Minister has ‘absolute certainty’ all procedures to be permitted in new NMH

Minister of State for European Affairs Thomas Byrne has said he has "absolute certainty" that all procedures legal in Ireland would be permitted under legal agreements governing the construction of a new National Maternity Hospital (NMH).

Mr Byrne, who is Fianna Fáil TD for Meath East, said he did not think that Cabinet would seek to remove the language, which has been the source of controversy as healthcare advocates and the opposition put it under scrutiny, suggesting it could allow for the influence of a Catholic ethos over the hospital.

Asked if he thought the Cabinet would change the language, he told RTÉ’s This Week programme that “the [legal] documents already cover off every single procedure that is legal in Ireland”.

Mr Byrne, who is a solicitor, said that he could say “with absolute certainty” that the procedures would be permissible under the documents. He said his hope is that Cabinet approves the deal on Tuesday, “because this has been delayed for far too long”.

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“Quite frankly, I’m not sure what else we could do because people will find fault with whatever is put forward,” he said.

Asked about whether a “codicil” could be appended to the agreement outlining what procedures are permitted, he said “we’ve had these words just thrown around – a codicil in law refers to a will, so I’m not sure who is proposing this, but it’s certainly something I’m not familiar with.”

“If you want to amend the documents, you can do that if you want, but the documents state that all legally permissible services will be provided in that hospital. I’m not sure how much further you could go.”

Asked about reports that Green Party TD for Dublin Central Neasa Hourigan could vote against the Government in an upcoming Sinn Féin motion on the topic, he said that the Government was going to go ahead "in the best interests of the women of Ireland" but that for "a TD to lose the party whip over this would not be a very sensible move in my opinion because I can say with absolute certainty… there is no issue whatsoever in relation to this".

‘No concerns’

Speaking to the same programme, Dr Jenny Walsh, a consultant obstetrician gynaecologist at the NMH said she had "no concerns" about the phrase "clinically appropriate".

“I believe it is as it reads, that procedures that are appropriate and clinically indicated” would be possible, she told the programme.

However, she indicated again that doctors at the hospital would be open to revisiting it if the Government felt it was needed. "Are we wedded to that phrase as clinicians? I think [NMH Master] Prof Shane Higgins has been very clear on that yesterday: absolutely not."

My preference is that our ability to provide that care is protected. I believe that is protected with that phrase, but if there’s a phrase the government … decide is more appropriate then NMH have been very clear that we are willing to come to the table on that, and absolutely have it removed, have it replaced,” she said, if it could be done in a “timely fashion”.

Fine Gael TD for Dublin Rathdown, Neale Richmond, said that he expects cabinet will be in a position to approve it on Tuesday. "The two weeks has been really, really useful and it's at the stage where let's not make the perfect be the enemy of the good".

He said, however, that defining the phrase “clinically appropriate”, which has been strongly objected to in some quarters, would be “useful” as would rolling reviews on the operation of abortion and other services in the hospital once it was built. “Having something written down would certainly help a lot of people outside the political spectrum, just to reassure them,” he said.

Minister for Agriculture Charlie McConalogue said there is “absolute determination” across Government to “ensure we move on and build this hospital which is massively needed”.

“I certainly hope that come cabinet on Tuesday, we will be able to make a decision which is really, really essential for women’s healthcare.”

He said that the phrase was the appropriate one which would “ensure all services are provided [and] will be provided into the future – both those which are legally available in the State now but also those that may become available over the years to come.”

He told RTÉ’s Week in Politics programme that there had been “good discussion” in the two weeks since cabinet decided to pause political assent for moving ahead with the project. “I certainly look forward to coming to the situation, hopefully at cabinet on Tuesday … where we actually get on with preparing to build the hospital.”

Speaking on the same programme, Sinn Féin social protection spokeswoman Claire Kerrane said that "nobody wants to delay the building of the National Maternity Hospital, but we have to get it right." Cian O'Callaghan, the Social Democrats housing spokesman, said that "it's really not acceptable to be proceeding with a project where there's such a level of ambiguity".

“If we don’t get this right when are we going to get to the point where we are building public hospitals, with public money, on public land?,” he said.

Removal of term

People Before Profit-Solidarity TD Bríd Smith said there was no "legal commitment" inherent in letters of comfort issued by Minister for Health Stephen Donnelly and St Vincent's Hospital Group last week with regard to the procedures that will be available in the hospital. "What is needed is for the removal of that term, clinically appropriate," she said.

Ms Kerran said the effort to build the hospital was "at the very end being rushed and we are not getting the chance to scrutinise what will be taxpayers' investment of up to €1 billion." Her party colleague and health spokesman David Cullinane said later in the day on the This Week programme that the legal standing or otherwise of the letters was "problematic".

However, Dr Rhona Mahony, the former master of the NMH, said that cabinet had a "really important" decision to make: "Whether to set back women's healthcare by two decades and abandon the patients and women of Holles Street or whether to enshrine the advances of the last two decades in a 21st century hospital on the leading Irish hospital campus that would bring so much more to women's healthcare".