National Maternity Hospital: ambiguities still remain
The devil is in the detail but so is the opportunity to resolve all issues
So it’s full steam ahead with the new National Maternity Hospital? After a fortnight of extraordinary and noisy polemics, the matter is now settled? One hospital board loses a difficult, dissenting member, the Health Service Executive’s project manager resigns in support of him, the Minister for Health appeals for calm and suggests a long-term “forum” on ownership of hospitals and, crucially, the two hospital boards directly embroiled in the controversy publicly agree that the new maternity hospital will be able to carry out any medical procedure that is legal. The important thing, all are apparently agreed, is to get the facility built. So that’s all right? Or is it?
The way forward proposed by the boards of the National Maternity Hospital (NMH) in Holles Street and St Vincent’s Healthcare Group (SVHG), owners of the site – on behalf of the Sisters of Charity – where the new hospital will be built, is to put into legal form an agreement between them crafted by mediator Kieran Mulvey.
Despite the Catholic ethos of St Vincent’s, they say the agreement will guarantee clinical independence for the company managing the new hospital and copperfasten it through a ministerial golden share. But former master Peter Boylan, who on Thursday resigned from the NMH board, has performed an important service in casting not only a light on the State’s dubious decision to give the Sisters of Charity ownership of the new hospital but in raising a series of detailed questions about the agreement.
He worries rightly about the independence of the casting-vote chairman of the new hospital’s “independent” board. The appointment to this post is to be made by a majority-St Vincent’s controlled committee. And while the deal promises “clinical and operational independence” to the new hospital, underpinned by a ministerial veto, that would apply only to the “reserved power” concerned with its autonomy, not to what the board does with its autonomy. Nor does the welcome promise to accept patients “without religious, or ethnic, or other distinction” guarantee per se that such patients will be treated according to a non-religious ethos.
The intentions of current NMH master Rhona Mahony and deputy chairman Nicholas Kearns are not in question but intentions are not enough. The memorandum and articles of the new company must include a commitment to perform all medical procedures that are legal now and in the future. It would be reassuring to hear directly from the Sisters of Charity in this context.
As Minister for Health Simon Harris accepted as late as Wednesday, there are still ambiguities “that we will [have to] tease through”. As ever, the devil is in the detail but so is the opportunity to resolve all issues unambiguously. This would be best achieved by exploring other forms of ownership or leaseback. It is not too late.