The Minister for Health Stephen Donnelly has said he is not ruling out changes to proposals around the relocation of the National Maternity Hospital (NMH) when a memo is brought back to Cabinet.
The Government has repeatedly said that it intends to proceed with the current plan as agreed between the various parties and that legal changes are not to be considered.
At the Oireachtas Committee on Health on Wednesday morning, Sinn Féin TD David Cullinane asked Mr Donnelly if there would be any fresh discussions with parties like St Vincent’s given recent concerns.
Mr Donnelly said: “It would certainly be the intention that this is agreed by Cabinet, however, it is important that we listen and this conversation happens. I wouldn’t rule anything out.”
He was pressed further on whether that means there will be fresh discussions, and said: “I wouldn’t rule anything out but my view, for what it is worth, is that there is no further movement.” Mr Donnelly was asked what the point was of the Oireachtas debates in that case and said: “Whilst I believe it is Cabinet’s intention to progress with this, in terms of what is brought to Cabinet, I wouldn’t rule anything out.”
Mr Donnelly was also asked why St Vincent’s do not simply gift the land to the State and he said: “They have been asked. They were asked by Minister Harris, they were asked by this Government and the previous government. They have been consistent for the last nine years that it is simply not something that has ever been on the table for them.”
The site of the proposed new hospital was owned by the Religious Sisters of Charity, who has transferred its shareholding to a new company, St Vincent’s Holdings CLG. The land for the new hospital is to be leased to the State for 299 years.
The hearing is continuing.
In his opening remarks, Mr Donnelly said the new NMH will be “fully clinically, operationally and financially independent. It will have its own constitution and its own operating license with the HSE.”
“All procedures that are currently carried out in the NMH in Holles Street will be provided in the new NMH. This includes terminations, tubal ligations and gender affirming procedures. This new hospital will provide all maternity, gynaecology, obstetric and neonatal services that are legally permissible.
"Ireland does not have a good track record when it comes to religion and women's reproductive health. It has a poor, dark, history. Women are therefore rightly demanding that when it comes to our new National Maternity Hospital, there is not, and there can never be, religious involvement whatsoever at any point now or into the future."
Former master of the NMH Rhona Mahony also appeared at the committee and said she understood Ireland’s history with women’s health “and that interplay between church and state” and that “it’s been really, really difficult for women and has had a profound impact on women’s health.”
“We are now moving forward, we are moving into a different Ireland, and we’ve really seen such huge advances in the last ten years.”
She said the new facility would be “magnificent” and that the “bit that has been missed is what is on the campus of St Vincent’s” in that women’s services would be hugely increased.
She said she was “absolutely not” worried about any potential religious influence and that there were layers of protection in the legal documents.
Questions were also raised after it emerged St Vincent’s will be providing some services in the new maternity hospital.
Soc Dems co-leader Roisin Shortall asked Mr Donnelly about the phrase “clinically appropriate” which is included in the legal documents in relation to procedures that will be available.
“The Taoiseach said it was a phrase that was inserted by the HSE to make sure it would not be a cardiology hospital, or a neurology hospital, or whatever else. However, the so-called fact sheet that was circulated among Fine Gael backbenchers said, and I quote, ‘the HSE will grant an operating licence to the NMH at Elm Park to run the new maternity hospital and also St Vincent’s which will deliver some other health services in the hospital such as dermatology.’ Why would the fact sheet contain that reference,” she asked.
Mr Donnelly said that “as part of the building, some existing services in St Vincent’s are being displaced so they are being accommodated in the new works.”
Ms Shortall asked if St Vincent’s would be providing public or private services in the new maternity hospital and Mr Donnelly said he was unaware and would have to check.
“We are to some extent protecting maternity services also against the pressures of the State, so the State doesn’t say ‘we have a state of the art building, we have a lot of extra beds, we have a lot of extra operating diagnostics, could we just maybe push in and start using those services.’ So it is very much around that,” Mr Donnelly said.
Ms Shortall said the phrase “clinically appropriate” was “very problematic.”
Fine Gael senator Martin Conway said he believed the influence of religion was “rampant” in hospitals.
He said the project needs “cast-iron safeguards” and he also asked Mr Donnelly whether the term “clinically appropriate” could be defined in a more explicit way in the NMH constitution.
Mr Donnelly acknowledged the phrase was causing concerns. He said he can write formally to the committee stating what procedures will be available but that he is also “going to reflect” on it.
Green Party TD Neasa Hourigan said she did not think correspondence between Mr Donnelly and the committee “is something that in 200 years or 150 years could be laid before a court as legally binding.”
Professor Mary Higgins also appeared before the committee and she said: “There are going to be tests and procedures and diagnoses coming up in the future that we don’t know about yet. And having this clinically appropriate means what is clinically appropriate for the time so we can continue to innovate for women. For me this is very respectful for women to have that term.”