Eamon Ryan (Dublin Bay South, Green Party) | Oireachtas source

I also commend Deputy O'Reilly on tabling this motion, allowing us the opportunity to present the arguments. There seems to be clear agreement that, as anyone who is acquainted with the Holles Street facility knows, the National Maternity Hospital cannot stay as it is and must move. Given the medical choices, St. Vincent's Hospital is the obvious location. Not only is it an excellent hospital in my experience, but co-location on that site allows for incredible efficiency and the ability to deal with patients in a far more effective way. I do not know any other site on which it would be appropriate to locate the new National Maternity Hospital.

There is also clear agreement on the need for medical independence. Central to this is the realisation that in all likelihood - it is up to the people - we will move towards a repeal of the eighth amendment to the Constitution. In any future system, we cannot completely legislate for every different eventually. The future arrangements will need to put the centre of responsibility in the relationship between the mother and the doctor, and give them the capability to provide the best service to the mother. In those circumstances we have to be certain of the medical independence of that doctor to provide for the mother.

Likewise, I have not heard a single dissenting voice from anyone who does not believe the hospital must be in complete public ownership. That should involve not the creation of a lease arrangement but rather the transfer of ownership of the site to the State so that there is no uncertainty or lack of clarity on the ownership. Along with a number of other Members, last week I pointed out that the mission of the Sisters of Charity surely now lies in the work they are doing in combatting the trafficking of women, in addiction counselling services, in climate change, in caring for the poorest of the world where they are active, and not in the ownership or running of a general public hospital. In those circumstances they should be gifting the site for this hospital to the State.

I agree with the Minister that we need to go beyond that and look at the wider issue of ownership of our hospitals which has been built up in a haphazard way with a range of different ownership structures, with approximately 20 public hospitals in the care of a variety of religious orders. As we go through this process we should be looking at mechanisms to arrange for the transfer of ownership. It is time for the State to step up, to manage and to accept its responsibilities. In the past that was not the case and it is now time for us to do that. Included in this process we must ensure we have ownership of those hospitals.

I add two other elements that have not been considered. One is the issue of the private or public nature of this hospital. I disagree with Deputy Harty; I have concerns over a master-led system. What I have seen of our National Maternity Hospital is that it is master led. Part of that involves highly lucrative well-paid positions for masters who run a private system to their own benefit. I have serious questions and concerns over creating a new National Maternity Hospital that will replicate a private facility within a public building; that should be just as much an issue of concern.

We also need to look at the nature of the service, based on the history of the active management system. I am not an expert; as a man, I cannot speak with any real authority, but those I trust and care for do. There are questions about the master system which was all about the doctor and not about the patient or the midwife. That active management system should be also called into question as we review the National Maternity Hospital. Let us have a public hospital of which we can be proud in every way, caring first and foremost for and centred on the patient and the doctor-patient relationship we need to provide for today.

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