Joan Collins (Dublin South Central, Independents 4 Change)
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Like Deputies Ó Cuív and Carthy, I wish to again register my frustration. When we put down these questions, we expect the Minister to be here. I wish to put on record that the Minister, Deputy Stephen Donnelly, seems to be operating not only at arm's length from the Dáil, but maybe at bridge length from it at this stage. The Minister of State will deliver a standard reply she got from the Department or whatever. I do not think it is good enough on an issue as important as the new national maternity hospital.

There have been three Private Members' motions proposing that the national maternity hospital should be publicly owned, run and controlled. The motions were accepted by the Government. That is an important point. The Taoiseach has come out and said it should be publicly owned. The decision was made in 2013 to relocate the maternity hospital from Holles Street to co-locate on the Elm Park site at St. Vincent's Hospital. That was the KPMG report, which was accepted by the then Minister for Health, James Reilly. This led to dispute with St. Vincent's Healthcare Group, SVHG, which rejected co-location and demanded full ownership of the new national maternity hospital.

SVHG is a private company owned by the Religious Sisters of Charity. It is a section 38 body fully funded by the State. The Religious Sisters of Charity have now set up a new private company, St. Vincent's Holdings, into which they have said they will transfer their shares in St. Vincent's Healthcare Group, though that has not yet happened, obviously. It has been reported recently that the Minister and the Department have had meaningful negotiations and arrived at some sort of proposition that would be imminently brought to Cabinet. I am seriously concerned about this because it is a fact that not one hospital in the whole world that is run privately by a religious order allows reproductive rights procedures to be carried out.

Professor Shane Higgins, the master of the National Maternity Hospital, featured on a radio programme to discuss the letter he and his colleagues wrote to the Taoiseach and the Minister for Health on 23 February this year. In the letter, they sought to give assurances on the provision of certain procedures at the planned new maternity hospital and to dismiss what they described as misleading and ill-informed commentary from certain Deputies and other people that is derailing the project. I reject and refute that comment. There are significant concerns in respect of the actual procedures that will be provided in this hospital. It is a 299-year lease, which is a massive extension from the 99-year lease to the hospital. It will cost more than €1 billion of public money to build and more than €70 million of public money to run. We want to make sure that every woman and man who needs reproductive procedures in the new national maternity hospital has access to them without being referred elsewhere.

Josepha Madigan (Dublin Rathdown, Fine Gael)
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I am sorry to disappoint the Deputy that I am not the Minister, Deputy Stephen Donnelly. He too was not disposed today to take this Topical Issue matter but I am happy to take it on his behalf.

I know the Deputy, like many other Members, has a strong interest in the ownership and governance arrangements of the new national maternity hospital and I welcome the opportunity to address the House on the issue. The Government is committed to the development of the new national maternity hospital, as set out in the programme for Government, as the Deputy is aware. The proposed corporate and clinical governance arrangements for the new national maternity hospital are set out in the Mulvey agreement. This was finalised following extensive mediation between the National Maternity Hospital and the St. Vincent's Healthcare Group and has been published for a considerable time.

The Mulvey agreement provides for the establishment of a new company to run the new hospital under a service level agreement with the HSE, as happens in the current National Maternity Hospital. This new company will have clinical and operational, as well as financial and budgetary, independence in the provision of health services in the new national maternity hospital. A draft legal framework has been developed based on this agreement and aims to copper-fasten these arrangements. This legal framework will address the State's core objectives, which are: first, to ensure all clinically appropriate services that are legally permissible are provided for women who need them in the new national maternity hospital; second, to prevent any undue influence, religious or otherwise, in the operation of the new hospital; and third, to protect the State's investment in terms of capital, revenue and service provision at the new hospital for the public good.

There are certain key points which are important to reiterate to the House. First, I recognise that concerns continue to circulate regarding the potential involvement of the Religious Sisters of Charity in the new national maternity hospital. Indeed, the Deputy has raised those concerns here today. However, the Minister for Health has been clear and informs me the order will not play any role in the governance or operation of our new national maternity hospital. In fact, the Religious Sisters of Charity have resigned from the board of SVHG and their shareholding is to be transferred to a new charitable entity, St. Vincent's Holdings. The constitution of St Vincent's Holdings has been published and anyone who has seen that document will know it makes no reference whatsoever to canon law. The Department of Health has previously been advised in writing by SVHG that canon law will not impact on St Vincent's Holdings. In addition, it has been stated previously that the Government will not be asked to approve any legal arrangements unless they ensure that all legally permissible services will be provided in the new hospital, as well as appropriately protecting the State's investment.

We know the buildings at Holles Street are no longer fit for purpose. It is essential that we move forward and build the new national maternity hospital and provide the necessary infrastructure to facilitate the delivery of a safe and high-quality maternity service for women and infants. We will do that with all the necessary safeguards and assurances in place. There is a process ongoing to finalise the legal arrangements.

The Minister for Health will not be making any further comment on this matter until the process of engagement and deliberation regarding the legal arrangements has concluded.

Joan Collins (Dublin South Central, Independents 4 Change)
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I thank the Minister of State for her reply. First of all, the Religious Sisters of Charity have physically gone from SVHG but their canon law has not. They have got permission from the Vatican and the Irish Catholic Bishops Conference to go ahead with this deal. Under canon law, St. Vincent's Hospital is the property of the Catholic Church. I did not hear anything in the Minister of State’s response to say it will not continue to use canon law while it gets the national maternity hospital. That is my very significant concern and that of many Deputies and many people outside of this Chamber. It must be made very clear that canon law has absolutely no input into this national maternity hospital.

I looked at the ownership structure. There will be St. Vincent's Holdings. Under that there will be the SVHG, and under that there will be St. Vincent's public, St. Vincent's Holdings private, St. Michael's and the national maternity hospital. The St. Vincent's Holdings board, the SVHG board, the SVHG group CEO, the group clinical director, the clinical directors and all of the practices and consultants, etc., will be under that clinical governance structure. It is quite clear that the clinical governance here is the canon law governance of Mary Aikenhead, under which the hospital is run. The Minister should be more open to meeting Members of the Dáil to let us know what is going on. In this deal, seemingly they just agreed with what they could do under law, but did not extend it to future legislation that could be brought in. It is too dodgy.

Josepha Madigan (Dublin Rathdown, Fine Gael)
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I would like to reassure the Deputy. I set out my understanding in my original contribution to this House. In fact, I said that canon law plays no part in the new maternity hospital. I have said that on a number of occasions here, including my initial contribution, and I will say it again to the Deputy. The House can be assured that maternity and reproductive healthcare at the new hospital will not be compromised. The Minister for Health is adamant about what will happen. He will not bring any proposal to the Government unless it provides assurances around all legally permissible services being provided in the new hospital and ensuring the State’s significant investment in the new hospital is appropriately protected. I hope that will give the Deputy some comfort. The Government is committed to this key project in the way I have set out. The Deputy mentioned clinical governance and it is not canon law and we are quite clear on that.

I emphasise that the Government is fully committed to promoting and improving women’s health outcomes more generally. That commitment is reflected in budget 2022, which includes a spend of €31 million for new development funding specifically to support women’s health. The relocation of the national maternity hospital is a very significant part of the Government’s objectives in that regard. We remain committed to providing the highest quality infrastructure and environment to facilitate the delivery of a modern, safe and quality maternity service for women and infants over many years to come. I note that the Deputy has mentioned that it is a 299-year lease. It is important that there is no canon law involved in it and there will not be, which is my understanding of this.