Coalition delay on approving new National Maternity Hospital due to ‘genuine concerns’

The Government decision to delay by two weeks its approval for the new National Maternity Hospital on the St Vincent's Hospital site was caused by "genuine concerns" about its clinical and operational independence, Minister for Health Stephen Donnelly has said.

Mr Donnelly said at Tuesday’s meeting, on the basis of those concerns, a decision was made to publish all the legal documents so that people could be reassured that the new hospital would have full independence.

He said Ministers and members of the public would be best served by seeing the details of the arrangements between the State, National Maternity Hospital and St Vincent’s. The legal documents were published on Tuesday night.

He said it was for that reason that the memo proposing the project be given the go-ahead has been delayed by two weeks.

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“People want absolute reassurance that the new hospital will be fully independent and operationally independent and will offer all the services [that are legally permissible in the State],” he said.

“That is absolutely the case.”

He said he was confident the project would be green-lighted by Cabinet in two weeks’ time: “There is no ambiguity over the clinical and operation independence.”

Asked why he was not able to convince his Cabinet colleagues, Mr Donnelly said there had been a clear and positive discussion on the legal protections in place. He said that Ministers had “also agreed” there were members of the public with reasonable concerns who were making a “reasonable ask” to see the documents for themselves.

He said given the history in the State in relation to women’s health care and its relationship with the church, it was thought best to publish the document.

“It’s a respectful approach,” he said.

Mr Donnelly was accompanied at the press conference by senior clinicians from the National Maternity Hospital including Master Shane Higgins, former master Rhona Mahony, director of midwifery Mary Brosnan, as well as consultant obstetrician Clíodhna Murphy, and HSE director of estates Paul de Freine.

While not publicly acknowledging it, it seemed the press conference had originally been arranged by the Department of Health in expectation of the go ahead being announced. The conference went ahead notwithstanding the setback at Cabinet today.

Dr Higgins said a new National Maternity Hospital building was a clinical imperative. He added that the Holles Street structure was substandard and a “constant building site”.

Dr Mahony said she hoped “we are really hope we are two weeks away from a Government commitment to build this hospital”.

She said the new facility would be in stark contrast to the conditions in which the hospital was operating.

“No more 14-bed wards, no more people sharing crammed rooms with six women sharing a bathroom,” she said.

“There has been so much misinformation in the public domain,” said Dr Mahony.

“Let it be said that every procedure that is permissible under Irish law will be performed in the new NMH on (the St Vincent’s site): termination; contraception; assisted reproduction; and tubal ligations.”

She added: “We must not let this project fall apart because of misinformation. This is an opportunity that must be missed.”

Ms Brosnan said that Holles Street still had nightingale wards with a lack of privacy for women at the most important moments of their lives.

‘Golden share’

Setting out the protections that were in place, Mr Donnelly emphasised that the lease on the site had been increased to 299 years and the number of public interest directors of the new entity had been increased from one person to three.

He also said that the Government held a “golden share” which would ensure that all legally permissible procedures were carried out.

Asked why a State-owned hospital was not being built, Dr Higgins said what was happening was that the new hospital would “recreate what we have at the moment”.

He said there was no ambiguity about the services provided by the National Maternity Hospital.

Similarly, Dr Mahony argued what would ensue would be a partnership between the State and two voluntary hospitals. She said the new hospital would have reserve powers which guaranteed clinical, operational and financial independence.

Asked about details disclosed in extracts from a new book, Pandemonium, about the politics of the Covid-19 pandemic, Mr Donnelly insisted he had not stayed on in the Department of Health headquarters when he began displaying symptoms of coronavirus, but had gone home.

The book, co-written by Irish Times journalist Jack Horgan-Jones and Hugh O’Connell of the Irish Independent, also discloses differences that emerged between Mr Donnelly and senior health figures, including HSE chief executive Paul Reid.

“I definitely was pushy but that was part of my job,” said Mr Donnelly, who said he had not yet read the book.

“I think the relationship between the department and the HSE and me as Minister needs to include challenges. We must always challenge each other,” he said.