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The proposed new National Maternity Hospital (NMH) at the St Vincent's hospital campus at Elm Park in Dublin will not be run by nuns. It will be run by an independent board under a new company. It will operate in accordance with the law of the land, not canon law – just as it does now. It will have no religious ethos.
The deal brokered by Kieran Mulvey after lengthy mediation says the company called the National Maternity Hospital at Elm Park DAC will exercise all key powers "in an undiluted manner" in order to preserve its autonomy "in specific clinical and operational matters". It could not be clearer.
And lest there be any doubt this is spelled out fully in the agreement between the two hospitals. This autonomy covers “clinical and operational independence in the provision of maternity, gynaecology, obstetrics and neonatal services (without religious ethnic or other distinction), in the hospital at Elm Park, Dublin and the provision of medical, surgical, nursing midwifery and other health services”. The agreement says we control our budget, and that we make our own agreements with the Health Service Executive on our service-level agreements. The first chairperson when the hospital opens will be nominated by the NMH directors.
Ministerial lien
A ministerial lien on the premises will mean the owners of the building cannot sell it without the Minister’s consent. So it is very misleading for people to claim there will be a “gift” of a new maternity hospital to nuns. St Vincent’s Hospital Group (SVHG) is in fact giving, at no charge, a chunk of its campus at Elm Park to a new National Maternity Hospital. They will not control it and they cannot sell it. It will be in the middle of the campus and will take probably five years to construct and be ready.
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Nobody could seriously imagine that the NMH is or would be moving to this location in circumstances where it could be turned out at short notice. On the contrary, its security of tenure will be provided for by appropriate legal instrument when the heads of agreement are committed to final legal form. Therefore, in so far as ownership is concerned, the ownership retained by SVHG will be as far apart from the usual notions of ownership as one can imagine.
The best news for women is that this hospital will be co-located with one of Ireland’s leading adult tertiary hospitals. Every year 70-80 patients are transferred from NMH to St Vincent’s and 40 patients go in the opposite direction. The majority are transferred because of a lack of diagnostic capacity at NMH or for medical or surgical opinion. At any given time five to 10 women are critically ill and are transferred to intensive care and these women will benefit greatly from closer proximity to an acute adult site, avoiding the need for transfer by ambulance of sometimes medically unstable patients.
Most women who travel from St Vincent’s to the NMH come arising from gynaecological disorders including ectopic pregnancies and ovarian cyst complications. Also, several hundred women a year need extra medical support during pregnancy which is complicated by an underlying medical disorder.
We have been looking for a new hospital since 1998. This new hospital was finally agreed after three difficult mediation processes. A planning application has now been submitted. It was 20 years in the making and there seemed to be nothing that could stop it.
In recent days, long after this deal was brokered so ably by Kieran Mulvey, all sorts of wild allegations have been put in circulation to the effect that nuns will run or influence clinical practice at the hospital, that patients could be deprived of care that is allowed by law because a religious order will control the hospital. I’ll say it again: a religious order will not control the hospital. It will be run by an independent board. That board will control the hospital. And whatever the law permits at any given time about carrying out particular procedures, these procedures will be available in this hospital.
No alternative
It has been made quite clear to both sides during the negotiation process that there is no alternative option available if this project is derailed. Speculation that the grounds of RTÉ might provide a site, or, as Dr Peter Boylan said on radio on Tuesday, a compulsory purchase order be made to acquire Elm Park Golf Club, and provide tunnels from there to the main hospital, demonstrate a disconnect from reality which is frankly worrying. It is extraordinary that such suggestions are being advanced at this late stage, when those who knew the proposed arrangements had time and opportunity to advance sensible alternatives – if such there were.
About 30 women gave birth at Holles Street on Tuesday. The same number are likely to do so again on Wednesday, in a dilapidated, antiquated building that is not fit for purpose. The building has continued to operate so well only because of the extraordinary commitment and dedication of the staff.
So by all means, let's have a debate about whether in the future religious orders should own as many hospitals as they do in Ireland. By all means express legitimate concern for the women who were badly wronged in Ireland in the past and who deserve redress.
But don’t hold this fine independent hospital to ransom. Don’t use arguments about the need for safe maternity services, and for redress for women, to erode political commitment to this project and condemn another generation of women to give birth in an inadequate antiquated building that is not fit for purpose.
Nicholas Kearns is the deputy chairman of the National Maternity Hospital and the former president of the High Court