Wednesday, 28 September 2016
National Maternity Hospital
I thank you, a Chathaoirligh, for selecting this Commencement matter for debate. I have raised this issue again out of frustration. Last June, I raised the issue of the National Maternity Hospital, which has been located in Holles Street since the 19th century. It was established as a hospital in 1894. It is now the largest maternity hospital in Ireland and one of the largest in Europe, based on delivery rates. Almost 10,000 babies are born there every year.
There has been for the 20 years since 1996 a plan to co-locate the National Maternity Hospital on the same site as St. Vincent's Hospital in Elm Park, Dublin. In October 2013, I was heartened when it was announced that the hospital in Holles Street would be moved out to the St. Vincent's Hospital site. A brand new hospital was to built which would be suitable for the children of the future and for women to have their babies in a specially designed facility instead of one built in the 19th century. There has been no significant investment in Holles Street hospital since the mid-1950s.
In October 2013, it was announced that €150 million would be spent to build a new hospital, with €25 million to invest to ensure standards were kept up in Holles Street hospital. Planning permission was to be applied for in the last quarter of 2015. Lo and behold, however, a turf war broke out over who would control the budget. It was not necessarily about what is best for women or their children, but whether the current structure operating in the National Maternity Hospital would continue on as an independent hospital or whether St. Vincent's University Hospital would take over all control. That was never in any plan and it was never a problem until it was ready to go for planning permission. Nine months on - although I do not believe that period is significant - we still have had no decision.
The Minister appointed a mediator after I raised this matter last June. It is unacceptable that women and children are being put at risk over what are mainly men in grey suits on boards arguing over who will be in control of what budgets. I understand it is a voluntary hospital and when the Minister for Health, Deputy Simon Harris, was in the House in June, he said he did not have a plan B. That is not an excuse. The mediator has been working since June but we have heard no result. The Health Information and Quality Authority, HIQA, has presented a damning report on Holles Street hospital - not on the staff but on the conditions, including overcrowding.There are ten delivery wards for nearly 10,000 births when one should have at least 24 delivery wards. What is planned for the new hospital is 24 delivery wards for a demand of 10,000 births. Only down the road, Holles Street is struggling with ten delivery wards for 9,000 births. It is no longer acceptable that we should have a turf war between two hospitals that is affecting the health of and good outcomes for our children, and for women who go into that hospital to deliver babies.
I call on the Minister - it is the Minister of State who is here - to accept the need for a certain amount of urgency. There are games being played by the two hospital boards. I will not judge who is right and who is wrong. I only want a quality facility for women to go in and have their children, and for babies to have state-of-the-art facilities in that hospital which is not the case at present.
I thank the Senator for raising this issue. I agree it is me who is here, unfortunately, but my colleague sends his apologies. My sentiments are the same as those of the Minister and I speak on his behalf.
The year 2016 is a landmark year for maternity services. Ireland's first national maternity strategy was published in January and HIQA is currently finalising national standards for better, safer maternity care. A Programme for a Partnership Government commitments to implementing the strategy and work to facilitate implementation is ongoing.
The €3 million development funding provided for maternity services in 2016 has been allocated in line with the strategy. This includes: the establishment of the national women's and infant's health programme; the establishment of maternity networks across hospital groups; the appointment of additional staff; the development of specialist bereavement teams; and the implementation of the maternal and newborn clinical management system.
In relation to the proposed move of the National Maternity Hospital to St. Vincent's campus, as Senator Humphreys stated, my colleague, the Minister for Health, Deputy Harris, and I remain hopeful that a solution to the current difficulties can be found. As the Senator correctly pointed out, issues have emerged in relation to the governance of the future maternity hospital on the St. Vincent's campus and this has unfortunately delayed the project much longer than any of us would have hoped.
There have been a number of attempts over the past 12 months, particularly in recent months, to bring both hospitals together in an effort to work through the problems. Shortly after the Minister, Deputy Harris, was appointed to the Department of Health, he met both hospitals and stressed to them the importance the Government attached to this major capital project. Co-location of acute adult and maternity hospitals is Government policy. The model of standalone maternity hospitals is outdated and not the norm internationally, and I would agree the 10,000 babies Senator Humphreys speaks about deserve to be born in a hospital that is fit for purpose and modern. Co-location helps ensure that, where necessary, mothers have immediate access to a full range of medical and support services.
In an effort to broker a solution, the Minister appointed Mr. Kieran Mulvey to facilitate this discussion between the two hospitals. Mr. Mulvey has engaged extensively with both parties since June and mediation talks are being conducted independently of the Department. However, the Minister has been assured that both hospitals have worked constructively and collaboratively and are focused on finding a resolution.
It is not acceptable that this is going on as long as it has but my understand is that the talks will conclude shortly. At this delicate stage in the negotiations, both parties should be afforded the space to work with Mr. Mulvey to identify a resolution away from the media spotlight, and to ensure that it does not continue to be, as the Senator put it, a turf war.
The Senator can rest assured that efforts to agree a future governance structure for the co-located hospitals are continuing. There are significant infrastructural deficits within the National Maternity Hospital and the Minister for Health is acutely aware that the future of the NMH is not at Holles Street. However, as both hospitals are voluntary independent hospitals, a solution cannot be imposed upon them. Ultimately, both hospitals will have to reach an agreement on the outstanding governance issues if this project, as envisaged, is to proceed, which we all hope it will. I certainly want it to proceed. We want to see a world-class, state-of-the-art maternity hospital development on the St. Vincent's campus.
On my own behalf, I would say this is a matter of urgency. Something like this takes time. If Mr. Mulvey was appointed in June, one needs to afford the period of time for him to work with both hospitals and get the best out of the negotiating process. It is my understanding that these talks will conclude shortly and, hopefully, we will have an adequate resolution.
I hate to say nothing has been added to this issue but time and both parties have been afforded the time. There is nothing new about this project as it has been known about since 1996. As I stated, the announcement was made in 2013. Moreover, as planning permission was to be applied for the last quarter of 2015, there is nothing new about this. If both parties believe they can resolve the issue, why not let the planning permission be applied for while they continue discussions? It had been planned that a new maternity hospital would open there in 2018 but that date now has long passed and we are contemplating 2019. Let the mediation continue for three years. Let the structures be hammered out and agreed but for heaven's sake, let the planning permission be applied for. It was estimated in 2013 that the building cost would be approximately €150 million. That has gone out the window because building costs are shooting up at this stage. Consequently, additional resources must be given to build a new national maternity hospital.
I do not know what is going on behind the scenes and I wish the mediator the very best of luck but historically, representatives of St. Vincent's University Hospital, Elm Park, have appeared before the Committee of Public Accounts and have been knocked about. Is that something that is happening in the background that is delaying this? I appeal to both sides to allow the planning permission application to go ahead and we can talk about the rest for three years. However, it is unacceptable to me and to the women and children of Ireland that this hospital be delayed further. I say to the two parties - not to the Minister of State - that they should get on about the business and get a proper national maternity hospital built for the country. The two bodies knew quite clearly that this has been planned for 20 years and was announced in 2013. I find it unacceptable that they still are playing tiddlywinks and power games with the health of women and children.
I apologise but I am quite passionate about this issue. I have been working at this since serving on the board of the National Maternity Hospital since 1999 and having seen the outdated facilities in which women are meant to have their children. It simply is unacceptable and we must move on from that.
I reiterate that I hear and see the Senator's frustration. I have faith in Kieran Mulvey as I have seen him work with previous projects that had been stuck and he has managed to move them on. I do not believe an indefinite time has been given and I certainly would not like to see another three years in mediation. It needs to happen now and if possible, I will revert to the Senator with a more definite timeline in this regard. My information is it is nearing a conclusion. While that answer obviously may not be good enough for the Senator, given this has gone on for so long, I will make inquiries to ascertain whether I can get a timeframe for the end of the discussions.