The Cabinet this week held off on approving the planned relocation of the National Maternity Hospital (NMH) from Holles Street in Dublin 2 to a site on the St Vincent's hospital campus in Dublin 4 to give the plan further consideration amid continuing concerns about the future ethos and governance of the maternity hospital.
What has happened this week?
Minister for Health Stephen Donnelly brought a memo to Cabinet proposing that the State lease the site for the new hospital for 299 years from a company with a charitable status. The land was owned by the Religious Sisters of Charity, who last week transferred their shareholding to that new company, St Vincent's Holdings CLG.
The religious order says it will have no further involvement in the project, while the NMH and St Vincent’s say every procedure available in the State, such as abortion, will be available to women at the new hospital.
However, some Ministers asked for more time to consider the relocation before giving their approval as they did not want the matter to be rushed.
So, what’s the problem?
Campaigners and Opposition TDs have raised a series of questions about the relocation, with the first in relation to the ownership of the land.
Critics of the move want to know why the State cannot own the land the hospital will be built on given it is set to spend somewhere near €1 billion on the project.
When asked about this and other related issues on Wednesday, Mr Donnelly described the land question “as a complete red herring”. He said critics of the move “have made this claim many times, but they’ve never actually explained how their claim could be taken seriously”.
“We have a 299-year lease, and it is essentially €10 a year. Essentially, we have been gifted the land for 300 years. The estimated working life of a hospital is 40 to 50 years.”
Why can the land not just be permanently gifted if this is such a major stumbling block?
Referring to negotiations between St Vincent’s and the NMH in regard to this, Mr Donnelly simply said: “They didn’t want to, they didn’t want to.”
He added: “We have the land for the next 300 years. So I took legal advice on this and there were various points raised. One was on the basis that we already have full access to the land for 300 years, so what case could we make that we need to own it.
“Secondly, we could buy it. It would be interesting to know how much you’d have to spend on that land in that place.
“Thirdly, remember, this is meant to be a partnership between the State and two voluntary hospitals. You don’t start the partnership by parking your tanks on the other person’s lawn and saying we’re going to be friends.”
I see . . . so are there other issues?
Former master of the National Maternity Hospital Peter Boylan has raised concerns about stipulations that the company running the new hospital will provide all "clinically appropriate" and "legally permissible healthcare services".
He says that it will thus be up to doctors to decide what may or may not be appropriate for a woman and therefore access to procedures like abortion or IVF could be complicated.
What does the Minister say about this?
When asked about this on Wednesday, and specifically if clinicians would decide what is best for a woman beyond her own choices, Mr Donnelly said: “That is categorically not the case. It’s in there to make the point that the maternity hospital will provide services that are appropriate for a maternity hospital.
“We put in very strong protections for the independence of the National Maternity Hospital but we’ve gone further than that. So not only have we protected the clinical operational independence of the NMH, we’ve actually put into the Constitution that it’s obliged to provide all services permissible under law.
“But what if somebody said, ‘Well hang on a second, what about cardiology? What about neurology?’ The point is no, it’s all services permissible under law. It’s very, very clear that all services under law not only can be provided but must be provided.”
Is that all?
Unfortunately not. One of the biggest issues that has plagued this long-mooted relocation is the terms under which the Vatican agreed to the transfer of the land by the Religious Sisters of Charity. Politicians and campaigners say they want to see all terms and conditions and any documents that underpin the transfer. They fear there are stipulations that mean canon law must be applied in the operation of the new hospital.
Are there documents saying this is not the case?
Sources in the Department of Health say no such files or documents exist. When asked about any possible Vatican influence or issues in that regard, Mr Donnelly said: “I guess you’d have to talk to the Vatican about that. We don’t have any such documents. The new company has been set up as a charity. Its constitution has been available online for a year. There is no reference to religion.”
When pressed further, he added: “What the Vatican thinks about our National Maternity Hospital is irrelevant. Any conditions would be in the [hospital’s] constitution.”
Asked if he was saying there were no such documents underpinning the handover of land, he said: “I can’t state what documents . . . I think it’s a really good line for people to throw up and say, ‘Oh, the Vatican.’
“The fact that someone somewhere is saying, ‘Oh, well, what about the Vatican?’ Well, my answer is, what about the Vatican? The Vatican has nothing to do with this.”
