A national maternity hospital built, managed and owned by the state

On Wednesday 18 May, a Sinn Féin motion calling for the Dublin Government to secure full public ownership of the proposed site of the National Maternity Hospital site was passed in the Dáil. Below, we carry an edited version of Waterford Sinn Féin TD David Cullinane’s speech. David is the Sinn Féin spokesperson on Health and brought this motion before the Dáil.

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I want to see a resourcing of the national maternity strategy. I want to see modern, fit-for-purpose maternity hospitals with modern, fit-for-purpose maternity suites for women right across this State. I want to see it for all women. I want to see investment in all of our maternity hospitals right across the State.

The Minister will be aware that while I accept Holles Street is not fit for purpose, and while some of the comments about the state of Holles Street may have been exaggerated, I certainly agree with him that it is not a hospital that is fit for purpose and we need a new National Maternity Hospital. 

Equally, the Rotunda Hospital has difficulties and challenges, as the Minister knows, and has for many years been fighting for resources to increase capacity and to make it a better maternity hospital for the women who use it. I could give many more examples of maternity hospitals across the State where we know buildings are antiquated and the services are not what they should be. We should all commit to better resourcing maternity services as we go forward.

I also want to see a new national maternity hospital. I want to see it built by the State, managed by the State and owned by the State, including the land. Why? I will go back to what the Minister said to me last week when I asked him this question. He stated; “My position...has always been that I would prefer public ownership and to own the freehold.”

That is what the Minister said when I asked him that question last week. His preference was for public ownership. He also said at the time that he had engaged in discussions with the St. Vincent’s Healthcare Group on the ownership issue and that is something he had put on the table. 

Unfortunately, that is not what was said to us at the Health Committee yesterday. What was said to us, in the words of the chair of the St. Vincent’s Healthcare Group, was that there were no meaningful discussions over the course of the last five or six years on the ownership of the land issue. 

• Sinn Féin TD David Cullinane

It strikes me that while the Minister, the Tánaiste, and the Taoiseach said that was their stated objective, in reality the Government raised the white flag on the ownership issue and just accepted what the St. Vincent’s Healthcare Group wanted, as opposed to standing up for taxpayers and citizens and getting the best outcome. 

Simply because St. Vincent’s Healthcare Group tells us what its best outcome is does not mean that is the end of the matter when it is after all the taxpayer who foots the bill, and who will also fund the day-to-day running of the hospital for decades and generations to come.

I genuinely believe that the decision that was made today by the Cabinet is the wrong decision. That is the case because we have now signed up to a legal framework that is very complicated, complex, convoluted and in my view unnecessary. 

It is all a product of the fact that we are proceeding to build, for the first time since Sláintecare, a hospital that will not be in full public ownership, and that will be run by an independent charitable company, as opposed to a HSE hospital. I do not believe it is beyond us as a people in the 21st century to build hospitals that are publicly owned, run and managed in the interests of the public and of patients. For me, that is a very clear policy objective that should be met.

We also heard an awful lot of commentary in recent weeks and months, if not years, to the effect that the Sisters of Charity were not interested in or did not have a preference to gift the land to the State, despite at one point them saying they wanted to gift the land to the people of Ireland. 

We know now what happened: the land was transferred to St. Vincent’s Healthcare Group. We have been told that the Sisters of Charity have divested all of their interests in the land, which I do not dispute, and the sole owner of the land is now the St. Vincent’s Healthcare Group. 

We had some very lengthy discussions with the board of the group at the health committee yesterday. All of the questions about ownership were put to its members. We put very straight questions to them. Who owns the land? They said: “We do.”

My point is that I had those discussions with them. I put very direct questions to them, and they were very clear that the landowners were St. Vincent’s Healthcare Group and that there was a lease arrangement in place between the HSE and St. Vincent’s Healthcare Group. I put it to them very directly. Who owns the freehold? They said St. Vincent’s Healthcare Group. That is a fact. No matter how many times the Government tries to spin it, that is a fact and that is what they said.

They also said that they were not going to gift the land to the State. If they are telling us they are not going to gift the land to the State, and that in fact they had no meaningful discussions on that issue recently, then what is the issue? 

The Minister is telling us that we own the land. He and they are also telling us that they will not gift us the land. It cannot be both. 

• St. Vincent’s: The reality is that they are the landowners and they have not gifted the land to the State, the people do not own the land

The reality is that they are the landowners and they have not gifted the land to the State, and if they did, we would not need to establish the company, the National Maternity Hospital at Elm Park, because we would be building a HSE hospital on public land. We would obviously have to have arrangements in place between the hospitals on the campus and the HSE hospital - different sorts of arrangements - but we would not need a company to be established that would then have directors coming from different sources.

That would be completely unnecessary. That company would not need to be formed. Then, of course, it would not be a subsidiary of the St. Vincent’s Healthcare Group. None of that would happen. 

The Minister therefore cannot credibly come before the House and say there are no contractual issues, no legal issues, we own the land and yet a company has been established to run and manage the hospital with a lease arrangement with St. Vincent’s Healthcare Group. The complications and legal contractual issues, constitutions, licenses and leases are all in place for one reason and one reason only, which is that we do not own the land.

I asked the Minister and the Taoiseach several times over the last number of weeks about what efforts are being made to persuade St. Vincent Healthcare Group to gift the land to the State. It transpires from yesterday, from the words of the chair of the St. Vincent’s Healthcare Group, that there was no communication from the head of Government, the Taoiseach, with the St. Vincent’s Healthcare Group. That is just absolutely bizarre. In fact, it is unbelievable given the importance of this.

We are going to lock ourselves into a legal framework for generations to come. It was not the right decision. I will finish on this point. It is deeply cynical not to oppose a motion while at the same time having no intention of supporting it.