Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I thank Deputy Kelleher for the question. As the Deputy is aware and will appreciate, voluntary and non-statutory providers, including religious bodies, have historically played an important role in the provision of health and social services in Ireland. It is fair to say the current arrangements have grown out of a complicated past. Policy must reflect current realities as well as available options over the medium term. The recent debate surrounding the location of the National Maternity Hospital has generated increased discussion of issues of ownership and governance in our health services, and in particular our hospitals.

I am anxious not to delay the long overdue National Maternity Hospital project while this wider conversation is taking place, and that is why I have set out a process I would like to follow that is separate and distinct for the National Maternity Hospital in order to tease out the important issues that the public has expressed concern about in recent days and weeks. It is important to note that over the years not only has the role of religious personnel in the day-to-day operation of hospitals reduced but in some cases there has been a transfer of ownership to the State. Examples include the transfer Our Lady of Lourdes Hospital, Drogheda, to the then North Eastern Health Board. Other voluntary or charitable hospitals have closed, such as Hume Street Hospital, or have been subject to mergers into newly created public bodies, such as Jervis Street and the Richmond into Beaumont Hospital. Therefore, evolution is not new and change has also taken place across the wider health service in areas such as nursing homes and disability centres.

A number of our largest and most developed acute hospitals are voluntary hospitals. In contrast with health board or Health Service Executive, HSE, hospitals they have evolved governance structures with significant non-executive involvement. It is important in looking to the future that such strengths are recognised. It is also the case that in recent years, the nature of the relationship between voluntary organisations and the State has been clarified in a number of ways. The HSE operates a governance framework that governs grant funding provided to all non-statutory service providers and provides for detailed service level agreements. In the voluntary sector, it is required practice for public capital investment to be accompanied by a lien that protects the State's interest. All public hospitals are regulated by HIQA and are subject to national clinical standards and guidelines. Moreover, as part of the establishment of hospital groups, voluntary hospitals have been required to plan and deliver services in a manner that integrates service provision with HSE-owned hospitals in the region.

It is long overdue for us to try to structure this conversation about the direction people would like to see. We have seen similar conversations taking place with education. I am interested in the Deputy's view and I suggest to the House that we could benefit from such a conversation.

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