“Mired in controversy” has become the default description of the plan to move the National Maternity Hospital (NMH) from Holles Street in Dublin 2 to a new site bang in the middle of the St Vincent’s University Hospital campus at Elm Park.
But after Cabinet’s wobble on Tuesday over a decision to finally sign off on the project, the hospital’s move will inevitably become mired even deeper in controversy.
The next period is likely to be filled with assurances by many in health, including Minister for Health Stephen Donnelly and the two hospitals, that the independence of the new facility will be guaranteed, despite concerns of critics of the plan about governance and possible clerical influence arising from St Vincent's traditional Catholic ethos.
It has taken years for the parties involved to hammer out a governance agreement, to their mutual satisfaction, behind closed doors. The result is a set of complex legal documents that, let’s face it, few in society are properly qualified to analyse.
Assurances
But for all the assurances that will be provided around the State’s stake, and the independence of the new maternity hospital, the central fact is that a large section of political and public opinion has lost trust in the proposal.
The campaign of opposition has been doggedly led by a former master of the NMH, Dr Peter Boylan, whose central point has been that Catholic health institutions "don't do" women's reproductive health, not when it involves procedures such as abortion, IVF and sterilisation.
If you accept this argument, it follows that the newly relocated maternity hospital will not provide these services, regardless of what legal ownership constructs are created to distance it from the wider Catholic ethos at St Vincent’s.
Current practice appears to bear out his argument. Yes, you can get a sterilisation at St Vincent’s currently, but only when it is clinically required and as part of another procedure, ie, not for the exclusive purpose of sterilisation.
Neither can you get IVF, but this is not available in Holles Street either, unless you’re prepared to pay for it in the adjacent private clinic.
St Vincent’s says the maternity hospital, when it moves, will become part of a wider secular campus. Promises about the withdrawal of the Sisters of Charity from control and ownership of the hospital have been made good, it insists.
Operating licence
According to the HSE board, in minutes from last March, the operating licence agreed for the new hospital is now “appropriate and unambiguous” so that the company operating it will be able to provide “all clinically appropriate and legally permissible healthcare services”.
The HSE board gave the deal the thumbs-up, but two members, including leading law professor Deirdre Madden, dissented from the decision over ownership and control issues.
Now, it is the turn of Government Ministers to be racked with doubt.
The problem for the doubters remains that there is no alternative to the current deal that will produce a new maternity hospital within a few years.
Almost a decade has been spent on this project with precious little to show. Millions will have been wasted on a point of principle, one that ended up not being even tested.