Wednesday, 15 June 2016
National Maternity Hospital
The next item is in the name of Senator Kevin Humphreys.
For the benefit of new Members, while the Minister, Deputy Harris, is coming, when matters are submitted for the commencement, I try to be fair to the parties when they are sent in first. This time there were three matters from Sinn Féin, of which I chose one, and there were three from Fine Gael, of which I chose one. I tried to achieve a balance between the different groups so that there is not four matters from one party and none from another. I will try to do that as best I can even though this time, with the new groupings, it may be a little more difficult. We will deal with it as we go along and if there are issues I will discuss those with the groups as well.
Senator Humphreys, ar aghaidh leat. The Senator has four minutes.
Given that information, I thank the Cathaoirleach for selecting this particular Commencement Matter. I congratulate the Minister, Deputy Harris, on becoming Minister for Health and thank him for attending to deal with this extremely important issue, which is the situation in respect of the co-location of the National Maternity Hospital, Holles Street, with St. Vincent's University Hospital in Elm Park.
I am disappointed because this is an issue which has been running since I was on the board of the National Maternity Hospital in 1999. At that stage, it was expected that the National Maternity Hospital, Holles Street, would move to the St. Vincent's University Hospital campus within ten years. It is now 2016 and there is a problem, which was not flagged before at any stage, relating to the governance of the hospital and the moving of the hospital is now in danger.The National Maternity Hospital at Holles Street was built in the 1800s. A total of 9,500 babies are delivered in very cramped outdated conditions, putting mothers' and babies' health, if not their lives, at risk because of the conditions in that hospital. The staff do a fantastic job and give a very high standard of care.
We face a turf war between two hospitals in the form of an argument over a budget. I do not believe this argument is about the health and well-being of up to 10,000 babies or their mothers, nor is it an argument about the quality of care. In Holles Street there are ten delivery wards where 9,500 babies are delivered. There should be 24 delivery wards for that number. There are knock-on implications.
I very much welcome that the Minister has appointed a mediator. I hope that is successful. I have raised this on a personal basis and I know the Minister’s personal commitment to it and that much of this is outside his control. I urge him to consider his next step if the mediation is not successful because we cannot allow up to 10,000 babies to be delivered in a hospital that was built in the 1800s. That has a real negative and possibly detrimental impact on the babies and mothers who deliver them in an outdated facility. I look forward to the Minister's response.
I congratulate the Cathaoirleach and all Senators on their election and appointment to this House, and I look forward to working with the Members of Seanad Éireann. I thank Senator Humphreys for raising this important issue. The proposal to redevelop the National Maternity Hospital on the St. Vincent's University Hospital campus has been under consideration for many years.
Within a couple of days of my appointment as Minister for Health, I visited the National Maternity Hospital in Holles Street. One cannot leave the place without thinking it is an entirely inappropriate and substandard building. It is not up to the standards we would want for expectant mothers and their infant children and indeed for front-line staff to work and deliver babies in. It is utterly unacceptable. It is quite disgraceful to think we went through the entire Celtic tiger period in this country without ever building the new national maternity hospital.
In 2008, the KPMG independent review of maternity and gynaecology services in the greater Dublin area noted that Dublin's model of stand-alone maternity hospitals did not align with the considered norm internationally and acknowledged that for optimal clinical outcomes, maternity services should be co-located with adult acute services. The report recommended that the National Maternity Hospital be relocated to the St. Vincent's University Hospital campus. In 2013, the then Minister for Health, now Senator Reilly, with the agreement of both hospitals, formally announced the Government's intention to relocate the National Maternity Hospital to Elm Park and said that funding had been approved in the HSE's capital plan to allow the project to proceed. Work on the design brief for the new maternity hospital has concluded. I have seen a scaled model of the new hospital and can say that it represents a very exciting development for maternity services.
The project is one example of the Government's commitment to maternity services. That commitment was underlined by the launch of the country's first national maternity strategy earlier this year. The programme for Government commits to implementing the strategy, and I look forward to leading the improvement of maternity services for women and their families over the lifetime of the strategy.
The House will be aware, however, that difficulties have emerged about the future governance of the new National Maternity Hospital on the Elm Park campus. Concerted efforts have been made to get the agreement of both hospitals to allow the project to proceed. Meetings were held last year with both hospitals at departmental and ministerial levels, and a facilitated dialogue was undertaken earlier this year. Unfortunately, that process did not achieve a solution.
Since taking office, I have met both hospitals separately and jointly and stressed to them the need to resolve the outstanding issues as a matter of urgency. I have also visited the National Maternity Hospital and I am acutely aware of the very significant infrastructural deficits there which are impacting on the ability of the hospital to deliver appropriate clinical services.I am heartened, therefore, that both hospitals have now committed to a further independent mediation process. I have appointed Mr. Kieran Mulvey as a mediator and the process has commenced. A number of meetings have already taken place. I want to acknowledge that a lot of work went on over the weekend. It is now important that we step back and let Mr. Mulvey and the two hospitals work on a solution outside the media glare. However, I want to assure the Senator and all other Senators that my overriding aim is to try to find a solution. I must stress that both hospitals are voluntary independent hospitals and, therefore, I cannot simply impose a solution. I intend to use my office to facilitate the finding of a solution. An unedifying spat between two of our great medical institutions does not serve patients well. It is important that the overriding objective of delivering property maternity services in appropriate accommodation for expectant mothers and their families is not lost in some bureaucratic row. It is frustrating, given that the project is fully funded and a plan is ready to go. We could lodge planning permission for the project within weeks if we find a solution.
Ultimately, both hospitals will have to reach an agreement on the outstanding governance issues. The process cannot go on forever. Agreement needs to be reached quickly. The hospitals are working constructively with Mr. Mulvey and I hope and expect to see the outcome of that work in the coming days. I remain hopeful that a solution can be found, and it is important that this happen as quickly as possible so this landmark project can proceed.
I do not believe that at any stage the Government or the HSE would have spent €5 million of taxpayers' money in preparing planning applications and doing the research that is needed to base the National Maternity Hospital at Elm Park. I am deeply disappointed and frustrated that this problem was raised at a very late stage. The plans should have been lodged at the end of the second quarter of 2015. As far as I am aware, they were substantially finished and were ready to be submitted, and at that stage the issue was raised.
Some €150 million has been committed to the project in the capital investment programme. We now know that €5 million has been spent on the preparation of the planning application. A lot of consultative work was done at the early stages of the project, and at a very late stage the issue of governance arose. I do not believe it is acceptable for there to be any further delay on the part of the two hospitals concerned. I wish the mediation every success and offer it every encouragement, but both hospitals have to be practical and put the health of mothers and children first. This is not a case of money not being available. The money is in place and has been ring-fenced, and €5 million of it has already been spent.
I know the Minister cannot comment on my final point. If mediation is not successful, the Minister will face a number of bad choices and will have to pick the best of them. I urge him to investigate and be ready to consider the possibility of a compulsory purchase of the site to allow the hospital to be built and the planning application to be lodged. I know they are two voluntary hospitals and this is a turf war. They have to set aside their interests and put children and mothers to the forefront.
I share the absolute frustration of the Senator. He is correct; about €5 million has been spent on the project already by a Government of which he was a part, because as a country we want to deliver this landmark project. Let me be very clear: this is a priority project for me. I have invested a significant amount of time in this project since becoming Minister for Health because we are close to delivering a landmark project for maternity services, not just a hospital for the Dublin area but a national maternity hospital that cares for some of our sickest newborn infants. It is important that we get this right. The national maternity strategy needs to be implemented, but if it is to be implemented correctly we need to have the appropriate physical infrastructure in place - that is, hospital buildings.
I have to be very honest with the Senator. There is not an apparent plan B. That is why it is so important that the hospitals get this right. We have decided as a matter of policy that co-location works. We know co-location of maternity and acute hospitals works. If these hospitals walk off the pitch, there is no simple option. The only people who will suffer, along with front-line staff, are the future expectant mothers of this country and their babies. We cannot allow that to happen. This process has to work. I need be very careful about what I say because I do not want to say anything that will undermine the mediation process in any way.My hope is that the mediation process under the stewardship of Mr. Mulvey will deliver an outcome, and that it will happen very quickly.