Bríd Smith (Dublin South Central, People Before Profit Alliance)
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5. To ask the Minister for Health the way in which the agreement with a religious order (details supplied) for the running of the new National Maternity Hospital will ensure women will have access to all services and operations, including abortion, in the future; and if he will make a statement on the matter. [20883/17]

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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I was fascinated listening to the conversation between the Minister for Health and Deputy Billy Kelleher. I regard it as a conversation because there was a lot of agreement. I think I counted the number of times they both used the phrase "Conversation has to be had". A conversation has to be had. The Minister needs to have a very loud, honest and public conversation with the people and explain to them why he has an agreement with a religious order to run the new National Maternity Hospital and will allow it ownership of the hospital. Some €300 million of our money is to be used to build the hospital. I ask the Minister to outline how he can justify this and ensure it will provide proper facilities to ensure women's health in the future, including abortion.

Simon Harris (Wicklow, Fine Gael)
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I welcome the Deputy's agreement that it is important that we have a conversation on future ownership and governance of the health service. It would be both very important and timely. In fact, it is overdue. Let us remember and recall how we arrived at this point in the case of the National Maternity Hospital.

Following extensive mediation discussions, agreement was reached late last year between the St. Vincent's Healthcare Group, a very important teaching acute adult hospital, and the National Maternity Hospital on the relocation of the maternity hospital to the Elm Park campus. The terms of the agreement which have been published in full provide for the establishment of a new company, The National Maternity Hospital at Elm Park DAC, limited by shares. The new company will have clinical and operational, as well as financial and budgetary, independence in the provision of maternity, gynaecological and neonatal services. This independence will be assured by the reserved powers which are set out in the agreement and copperfastened by the golden share which will be held by the Minister for Health of the day. The reserved powers can only be amended with the unanimous written approval of the directors and the approval of the Minister for Health. This is a greater level of input than the Minister for Health has today in some maternity hospitals. The agreement ensures a full range of health services will be available at the new National Maternity Hospital without religious, ethnic or other distinction. In that regard, I welcome the further confirmation by the board of the St. Vincent’s Healthcare Group that any medical procedure which is in accordance with the laws of the land will be carried out at the new hospital.

Now that the planning application for the development has been submitted, we must turn our focus to the legal mechanisms necessary to complete the project. The hospital will be publicly funded, built on lands in the ownership of St.Vincent’s University Hospital and operated by the new company. In the next few weeks I intend to meet representatives of both hospitals and will further consider the legal mechanisms necessary to absolutely protect the State's considerable investment in the hospital, including the ownership of the new facility. I have indicated that, prior to the HSE entering into any construction contract, I will formally sanction the necessary arrangements to ensure the facilities will be legally secured on an ongoing basis for the delivery of publicly funded maternity, gynaecological and neonatal services. Over the years we have made a significant capital investment in voluntary hospitals and such facilities have always continued to be used for the delivery of publicly funded health care as intended, including Holles Street hospital.

Additional information not given on the floor of the House.

I intend to report to the Government on the project at the end of May. At that stage I expect to have further details of the legal and other arrangements envisaged and will make this information available publicly. This will allow for the necessary clarity well in advance of contractual or other commitments being entered into in respect of the project.

I reaffirm my commitment to this hugely important project. The facilities at Holles Street are no longer fit for purpose. It is also acknowledged that for optimal clinical outcomes, maternity services should be co-located with adult acute services. We need to move on with the project and provide women and infants with modern health care facilities. I look forward to working with all stakeholders to deliver the new state-of-the-art facility.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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The question the Minister asked, namely, how we had arrived at this point, is poignant. We arrived in the middle of the discussion with most of the country up in arms. Within five days 100,000 people had signed an online petition calling on the Minister not to do this. Why did they do it? I have a letter, a copy of which I understand the Minister has received. It gives a very compelling example of why we have to ensure the Sisters of Charity will have nothing whatsoever to do with the running of the new National Maternity Hospital. It points out that only last month St. Vincent's University Hospital told a woman to contact the National Maternity Hospital at Holles Street because it would not provide the procedure of tubal ligation. For those who do not know, tubal ligation is a surgical procedure of sterilisation in which a woman's fallopian tubes are clamped to stop her becoming pregnant.

This very basic, longstanding service is denied to women by the board of St. Vincent's Hospital. How, in the name of God, is it going to deal with issues like IVF and termination of pregnancy in whatever circumstances as well as the question of sexual reassignment, which is one to which the Minister's Department is committed?

Simon Harris (Wicklow, Fine Gael)
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It is important to note that the arrangements in respect of this new hospital were published by my Department on 24 November 2016 of last year. The statement of 24 November covered all of these issues, including the ownership of the company, clinical independence and the composition of the board. As such, that information was first put in the public domain on 24 November which is a point it is important to make.

I want to be crystal clear about this. The hospital will have full clinical independence. I intend to ensure that clinical independence is further underpinned in legal arrangements. The Deputy does not need to take only my word for it. The Master of the National Maternity Hospital, Holles Street, Dr. Rhona Mahony, has made it very clear. Every single service available in the National Maternity Hospital, Holles Street, will be available in the new national maternity hospital, including, if the people of this country decide to change the law, any services which could then be provided which are not legally permitted now. Many people asked whether Holles Street would be able to comply with the Protection of Life During Pregnancy Act. I was in the House at the time when that was debated. The question was asked whether voluntary hospitals would comply and they have complied. This hospital will have full clinical independence, which is in black and white in the agreement. I will underpin that further in legal agreements. Let us take the next month to get this absolutely right.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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I do not understand this business of the next month and I do not think anyone else does either. On Sunday, there will be another major demonstration from 2 p.m. at Parnell Square, organised by Parents for Choice, to ensure that we try to get it through to the Minister and the rest of the Cabinet that they do not get where the rest of the country is at. The vast majority wants to move to a situation where we can separate the church from the State. That is clear. It is about the fundamental democratic structure under which we should live in 2017. It will not happen overnight and we have no intention of seizing hospitals under the noses of those who run them; hospitals which, by and large, we own and which the Minister listed. We have no intention of sneaking in during the night to undermine people who provide services. However, as with the prayer debate we had last night, we should go forward on a different footing and start by pronouncing that the brand new, state-of-the-art national maternity hospital which is urgently needed and which will cost the taxpayer €300 million is not going to be subject in any way to the input and control of the Catholic Church. In particular, I refer to a discredited order like the Sisters of Charity. Can the Minister guarantee that?

Simon Harris (Wicklow, Fine Gael)
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No matter how often I say it, the Deputy will never be convinced or accept it because she wants to be in the politics of protest while I want to be involved in the politics of solutions.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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The Minister is not saying it.

Simon Harris (Wicklow, Fine Gael)
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The people of this country want a new national maternity hospital which they need and deserve. If the Deputy does not believe me, she should go down to the hospital and speak to those who deliver services.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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I have just said that.

Simon Harris (Wicklow, Fine Gael)
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Fine. She has said that.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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We do not want a church-controlled one.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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No, no.

Simon Harris (Wicklow, Fine Gael)
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That is fine. The Deputy has said that and no matter how often she says it is church-controlled, it will not be. We have heard the public's concerns and I want to use the next month to further engage with the hospitals, which is the appropriate thing to do. It is what a politician does when he or she listens to public concern. I will further engage on the issues, including the issue of ownership. However, some of the things the Deputy has said are factually incorrect. She presents them as fact but it is not true. She says the new hospital is going to cost the State €300 million. Has she considered what the proceeds from the sale of Holles Street will contribute towards that cost?

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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I am not worried about the cost.

Simon Harris (Wicklow, Fine Gael)
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Has she considered the fact that the National Maternity Hospital at Holles Street today is a voluntary hospital and not a HSE-owned one? This hospital will have full clinical independence and provide every service a women needs. Dr. Rhona Mahony and Professor Declan Keane have said it. Many doctors have said it. It will be robust in its clinical, budgetary and financial independence. We are going to get it right. What we are not going to do is fail to build it, because we need this hospital.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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Has the Minister listened to the Bishop of Elphin?

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Do not mind the Bishop of Elphin. Can we get on? We want to hear from Deputy Pringle.

Simon Harris (Wicklow, Fine Gael)
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I do not answer to the Bishop of Elphin.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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That is good.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Please, Deputies.

Simon Harris (Wicklow, Fine Gael)
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I apologise.