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SVHG says 'clinically appropriate' could be removed from NMH plan but Taoiseach says there are no changes

Representatives from St Vincent’s Healthcare Group appeared before an Oireachtas Committee today.

Updated May 16th 2022, 4:41 PM

THE CHAIR OF the St. Vincent’s Healthcare Group has said in his estimation it would be possible to remove or define the term “clinically appropriate” in the framework of the new National Maternity Hospital (NMH) before the plan goes to Cabinet tomorrow.

James Menton told an Oireachtas Committee today that this would require the engagement of all stakeholders in the project but that “it wouldn’t take a huge amount”. 

The phrase is one of several issues that has caused concern among opponents of the plan, with former NMH master Dr Peter Boylan telling the same committee last week that the phrase was “a major red flag”. 

The relocation of the NMH to a site on the grounds of St Vincent’s Hospital in Dublin has proved highly controversial and a previous decision on the plans two weeks ago was delayed to allow time for greater scrutiny by politicians.  

A number of committee hearings took place last week in addition to today’s hearing but it is expected that a decision will be made by Cabinet tomorrow.

Speaking today in response to questions from Sinn Féin’s David Cullinane TD, Menton indicated that he felt it would be possible to remove the phrase or add an addendum to the text before it returns to Cabinet tomorrow. 

“We believe so yes, I think we’ve had due consideration to the legal impact,” he said.

Any change seems unlikely however, with Taoiseach Micheál Martin telling reporters this afternoon that “we haven’t made changes to the legal documents.”

Martin said the legal documents that were agreed between the three parties – the HSE, the NMH and St Vincent’s Healthcare Group – are “very clear” and set out that all lawfully permitted services will be provided.

“Of that there can be no question,” he said.

The Taoiseach said the documents are very clear, adding that the Attorney General is “very, very clear” also.

People Before Profit TD told the committee today that a further delay should be made to allow for engagement between the parties. 

‘Six years’ 

Menton also said today that SVHG held discussions with the Department of Health about selling the land earmarked for the NMH “five or six years ago” but not during the lifetime of the current government. 

The entire controversy arises from the fact that the site of the new NMH was until recently owned by the Religious Sisters of Charity.

The religious congregation has now transferred its ownership and if the relocation plan goes ahead the State would lease the land from St. Vincent’s Healthcare Group for 299 years.

An Taoiseach has said the 299-year lease for the State is “effective ownership” but opponents of the current plan have said that the State should have full ownership of the site. 

Hundreds of protesters gathered outside Leinster House on Saturday to call on the government to ensure the site of the new NMH is fully publicly owned. 

Minister for Health Stephen Donnelly has said SVHG were not willing to transfer the land to the State and members of the committee therefore wrote to the group last week asking that they attend the committee. 

In the Dáil last week, Donnelly was asked by Cullinane if he had asked since coming into office (in June 2020) for the land to be brought into public ownership. 

Donnelly said that he had, adding that he would “prefer public ownership”. 

Under intense questioning today from Social Democrats TD Róisín Shortall, the chair of SVHG said that the current government had not made such a request. 

“We had discussions five or six years ago with Jim Breslin, the former Secretary General of the Department of Health,” Menton said.

Shortall: They haven’t asked you currently in the recent weeks or months? Menton: No, they haven’t. 

Opposition politicians have now sought clarity over when the department had most recently sought ownership of the land, with The Journal also seeking a comment from the Department of Health today. 

An Taoiseach has said that it is “my understanding” that the Minister for Health had sought ownership of the land. 

“It is my understanding that the Minister had gone to Vincent’s about that. Vincent’s were never of a mind to sell the entire site because of the fact that it’s a broader campus,” he said. 

‘Essential’ 

Regardless of when such a request was made, Menton argued today that SVHG maintaining ownership of the land was “essential for best possible care”.

Menton told the that having two landowners on the same wider campus would be “very difficult, if not impossible, to manage” and that it would ”present significant risks to patient care”.

He said that this decision that ownership should be retained “goes back 10 years” and was made so there would be “no impediment that would adversely affect care”. 

Alongside Menton, SVHG was also represented by a number of other board members, medical consultants and a legal advisor.  

Menton told the committee that the transfer of the shareholding by the Sisters of Charity was “without any conditions” and achieved SVHG’s objective of being “truly secular”. 

ment 2 SVHG chair James Menton. Source: Oireachtas.ie

“SVHG is now embarked on a new course. It is lay. It is secular,” he told the committee. 

The reasoning for the co-location of the new NMH alongside the existing St. Vincent’s University Hospital (SVUH) is that it would allow women and patients of the NMH to be provided with additional care if required. 

It was argued by proponents of the plan last week that a full transfer of site ownership to the State would breakdown the partnership between the State, the NMH and SVHG. 

Mention said today that the plan as proposed is “essential” for patient care: 

The new NMH facility will be located in the centre of the campus and will be physically integrated with SVUH to ensure the best and seamless care for high risk and pregnant women. This seamless care to NMH patients will be provided by ready access to over 250 Consultants covering over 50 healthcare specialities. The lands at the Elm Park campus have been owned outright by SVHG for 20 years.
Ownership of the Elm Park campus lands is essential to ensure the ongoing provision of the best possible care for all patients attending the Elm Park campus either in SVUH, SVPH or in the new NMH at Elm Park.The SVHG campus is large and complex with many different health and related services on its site. Two landowners and thus two separate independent hospitals would make it very difficult, if not impossible, to manage the Elm park campus and would also present significant risks to patient care. 

An Taoiseach also said this afternoon that there had been a “good debate over the last two weeks:

“There’s a lot of strength and substance to the agreement, which originated because of the necessity of co-location to be the best way to ensure better outcomes for women and their babies. That’s the only motivation here. I mean, there’s no other agenda than to make sure that we have a modern facility that could provide the best of care.” 

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Committee members

rois Roisin Shortall TD. Source: Oireachtas.ie

Speaking ahead of today’s hearing, committee member Róisín Shortall of the Social Democrats said earlier that tomorrow’s Cabinet decision must be deferred as “a number of significant questions remain outstanding”. 

“This deal has taken nearly a decade to get to this point – and the legal documents, which underpin this 300-year deal, were published less than two weeks ago,” Shortall said. 

Why is the cabinet so determined to rush this through, without proper scrutiny, in the face of all of these outstanding questions? It must defer the decision to allow this scrutiny to take place.

During a hearing of the Oireachtas Health Committee last week, both current Master of the NMH Professor Shane Higgins and former Master Dr Peter Boylan shared their differing views. 

Dr Boylan told TDs and Senators that the term “clinically appropriate” as part of the framework for the new NMH “is a major red flag”. 

Professor Higgins said the discussion around the phrase ‘clinically appropriate’ has led to a “misplaced fear” that it will allow the Vatican to stop certain procedures.

However he has also said he would have no problem with the removal of this term or the inclusion of a clarification to ease concerns. 

- With reporting by Christina Finn and Michelle Hennessy

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Rónán Duffy

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