Fintan O'Toole: A real republic should not have charity delivering public welfare

There is something Gothic about the story of the new national maternity hospital. It is populated by the undead. Habits of mind that should be long extinct still stalk the land. The most important of these zombie ideas is not religion. It is charity.

The new maternity hospital will cost at least €800 million, every cent of it public money. But while the State will own the hospital buildings, it will merely lease the land for 99 years from a private charity and the hospital itself will also be a private charitable institution.

The Religious Sisters of Charity are transferring their shares in St. Vincent's Healthcare Group, which owns all the hospitals on the site, to St Vincent's Holdings CLG (SVH CLG), a company with charitable status that will also control the maternity hospital. The Sisters of Charity, in announcing this last year, made things admirably clear: "The State will have no involvement in SVH CLG."

The most obvious worry about this – powerfully articulated since the start of this saga by the former master of the existing National Maternity Hospital at Holles Street, Peter Boylan – is that the Catholic religious ethos of the nuns will continue to influence the provision of services for women.

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The primary school system was created by the State – the church took it over in the late 19th century because it wanted a monopoly on the provision of public services

But there is something even more fundamental at work here. It is the inability of the State to exorcise the ghost of charity. It is still possessed by ways of thinking that have their roots in the 19th century.

Last week, Tánaiste Leo Varadkar finally acknowledged that the Government is "not happy with the lease proposal or the governance arrangements" for the new hospital. He did not acknowledge that this mess was created when he was in government and his party colleague Simon Harris was minister for health.

Undead ideology

In 2016, when Harris confirmed the decision by his predecessor James Reilly to co-locate the new hospital with St Vincent's, he was just 30 years old. He belongs to a generation that came to political consciousness in post-Catholic Ireland. He was the minister who steered through the repeal of the anti-abortion clause in the Constitution two years later.

And yet he never saw the problem with giving ownership of the national maternity hospital to a private charity. Under the influence of an undead ideology, it didn’t occur to him that this ought to be completely unacceptable in a republican democracy.

There is, of course, nothing wrong with private charity. The problem is with charity deployed as a substitute for the State’s responsibility to meet its basic obligations to its citizens.

As a scheme for delivering public welfare, charity is a hell of a lot better than nothing. But it is a hell of a lot worse than a real republic in which citizens have rights to the services they need.

Charity makes the citizen a supplicant, placing her at the mercy of someone else’s benevolence, and someone else’s judgments about what is best for her. Rights are exerted; charity is bestowed. It always requires at least a figurative tugging of the forelock.

It is time to put a stake through the heart of this slavishness. Maternity and reproductive services are not charitable gifts

Generations of Irish people were indoctrinated into this infantilising attitude. One of the characteristic Irish sentences is: “Say what you like about the church, but if it wasn’t for them, we’d have nothing.”

This was always a distortion of reality. The primary school system was created by the State – the church took it over in the late 19th century because it wanted a monopoly on the provision of public services.

Citizens’ rights

At almost every stage the church used its power to set severe limits to the State’s efforts to expand citizens’ rights to health, education and welfare. It tried to stop the ground-breaking National Insurance Act of 1911 being applied to Ireland. It denounced the “menace” of the postwar welfare state. It blocked Noel Browne’s Mother and Child scheme. It crushed Fianna Fáil’s ambitions in the 1950s to move towards a free public health service and promoted private insurance instead. It did nothing to open up secondary schools to all pupils until it was effectively forced to do so by the State. It opposed all efforts to create services that would give women control over their own reproductive health.

The common theme in all of this was the need to maintain the idea that the church itself, from its charitable bounty, was the provider (and therefore the proper controller) of hospitals, schools and other basic services.

As a reality, this system died a long time ago: the church neither funds nor staffs these services. But it has a strange posthumous power. It lingers in habits of deference and dependency, in the need to show our gratitude for the things we ourselves create and pay for.

It is time to put a stake through the heart of this slavishness. Maternity and reproductive services are not charitable gifts. They are rights to which every woman and girl must be entitled. Public ownership is a guarantor of those rights. Control by a charity is a subversion of them. No self-respecting republic could tolerate that.

What happens with the hospital matters greatly for its own sake. But it is even more crucial as a test of whether we have enough self-respect not to accept being graciously granted what is already ours.