Tuesday, 17 May 2022
Ceisteanna ó Cheannairí - Leaders' Questions
The Cabinet this afternoon signed off on the deal for the new national maternity hospital. Instead of securing a clean-cut transaction where the site will come into public ownership, the deal ensures the hospital will have a private landlord under a very convoluted ownership model. This is the wrong decision. It falls short of protecting the State's proposed investment of between €800 million and €1 billion of taxpayers' money. It is obvious that the best way to safeguard this investment and allay public concern is for the Government to secure the transfer of the land into State ownership by means of a clear and explicit agreement that ensures we get a publicly built national maternity hospital on publicly owned land. I asked the Taoiseach several times, together with the Tánaiste and the Minister for Health, Deputy Donnelly, to get around the table with the St. Vincent's Healthcare Group in order to convince it to agree to that transfer. I am of the view that such a high-level Government initiative would have yielded success.
Yesterday, at a meeting of the Joint Committee on Health, the St. Vincent's Healthcare Group confirmed the Sisters of Charity transferred the land to the group without precondition. This means that there is no legal barrier to the land transfer. It is entirely within the gift of the group. Yet it transpires that far from proactively seeking the best outcome, the Taoiseach and the Government made no real effort to secure State ownership of that land. Last week, the Minister for Health told the Dáil he had formally requested the land be transferred to the State. However, what the chair of the St. Vincent's Healthcare Group told the committee yesterday directly contradicts the Minister. Mr. Menton said that the last time the State directly engaged with the group as regards bringing land into public ownership was five years ago. It gets worse because Mr. Menton also said the group has received no correspondence from the Taoiseach requesting the land be transferred to the State. This is something the Taoiseach later confirmed to the media. We know now that neither he nor the Minister for Health made any serious or meaningful effort to bring this land into State ownership.
The Taoiseach came before the House and told us that such a transaction was not possible, but the truth is that he did not even bother to ask. He has now signed off on a deal that fails to provide the best protection for almost €1 billion of taxpayers' money and copper-fastens an ownership model whereby a critical piece of public infrastructure will have a private landlord. Is an socrú a shínigh an Rialtas ar maidin an socrú mícheart don ospidéal náisiúnta máithreachais nua. An bealach is fearr chun infheistíocht an Stáit a chosaint ná má aimsíonn an Rialtas úinéireacht Stáit ar an talamh. Everyone in the House wants this hospital built. We want it built quickly and we want a new departure in maternity care. I absolutely accept the Taoiseach's bona fides in all those regards but what is at issue is the failure of the Government to secure the land in public ownership. This is big stuff. The contract the Government signed locks the State into a deal whereby the State does not have ownership of the site for the national maternity hospital. I ask the Taoiseach to directly explain why neither he nor the Minister for Health made any real or significant effort to secure State ownership of that land.
I will put this point to the Deputy.
It is a good decision today for the women of Ireland and for newborns into the future that we will have a new maternity hospital and a neonatal centre of excellence in public ownership, in State ownership for the next 300 years. When it is built and it is proven to be a good decision I hope that Deputy McDonald and her party will have the good grace to acknowledge that is the case and will not try to erase from the public memory their ongoing downright opposition to it. It is my sincere belief that this will be a hospital that will serve the interests of women in Ireland for decades to come, facilitating all legal and lawful services to be permitted there. It is in State ownership. It is 300 years at a tenner a week. No matter how often the Deputy tries to tell a different story or to spin it or try to present it as not being in State ownership she is wrong by any yardstick. By any legal analysis she is wrong about the ownership. It is precisely what I said to the Minister on the negotiations with the St. Vincent's Hospital Group. It has gone from 99 years with an option of 50 more on the lease to 300 years. In July of last year, the Secretary General of the Department of Health wrote to the chairman of St. Vincent's Holdings Group, Mr. James Menton, making it crystal clear that it was the State's objective and desire to have outright freehold ownership but acknowledged that St. Vincent's was not going to do that, as communicated to the Minister when he had requested that from the chairman in their conversations. There has been an attempt to try to undermine the nature of the freehold lease. Some of it did not last too long. There was an attempt by the Deputy and others to say that it was actually €850,000 not a tenner but when you look a little into the detail it is €850,000 if you do not build a maternity hospital and what we are obliged to do. There is nothing in the lease that is an imposition on the State whatsoever.
There is nothing in the lease that is an imposition on the State at all despite attempts to muddy the waters and, in my view, deliberately confuse that issue.
On the broader issue, the concerns that were raised after the Mulvey deal and over a year ago have been comprehensively addressed by this Government and by the Minister, first in the constitution of the new national maternity hospital which is absolutely clear in terms of all lawfully and legally permissible services being made available; the operating licence that will be issued by the Health Service Executive to the hospital which will oblige the hospital to provide such services; and also the Minister having the authority, through the golden share, to ensure that all directors fulfil their duties and they must comply - they are obliged to comply.
The overall motivation behind the Government's decision is to provide modern physical facilities that are required now. I am struck by the very strong representations that have been made by all the national directors of midwifery across the country representing every maternity unit who said please get on and build the hospital and by the national director of Holles Street, all the assistant directors of midwifery of Holles Street and the 52 clinicians who wrote a letter to us saying please build the hospital. I accept that the Deputy's concerns were raised. They have been genuinely, comprehensively addressed.
And I am struck that the Taoiseach is in any way surprised that there is widespread clamour, and has been for some time, for proper investment in maternal and neonatal care and women's healthcare more generally. Everyone wants that. I can assure the Taoiseach that I want that. I want to see the speedy delivery of first-class services of excellence for the women of this country that for far too long we were denied. He also ought to be struck that there is no doubt in the mind of the St. Vincent's Healthcare Group as to who owns the land. It is very clear. It is very clear that it is the landowner.
It was also clear in setting out at the committee meeting that there was no meaningful engagement on the part of the Taoiseach or the Minister for Health to secure State ownership of that land. It could have been done by means of a simple transfer, which, bear in mind, had been promised initially. That is the St. Vincent's Healthcare Group's version of events. I would like the Taoiseach to confirm and set out for the Dáil what engagement he had, if he claims he had any, to secure this site into State ownership. When did that happen? Is the Taoiseach saying that the chair of the St. Vincent's Healthcare Group is incorrect or that he has misled an Oireachtas committee?
The chair is ready to correct the record in respect of what I said earlier. I have made the point. have the correspondence, which has been published and which was sent to the chairman as well.
The Deputy obviously paid close attention to yesterday's deliberations. When doing so, she would have heard the legal representative of the St. Vincent's Healthcare Group making it clear that the State will own the land for the next 300 years. That is the reality.
It is as simple as that. There should be no attempts to cloud the reality of that as ownership. That is effective ownership by any yardstick. I ask the Deputies opposite to stop.
It is time to wrap this part of it up. The arguments presented by the Government on this have held up robustly, and we have strengthened the position. The original position was 99 years plus-----
We have to ask what was the point of the past two weeks. After nearly a decade of negotiations, the legal documents were finally published just two weeks ago. The Taoiseach stated that he wanted the documents to be scrutinised and indicated that he was open to changes being made. It is quite clear that this was a charade. We did not know how much of a sham this whole process was until we heard from Mr. Menton yesterday at the committee. Mr. Menton made it absolutely clear, in reply to a question I asked, that it has been five years since any serious attempt was made to engage with the St. Vincent's Healthcare Group on the possibility of buying the site. Despite repeated claims by the Taoiseach and the Minister for Health in recent weeks, we now know there was no meaningful engagement at all. Those are Mr. Menton's words; not mine.
In addition, in recent days we have heard a succession of people who support this deal agree that the phrase "clinically appropriate" is both open to misinterpretation and a cause of public concern. It is clearly ambiguous. Representatives from the National Maternity Hospital, Holles Street and St. Vincent's University Hospital and the Minister for Health all said they would have no problem including a definition of the term in the legal documents. That was yesterday. What did we get today instead? We got a note that the Cabinet has agreed that it knows what the term means. We have been told that a binding legal definition is not required. What is the message to the women of Ireland? Is it that they should calm down and that they do not need legal guarantees because the word of the Cabinet will suffice? Is the Government asking them to trust it? The Taoiseach can forgive the women of Ireland if they are not reassured.
At the press conference earlier, the Minister for Children, Equality, Disability, Integration and Youth, Deputy O'Gorman, discussed his party's decision to support this deal and break the commitments the Green Party made during the last election campaign. He said that the past two weeks had been useful because people had genuine concerns. He told us, however, that those issues had been teased out and that there is now clarity. Apparently there is clarity because he has decided that there is. Maybe he should ask his colleague, Deputy Hourigan, about that clarity.
The overall attitude of the Government has been incredibly patronising and completely dismissive of good-faith attempts by the Opposition and the public to engage in respect of these documents and improve the deal.
The unseemly rush to ram this decision through the Cabinet is inexplicable. This is especially the case when the Department of Health has not even managed to publish the business case for the deal which it has been negotiating now for almost ten years. Can the Taoiseach explain why the Government never attempted to buy the site and meaningfully address genuine concerns? Why does he think the women of Ireland do not need cast-iron legal guarantees and that somehow the word of the Cabinet is in any way sufficient to address those concerns?
I am not accepting the premise on which the Deputy's first question is based - that we do not have ownership. This State does have ownership of this hospital. The State does have public ownership of this - 300 years at a tenner is effective ownership. That has been well tested over the last two weeks. The purpose of the last two weeks was to have the debate, tease the matter out and have full transparency on the publication of the documents. If you do not mind me saying so, I think many of the arguments against going ahead with the hospital did not hold up under the full scrutiny of the-----
That is my more personal view of the situation. That is the first point.
The second point is that the chairman was in no doubt as to the State's desire to have the entire site. That is communicated again in correspondence dated 26 July 2021 where the Secretary General of the Department of Health stated that the Minister, Deputy Stephen Donnelly, had already reiterated his predecessor's request for St. Vincent's Healthcare Group to transfer ownership of the site to the State.
He acknowledged the clear response that the group's intention that the site would be neither transferred nor sold to the State. This has been made clear on an ongoing basis by the board. That correspondence referred to a telephone conversation indicating that a long-term lease of 299 years could be considered. That is the Government's position - that the extended lease of 299 years could be considered to address the issue of ownership, and it does by the way. Let us put away all the nonsense. Of course, it does - 300 years at €10 a year is ownership.
You cannot keep saying the opposite and try to get some credibility attached to it.
The next question that the Deputy asked was that the women of Ireland do not need legal guarantees. They do need-----
Sorry, I did not interrupt. I would be grateful if you would allow me to answer the questions you asked. You suggested we feel that the women of Ireland do not need guarantees. That is not fair. We have addressed those issues through legal guarantees. The advice to Government is that those legal guarantees are watertight.
Watertight is legal advice that the Government received this morning in respect of the constitution of the hospital in the first instance, in respect of the operating licence that the HSE will be giving to the new hospital, in terms of having to ensure that all lawful services are provided-----
-----in terms of the ministerial golden share which gives the Minister the power to direct the directors to follow the implementation of the constitution-----
Just a moment, it would be helpful if the remarks were addressed through the Chair rather than directly to the Deputy because she keeps responding and interrupting the Taoiseach. I wish that would not happen. Would Deputy Shortall please not continue? Would all Deputies not interrupt when a Minister or the Taoiseach is attempting to respond?
Earlier today the Minister said we will own the building and the land for the next 300 years in the same way that anyone who buys an apartment owns their apartment. This is just patent nonsense. The real value of the new asset centres on the licence. Has the Taoiseach read the licence? The freehold ownership of the hospital site plus the 299-year lease plus the 299-year licence adds up to an extraordinarily valuable asset. The HSE cannot unreasonably withhold its consent to the mortgaging of the land underneath the new building nor can it prevent the sale of the lease nor revoke the licence that effectively shuts out the State from the new building.
That is what is in these legal documents. This gives an extraordinarily valuable asset to St. Vincent's Healthcare Group, which it is free to mortgage or sell. The HSE has essentially been shut out of this. It cannot make what is determined to be unreasonable objections to that.
A lease of a tenner per year for 300 years is not too valuable. We need to bring some common sense and reality to this issue. The motivation of everybody here is to provide a modern hospital. That is the only objective here. Co-location was the origin of all of this. The idea is that if we co-locate a maternity hospital with a tertiary hospital, we get the best outcomes for women and newborns. That is the whole idea. We have only done one such major centre, which is the maternity hospital and neonatal centre in Cork.
The Deputy said this has been done in an unseemly rush. This was announced as a Government decision in 2013. Planning permission was secured for this in 2017. People talk of an unseemly rush.
I am clear in my conscience. As Taoiseach, I am not prepared to prevaricate. I am not prepared to allow this to go on for another couple of years with no decision taken. I know how these things can get dragged on for a variety of reasons. I am determined that we move on and build modern, proper facilities for women in the 21st century.
Deputy Naughten is next on my list but he is not here. Does somebody else from the Regional Independent Group want to take his slot? No. That is odd. We will proceed to the Independent Group. I call Deputy Pringle.
I sat in the Taoiseach's office in 2016 following a general election as he was making his first attempt to ascend to the position he now holds. We talked at some length about privatisation within healthcare. I remember he used the private Bon Secours hospital in Cork as an example of private healthcare's over-reliance on the public system and the public purse to prop up its operations. He told me he was committed to the public provision of healthcare. Perhaps as a former leader of the Labour Party said, "Isn't that what you do during an election?" The Taoiseach's actions today speak volumes and tell me that his words to me on that day were not what he believes.
The spin machine has been working overtime this morning. The Taoiseach has been quoted as saying he has "no doubt that all the guarantees are there". The Minister for Health, Deputy Donnelly, said, "There will never be any religious influence on the services." The Minister for Justice said she is confident that the hospital will be secular. The Minister for Children, Equality, Disability, Integration and Youth, Deputy O'Gorman, said that the past two weeks have provided absolute clarity on the secular status of the new hospital. The women of Ireland know that talk is cheap, particularly talk from Fianna Fáil, Fine Gael and the Green Party. Over the course of the hearings held during the past two weeks, a number of questions, including questions I tabled to the Minister for Health last Thursday, remain unanswered despite the Minister's promise that answers would be forthcoming.
The recurring issue has been the unexplained term that appears like a rash throughout the various contracts, licences, constitutions, leases, fact sheets and option agreements. That phrase is "clinically appropriate". The Minister, Deputy Donnelly, initially explained that the term needed to be included to prevent St. Vincent's from turning the place into a drive-through McDonald's or the likes. That explanation holds no water and no better explanation has been put forward since. The National Maternity Hospital, Holles Street did not put that phrase there. St. Vincent's Hospital holding company, or whatever you are having yourself, said it did not put it there. The representatives put forward by those organisations at the committee meeting last week said they were happy for it to be removed and yet it is still there. Why? Its removal would go a long way to removing the ambiguity that the spider's web of corporate structures has created. It does not need to be clarified; it needs to be removed.
We all agree that the hospital should be a public hospital on public land. The Government even supported Deputy Joan Collins's Private Members' motion in that regard. As the Government appears to be hell-bent on ploughing on with a second-rate option, will it commit to the removal of the term "clinically appropriate" from all documentation relating to the development of the new maternity hospital? That is within the control of the Taoiseach and it emanated from a Government Department.
I will respond to the Deputy's comments and remarks. On the issue of ownership, I must be strong because this debate is focused on the nature of leasehold versus freehold ownership.
Leasehold ownership is very common across the State. It is not some new concept. It has been clarified that leasehold ownership is common-----
I will come back to the Deputy's question. I have three minutes but I am entitled to refer to points that the Deputy made, in terms of the ownership question. This is a publicly-owned hospital. That is the point. I am not going to allow people to stand up and say that it is not a publicly-owned hospital, that there is somehow a private agenda. It is anything but a privatised agenda.
It is a publicly-owned hospital and given the way healthcare is evolving, there will be more of this. Healthcare has evolved over the last 100 years through different methods, in all countries, with non-religious voluntary hospitals like St. James's Hospital, which have their own independent governance mechanisms, and voluntary hospitals like St. Vincent's hospital. We have to deal with where we are and move on and co-location was the origins of this.
In terms of the issues in relation to lawfully and legally permissible, all of the legal documentation is there and all of the guarantees are there in terms of legally permissible and lawfully permissible services. The HSE put in the term "clinically appropriate" - not the other interest, but the HSE - to protect the maternity hospital and to ensure that it would provide maternity facilities and services, gynaecological services and the full range of clinically appropriate activity that happens in maternity hospitals, as opposed other uses being made of the maternity hospital or of facilities within the hospital. The lease is clear on that as well, that it has to be used as a maternity hospital.
Attempts have been made to conjure up the idea that there is some conspiracy behind the utilisation of that language but there simply is not. Stating that there is does not make it a reality. There simply is not and time will prove this. Time will prove it but if the Deputy does not want to take my word for it, the clinicians in Holles Street are very clear about this. They provide all legally permissible services now, from termination right through. There is no issue in the hospital at the moment and there will be no issue in terms of the new hospital either. That is the reality. This has been debated now for seven years or nine years and it needs to be brought to a conclusion. There are three contracting parties to it, namely, the HSE representing the State, St. Vincent's Holdings and the National Maternity Hospital. There has to be a partnership arrangement on the site because it is a very expansive medical and hospital campus. That is the objective and the rationale is a bone fide, noble one.
The problem is that the term "clinically appropriate" is not accepted because nobody really knows what it means. The Taoiseach has had to give lots of convoluted explanations today as to what it means to try to get it over the line. Why is the Government so hung up on it when everybody agrees that if those two words were removed from the lease, it would be acceptable? Indeed, even at the meeting of the Joint Oireachtas Committee on Health last Thursday evening Professor Peter Boylan and Mr. Simon McGarr, who were there to object to the lease, said that as a best case, if those words were removed it would be a reasonably acceptable lease. Why is the Government still hanging on to it? That is the question that must be asked and answered. Unfortunately, the Taoiseach is not going to answer it. If the Government removes those two words, it would solve the problem. The problem would go away but the Government is not willing to do it. Why?
If that is the case then why, for the last two weeks, have we been arguing about ownership? Now the Deputy is saying to me that last night that all disappeared.
What I am saying is that over the last fortnight, or for the first week or ten days of this debate, from all sides of the Opposition, it was all about ownership. In other words, this keeps shifting and the goalposts keep changing. There is an element of that but what we must do is address the real concerns people have in terms of what can happen in the hospital and what services can be permitted. The Government received very strong legal advice, the strongest of legal advice, that the legal guarantees mean that all services which are lawful in this State not only will be, but have to be, permitted.
The directors of the hospital are obliged to ensure the provision of all legally permissible services. That is the point. The legal guarantees have been given and address all of the issues raised by people genuinely.
I thank the Ceann Comhairle and I apologise to the House.
Today is world telecommunications day. Every day I receive complaints from constituents about the dropping of mobile phone calls. Every day I must ask people to move their location so I can hear what they are saying. This is because of the quality of the mobile phone coverage.
On 1 February the Government launched its new national digital strategy, Harnessing Digital - the Digital Ireland Framework. One of the objectives set out in the framework is to make connectivity available to everyone. It set a target that all populated areas would be covered by 5G not later than 2030. Today, Eir has 5G coverage of more than 70% of Ireland's population, covering 322 towns throughout the country. That is close to providing coverage to every town with a population of 500 or more. Three has a population coverage of 79% for 5G technology. By 2028 we will have 146,000 km of fibre cable stretching across 96% of Ireland's land mass. Setting a goal, therefore, of only covering the populated areas of the country two years later, by 2030, is not very ambitious. On top of that, Government will have to tender for the new Tetra radio communications network, a digital radio service for An Garda Síochána and for the other emergency services, which is costing the taxpayer €40 million per annum at the moment. This network needs to be replaced with a 5G network to have geographic coverage.
Today there is a real gap in providing mobile voice and data services to address the black spots around the country that have a negative impact on businesses and tourism in our rural areas. This will have a significant impact on medical care, the care of older people, and the use of technology on farms into the future. As one of the most dispersed populations in Europe, Ireland has a relatively high percentage of its land mass with no mobile data coverage.
Now is the time to focus on the opportunities the State has by working in collaboration with industry to develop a shared rural network to address this issue, and to assist in the further balanced regional and economic development of our rural areas. This shared rural network could provide the critical 4G and 5G coverage that would enhance the operation of our rural economy, support key activities such as farming, medical services, older people's schemes in rural areas and SME business operations, and it could ensure that people would remain connected when travelling around our country, working in rural Ireland or living in rural areas.
I am aware that the telecoms industry is already engaging with Government via IBEC to progress a phase 1 proof of concept roll-out of a shared rural network, which would cost approximately €5 million. Will the Taoiseach consider this proposal?
I thank the Deputy for raising this important issue about connectivity, particularly as it applies to rural Ireland, the economic life of rural Ireland and the quality of life in a modern digital era.
The main twin pillars of the Government's economic recovery plan were digitalisation and the green economy. The economic recovery plan has been particularly successful in its objectives. Consider the employment created since we published that plan and the actions on climate. It is quite dramatic. As a result of that plan we are close to full employment much earlier than anticipated. Without a doubt, the new national digital strategy is designed to advance the country into a better performer digitally speaking. It relates to the worlds of education and enterprise, and enabling people to be far more connected.
The Minister for Social Protection, and Rural and Community Development, Deputy Heather Humphreys, has set up with the Minister of State, Deputy Ossian Smyth, a national mobile phone and broadband task force.
It will be co-chaired by both the Minister, Deputy Humphreys, and the Minister of State, Deputy Smyth, to address and deal with the issues that Deputy Naughten has identified.
The Deputy mentioned and referenced collaboration with the private sector. There will be engagement with the private sector. We must also learn lessons from previous engagements and collaboration in terms of technology partnerships. Above all, what the Deputy said does dovetail with the Government's wider economic agenda of rebalancing the country economically to get greater development along the western seaboard and in particular the south west and south east. Connectivity is the key to that. It is important that we set targets and milestones. The Deputy is familiar with the national broadband plan and would have been involved in that at an earlier phase. Targets were set and so on and, obviously, Covid-19 intervened and slowed down some of the progress in that regard. It is important that we set realistic targets that can be achieved and that we do so as effectively and quickly as we possibly can.
The Government has big ambition for providing fibre but none for mobile services. I am talking about establishing a shared rural network with all the operators on it. This would be complementary to the national broadband plan. Similar models are already operating in other markets such as the UK and Germany. In fact, such a shared rural network is currently being built out in Northern Ireland. The estimated cost of replicating that here would be between €30 million and €50 million. This is small money and would also slash the cost of the provision of an emergency Garda communications network, which must now be tendered for and a new separate network built. I ask the Government to reconsider this in the interests of putting an effective shared network in place that can provide for our emergency services and An Garda Síochána, as well as providing 5G coverage across the country.
First, I thank the Deputy again for raising this issue. There are very serious issues and he made reasonable points in respect of this. I would be wary of estimates that we get from time to time. We should all be wary of estimates in respect of projects of this kind, particularly in the communications area because they tend to balloon, particularly when the State signals too early an interest in getting involved. Costs can go up. I think we should take this step by step. The overall principle is about enhancing coverage with less drop out for telephones, although from time to time, public representatives do not mind the odd telephone call being lost in terms of getting some respite from the volume of calls. More broadly speaking, however, in terms of connectivity in rural Ireland, the task force will work with the Deputy if he wishes to make submissions to it and, obviously, the Minister, Deputy Ryan, will as well in terms of complementing the broadband roll-out.