NMH build to be expedited as Cabinet clarifies term ‘clinically appropriate’

The relocation of the National Maternity Hospital (NMH) from Holles St in Dublin to St Vincent's has been approved by Cabinet.

The Minister for Health Stephen Donnelly has also revealed that the Government intends to expedite the process around building the new hospital.

“The Department’s view is that four and a half years from a tender process would be the expectation (for the hospital to be built). We had a discussion this morning around whether anything can be done to speed that up. For example, the tendering process on some previous hospitals has taken up to two years. We are going to look to see if there are ways that we can shorten the procurement process.”

Mr Donnelly addressed concerns around the term “clinically appropriate” and said a clarification on what this phrase means was added to the Government decision.

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That clarification in the memo, seen by The Irish Times, states that the Cabinet agrees that “the term ‘clinically appropriate’ allows the new hospital to provide all legally permissible procedures in the areas of maternity, gynaecology, obstetrics, neonatology, and gender recognition; and that it is not expected that the new NMH will provide cardiac or orthopaedic surgery, for example.”

Mr Donnelly said this amounted to a change in the original Government memo which he brought two weeks ago.

“I think it has been addressed, I don’t think it is correct to say that concerns that have been raised haven’t been addressed. The deal was robust two weeks ago, it had been worked on for many years and was pored over by doctors, midwives, by lawyers. If something had come up over the last two weeks that the HSE, the National Maternity Hospital, St Vincent’s genuinely had missed we were of course open to addressing it.”

“The Government’s view is that concerns that have been raised have been dealt with legally and robustly within the agreement. But we added three additional decisions today on the back of the process.”

Mr Donnelly said that Cabinet also agreed that a report will be published annually for the first five years of operation of the hospital providing detail on the services provided, and that a scoping exercise will be carried out into establishing a centre of excellence for women’s health.

It is understood the attorney general once again gave his backing for the relocation and the legal documents surrounding it.

In April, the Religious Sisters of Charity transferred its shareholding in St Vincent's Healthcare Group (SVHG) to another entity, St Vincent's Holdings, which will lease the land on which it is proposed to building the new NMH for 299 years.

There are fears in some quarters that potential lingering religious influence could mean abortions or fertility treatment would not be allowed to take place at the new hospital. Questions have also been raised about why the land is not being sold or gifted to the State.

Such concerns have been dismissed by the Government and the hospital’s supporters in the medical community.

Inexpliciable

Opposition leaders have described the Cabinet’s decision as “wrong” and “inexplicable”.

Meanwhile, Taoiseach Micheál Martin has defended the move, describing it as “a good decision” for the women of Ireland and newborn babies into the future.

Sinn Féin leader Mary Lou McDonald said instead of ensuring a “clean cut transaction”, where the site would come into public ownership, the deal signed off on by Cabinet “ensures that the hospital has a private landlord under a very convoluted ownership model”.

“This is the wrong decision,” Ms McDonald said during Leaders’ Questions on Tuesday. “It falls short of protecting the State’s proposed investment of between €800 million and €1 billion of taxpayers money.

“It’s obvious that the best way to safeguard this investment and to allay public concern is for Government to secure the transfer of the land into state ownership; a clear and explicit agreement that ensures that we get a publicly built national maternity hospital on publicly owned land.”

The Dublin Central TD also pointed to comments from James Menton, the chairman of SVHG, to the Oireachtas Committee on Health on Monday, that there had not been a substantive attempt to buy the site by the current Government.

Mr Martin said it was his understanding that Mr Menton was prepared to correct the Oireachtas record in respect of this claim.

Greens

Following the decision some Green TDs reiterated their concerns. Green Party TD Patrick Costello said in a statement that the decision was the wrong one and the failure to remove the phrase clinically appropriate was “an affront to women”.

Speaking on RTE’s Drivetime programme Green Party TD Neasa Hourigan said because it is a Cabinet decision there was “no democratic vehicle to register your objection to these things, one of the ways to do it is to deviate from the whip.”

“This is a 299-year deal. This is generations of women. And I would have liked the opportunity to have it on the record for those 299 years that I object to this. This isn’t good.”

Ms Hourigan said “it might be easier for everybody” if she wasn’t in Government.

“There’s a perception that maybe I’m just being difficult here. On the other hand, I’m increasingly realising that it’s important for difficult women to stay in the room.”

In the Dáil Social Democrats co-leader Róisín Shortall asked what was the point of the last two weeks.

“Just two weeks ago, you [The Taoiseach]said that you wanted the documents to be scrutinised, and you indicated that you were open to changes being made, but it’s quite clear now that that was actually a charade,” she said.

The Dublin North-West TD said the overall attitude of the Government had been “incredibly patronising and completely dismissive of good faith attempts” by the Opposition and the public to engage with the documents and to improve the deal.

“The unseemly rush to ram this decision through the Cabinet is inexplicable,” she added.

“This is especially the case when the Department of Health hasn’t even managed to publish the business case for the deal, which it has been negotiating now for almost 10 years.”

Mr Martin said all legal and lawful services would be permitted at the new hospital and that the 300-year lease was effective State ownership “by any yardstick” and “any legal analysis”.

He said he believed that “a lot of the arguments against the going ahead with the hospital didn’t hold up”.