David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I commend the Social Democrats on tabling this motion and for giving us the opportunity to discuss this issue. I discussed this privately with the Minister a number of weeks ago and have raised it a number of times in the Dáil and at meetings of the Oireachtas Joint Committee on Health. In recent months the Minister has given us some assurances, as he would see it, regarding religious ethos in the context of the management and running of the new national maternity hospital but those assurances were not strong enough. Indeed, when the Minister was in opposition, he accepted that there are real difficulties and challenges in respect of the ownership of the site and the governance structures that are being proposed. The Tánaiste, in response to questions from me and Deputy Bríd Smith last week in the Dáil, agreed that there are fundamental issues of concern here.

In fact, he went as far as saying that he agrees with us more than we would have thought. Some would argue that it is a little late in the day for the Tánaiste to finally come to the conclusion that there are fundamental issues with regard to governance matters and the ownership of the land. This is a mess, and it is entirely of Fine Gael's making. It dates back to when the former Deputy, Dr. James Reilly, was Minister for Health as well as to when the Tánaiste and Deputy Harris were the Ministers for Health.

The statement yesterday from St. Vincent's Healthcare Group was also very telling in that regard. It made it clear that, from the group's perspective, it understood it had an understanding from the Department, and I would argue from the Government, that the lease, governance and ownership arrangements that are being put in place were signed off by the State and the Department in principle, and what had to be worked out is a little more detail. That is a far cry from what the Tánaiste said in the Dáil last week. As usual, Fine Gael has come to this with too little and too late. Deputy Stephen Donnelly is now the Minister and it falls to him. I agree with the previous speakers that this is a test of the State's ability to ensure we do the right thing if we are going to build a new national maternity hospital. We all want to see it built as quickly as possible and without delay. It is already about six years behind schedule and subject to additional costs. Initially the cost was to be €300 million, then it was €500 million and it is now potentially €800 million, with some saying it will be €1 billion. We do not know what the full cost will be in respect of the capital cost and the fit-out cost, but it will be very substantial. It is a very important hospital and we all want to see it built. However, we also must get the foundations right in terms of both the governance foundations and the ownership foundations.

It was disappointing to read the statement from St. Vincent's Healthcare Group yesterday. While there is now a tug-of-war taking place between that organisation and the Government, the problem is that, again, women and the future of maternity services are left in the middle. The group referred to integrated hospital patient care and offered that as a reason the land cannot either be gifted or sold to the State. It wants to ensure integrated hospital patient care. I believe it is talking about integrated care within the St. Vincent's Healthcare Group, but we are talking about integrated care within all the maternity hospitals, which must be publicly owned, managed and governed. That is the integrated hospital care that concerns me and, I hope, all Deputies in the House. The fundamental question is: what happens now? I very much hope that we will not be sold a pup again and told that the lease will be extended from 99 years to, perhaps, 149 years and that we will look at tinkering around with some of the legal and contractual arrangements but, essentially, we will proceed with the convoluted process that has been put in place. It simply is not good enough. It beggars belief that the State would build a new, state-of-the-art hospital and pay for the building, the fit-out, the staff and the management and running of the hospital, yet some private charity would own the land, with a board of governors put in place where the Minister would not appoint all the people on the board. It cannot be argued that the board would be fully governed by the State on behalf the public. None of that makes sense.

While we are discussing the ownership of the new national maternity hospital, I must point out that there are other maternity hospitals that are chronically underfunded. The Minister is aware of the situation in the Rotunda Hospital. I have raised it with him on previous occasions. A report by KPMG identified real clinical risks in the neonatal emergency department, the inpatient and outpatient departments and in other areas. The hospital cannot wait for the co-location option with Connolly Hospital before it gets a resolution to its problems. There are capacity issues in St. Luke's Hospital in Kilkenny and in University Hospital Waterford. There are problems with capacity across all our maternity hospitals. There is a need to continue to invest in the national maternity strategy. I welcome the additional funding that was made available last year. We must continue with that, but we also have to increase capital funding for those maternity hospitals to ensure we provide services to the highest standard across all maternity hospitals.

Women's healthcare has been left behind by successive Governments for far too long. We all know the track record, which includes CervicalCheck, symphysiotomy and even the mother and baby homes. We can chart the history of the relationship between women, healthcare and the State. It is not a very rosy one. We want to put that behind us and to move to a healthcare system that is truly secular, that delivers for women and in which there is absolutely no ambiguity about the type of healthcare that can be provided in hospitals. Notwithstanding any legal guarantees or assurances that the Minister can offer this House, and he spoke about this on national radio, when there is a doubt, where ambiguity exists and when there is a convoluted process that involves a board and company that are not owned and managed by the State, there is a problem.

My final point relates directly to the St. Vincent's Healthcare Group. The State and the Minister have a responsibility, but the Religious Sisters of Charity is telling us that it is essentially gifting the land to the State. If it is genuine about that, why not go the full distance and simply gift the land to the State, as opposed to gifting it to a private charity? What is the reason for this? I do not buy the argument that the need for integrated patient care is the reason the St. Vincent's Healthcare Group will not gift the land to the State. That does not make sense. It only makes sense if one wishes to have some level of control. For that reason, it arouses a suspicion that is genuine, real and profound, and to which the Minister must respond. We need a resolution to this, and the resolution can only be public land, a public hospital, public ownership and a hospital governed by the State for the women of the State.

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