It is strange state of affairs when a former president of the High Court has to come out and publicly declare that a new maternity hospital will not be run by nuns. But such is the level to which the debate about the National Maternity Hospital (NMH) moving to the St Vincent's hospital campus has descended.
It is of course physically impossible for the Sisters of Charity to run anything at this stage. There are just 213 of them in Ireland and their average age is 76. You cannot help feeling that after a lifetime of thankless personal service all that the majority of them want to run is as far away from this mess as possible.
Their ability to influence what sort of medicine is practised at St Vincent’s and possibly the new NMH is very limited, and by the time the new hospital is built and opened it will be even less.
In any case Nicholas Kearns, the former High Court president and deputy chairman of the NMH, is confident the agreement they have with the St Vincent’s Hospital Group (SVHG) is bulletproof. Rhona Mahony, the master of NMH, is equally confident.
But like any agreement it requires good faith on the part of both parties and, given that the Sisters of Charity’s direct influence is on the wane, it is worth looking in a little more detail at who are the members of the board of SVHG.
Boards are incestuous creatures. The current members tend to have a role in appointing the new members and human nature being what it is, they tend to appoint people they know. It is not an entirely bad thing because it ensures that the new members are compatible with the culture and the values of the organisation. But the downside, as we saw so clearly with the Irish banks, is that when a culture is unhealthy it gets perpetuated.
For this reason, if the NMH should fear anyone it is not the Sisters of Charity but the lay people they are leaving control of the SVHG to. If they were all Knights of Columbanus or similarly hard-core Catholics, then perhaps the fears of Peter Boylan and other opponents of the move might be justified. But a quick look through the board indicates that the common thread running through it is much more likely to be corporate finance than the Opus Dei.
There are 12 members of the board, according to the SVHG website. Two are members of the Sisters of Charity and three – including acting chief executive Prof Michael Keane – are doctors.
The other seven are out of corporate Ireland's top draw. Two are former partners in the accountancy firm KPMG: Gerard Flood and the chairman James Menton. Myles Lee, the former chief executive of Ireland's largest and arguably most successful company CRH, is also a director. Sharen McCabe, the founder of the eponymous pharmacy chain, is on the board and so is Frank O'Riordan, a previous managing partner of corporate law firm A&L Goodbody.
The final two are John Compton, a former chief executive of Northern Ireland's Regional Health and Social Care Board, and Willie Shannon, the former chief financial officer of the VHI.
Right now the only thing that can be said of the Irish health system with any accuracy is that it is a mess. At the core of the problem is the overlap between the public health system and the private health industry: a relationship that many would see as parasitic.
The situation is unsustainable but it is difficult to predict where it will end up. The SVHG has a foot in both camps and has been expanding into private medicine very aggressively and, to a certain extent, controversially over the last few years. From this perspective the last thing it wants or needs is to enter into some sort of complex joint venture with another entity that it neither owns or controls.
This is not to suggest that the hospital group has some hidden agenda to privatise the NMH. But there is a salutary lesson in Irish Sugar. When the State gifted the Irish sugar quota to Greencore – the newly privatised Irish Sugar – in 1991 nobody could foresee a situation in which it would be used for anything other than producing sugar from beet grown in Ireland. There was even a special share held by the government to guarantee this (sound familiar) . Fast forward to today and Greencore is the world's biggest sandwich-maker with hardly any Irish employees; its expansion driven by the €127 million it pocketed by handing back the Irish sugar quota to Brussels 2006.
The structuring of the NMH deal probably has as much to do with the finances of SVHG as it does with imposing Catholic dogma.