Thursday, 20 January 2022
National Maternity Hospital: Motion [Private Members]
That Dáil Éireann: notes that:— in 2013 a decision was made to move the National Maternity Hospital (NMH) from Holles St to the Elm Park site to co-locate with St. Vincent's University Hospital (SVUH), which was to be part of the construction of four new co-located maternity hospitals; andfurther notes that:
— this led to a dispute with the St Vincent's Hospital Group (SVHG) who rejected co-location and demanded full ownership of the NMH under SVHG;— SVHG is a private company owned by the Religious Sisters of Charity (RSC) and a section 38 body fully funded by the State, and the RSC have now set up a new private company, St Vincent's Holdings (SVHs), into which they have said they will transfer their shares in SVHG though this has not yet happened;insists that the new National Maternity Hospital is fully owned and controlled by the State and rejects any agreement with SVHG, SVHs or the RSC which does not achieve such State ownership and control of the facility; and
— the RSC apparently have Vatican approval for this along with approval from the Irish Catholic Bishops Conference, as under canon law SVUH is the property of the Catholic Church; and
— the construction of the new National Maternity Hospital is currently estimated at a cost of €800 million, with the original estimate in 2013 being €300 million, while the day to day running of the hospital will be fully funded by the Health Service Executive (HSE);
calls on the Government to acquire the Elm Park site through a Compulsory Purchase Order by the HSE with the approval of the Minister for Health.
I am disappointed that the Minister is not present to respond. I mean no disrespect to the Minister of State, Deputy Rabbitte, but the ownership and control of our national maternity hospital is an important issue that has been rumbling on for ten years. There were two Private Members' motions last June, one from Deputy Connolly and the other from the Social Democrats, that called on the Government to ensure the public ownership and operation of the new maternity hospital. The Minister did not oppose those motions.
I thank my personal assistant for assisting me in drawing up and working on this motion. I thank Uplift, which commissioned the legal opinion on the compulsory purchase order, CPO, options for the national maternity hospital and engaged Mr. Stephen Dodd, SC. From the ospidéal campaign, I thank Ms Marie O'Connor, who worked hard to put together the briefing that was emailed to all Deputies yesterday. I also thank Dr. Peter Boylan. All of these people have given of their time and energy to support this motion and the compulsory purchase of the grounds at Elm Park.
I welcome the fact that the Government is not opposing the motion. However, it is not clear whether this means that the Government is in favour of proceeding with a compulsory purchase order, CPO, is keeping a CPO as an option while continuing to negotiate with St. Vincent's Healthcare Group, which I strongly suspect is the case, or is not even contemplating using a CPO.
It is now abundantly clear that the St. Vincent's Healthcare Group has not moved an inch from the position it has adopted since the original proposal to co-locate the new national maternity hospital with St. Vincent's at the Elm Park site. Its position is clear, in that it has rejected co-location and, in effect, demanded that the national maternity hospital be fully integrated into its group. That is what will happen if the State agrees to lease the site under conditions laid down by the group.
We are facing a key test of this State. We should not be in any doubt about what the issues at stake are. St. Vincent's Healthcare Group is a private company owned by the Religious Sisters of Charity, a Catholic religious institution. The Religious Sisters of Charity have set up a new company – St. Vincent's Holdings – into which it intends to transfer its shares in St. Vincent's Healthcare Group. It apparently has approval for this from the Vatican and the Irish Catholic Bishops' Conference but the transfer will only go ahead if it gets its way on the national maternity hospital. It should be noted that, under Canon Law, the assets of the Religious Sisters of Charity constitute church property.
It is not just a question of the State handing over the management of a public hospital, to be built at a cost likely to exceed €1 billion and to be fully funded on a day-to-day basis by the State at a cost of approximately €60 million per year, to a private company. That in itself would be a travesty but there is also the question of the range of services for women that would be provided in such a scenario. The ethos of the Religious Sisters of Charity, St. Vincent's Healthcare Group and St. Vincent's Holdings is clear. Under Canon Law, the assets of the Religious Sisters of Charity are church property and cannot be disposed of without the consent of the Vatican. It is inconceivable that the Vatican would agree to any arrangement that would allow abortions or other services forbidden by Catholic doctrine to take place in a hospital owned by a Catholic successor organisation to the Religious Sisters of Charity and built on land owned by such an organisation. There is not a single hospital anywhere in the world built on Catholic-owned land that allows procedures such as elective sterilisation, IVF, genetic testing, abortion and other procedures that are specifically forbidden by universal Catholic teaching. This would compromise patient safety. The national maternity hospital is to act as a tertiary centre for complicated pregnancies. Miscarriage can occur in up to 20% of pregnancies. Catholic teaching cannot be allowed to compromise the treatment of sepsis, as in the case of Savita Halappanavar.
Despite repealing the eighth amendment and the subsequent legislation, abortion services are limited in this State. Only ten of the 19 maternity hospitals or units provide pregnancy termination and only one in ten GPs provides abortion services. Although the numbers have reduced, women must still travel outside the State. One of the hospitals providing abortions is the current national maternity hospital at Holles Street. This provision would be ended if the hospital came under the control of St. Vincent's Healthcare Group or St. Vincent's Holdings.
The only way out of the mess that the State finds itself in and to achieve co-location for the national maternity hospital with an acute hospital is to CPO the Elm Park site. The campaign group Uplift commissioned legal advice on the pros and cons of a CPO. The advice it received from Mr. Dodd, SC, was that a CPO would have an excellent chance of surviving a legal challenge through the courts. He carried out an extensive review of case law in Ireland and the EU alongside the constitutional issues involved. Articles 40.3.2oand 43 cover issues such as the right to private property, the common good and the rights of religious institutions. Property rights are protected by the Constitution but subject to the common good, provided that the action proposed is appropriate and an important development in the public interest. The building of a maternity hospital to modernise and update healthcare for pregnant women is certainly in the public interest. The State controlling such a hospital and the services it provides is also appropriate. Article 44.2.6oprotects the property of religious institutions against diversion. However, that is subject to necessary works of public utility and on payment of compensation. It is the opinion of Mr. Dodd that the national maternity hospital would clearly constitute works of public utility in the broad sense of the public use. He also believes that a narrow approach to the meaning of "public utility" is unlikely to be adopted by Irish courts.
A legal challenge to the CPO would obviously mean a further delay, but an appeal to the High Court must be exercised within three weeks of the confirmation of the order, and an issue of such public interest would likely be heard quickly. This issue has in, any case, been ongoing for almost ten years. There is very little guarantee of a successful negotiation within the short term.
The minutes of the HSE board meeting on the national maternity hospital, held on 25 June 2021, state:
The issues of concern can be summarised under three objectives in terms of the proposed ethos of the hospital and the service it will provide (on which we understand further discussions are under way), protection of state interest in assets (ownership structure), and especially the proposed ... structures of the hospital.
Discussion around the ownership of the site took place. The Board raised concerns regarding the ultimate ownership of the site which is being provided through long term lease rather than by means of being sold to the state.
We have gone through May 2017, when the then Minister for Health, Deputy Harris, promised we would have a legal framework in the coming month. In 2019 the then Taoiseach, Deputy Varadkar, assured the House that the details of the legal transfer would be resolved over the following weeks. The current Minister for Health, Deputy Stephen Donnelly, gave similar assurances last year when we discussed Private Members' motions and has come out today in a newspaper article saying something similar. This charade came to an end last year when Deputy Varadkar finally admitted the obvious, that is, that the deal is potentially fundamentally and fatally flawed. Will we have to wait another ten years before we see a national maternity hospital built on public land and in public ownership?
I call on the Government to act now. This has gone on too long. The way the Sisters of Charity are dealing with it, it will go on a lot longer. I call on the Minister to move to obtain legal advice on behalf of the Government and the HSE on acquiring the site through CPO without any further delay. The women of Ireland deserve better. We have debated this issue over recent weeks. This is about our health rights and our legal rights. It must be dealt with and cannot go on any longer. If the Government were to impose a CPO on the site, if the Sisters of Charity are not pushed about this and if land ownership is not the issue, they would welcome that move and negotiate with the Government on it. We have to move on it.