Sisters’ hospital decision is good news – now we must ensure it belongs to citizens

May 31, 2017

The news that the Sisters of Charity have abandoned their plan be involved in the new national maternity hospital at St Vincent’s campus at Elm Park in Dublin is to be welcomed.

It was always odd that they would own the new facility and it now appears that the Sisters and the St Vincent’s board finally recognised what was obvious to others – that their ethos was simply not compatible with the need for the new hospital to provide a full range of maternity and obstetric services to Irish women.

The Sisters of Charity announcement on Monday indicated that it intends to relinquish all ownership of the St Vincent’s Healthcare Group so that the three hospitals in the group (St Vincent’s public and private hospitals, and St Michael’s in Dun Laoghaire) will be placed into a newly formed company with charitable status to be called St Vincent’s.

It remains to be seen who will ultimately control the new St Vincent’s, and whether they will feel any obligation to continue the Catholic ethos in the new company.

The withdrawal of the nuns from the Elm Park campus is a direct result of the courageous stance of Dr Peter Boylan, Dr Chris Fitzpatrick and all who campaigned and marched against the proposal to hand over our new national maternity hospital to a religious order.

But serious questions still remain for the Minister for Health Simon Harris. Why was he content to give a new €300 million maternity facility to a religious group in the first place?  How could he insist on the need for a “national conversation” about separating church and State in healthcare, while backing the Elm Park deal?

It appears that the new St Vincent’s company intends to replicate the corporate structure laid out in the deal between Elm Park and Holles Street mediated by Kieran Mulvey last November.

The Mulvey deal made clear that despite much talk of “reserved powers”, the new maternity hospital would not be independent, but would be a wholly-owned unit of the St Vincent’s group, with the Master of Holles Street reporting up a managerial chain through the St Vincent’s clinical director, and the chief executive, to the St Vincent’s board.

If any elements of that plan remain in place, the proposal will fall short of what we need.

If the State is going to spend €300 million or more on a new national maternity hospital, then the State should own and control it on behalf of the citizens. The whole corporate structure set out by the Mulvey report must be dismantled, so that the new maternity hospital has complete independence, with no ownership or corporate oversight whatsoever in the hands of St Vincent’s.

Just as it was always wrong to give the new €300 million hospital to a religious order, it would be wrong now to hand over this enormous asset, which will be a crucial part of the State’s infrastructure and a key element of the healthcare system, to a private company that is not answerable to the citizens.

For reasons that remain unclear, the Mulvey deal gave St. Vincent’s a triple-lock on ownership of our new hospital.  They would own the building and the land it sits on, they would own 100 per cent of the new company set up to run the hospital (which would be a subsidiary of the St Vincent’s group), and they would effectively control a majority of the new company’s board.  This plan cannot be allowed to go ahead, in any form:  it would not be co-operation, or a merger, or a joint project; it would be a takeover.

We are told there are extensive borrowings on the Elm Park campus which would make it difficult for Vincent’s to hand over the site for the new hospital, but I cannot believe it is impossible to find a way around this problem. I am more concerned about the description of the St. Vincent’s group given by the HSE director general Tony O’Brien, who told an Oireachtas committee that the private hospital at Elm Park appeared to be “parasitic” on the publicly funded hospital on the campus.   The HSE has also sent in independent auditors to examine the work practices of consultants as they move between the private and public buildings on the campus.  The taxpayer gives more than €200 million a year to St Vincent’s, and clearly the HSE is worried about how it is being used.

Our new national maternity hospital should not be part of this setup.

Despite all the talk of safeguards and reassurances about clinical independence at the new hospital, nobody has ever really explained why St. Vincent’s needs to own the hospital.  All the benefits of co-locating a new maternity hospital with an acute hospital, and all the advantages of clinical co-operation, can be achieved without a corporate takeover of the new hospital by St. Vincent’s.  The new national children’s hospital will be located on the St James’s Hospital campus in Dublin, but no-one has suggested that St James’s must own it.  By the same token, why can’t St Vincent’s let the new maternity hospital own and control its own operation, and agree protocols for clinical co-operation?

Why can’t we just decide that if the State is going to spend €300 million on a new state-of-the-art maternity hospital, then it should belong to the citizens?

This comment piece by Róisín Shortall TD was published in the print edition of The Irish Independent on 31st May 2017. The full text of the piece is reproduced below.