Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I want to thank everybody who has contributed and who will contribute to what I believe has been an important and good debate. I just want to pick up on a few points. I will begin with the issue of safety. This is an issue that many people have raised throughout the debate. Safety is and must remain an absolute priority in our health service in general. The Department and the HSE continue to work together to make improvements in this regard. I referred earlier to the monthly publication of the maternity patient safety statements. In terms of wider patient safety developments, last December I launched a new national patient safety office. This is an office located within my Department to prioritise and drive patient safety work in this area.

I have directed the office to work on a range of initiatives including new legislation, the establishment of a national patient advocacy service, the measurement of patient experience, the introduction of a patient safety surveillance system and extending the clinical effectiveness agenda. Within the programme of legislation, it is intended to progress the licensing of our public and private hospitals.

I want to pick up on the point raised by Deputy Daly about why we do not say it is midwifery centred. I refer her to page 3 of the strategy which states that the mother is at the centre of the strategy. We have avoided as far as possible professional-centric terms such as consultant-led or midwifery-led as they incorrectly place an emphasis on the profession rather than on the woman. In future, maternity care in Ireland will be provided in an integrated manner by a multi-disciplinary team with women seeing the most appropriate professional based on their need.

At its core, the agreement that has been mediated by Kieran Mulvey between the two hospitals ensures and endeavours to ensure a full range of health services. We have heard the master of the maternity hospital and the former master, Professor Keane, on this. I welcome and acknowledge on the record of the House the further confirmation by St. Vincent's Healthcare Group that any medical procedure in accordance with the laws of the State will be carried out in the new hospital. I have made it clear that I want to use this month to further engage because I have heard public concern about this. I expect to have further details on the legal and other arrangements envisaged and will make available that information to the House and to Government. I hope this will allow the necessary clarity on the issues of concern that have been raised in advance of any contractual or other commitments being entered into in respect of this agreement. I have heard a lot of people talking about secret agreements. I refer people to the Department of Health's website and a statement on 24 November which was published when the announcement was made by the Taoiseach and me. It talks about much of the detail people are raising in the House. People are right to raise it but on 24 November much of that information was published.

It is also important to talk about the process to date. If this were straightforward one would suggest many people would have done it. I am not afraid to address this issue and to work with people in the House and in both hospitals to make sure we get this right. We have two voluntary hospitals. People talk about the national maternity hospital as a publicly owned hospital. It is a voluntary hospital. Legally the Archbishop of Dublin is the chair of that hospital. He does not play an active role but legally he is its chair. There are a number of religious people on the board of the national maternity hospital. The Minister of the day has no such golden chair or veto. It is important that we look at this in the context that two voluntary hospitals have to come together to deliver a new national maternity hospital. We had three mediation processes, two of which predate my time in this position. It is important to acknowledge we have an agreement between two hospitals; we do not have the legal and contractual arrangements in terms of the running of the new hospital. We have the document to which the hospitals have signed up. This is how they envisage working together. There is now an onus on the State and me to try to put in place the legal and contractual arrangements. We are not talking about just building a hospital. When we talk about co-location we are talking about two hospitals working together. We are talking about sharing ICUs, high dependency units and consultants. We are talking about a woman in need of emergency care going down a corridor bringing her from a maternity hospital into an adult acute hospital. It is appropriate for the adult acute hospital to want input into patient care and arrangements in terms of the overall running of a campus. It is important to say that.

In response to Deputy Kelly, I am terribly consistent on these matters. The issues I raised at the Committee of Public Accounts on St. Vincent's is exactly what we are making sure will not happen. We now, as a State, put in place liens so that a hospital cannot mortgage or borrow off buildings in which the State invests. That is right and proper. There is space to further examine the ownership issue. I have been very clear about that. There are a number of creative issues that can be looked at in that regard, including the issue of a long-term lease.

On the issue of clinical independence, it is important to say the agreement states it in black and white. People talk about church and religious interference. The agreement states there will be no religious interference. It is there in black and white. It is my job to make sure it is absolutely copperfastened in contractual and legal arrangements. I am entirely committed to that. Let me be very clear when speaking to the women in this country. We will not build any hospital that does not provide women with access to every health service they need today and any services that may be legal in this country in the future that are not currently legal. I cannot be clearer than that. The full range of services and full clinical independence will be provided at this hospital. People said the Protection of Life During Pregnancy Act would not be implemented in a number of these voluntary hospitals. We now see it is not the case. We will make sure we get this right. There has been a broader conversation. It is important. Deputy McDonald said sin é and I get the point she makes. When we say sin é, at least 15 of our hospitals today are voluntary hospitals. I pose this as a question rather than something to answer this evening. Are we now saying as a country that if we invest in any voluntary hospital we must own the asset? If we are saying that, it is not without consequences. It is a conversation we need to have. We need to have it in the responsible structured way we had the conversation on education in 2012 with the forum on pluralism and patronage. I intend to bring proposals on this to Government in the next month that I hope can facilitate a conversation that quite frankly the country is already having and that we in the Oireachtas and Government need to participate in.

I could pick holes in elements of the Sinn Féin motion and we could debate them politically back and forth and debate the numbers and the OECD numbers but in the interest of bipartisanship I will not. It is an important issue and in the interest of the House wanting to send a message that collectively we are committed to working together to improve our maternity services and that we want to see the issue of ownership addressed in the conversations my Department will now have with the two hospitals, I will withdraw my amendment.

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