St Vincent's hospital requires "corporate unitary oversight" of all services after the National Maternity Hospital moves to its campus, according to the agreement reached between the two hospitals.
St Vincent’s wants “integration” of the activities of the NMH with existing activities on its campus to ensure their effective and efficient operation, the agreement states.
The 25-page document, seen by The Irish Times, says the new hospital will be required to treat patients "without religious or ethnic or other distinction".
It takes the form of a report by mediator Kieran Mulvey to Minister for Health Simon Harris on the terms of agreement between the NMH and St Vincent's Hospital Group last November.
An agreed single system of clinical governance will operate for the primary benefit of patients on campus and the provision of obstetrics and gynaecology care will be “seamless”.
“The consultant with primary responsibility for care of the patient will decide what care services are required and in which location these services should be provided.”
Under the deal, the new hospital will be operated by a new company, The National Maternity Hospital at Elm Park DAC (limited by shares), which will be a 100 per cent subsidiary of SVHG.
SVHG is itself fully owned by the Religious Sisters of Charity, although this is not spelled out in the document.
An objective of the new company will be to provide a range of health services at the new hospital “in succession to the objectives and services and heretofore provided by the current NMH”.
These services are to provide “as far as possible . . . for the health, happiness and welfare of those accepted as patients, without religious or ethnic or other distinction”.
The document sets out eight “reserved powers” designed to preserve the autonomy of the new company running the hospital. These include “clinical and operational independence in the provision of maternity, gynaecology, obstetrics and neonatal services (without religious, ethnic or other distinction); control over finances and budgets; and the retention of the role of master of the maternity hospital.
The NMH will also be allowed keep its branding and to control and appoint staff, and the proceeds from the sale of Holles Street will be for the sole use of for maternity services.
Both hospitals agree the creation of a special “golden share” is the best mechanism to provide legal protection for the reserved powers arrangement, according to the document.
Under this arrangement, the reserved powers cannot be amended without the agreement of all directors and the consent of the Minister.
Board members on the operating company who are “aggrieved” may consult with the Minister on any matter.
“These provisions, alongside the ‘reserved powers’, should ensure that the future Board of the NMH at Elm Park DAC operates within both the spirit and legal intent of this Agreement.”
Four directors apiece will be nominated by each hospital with the ninth member being an independent international expert in obstetrics.
Mr Mulvey describes this composition as a “fair balance” between the corporate/hospital interests of both entities.
In a section on ownership, the agreement says SVHG will be the sole owner of the company operating the hospital, subject to the Minister holding a “golden share” with powers that protection the “reserved powers, constitution and board composition.”
In addition, the State will require a “lien” on the hospital in accordance with future funding arrangements.
The document concludes by saying it will be necessary for the “appropriate legal mechanisms” to be put in place in a final agreement.
