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Explainer: How an ownership row is still holding back Ireland's new National Maternity Hospital

The Tánaiste has even raised the prospect of building the hospital elsewhere.

Image: Department of Health

PLANS FOR THE new National Maternity Hospital have been back in the news in recent weeks, with a protest planned for this weekend and various Oireachtas debates planned in the coming weeks. 

The new hospital has been in the works for years, with the location of the hospital being confirmed at St Vincent’s Hospital in Dublin 4 in late 2016. 

That site’s ownership by religious order the Sisters of Charity prompted various debates in previous years about whether Catholic doctrine could influence medical practices.

Assurances given by government and the religious order had quelled the debate in recent years but have again come to the surface. 

So how did we get here and what does the debate mean for the hospital?

A new NMH

The National Maternity Hospital is currently located at Holles Street in Dublin and is also popularly known by the street’s name. 

The hospital is the largest maternity care facility in the State, with about 8,000 women a year using its services. 

Parts of the building date back to the mid-1700s and there is a wide consensus that moving the location of the NMH is preferable to updating the current location. 

In November 2016 it was confirmed that the new NMH would be developed at Elm Park in Merrion, Dublin 4. This would mean the NMH would be alongside the existing St Vincent’s Hospital, allowing patients at NMH to also have access to that facility. 

Ownership of the hospital

Holles st 828 The National Maternity Hospital at Holles Street. Source: Sam Boal

Despite support for the construction of the new hospital, which was estimated in 2017 to be €300 million, there was soon controversy over its ownership structure. 

The Sisters of Charity owns the land on which the NMH was be built and the proposed deal would see the religious order owning the facility because it was providing the lands at no cost to the State. 

Tens of thousands of people signed a petition is protest at the move, calling for the Sisters of Charity to be prevented from becoming owners.

In April 2017, the Department of Health sought to ease concerns about potential religious influence at the hospital by saying that a new company would be established to run it that would have “clinical and operational independence”.

Various polls showed that public concerns were not eased  by these assurances

The plan was for the NMH board to be made up of nine directors. Four nominated from St Vincent’s Hospital Group, four from the current NMH, and one international expert in obstetrics and gynaecology.

Opponents to the plan pointed to the board nominees from the St Vincent’s Hospital Group as potentially being influenced by religious ethos. 

Opposition to the plans for the ownership structure included various political parties and former master of the NMH Dr Peter Boylan

One of the suggestions Boylan raised was that a compulsory purchase order (CPO) could be used to allow the State to buy the lands from the Sisters of Charity. 

Some of the obstacles to this included costs, potential legal delays and the fact that the new NMH was envisaged as a voluntary public hospital instead of a HSE facility. 

Sisters act

Following the increasing opposition to the plans, the Sisters of Charity announced an end to their involvement with the St Vincent’s Hospital Group and said that they would therefore not be involved in the ownership or management of the new NMH

The Sisters of Charity were the major shareholders of the St Vincent’s Healthcare Group but said they would be transferring ownership of the group to a newly formed company with charitable status to be called ‘St Vincent’s’.

This pledge would also see the Sisters of Charity essentially giving up its ownership of the land on which the NMH was to be built, land which was valued at some €200 million. 

hse Dr. Peter Boylan Source: Sam Boal

This presented some issues however and 30 months in late 2019 it was revealed that the transfer of ownership to the charitable company had not taken place

This is due to the fact that the the Religious Sisters of Charity required formal approval from the Vatican to relinquish ownership of the land. 

The Sisters of Charity said in November 2019 that it had sought approval from the Vatican and that formal sign-off  was “imminent”. 

The order also said that this should not delay the hospital project “in any way” but despite this ten minister for health Simon Harris said that “all outstanding issues” must be addressed before any substantial building works take place.

Last year, there appeared to be a significant development in the saga when the Sisters of Charity said they had received the required approval from the Vatican, allowing them to transfer ownership of the land. 

It said this now marks the final movement towards completion of all legal, financial and regulatory matters involved in the transfer of the sisters’ 186-year involvement in the hospital.

The sisters added: 

The new St Vincent’s Holdings CLG will continue to be a not-for-profit organisation. In the event of the new St Vincent’s Holdings CLG going into liquidation, its surplus assets will be vested with the Charity Regulator and used for future healthcare purposes with similar values, to benefit the people of Ireland.

The plans for the site would see St Vincent’s Holdings CLG lease the NMH lands to the State for 99 years.

Problems continue

Now, over a year from that point, the issue of the ownership of the land is still proving to be a stumbling block. 

Current Minister of Health Stephen Donnelly said early this month that legal documents to transfer the lands to the charity “are ready”

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He also again sought to reassure the public that the Religious Sisters of Charity would have no involvement in the management of the hospital and would not influence the care the hospital provides. 

“Services will be provided in accordance with the law, and in accordance with national policy, and that’s it,” he said.

Last week however, Tánaiste Leo Varadkar  said there are “problems, quite frankly, in going forward with this project”.

Taoiseach Micheál Martin also described it as “very odd” that the State was to invest so much money in the project but that it would have ownership of the site.

He described this situation as “not entirely satisfactory” but said that stakeholders should not be “overly obsessed” with ownership of the hospital. He added that “nothing has been signed off”, and that it has always been his view that any new hospital should be owned by the public.

Speaking on Saturday, Varadkar suggested that a new location for the hospital may be needed to resolve the ongoing issues. 

He also suggested that the State could buy they site from the Sisters of Charity instead of the current plan that would see the Sisters of Chairty transferring the ownership to the charitable company. 

Sinn Féin and the Social Democrats are also seeking that the Sisters of Charity transfer the ownership of the land directly to the State, with the SocDems set to table a motion in the Dáil on Wednesday calling for this to happen.

About the author:

Rónán Duffy

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