David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I commend the proposers of the motion and thank them for giving us the opportunity, for a third time, to discuss and debate this important issue in the Chamber. I have debated and discussed this issue with the Minister for Health at the Joint Committee on Health a number of times. I have had private conversations with him by telephone and we have had discussions and debates in the Dáil Chamber as well. I concur with Deputy Connolly that it is completely unacceptable that the Minister is not here. I will always give fair dues to a Minister because there may be a good reason not to attend the House but from listening to the Minister of State, the Minister's rationale for not being here is that he is still involved in discussions on this issue. That is not an acceptable excuse for his absence.

The question of ownership of the national maternity hospital is very important. It matters and it is vital that we get it right. For this reason, I will support this motion. There is no justification for leaving the ownership and governance structures in the hands of a private company when the State is making the investment and will be paying the bills. I imagine many women listening to this debate and, I hope, a majority of men will be saying that this is another case of déjà vuin terms of how the State sees, values and treats women and with respect to the lens through which the State and public healthcare system views women’s healthcare. There can be no justification for the State building a maternity hospital that it is does not own or for the convoluted governance structure for the hospital when many people are asking serious questions about potential interference in healthcare, including women’s healthcare in maternity services. These are deeply held and legitimate concerns being raised by many people.

I have two primary concerns about the current proposal for ownership of the site. First, the State’s investment must be safeguarded. This project is going to cost hundreds of millions of euro. It is not radical to ask that the State would own the hospital once it is built. It is reckless to proceed with building a hospital when the State will not own the land at the end of the process. Far from this being a radical proposal by members of the Opposition, it is a sensible one that is about safeguarding the investment of the taxpayer. Without doubt, the more significant concern is the potential for interference in the running of the hospital. There are good reasons for that concern based on the history of this State when it comes to how it treats women and women’s healthcare. I do not have to remind the Minister of State of the many failings and issues, even in more recent times, where women were failed in the Irish healthcare system.

To avoid any potential complications which could arise for any number of reasons, the full ownership of the site by the State is in the best interests of women and the people of this State. This is a principle which must underpin public expenditure on major capital projects, particularly in healthcare, where organisations with a religious ethos are involved.

As I said, I have discussed this issue privately with the Minister. I and members of my party have raised it a number of times in the Dáil and at Oireachtas committee meetings. An Teachta O'Reilly raised it when the Minister for Health was in opposition raising concerns very similar to those the Opposition is now raising. The Minister for Health seems to be taking a different position now that he is in government and a Minister from the position he strongly articulated when he was an Opposition health spokesperson.

In the past number of months and again this evening in the written script delivered by the Minister of State in the Chamber, the Minister for Health has given us some assurances, as he would see it, regarding protections against any interference in the management and running of the new national maternity hospital. It has to be said that those assurances are simply not good enough and many people simply do not believe them. I do not need to remind the Minister or the Minister of State of the importance of ensuring there is no religious interference in the running of any maternity hospital. The reasons for that are obvious. The guarantees the Minister has given us are not sufficient for us to back him. Like the previous speaker, I will not support the Government's approach to this matter unless I see a fundamental shift.

There are fundamental issues with the proposed arrangements. This mess dates back a number of years and the periods in which Dr. James Reilly, the current Tánaiste and the current Minister, Deputy Harris, were Ministers for Health, yet the controversy has trundled on unresolved. This is a mess of Fine Gael’s making and that party must take ownership of it.

This issue comes down to two simple facts. The taxpayer is paying for it and I have yet to be convinced that there is no potential for healthcare services which are entirely legal in this State to be curtailed on non-medical grounds. I do not doubt for one minute the ability of clinicians in St. Vincent’s University Hospital or in the National Maternity Hospital, Holles Street, in their determination to deliver the high-quality services their patients need. I have listened to many in those hospitals and read newspaper articles and letters to the editor submitted to national newspapers by people who work in those hospitals in which they have also set out assurances. I do not doubt the effectiveness of the voluntary public hospital model, from St. Vincent’s and Holles Street hospitals to St. James's Hospital and Children’s Health Ireland, because this governance model has served us well. In fact, I would argue that it should be a model used to roll out regional health areas because of the accountable autonomy nature of voluntary hospitals. I do not doubt the sincerity of the people who work in the system and of those who work in any of the maternity hospitals. However, their ability to deliver top class healthcare is not what concerns me. I have every confidence that they can deliver the best healthcare. It is the behind-the-scenes politics, which could infringe on women’s healthcare, the rights of women and the future of maternity services, that concerns me.

The last time we had a debate of this matter was shortly after the St. Vincent’s Healthcare Group stated the land could not be gifted or sold to the State because it would disrupt integrated patient care on the site. I did not buy that then and I still do not buy it. Similar arrangements are in place for the Mater and Rotunda hospitals, two different hospitals on two different sites which have a relationship. It can, therefore, be done.

I am looking at the script of the Minister of State in which she stated that concerns continue to circulate regarding the potential involvement of the Religious Sisters of Charity in the new national maternity hospital. The script goes on to say that the Minister for Health wishes to make it absolutely and unambiguously clear that the sisters will not play any role in the governance or operation of the new national maternity hospital. It refers to the sisters resigning from the board and transferring their shareholding to a new charitable entity, St. Vincent's Holdings CLG. With all due respect, why are the Religious Sisters of Charity going down such a convoluted road? If they are genuine and sincere about relinquishing all control, why not simply gift the land to the State? Then there would be no issue. There would be no need for a compulsory purchase order or to set up this convoluted structure where there is a distant relationship between the management of the hospital and the HSE and the State. Indeed, it would resolve the ownership issues.

That is why there is suspicion. It does not make sense that, on the one hand, the Religious Sisters of Charity are saying the order will not have any role, does not want to have any say and essentially is gifting the land to the State but, on the other hand, the sisters are going to do it through this convoluted process of setting up this charitable group rather than, as most reasonable people would want, the land being gifted to the State. I am not convinced by anything I heard from the Minister on the last occasion we debated this issue at the Oireachtas health committee, in any private conversations I have had with him or in this Chamber. It is regrettable that, in a week when women's rights, women's healthcare and the safety of women were tragically brought into sharp focus, the Minister is not here for this debate, given the seriousness of the issue.

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