Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I welcome the Bill. I watched with interest how efficiently it passed through the Seanad. Given recent events here it was quite refreshing to see it progressing quite quickly. The Bill relates specifically to the board of the children's hospital but the construction of the hospital is progressing quite well. I wish it every success as it is much needed. I commend the work on the project to date by all those involved, from the Department to those constructing the new hospital as well as those who worked on the legislation. The Bill focuses on the structure of the new board to take over the running of the children's hospital and on the transfer of employees and property rights and liabilities to the new board. The transfer of contracts and provisions for preservation of contracts in this manner is always a tricky thing to do but, having spoken to the workers and members of the unions, I accept there has been some dialogue and engagement.

I wish to raise a number of points and I seek some clarifications which I hope will be provided on Committee and later Stages. First, with regard to the name of the hospital, I ask the Minister to agree to naming the hospital the "Kathleen Lynn Children's Hospital". That name would be recognition of her important role in delivering medical care for the women and children of Dublin, particularly the poor, in her pioneering St. Ultan's hospital, which was only down the canal from the St. James's Hospital site. It also would be appropriate in this commemorative period that her role as a suffragette and a volunteer in the Irish Citizen Army during the 1916 Rising would also be marked. This would be appropriate at the St. James's Hospital site given that it is the site of the republican strongholds during the 1916 Rising in the South Dublin Union.

Dr. Kathleen Lynn was a Mayo woman who challenged many of the norms in society at the time in regard to women. She was a suffragette, a fellow of the Royal College of Surgeons in Ireland and the first resident doctor in the Royal Victoria Eye and Ear Hospital. She was instrumental in the roll-out of the BCG vaccine, a soup kitchen worker during the Lock-out of 1913, an Irish Citizen Army volunteer and the officer commanding the City Hall garrison at the end of Easter Week 1916. She also was a prisoner of war, a Deputy, a councillor and the founder of St. Ultan’s hospital, where she worked until she was over 80 years of age. There is no more appropriate name for this hospital than the Kathleen Lynn children's hospital. I hope this proposal will at least start a discussion on the naming of the hospital.

On section 6 of the Bill, I suggest that a reference be included therein to medical and health professionals, under objects and functions, ensuring that their well-being is prioritised and that there are no barriers in their way as regards training or services. At a time of crisis among our healthcare professionals, it is imperative that the objects and functions of Children's Health Ireland ensures this.

Section 9 makes provision for borrowing for capital purposes against the income and the assets of the hospital, which I understand. This provision is similarly used by many universities across the State. However, I do not understand why the hospital would need to borrow for current purposes given that the State should be funding the hospital to deliver in line with demand. Hospitals run by the State should be funded for the provision of current services by the State from the Exchequer. If this provision remains in the Bill, any Government can underfund the hospital and instruct it to borrow money to provide paediatric healthcare services. Its inclusion would allow for exploitation, and we should all be wary of this.

Section 8(3) is questionable. It exemplifies what is called "mission creep", which is a gradual shift in objectives, often resulting in unplanned longer-term change. I do not understand why Children's Health Ireland would need to acquire, hold and dispose of shares or other interests in a company, or become a member of a company. The hospital and board has a mission, namely, to provide paediatric healthcare to children across the State. I do not understand why the board of the children's hospital would need to become a member of a company. The board has the scope under other subsections of section 8 to establish subsidiaries and so forth and it has room to take part in the formation of a company. Therefore, I find it a little curious that Children’s Health Ireland would require the power to become a member of a company. I do not feel this is appropriate and there is more here than meets the eye.

As regards the board of the hospital, there could be more of a role for the Oireachtas in this process. There is a history in this State of Ministers appointing to boards people who are completely unsuitable to be members of such boards. To ensure that candidates are satisfactory there may be an oversight role for the Oireachtas in this process. If people have a problem with that, I assume they have a problem with transparency and ensuring accountability. As regards the board, I propose that membership with non-voting observer status be given to a representative of ICTU, a patient advocate and a member of Dublin City Council. Sinn Féin believes that a representative on behalf of ICTU would be important in relaying the concerns of staff across the hospital and would also guarantee a healthy working link between the board and the staff in the hospital.

Dr. Scally has highlighted the need for more patient advocates within the health service and I believe the inclusion of a patient advocate on the board would strengthen the relationship between it and the parents and their children in the hospital. There is a Dublin City Council representative on the current board of Crumlin children’s hospital and I believe this practice should be continued. With regard to the current children’s hospitals that will move to the new hospital, I would welcome an assurance that the existing facilities will remain in use for health service purposes. Has the Department considered turning the Crumlin site into an elective-only hospital, a step-down facility or to using it for some form of health use given our capacity problems?

On section 24, will subsidiaries be added here in order that the Committee of Public Accounts will have powers to ensure public accountability of the subsidiaries of the children’s health board? The Committee of Public Accounts often has been precluded from examining or asking questions in respect of subsidiaries because they are not covered under the legislation which established them. The inclusion of subsidiaries would be both sensible and practical and would ensure transparency when it comes to public moneys.

Sinn Féin supports the Bill and asks that the Minister consider its suggestions prior to Committee Stage. As a former trade union official, I have some experience of what happens in the aftermath of hospitals amalgamation. While this is not an issue material to this Bill it is one that requires consideration. In the amalgamation process in which I was involved, only some staff members were consulted about the process. It appeared to be the case that the higher one's professional grade the greater the level of consultation, despite the necessity for all staff to move. The remaining staff, often referred to as ancillary staff - a term I do not like - were not consulted until close to the end of the process. I do not think this should be allowed to happen. The process needs to be inclusive so that everybody is involved and when the move happens everybody believes they have been consulted and involved in the process.

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