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NMH, What Happened? What Next?

28 May 2022

An artistís impression of the new National Maternity Hospital.

What happened?

On Tuesday 17th of May the Cabinet approved a plan for the National Maternity Hospital (NMH). The plan proposes to lease the hospital site from a private company, St Vincentís Holdings CLG, set up by the religious order The Sisters of Charity, for 299 years at €10 per year. The Government claims it is the same as ownership.

"There were concerns that access to essential healthcare services could potentially be restricted due to the religious beliefs or ethical code of the hospitals concerned," said Health Minister Stephen Donnelly. "I am absolutely satisfied that this legal framework ensures this will not be the case".
Roisin Shortall, the co-leader of the Social Democrats said:
".... the government hasn't acted in good faith because they haven't taken on board any of the issues, or any of the concerns raised within Leinster House and raised by many, many people, medical and legal expertsÖ I think today is a bad day for Ireland"
Sinn Feinís David Cullinane said that the future of Irish healthcare is not safe with the Government.

The government suffered minor damage from the passing of a Sinn Féin motion calling for state ownership of state land for the new hospital. The resolution was not binding but led to the withdrawal of the whip from two Green TDs, temporarily reducing the government majority to one.

The plan to surrender a new maternity hospital to thinly disguised religious control only four years after a constitutional referendum supporting the right to abortion has led to enormous chaos in a weak coalition government and to ministers telling transparent lies to force the deal through.

So why did the scheme roll through?

In part, it was because of the central importance of health privatisation (and privatisation in general) to Irish capitalism. In part, it was the political weakness of the Irish left. Connecting the two issues is the broad church of social partnership that links left to right and constrains popular protest.

Outsourcing to the church

The fact is that Irish capitalism has never been able to develop a full welfare state. In particular, health and education have historically been outsourced to the Catholic Church, with horrific results for Irish women and children.

One would think, with the billions that flow into the state exchequer from transnational companies, that a modern welfare system would be developed.  However, the mechanisms that keep capitalist Ireland afloat do not involve the transfer of wealth from transnationals to the working class but rather the reverse. Large amounts are raised on incoming capital, but only through assurances of low tax and lax regulation. Instead of funds building supports for workers, more and more areas such as housing and transport are opened up to mass privatisation.

The government, having bankrupted the country in defence of the banks and with an ongoing sovereign debt, is obsessed with keeping capital spending off the books and within a 3% GDP limit set by the European Central Bank. State funds, rather than going directly to meet social needs, are used to subsidise big capital.

The policy was summed up by Tánaiste Leo Varadkar as the current deal was being drawn up. The tradition was to provide public service through public/private partnership and the new hospital was simply continuing that tradition.

The Government is not hostile to the Church, it forgives the many crimes against women and the working class in general carried out when the church deputised for the state. It made no attempt to force payment of reparations from the Religious and holds back from effective compensation from the state, waiting for victims to die. Once again it aims to fill the coffers of a private company, reinforce the background power of the Church and boost the low tax, low government expenditure regime that draws in vulture capital.

The weakness of the feminists and the left

The mobilisation on the maternity hospital was small despite the frantic work by the small number of campaigning activist. A national rally at the Dáil, prior to the cabinet decision, drew about 1000 protestors and this was not enough to force a government retreat.

This partly reflected the fragmentation of the women's movement in Ireland. International Women's Day in Ireland was marked by a "No woman left behind" rally. Government representatives complained that they had been left off the speaking lists and quiet threats were issued to the grants paid to the army of NGOs speaking. The government female representatives then mysteriously disappeared when the NMH issue was presented to the Dáil.

The anti-government "rebels" were little better. Only Roisin Shortall, leader of the Social Democrats, spoke to the dangers associated with the Maternity Hospital project.  Speeches went in all directions, with no proposals for mobilisation or action. A great deal of the focus was on electoral strategy and the Dáil. The fragmentation was made worse by the dominance of transgender ideology, which tends to eclipse the word women in favour of terms such as "Pregnant People", a definite handicap when defending abortion rights.

The broader "left", Sinn Fein and the socialist groups, are focused on parliamentary activity. This has a number of detrimental effects. The stress on questions in the Dáil and parliamentary resolutions makes them blind to the fact that they have no impact.  Four Dáil resolutions calling for a public maternity hospital on public land have been passed and been ignored.

The groups involved become blind to the effects of electoralism.  In campaigns, socialists want to sharpen demands and draw out radicalised workers. In elections, they tend to soften their line in order to broaden the vote. Using the Dáil to advance struggle requires a large class consciousness movement in control of the parliamentary activity.

Also, it shouldn't be forgotten that Sinn Féin is a capitalist party, with a long history of saying one thing and doing another. Their support is a sign of desperation in a system that is failing spectacularly.

The parties draw their cue on tactics in part from the trade union bureaucracy, enmeshed in partnership deals and civic committees, who see all issues through the lens of private lobbying of the government. For example, Patricia King, General Secretary of the Irish Congress of Trade Unions, provided a letter of support for the campaign but the trade unions did not mobilise at all, nor did the parties.

The facts speak for themselves. Campaigns such as the fight against water charges had formal representation from political parties and trade unions. The fight for a secular and public National Maternity Hospital was organised by a handful of individuals.  On the issue of property tax, the socialists had demonstrations of over 5000. On water charges, endorsed by the left unions, the largest demonstration approached 100,000.

Ireland's populist consensus

Yet in the long struggle from the credit crunch 0f 2008 to now, despite many convulsions, workers have not broken from their union leaderships, the unions have remained in partnership with the government, the socialist groups have become more uncritical of union leaders and more narrowly focused on elections and the Dáil.

The factual record shows a long retreat but the narrative of many victories. What actually happened?

The major mobilisation was around water charges. Clearly here, after years of wealth transfer from workers to the banks, the government reached a red line and were beaten back by a spontaneous mass mobilisation. It should be remembered that this is substantially the same issue as the maternity hospital fight - outsourcing services

That was undoubtedly a victory.  Most workers aren't charged for their water. However, it was limited. The deal negotiated by the unions left the privatisation structure in place and attempts by the union left to build a populist left party or to extend campaigning to the issue of housing were defeated.

The major campaigns that followed were on social, rather than economic issues, such as, gay marriage and the abortion referendum. However, they had unusual characteristics. They were based mostly on the collapse of public support for the church as the long history of abuse, especially against women, was exposed rather than a growth in the feminist movement, which remained dominated by NGOs and civic bodies. As a result, the road to abortion reform was rather convoluted. The government farmed the issue out to a Citizen's Assembly and was somewhat shocked when it indicated overwhelming support for radical change. It watered down the proposals somewhat and held the successful referendum.

The problem here was that the existing organisations adopted what was known as the popular front approach. That was for everyone, left and right, to unite behind the government to Repeal the 8th! (Amendment). In the process the call for a right to choose for women was largely left to one side. When the mobilisation subsided, no serious work had been done to build an independent left feminist organisation.

That left the way open for the present situation. We do not live in a post Catholic Ireland. The church has little support but enormous power in health and education. Abortion rights are limited, doctors and nurses are able to exercise a conscience clause.  Hospitals are required to offer a service but many do not. The representatives of the church are everywhere and the real clause has benefited the rich while leaving the poor without provision.

Where do we go from here?

There is much work still to be done around the issue of the National Maternity Hospital.  The government has pushed ahead with a bare-faced lie that women's rights will be respected. Activists need to police this lie, to draw attention to other hospitals not providing abortion services and to do so under the banner of a woman's right to choose and a demand for a secular society. Repeal the 8th! is rather like the US Roe vs Wade, a reliance on legal forms that fail to deliver as opposed to the mobilisation of women and the working class that can be the only true guarantee of rights.

We cannot ignore the increasing role of NGOs, these organisations are largely funded by governments and often limit the potential for mobilisations. They also play a major role in advancing the cult of gender self-identity, which weakens the women's movement. Clearly a demand for abortion rights which, rather than recognising women as a sex, talks about pregnant people or uterus owners, can only confuse and divide.

A broader movement needs to be built on the issue of the outsourcing of public services. The failure to oppose the NMH handover goes alongside continued church control of education, the accelerating privatisation of transport and, above all, the massive subsidies paid to developers to deliver unaffordable mortgages and rents.

This movement needs to be political. It is taken for granted that campaigns are run by individuals, but this is simply a sign of the weakness of parties that are happy to stop at statements. This can be changed by actively targeting groups. The betrayal of the Green Party, one of many betrayals when they joined coalitions, should not be forgotten.

Equally, expressions of support should not simply sit. Campaigners should ask how the party in question intends to act and demand formal representation in the campaign.

For example, the Patricia King letter in support of the campaign should lead to a request for action and also be used at every level of the trade union movement to get further support.

A renewed campaign must be extra-parliamentary. Questions and motions in the Dáil, taken on their own, only encourage activists to step back and wait for the processes to wind their way through committees. We need mass action on the streets to achieve anything. One of the lessons of the NMH campaign was the thin film of democratic procedure that proves ineffective. The Dáil can vote over and over for a public hospital, only for the vote for be ignored.

We are entering a new era. A period of retreat where the left focused on reformist demands and electoral activity has come to nothing. On a whole series of fronts capitalist society is moving towards an all-out offensive that will drive the majority of workers into dreadful poverty, dispense with democratic rights and advance towards ongoing war.

A new revolutionary surge is coming that will put women's rights and worker's rights back on the front of the agenda.

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