LAST UPDATE | 17 May 2022
TAOISEACH MICHEÁL MARTIN has said that “a lot of the arguments” against going ahead with the National Maternity Hospital (NMH) plan “didn’t hold up” over the past two weeks.
Cabinet today signed off on the legal framework for the planned move of the NMH to the Elm Park site alongside St Vincent’s Hospital in Dublin.
The decision paves the way for the new hospital to be built, with Minister of Health Stephen Donnelly saying today that construction could take “four and a half years” once the tender had been completed.
Donnelly said that previous tender processes have taken up to two years but that the government was “looking at ways to shorten this”.
The decision to approve the NMH’s move to St Vincent’s Hospital was set to be approved a fortnight ago but this was delayed to allow for greater scrutiny of the plans.
The government said this pause provided the opportunity for opponents to voice their concerns and several Health Committee hearings were held over the past week.
Speaking today, Donnelly claimed that the concerns that were raised have been “comprehensively addressed” by both medics in the NMH and legal experts.
The Health Minister said today that the same legal framework for the hospital that was presented to Cabinet a fortnight ago has now been agreed but that there are now three additions.
He said among these “significant” changes was a commitment that when the new NMH is built there would be a report published annually for the first five years of its operation.
Donnelly said that this report would “detail the services provided”, adding that the hospital would be “a state of the art secular, voluntary public hospital”.
There had been concerns raised by some opponents about language used in the legal documents that govern the new hospital, with the phrase “clinically appropriate” labelled as “a major red flag” by former NMH master Dr Peter Boylan.
Chair of the St Vincent’s Healthcare Group James Menton said yesterday that in his estimation it would be possible to remove or define the term “clinically appropriate” in the framework of the new NMH before the plan goes to Cabinet.
Following today’s Cabinet approval, however, Donnelly said that the term would not be specifically defined in the framework.
Instead, he said that Cabinet agreed that the term “allows all legally permissible services in maternity, gynecology, obstetrics, neonatology and gender recognition”.
Donnelly added that the term was requested by the HSE who had sought to ensure that the hospital would be used for maternity services only and not for other urgent services like cardiology and neurology.
“Part of the reason ‘clinically appropriate’ is in there is to make sure that other services can’t simply, you know, force their way in and start taking up all of these resources. So there is a very good reason why it’s there,” he said.
Questions were asked around could it in some way be used as a backdoor to withhold any services and the absolutely, clear, categoric answer to that is no it can’t.
He said the phrase is used by health professionals like clinicians, doctors, nurses and physiotherapists “all over the system, all the time”.
It didn’t say ‘ethically appropriate’ or ‘morally appropriate’ or anything like that, it’s clinically appropriate, timely, high quality care, but critically, for a maternity hospital. So really it’s there to protect those services in the future for women.
Ownership
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.
Following the increasing opposition to the plans five years ago, the Sisters of Charity announced an end to their involvement with the SVHG in 2017 and said they would therefore not be involved in the ownership or management of the new NMH.
The transfer of their shareholding of the SVHG has been beset with delays, however, but was finally completed last month.
Taoiseach Micheál Martin has said the 299-year lease for the State is “effective ownership” but opponents of the current plan have said that the State should have full ownership of the site.
During Leaders’ Questions today, Taoiseach Micheál Martin repeated his view that the 299-year leasehold equated to ownership, saying that this assertion had been “well tested over the last two weeks”.
Responding to Social Democrats’ co-leader Róisín Shortall, Martin said:
The purpose of the last two weeks was to have a debate and to tease things out and have full transparency in relation to the publication of the documents. And if you don’t mind me saying , I think a lot of the arguments against going ahead with the hospital didn’t hold up actually under the full scrutiny. That’s my own personal view of the situation.
Shortall disagreed with Martin’s view, however, describing the last two weeks as “a charade and a sham”.
She said the idea of providing a legal definition of “clinically appropriate” has been cast aside in favour of “the word of the Cabinet”:
A binding legal definition is not required we’re told. What’s the message then to the women of Ireland? Is it calm down? You don’t need legal guarantees, the word of the Cabinet will suffice.
‘Milestone’
In a statement confirming Cabinet’s decision, Donnelly described it as “an important milestone as we work to improve maternity services for the women and children of Ireland”.
“The new National Maternity Hospital is a critical piece of health infrastructure that will ensure women and infants are cared for in a state-of-the-art hospital that will help our clinicians deliver improved outcomes,” he said.
The Minister said that the legal framework addresses both the ownership and governance of the new hospital and will:
Donnelly added: “There were concerns that access to essential healthcare services could potentially be restricted due to the religious beliefs or ethical code of the hospitals concerned. I am absolutely satisfied that this legal framework ensures this will not be the case and that all lawfully permissible services will be provided in the new NMH, as they are in the current NMH.”
Meanwhile, the CEO of the HSE, Paul Reid, said that delivering the new NMH “is a hugely important development in our efforts to improve maternity and gynaecology services in Ireland”.
The current Master of the National Maternity Hospital Shane Higgins said the Cabinet decision was: “A welcome relief to the doctors, nurses and midwives at the NMH who have worked to ensure that this vital national healthcare project proceeds.”
“I want to again reassure those who have doubts or concerns that the NMH currently has no constraints on the procedures it offers patients, and this will continue when the hospital moves,” he said.
Controversy
Speaking to reporters on his way into Cabinet this morning, the Health Minister said “we can’t keep debating” the new NMH.
“Ultimately, there will always be people with legitimately held views as to things that should be different, but what’s important is the concerns that have been raised have been comprehensively addressed,” Donnelly said.
I think people, very rightly, for the reasons of Ireland’s history, have said there can be no religious influence. That’s guaranteed. People want a public hospital, it is a public hospital. People want the state to own the building and own the land, we own the state and we own the land in leasehold ownership for the next 300 years.
“It is a very, very strong and positive project, and ultimately, we can’t keep debating these things and discussing these things for more years. We have to get on we have to build a hospital,” he added.
Protest
Hundreds of protesters gathered outside Leinster House on Saturday to call on the government to ensure the site of the new NMH is fully publicly owned.
Green Party deputy leader Catherine Martin is understood to have raised concerns around the Cabinet table two weeks ago, but has now said she is giving her full support to the plans to relocate the hospital to the Elm Park site.
Green Party leader Eamon Ryan said this morning:
“I think there’s been a lot of clarification in the last two weeks and I think that’s a good thing, around that issue: what is ‘clinically appropriate’? It’s been clear at all times that this was led by medics, often the same medics, female medics who led out in the Repeal Campaign, saying this is the best approach.”
“So I, I’m sure like a lot of other people over the last two weeks, listened to them and I think they’re confident [clinically appropriate] allows them the full freedom to do every procedure within the law.”
Motion
In the Dáil today, Sinn Féin leader Mary Lou McDonald said that the government “made no serious, meaningful effort” to bring NMH land into State ownership.
“It’s obvious that the best way to safeguard this investment and to allay public concern is for government to secure the transfer of the land into state ownership,” she said.
What’s at issue here is the failure of your government to secure the land in public ownership.
Sinn Féin is to bring forward a motion in the Dáil today calling for public ownership of both the site and building of new NMH.
It is understood that the government will not oppose the motion when the non-binding vote is held in the Dáil tomorrow. Sinn Féin’s David Cullinane TD said this decision by the government was “a cynical move to avoid TDs having to stand on their record”.
Yesterday, the St Vincent’s Healthcare Group told TDs and Senators that maintaining ownership of the land on which the new maternity hospital is planned to be built is “essential for best possible care”.
- With reporting by Christina Finn and Jane Moore
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