Minister for Health Simon Harris says there is a need for a national conversation on the health service, similar to the conversation about patronage and pluralism in education which was initiated in 2012.
“I’m conscious that in Education there was a conversation about patronage and pluralism. I think Ruairi Quinn was the Minister in 2012 when he put in place a forum on pluralism and patronage. I think it is time for a similar process, maybe not an identical process, but a similar process in health, to actually examine the questions,” he told RTÉ’s Morning Ireland.
“We have a rich tapestry in terms of health care, we have public hospitals, we have voluntary hospitals, we have charitable groups involved in hospitals, we have voluntary hospitals that have religious stakeholders and we have voluntary hospitals that don’t. I think it’s time that we have that conversation.”
This call follows the recent controversy over the Government’s decision to give the St Vincent’s Healthcare Group sole ownership of the National Maternity Hospital (NMH) when it moves from Holles Street to the Elm Park campus next to St Vincent’s University Hospital.
The St Vincent’s Healthcare Group is a non-profit group whose shareholders are the Sisters of Charity, a religious congregation which managed residential institutions for children. The religious group was investigated by the Commission to Inquire into Child Abuse, and was part of a €128-million indemnity agreement with the State in 2002. Following the publication of the Ryan report in 2009, the group offered to contribute €5 million towards the redress of former residents of these institutions. The Comptroller and Auditor General’s report states that €3 million of this is still owed to the State.
The announcement that the new €300 million maternity hospital would be given to the Sisters of Charity-owned healthcare group was met with public protest, and the resignation of several prominent members of the board. On his resignation, Dr Peter Boylan, former master of the NMH, told the Pat Kenny Show on Newstalk: “I can’t remain a member of a board which is so blind to the consequences of its decision ... and so deaf to the concerns of the public which it serves.” An online petition to prevent the Sisters of Charity becoming ‘sole owners’ of the new hospital now has more than 100,000 signatures.
Mr Harris also told Morning Ireland that the issues in health care that had been ignored for too long. “I think it’s very evident that the public has begun the conversation, as Minister for Health, I feel I have a responsibility to try and facilitate that conversation.”
He added that it was important to have the time to make sure that ‘we absolutely get this right.’
“I’ve heard the public concerns and I know they’re genuine and that people feel very strongly. It is so vital that we build a new National Maternity Hospital - this is really, really badly needed and we have the time to ensure that the public concerns are adequately addressed.
“This project is only at the planning permission stage - it’s not likely that a decision will be made on planning until the autumn at the earliest, so there is a time period here - so I have asked that we be given that time to meet with both hospitals, to meet with Kieran Mulvey to tease out issues.
“I want to make clear that does include the issue of ownership.
“It is an issue that can be examined; I think there are creative ways of addressing that. I don’t want to be prescriptive now, I’m asking for a month for a reason.
“But if we can have a period of cool heads as I’ve called for, not to have a daily commentary of he said, she said where we can actually get people in the room together, talk this through, look
“It is essential that we do. We need a new National Maternity Hospital and we need it co-located.”
The Minister repeated that the discussion will include the issue of ownership.
“The agreement that Mr Mulvey drew up with the two hospitals, puts a number of safeguards in place and does talk about a lien and a charge on the building. I think these issues need to be further examined, as would always be the case as you get towards the legal and contractual stage of any significant investment on behalf of the State.
“Also it’s important to say that we’ve seen an important conversation begin in this country, a conversation that goes beyond this project and that is a conversation about involvement in health care - who should be involved, who shouldn’t be involved.
“Separate to this issue and separate to the process I’m going to undergo with the National Maternity Hospital, I do intend going to the Cabinet in the next month and bring proposals to try and structure and facilitate that conversation.
“Moving the National Maternity Hospital has been in the pipeline since 2013, there have been three mediation processes, including the most recent, the absolute determination to build this hospital is paramount, but I absolutely accept the public’s view that we need to make sure that we absolutely get this right.
“I want to say to people, very clearly, I have heard their concerns, please provide me with the time to further engage with both hospitals. I will then report back to Cabinet and to the Oireachtas and to the public at the end of May and let’s see where we are then.
“I believe if there is a willingness from all parties, and both parties have shown great willingness to date, we can get this right.
“I accept that the public has very genuine concerns, I also accept that the agreement endeavoured to put a range of measures of safeguards in place, but I do think it is important that we can provide further clarity in relation to the issue of ownership, that the issue of ownership can be further examined, and that we can try and come up with a mechanism, with a solution that addressed the public concern over ownership.
“It is important that we do that, but also that we absolutely keep our eye on the big prize here for woman and infants, the big prize for the health service, building a state of the art National Maternity Hospital which is so badly needed.”
The Minister added that Holles Street was first hospital he visited when he took over the health portfolio, which was the first time he was in the hospital since he was born there.
“It has an excellent service, excellent staff, but it is a crumbling building. It is not adequate, it is inappropriate.
“There are risks for women there; these have been long pointed out by Hiqa. We need the new Maternity Hospital - there are huge benefits to co-locating it.”
When asked about ‘Scaremongering’ he said: “I don’t ever like to attach any such label to any member of the public who raises concerns. We live in a democracy, people have the right to question and to probe, and that’s exactly what they’ve done.
“I do believe the issue of clinical independence has been addressed by Rhona Mahony, by Declan Keane, there have been many safeguards put in place in relation to clinical independence.
“In fact more safeguards than there are in place now. The Minister for Health of the day will have a veto, a golden share, if there was any deviation from the implementation.
“The structure put in place by Kieran Mulvey, with both hospitals, would mean that if the Board of the new entity decided to make some change to the structure that they’d need, not only unanimity of the Board, which is very rare, they’d also need the consent of the Minister of the day.
“That’s a safeguard that’s not in place today. Today the chairperson is the Archbishop of Dublin, to be fair he doesn’t play an active role, but he is the legal chairperson of that entity. There are a number of religious people on the Board, not saying this in any way to be disrespectful to them, but the reality of the situation is the new model that we can put in place will give the State a greater input in making sure that the National Maternity Hospital 110 per cent delivers on what is health policy and on all of the health services that women need now and could need in the future.
“This is a huge project and we’re going to get it right.”