LAST UPDATE | 11 May 2022

THE OIREACHTAS HEALTH Committee has formally asked Minister Stephen Donnelly for a further pause to a Cabinet decision on the plans for the National Maternity Hospital (NMH). 

Cabinet was due to sign off on plans for the hospital last week but this was paused for two weeks due to ongoing criticism on the project and to allow Donnelly appear before the committee. 

Speaking at the committee this morning, Donnelly said it is the intention of government to proceed with the project but he also left the door open to changes to the proposals. 

The minister was responding to questions from Sinn Féin’s David Cullinane TD, who asked him whether the pause allows room for more negotiations with the St Vincent’s Hospital Group or whether the pause was “an exercise” for the minister to “sell this deal”.

“Whilst I believe it is Cabinet’s intention to progress with this, in terms of exactly what is brought to Cabinet I wouldn’t rule anything out,” Donnelly said in response. 

Social Democrats co-leader Roisín Shortall TD also sought to quiz the minister on the two-week pause in the plans, asking Donnelly whether it could be extended further. 

“Are you prepared to recommend to Cabinet to hold off for another couple of weeks?” she asked, noting that the committee only had this week to consider the plans. 

In response, Donnelly said “it’s a matter for Cabinet”, before adding: “Let’s see how this week goes, there has been an awful lot of scrutiny.”

The committee is scheduled to address the matter again tomorrow and will be hearing from former master of the NMH Dr Peter Boylan, who has been a staunch critic of the proposed move to the Elm Park site at St. Vincent’s Hospital.  

Following today’s hearing, the committee has now written to Donnelly to seek a further delay on the Cabinet decision to allow more for consideration of the matter

The letter to Donnelly seeks that the minister provides extra time to the committee before Cabinet makes a decision. The requests asks for a response from the minister as soon as possible. 

The committee is also expected to write to St Vincent’s Healthcare Group asking them to attend a hearing next week. 

Cullinane said following today’s meeting hat it is important the committee has “sufficient time to do its work”

“The owners of the land are now St. Vincent’s Healthcare Group. It is only right that we hear from them as many of the issues and concerns centre around the ownership of the land,” he said.  

In his opening statement to the committee earlier today, Donnelly said that religion and women’s reproductive rights in Ireland “do not have a good track record” and that people’s concerns are therefore valid. 

The relocation of the NMH to a site on the grounds of St Vincent’s Hospital in Dublin has proved highly controversial as, until recently, the site was owned by the Religious Sisters of Charity.

The religious congregation has now transferred its ownership and if the relocation plan goes ahead the State would lease the land for 299 years.

Donnelly told committee that there must be “no religious influence, now or in the future” with the NMH that this goal is achieved by the current proposed structure.

“Ireland does not have a good track record when it comes to religion and women’s reproductive rights. People are rightly demanding that when it comes to our new National Maternity Hospital, there is, and there can be, no religious involvement,” Donnelly said in his opening statement.

Dr Rhona Mahony, who was was the first female master the NMH.

Former master of the NMH Dr Rhona Mahony said the new NMH is “saying goodbye to the church completely”.

Mahony referenced the Repeal the 8th campaign, which she describes as a “real moment”, and noted that she was one of the voices at the centre of it:

By 2018, we had all come together and we had a movement and we were able to talk and express what happened to women. That was a pivotal point I think in our history in terms of moving forward and moving forward with women’s health. With this project, we’re moving forward again. We’re saying goodbye to the church completely, there is no religious ethos pertaining St. Vincent’s Hospital, there’s a complete separation. 

Ownership

Taoiseach Micheál Martin has previously described this model as “effective” public ownership of the NMH.

Taking questions from Sinn Fein leader Mary Lou McDonald in the Dáil today, Martin also insisted that there was no “conspiracy” behind the plans.

McDonald told the Taoiseach: “I want to put it to you that the very best way to allay fears and resolve this problem is for the Government to secure full public ownership of the land.

“This would provide absolute, airtight clarity. It would ensure the best protection for the state’s interests in what will be a very, very expensive project.

“Government must step up, because by inaction you will be acquiescing and colluding in a deal and arrangement that does not adequately protect the public interest.”

However, Martin, who has stressed the urgent need for a new maternity hospital, said: “The 300-year lease, at 10 euro a year, is effective ownership and I have received legal advice to that effect.”

Citing the legal agreement for the new hospital, he said: “I have read it all. There are no impositions. It basically says, ‘go and build a maternity hospital’.”

Speaking at tonight’s parliamentary party meeting, Martin also said that “every director of midwifery in Ireland has written to us in recent days to progress this.”

He added: “All the clinicians are clear that women and children deserve a 21st-century modern maternity hospital that is colocated and provides the best care and also a neonatal centre of excellence.”

An Tánaiste Leo Varadkar said the pause taken on the National Maternity Hospital (NMH) was a good idea to allow questions to be answered and provide greater reassurance.

The Fine Gael leader said the NMH decision should not be put off forever and told party colleagues, that proceedings on the issue between now and next Tuesday will be closely followed.

I want to take this opportunity to give the background to the decision to co-locate the new National Maternity Hospital on the grounds of St Vincent's Hospital. pic.twitter.com/0qXEzxLKVP

— Micheál Martin (@MichealMartinTD) May 11, 2022

HSE legal advisor John O’Donoghue argued this morning that leasehold means that someone “owns a property for a specific period of time”. 

“It is not the case that the State won’t have an ownership interest in the land,” he said.

So it is this issue of freehold versus leasehold. There are two different types of ownership interest in Ireland there is freehold, where you own a property into infinity and there is leasehold which is you own a property for a specific period of time. 

O’Donoghue was responding to Cullinane, with the TD saying he himself was “not a legal expert” but that the ambiguity around the matter “is a product of the State not owning the land”.

Government unease 

Following a meeting held by Fine Gael and the Green Party on the proposed relocation last night, which was also attending by board members of the NMH, Justice Minister Helen McEntee said the meeting had assuaged her concerns over the relocation.

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“There are absolutely no circumstances under which I as a legislator, but as a young mother, as a young woman, would agree to anything other than a world class national maternity hospital, one that provides absolute clinical and operational independence, but also one that provides the services that the women of this country are legally entitled,” she said.

“That is maternity services with postnatal care, that is gender reassignment, that is access to assisted human reproduction, it’s access to safe abortion, and I am absolutely convinced, I am certainly reassured by the discussion this evening that the proposal by Minister Donnelly will do all of that.” 

Midwifery directors from Ireland’s maternity hospitals have voiced their support for the move to the grounds of St Vincent’s.

The directors addressed a letter to the Health Minister outlining their support for the move from the current location on Holles Street in Dublin 2 to the Elm Park Campus in Dublin 4.

In the letter, seen by The Journal, the directors say they are unanimous in their support for the project.

“As a world class facility providing 21st century maternity, neonatal and women’s healthcare; this new hospital will continue to serve, not only women in South Dublin but from any county in Ireland where women need specialist care,” the letter reads.

“We urge that the decision to relocate be approved, urgently, as a signal of the future development of maternity and women’s healthcare in Ireland,” it adds.

The letter was signed by Fiona Hanrahan, Director of Midwifery and Nursing at the Rotunda Hospital, and co-signed by 17 other midwifery directors from maternity units and hospitals around Ireland.

It notes that it is signed on behalf of the National Directors of Midwifery Forum.

The government and the Department of Health has repeatedly stressed that the clinical integrity of the hospital is preserved in its constitution, and defended the structure of the deal.

However, campaigners, opposition TDs, and some members of government have raised concerns.

Yesterday, two HSE board members reiterated their concern over both the ownership, as well as the governance and control in a statement submitted to the Oireachtas Health Committee. 

Green TD Neasa Hourigan.

Speaking at the committee this morning, Green Party health spokesperson Neasa Hourigan said that she had an issue with the phrase “clinically appropriate” contained in the framework of the new hospital. 

“The issue around clinically appropriate is that it places all of the power in the hands of clinicians and in the hands of those legal professionals who will then interpret what last clinically appropriate means,” she said. 

Shortall also sought to focus on that phrase “clinically appropriate”, describing it as “very problematic” and that it will “in all likelihood be challenged in court on several occasions over the next 300 years.”

Obstetrician Professor Mary Higgins said the “clinically appropriate” is about future-proofing services and allowing doctors carry out new procedures.

“There are going to be tests and procedures and diagnosis coming up in the future that we don’t know about yet and having this clinically appropriate term means clinically appropriate for the time, so we can continue to innovate for women,” she said. 

With reporting from Céimin Burke, Christina Finn and Jane Moore