Religion’s role in health sits on fault-line of old and new Ireland
:: Maternity hospital saga will leave legacy
THE National Maternity Hospital saga was 21st-century Ireland having a row with 20th-century Ireland. The three-year dispute over the ownership of the land for a new hospital embroiled the Church, the State, the medical profession and the pro-choice movement.
The current National Maternity Hospital (NMH) has been based at Holles Street since 1894. It was last re-designed in 1936, and staff are working in cramped conditions as they try to manage 30 births a day.
In 2013, it was announced that it would relocate to a site on the campus of St Vincent’s Hospital, Dublin 4.
It is best medical practice for a maternity hospital to be co-located with an acute adult hospital. The St Vincent’s
Healthcare Group was run and owned at the time by the Sisters of Charity.
This is where the trouble started. Holles Street wanted to retain its own board for the new NMH, with an obstetrician or master as its chief executive. St Vincent’s wanted the maternity hospital and the existing hospital to be run by the same board.
In 2016, Kieran Mulvey was appointed as an intermediary by the government to try to sort the dispute. But the eventual agreement between the hospitals caused chaos.
It emerged late in March 2017 that the Sisters of Charity would effectively own the hospital after it was built on its land with hundreds of thousands of euro of taxpayers’ money.
The timing of this revelation was poignant. It came weeks after “significant quantities” of human remains were found at the site of the Tuam mother and baby home.
The following month, a citizens’ assembly would call for a the repeal of the Eighth Amendment. Ireland was in a state of convulsion over its historic treatment of women and there was a major social appetite for the clean separation of Church and State.
News that a religious order – which still owed €3m to a redress scheme for child abuse – was going to own a hospital responsible for women’s health caused uproar.
The row quickly became about much more than a dispute over land ownership.
Questions immediately rose over whether abortion services would be blocked at a hospital owned by a Catholic order.
There were protests. A petition against the deal attracted more than 100,000 signatures.
In April 2017, Dr Peter Boylan, the former head of the Institute of Obstetrics and Gynaecology, resigned from the board of the NMH in protest at the possible influence of Catholic ethos on women’s healthcare. He publicly fell out with colleagues, including Rhona Mahony, who was then the master of Holles St.
Dr Mahony was anxious that the scandal could derail the much-needed new hospital.
She was reported telling a colleague that “the feminists are going to unravel this fantastic hospital for women”.
Meanwhile, inaccurate suggestions that nuns were going to ‘run’ the new maternity hospital spread like wildfire.
The perceived vilification of the Catholic Church caused major damage to relations between the Sisters of Charity and the State.
But some of the Church’s responses courted controversy. At times, it seemed to believe it was entitled to impose its ethos.
Some senior clerics vowed that the hospital would have to obey the Church.
Eventually, the Church published a new code of ethics for Catholic hospitals. This may be a moot point in the long term, as it’s expected the number of faith-based hospitals in Ireland will reduce from 12 to four in the coming years.
However, as recently as last year, conscientious objection was still preventing the rollout of abortion services in a number of maternity hospitals.
At one point during the row, the Sisters of Charity threatened to pull the entire hospital project; blaming “controversy and misinformation” and singled out remarks from Health Minister Simon Harris.
The controversy prompted him to order a report into the relationship between the State and voluntary healthcare groups.
The report was nuanced, saying that if the State defunded any of the 12 hospitals run by faith-based organisations for refusing to perform a public health service – like abortion – “in reality, the State would not be in a position to replace the extensive range of services provided by Catholic organisations”.
This inconvenient point was skilfully pushed off the news agenda with selective leaks from the government the day before the report came out, which focused on quirky headlines about removing holy statues from hospital wards.
On March 29, 2017, the Sisters of Charity announced it was stepping back from St Vincent’s Healthcare Group after 183 years.
It led to yesterday’s announcement that, having secured permission from the Vatican, ownership of the St Vincent’s Healthcare Group would transfer to a new independent charitable body called St Vincent’s Holdings CLG.
Concerns remain that the maternity hospital is still not guaranteed to be publicly owned.
The NMH scandal brought the problematic nature of religious involvement in public health into sharp relief, and has likely set a new precedent for future infrastructure projects with voluntary groups.
Speaking to the Irish Independent yesterday, Mr Boylan said he had been “vilified” during the NMH dispute.
“The impression was given that I had been talking through my hat. But everything I said turned out to be true,” Mr Boylan said.
“I sacrificed 40 years of involvement with the NMH on a point of principle. That was a source of great sorrow to me, and continues to be. I just feel, perhaps, that an apology might be forthcoming from those who said those things.”
‘I just feel, perhaps, that an apology might be forthcoming’