there will have to be a degree of integration because that is the point of co-location in the first place. Regarding what laws will apply, they will be the laws enacted by the Oireachtas, not canon law or any other law. The ethics that will apply are the medical ethics laid down by the Medical Council, not any other ethical framework. As regards conscientious objections, the laws relating to conscientious objection will apply in the same way in every hospital.