Analysis: The Masters of the Dublin maternity hospitals did express concern about "citizenship tourism" and immigration rules to the Government, reports Mark Brennock, Chief Political Correspondent.
Documents released yesterday by the Minister for Justice, Mr McDowell, show that the three main Dublin maternity hospitals have been expressing serious concern to the Government at least since October 2002 about the growing number of non-national births.
The correspondence supports Mr McDowell's assertion that the Masters of the Rotunda, the National Maternity Hospital and the Coombe Hospital pointed to the phenomenon he has called "citizenship tourism" as a contributor to the problem.
Mr McDowell told the Dáil yesterday that this involved women from outside the EU "who have come here on holiday visas, given birth, collected the birth certificate and the passport for the child and returned home."
However, despite the documents and statistics released yesterday, there are still no reliable statistics to show that this is a major cause of the growth in non-national births.
They do not back up Mr McDowell's initial claim that the Masters had "pleaded" with him for a referendum, but they report that at a meeting with officials in August 2003, they did say immigration controls should be tightened.
The Masters had earlier suggested that the better management of asylum seekers who were supposed to be housed outside Dublin could provide a solution, and they raised the prospect of the building of a new maternity facility in the capital to cope with the growing numbers.
The first letter among those released yesterday was on October 16th, 2002, from the Master of the Coombe Women's Hospital, Dr Seán Daly, to the Minister for Health, Mr Martin. He said he was also writing to Mr McDowell. He wrote that the number of non-national deliveries comprised 20 per cent of the workload in 2002.
His concern was the "increasing tendency for non-nationals to be aggressive, cite a racist plea and become more aggressive when their demands are not met".
Two days later, on October 18th, 2002, Dr Daly and the Master of the Rotunda Hospital, Dr Michael Geary, met Mr McDowell and officials from the Departments of Justice and Health. The note of this meeting published yesterday shows that Mr McDowell said his concern about the situation was that the difficulties in maternity hospitals would fuel racist thinking.
Dr Daly said deliveries to asylum-seeking women alone - rather than to non-nationals as a whole - accounted for around 20 per cent of all births at the Coombe and about 28 per cent at the Rotunda, according to the note.
He said there was a category of people, who were not in the asylum process, who "arrive from the UK, have their baby and return", the note says.
He also said non-nationals usually stayed, on average, two days longer in maternity facilities "and 'the race card' is regularly played by many of them in seeking services".
He said that in one incident the male partner of a patient had knocked out a midwife.
Dr Geary, meanwhile, said the high rate of infectious diseases among non-nationals had huge cost implications for the maternity hospitals, and that it was "surprising that there had not been a major catastrophe within the maternity services as yet".
The note also says there was "a brief discussion on the legal and constitutional position and the Minister said both he and the Government are actively considering a number of options in this area". Mr McDowell said he would act decisively to ease the pressures on the maternity services "and defuse the potential for future difficulties with racism in the country".
A further joint letter from the Masters of the Rotunda, National Maternity Hospital and the Coombe on January 20th, 2003, provides an alternative explanation for the arrival at the hospitals of non-national women late in pregnancy - something that Mr McDowell believes is evidence of "citizenship tourism".
The Masters said that many pregnant women housed outside Dublin - under the "dispersal" policy designed to avoid a concentration of asylum seekers in the capital - were coming to Dublin at the last minute to have their babies.
These women were likely to be on the "direct provision" system for asylum seekers whereby they were provided with accommodation and board in dedicated centres around the State, and given very modest amounts of money in cash.
Once they were 32 weeks pregnant, the Masters wrote, they became entitled to receive full social welfare payments and were therefore able to move to Dublin, the preferred location for many asylum seekers.
The Masters' letter suggests that this, and not the "citizenship tourism" phenomenon talked about by the Minister, was their prime concern in January 2003.
In August 2003 a memo from an official in the Department of Justice's Reception and Integration Agency, Mr Frank Edwards, to its director, Mr Noel Waters, backed up the suggestion that "dispersed" asylum seekers arriving at Dublin hospitals in or near labour were a significant contributor to the problem.
However, the memo, which reported on a meeting with the Joint Hospitals Committee of the three major Dublin maternity hospitals, shows the hospitals raised concern about significant last- minute arrivals from the UK of women late in pregnancy.
It said that the major concern of the Masters and management "is not about asylum seekers but about non-asylum seeking non-nationals availing of maternity services in Dublin".
The memo says the Masters were concerned with the apparent ease with which pregnant women could travel to Ireland, ostensibly for a week's holiday, during which time they have their children and return home.
They reported they were receiving requests from as far away as Moscow for information on how they could have a child in a Dublin maternity hospital. They said the projected numbers for non-nationals giving birth warranted a fourth major maternity facility in Dublin.
This memo reports that the Masters wanted to see immigration controls tightened.
The official wrote: "While I did explain the constitutional issues and the difficulties faced by immigration personnel due to the Irl/UK common travel area and possible accusations of discrimination if they appear to concentrate on one nationality or ethnic group, both hospital Masters and management made it clear that, in their view, something needs to be done to tighten up controls in the immigration area such that the State does not have to continue to bear an undue burden in maternity services."