Make NMH Ours
by Bernie Linane (Campaign against Church Ownership of Women's Healthcare)
2 May 2022
An artist’s impression of the new National Maternity Hospital.
In 2013, the then-Minister for Health proposed building a new National Maternity Hospital. Best practice suggested that new maternity hospitals be co-located with adult acute hospitals and so a plan was drawn up to move the hospital to the St Vincent’s site at Elm Park. Since that time, the project has been mired in controversy, as it transpired that the original plan was for the State to finance the building of the hospital which it would then hand over - lock, stock and barrel - to the Religious Sisters of Charity, who owned the proposed site.
Some background is probably useful at this point.
Our State since its foundation has been content to allow the Roman Catholic Church to provide healthcare and education services in this country. In areas where a fledgling State was not in a position to fund or manage its own affairs adequately, the church was happy to step in, and though it did the State some service, it was handsomely rewarded with a majority ownership position and enormous influence since 1922. One hundred years later, The State funds its own services but close to 90% of our National, State-funded schools operate under the patronage of the Catholic Church, which has assumed ownership of school buildings and the lands whereon these buildings sit. Similarly, many of our voluntary hospitals, though funded by the State, remain within the ownership of religious orders.
Mother Mary Aikenhead, founder of The Religious Sisters of Charity, opened St Vincent’s Hospital at St Stephen’s Green in 1834. One hundred years later, in 1934, the Sisters purchased lands at Elm Park. They had begun to receive monies from the Irish Hospitals Sweepstakes in 1931. Over the next almost 40 years this amounted to millions of pounds. The new hospital was opened in 1970 and continued to benefit from Sweepstake funding, even with the Sisters managing to extract from the State an agreement that there would be no interference by the State in the control and management of the hospital.
Apart from the hospitals,
the Religious Sisters of Charity owned and operated five industrial schools,
where children in their care were abused, as detailed in the Ryan report.
They refused to offer an apology for fear it would invite further cases
against them. The Sisters also ran two Magdalene Laundries. They operated
the State’s most infamous adoption agency, St Patrick’s Guild, where we
now know documents were routinely falsified and babies were sold.
Given all of this it was unsurprising that the public were not content to allow their new hospital to be handed over to any religious order, given the sorry and shameful history of religion in the treatment of women and children in this country, and came out on the streets in numbers to protest such a move.
The government responded by commissioning the Mulvey agreement of 2016, which resulted in the announcement in 2017, amid much fanfare, that the Sisters of Charity would relinquish control of the St Vincent’s Hospital Group and ‘gift’ the site to the State. Firm assurances of clinical independence were given, suggesting that the hospital to be built on this site would be the first in the history of the world to deliver modern reproductive healthcare free from the religious ‘ethos’ which bans abortion, contraception, IVF, gender affirming treatments and sterilisation, and remains a condition of ownership of every other such property transferred by Catholic institutions.
The truth was somewhat less exciting, as it turned out that the nuns, after consultation with the Vatican, would actually transfer ownership of the St Vincent’s Hospital Group to a private company, of which they would appoint half the board, with the present National Maternity Hospital appointing the other half. In effect, Mulvey was no more than an agreement between two private companies (SVHG and NMH) on forming a third private company to take ownership of land on which the State would pay all the construction costs (now estimated to be upwards of €1billion) for a brand new hospital, which it would then hand over to the new company to run at the public expense, under the terms of a proposed lease for the site. The new company, St Vincent’s Holdings, has identical core values to those of Mother Mary Aikenhead, including a commitment to human dignity which respects the uniqueness of each person – a definition of dignity which is increasingly being weaponised to restrict choice in reproductive healthcare.
The proposed legal arrangements are labyrinthine and have been described by Stephen Dodd SC as “Kafka-esque”. The new hospital will be operated by a company called The National Maternity Hospital at Elm Park DAC which will be owned by the St Vincent’s Hospital Group, along with St Vincent’s Hospital, St Michael’s Hospital and St Vincent’s Private Hospital. This in turn would be owned by another company, called St Vincent’s Holdings, which will be a private company with charitable status. Hence, the Sisters of Charity’s current practice of subsuming the profits of their private hospital into a group vehicle with charitable tax-exemption will continue, while a public asset, costing upwards of €1billion euro at current estimates is handed into private ownership.
We have been assured that the presence of so-called “public interest directors” on the board of St Vincent’s Holdings is sufficient to protect the State’s massive investment in the new hospital, but anyone who remembers the banking crisis will be aware of how little difference a public interest director can make when the chips are down. St Vincent’s Holdings is a company limited by guarantee. Its directors are also its members and will own the entire hospital group, lock, stock and barrel. They are bound by company law to act in the best interests of the company to which they are appointed, not anyone else – even the public. The Mulvey Agreement envisages a “golden share” which would enable the Minister for Health to protect the public interest. As the Minister will not be a shareholder, this makes little sense. It has been suggested in the latest tranche of leaked proposals that directors appointed by the Minister will increase in number from one to three, with three further directors from the existing National Maternity Hospital at Holles Street and three from the St Vincent’s Hospital Group. That still leaves the State’s appointees in a minority position and does not release them from their obligation to act in the interests of the company.
Extensions to length of the proposed lease – originally envisaged as 50 years, then 99, and now 299, have done nothing to mitigate concerns around land ownership and Catholic “ethos”. Nowhere in the world has any healthcare facility on Catholic land been able to offer procedures which conflict with the ethical codes of the bishops. We know that the Vatican granted permission to the Sisters of Charity to transfer the property to St Vincent’s Holdings on condition that certain provisions of Canon Law be observed to avoid harm to the Church. This does not inspire confidence that a secular ethos could prevail in the new hospital.
So, despite excited announcements of a settlement, no changes in its composition will alter the fact that the board is to be in control of a private company. The appointment of so-called public interest directors does not guarantee that the public interest is protected. No changes in the length of the lease will alter the fact that the site is to be owned by a private company, the successor to the Religious Sisters of Charity, bound by Canon Law to uphold the values of the Roman Catholic Church. How could this be acceptable for any publicly funded health facility in a supposedly secular republic of the 21st Century?
The repeal of the Eighth Amendment to our Constitution in 2018 has changed the landscape in relation to reproductive healthcare significantly. Abortion is now legal in Ireland for the first time since the foundation of our State. Ten of our 19 maternity hospitals provide this service, including the existing National Maternity Hospital at Holles Street, which is not religiously owned, although it has the Archbishop of Dublin as its titular chairman. Another anachronism. The proposed move has thrown into sharp focus the refusal of St Vincent’s hospital to provide any service which is prohibited by Catholic teaching, and assurances from the Minister for Health that all legal healthcare services will be available in the new hospital ring hollow when he cannot even convince nine of our existing maternity hospitals to provide abortion care.
Everything that has happened since the Mulvey Agreement is merely “moving the deckchairs on the Titanic”, to quote Dr Peter Boylan, former Master of the National Maternity Hospital at Holles Street, as despite protracted negotiations, the nuns have not budged one inch on ownership of the site, and have refused to sell to the State, insisting that they must retain it for reasons of governance. Given that they say they will not be involved in the new hospital or the St Vincent’s Healthcare Group in any way, one wonders what it is they plan to govern?
The National Maternity Hospital debate is part of a larger discussion which is urgently needed in this country. How is the Roman Catholic Church still allowed to dominate healthcare and education in a secular republic of the 21st Century? What must be done to ensure that the influence of religious ethos is not allowed to prevent people from accessing services to which they are legally entitled?
I don’t believe it is going too far to say that this issue – the new National Maternity Hospital and its ownership - is a critically important battle in the ongoing war of this young State against religious domination and should be seen as a watershed moment. I have no doubt that the outcome will have repercussions not just at home but on an international stage. As we saw when we legalised equal marriage and when we repealed the Eighth Amendment, what we do here in Ireland can inspire people in other countries to strive against repressive religiously controlled regimes. Equally, if we fail, it will embolden our opponents and anti-choice factions in our society will redouble their efforts to roll back our hard-won rights. We have to win this one.
Our demands are simple:
• Our (yes, our) new National Maternity Hospital and the site on which it stands must be publicly owned.
• The hospital must be wholly secular and free to provide all legal medical services without any religious interference in its operation.
Our Maternity Hospital must
be Public and Secular.
We will not settle for anything less.