Leaders' Questions | The National Maternity Hospital #MakeNMHOurs #OurMaternityHospital

I return to the question of the national maternity hospital. First, I thank the Minister, Deputy Stephen Donnelly, for his engagement with the Labour Party Parliamentary Party yesterday evening. We were very appreciative of the opportunity to engage with the Minister, clinicians and legal advisers to hear more about the Government's proposals, to dig into the legal documents somewhat and to hear more about the choice of the St. Vincent's site. While we did receive clarity, our concerns remain. We received much greater clarity as to why the St. Vincent's site is optimal in the view of clinicians. It is clear from the view of senior clinicians that this is almost the only site on which they might envisage that the new maternity hospital would be built.

However, this clarity just crystallised the position for us which is that if that is indeed the optimal site, the optimal approach to acquiring that site for the building of the hospital is to acquire it freehold, to ensure it is either gifted or sold at a nominal fee to the State. That is why we renew our calls today, as we renewed them last night with the Minister, for the State to consider the compulsory purchase order, CPO, option. If this is the optimal site, we need to look at the best approach on which the site is to be held. That is clearly a freehold ownership by the State. That is clear from the evidence given by the Minister, Deputy Stephen Donnelly, to the health committee yesterday where he stressed that successive Ministers for Health including the Minister, Deputy Harris, repeatedly asked the Religious Sisters of Charity and the St. Vincent's Healthcare Group to gift the land to the State but that this had been refused.

We say that the Minister should now have the courage to take on the successor company that holds the land and to seek that the land be gifted, to renew calls that the land be gifted or sold at a nominal fee to the State or indeed to take up the CPO option. The State has real history of taking up the CPO option. It is not some kind of far-fetched notion. Our colleague Deputy Howlin, who has extensive experience, has advised that this is a realistic option. It is time that we stood up to the religious orders and their successor companies. For far too long, the State has been submissive in enabling ownership of land to continue in the hands of religious organisations, and the lay-run trusts that have succeeded them in property ownership, in our school system and in our hospital system.

If we know that the optimal way to have this hospital built is on land that is owned freehold, then let us go back and ensure that that is done, that the land is gifted or sold to the State for a nominal fee. I know the health committee has sought a further short delay on the making of the Cabinet decision in the interests of further engagement to allow us to hear from further stakeholders. I ask the Tánaiste to consider that request and to consider the Government's policy by looking now at taking on the power of the religious orders and successor entities.

An Tánaiste Leo Varadkar

About two weeks ago, the Government decided to pause making a final decision on this matter. I think that was a sensible approach. It allowed people to ask questions and, in many cases, to get answers. It allowed for transparency and the publication of documents. It allowed for some people to be reassured and also allows us to consider what additional safeguards we might be able to add to the Government decision next Tuesday. I expect there will be a Government decision on the matter next Tuesday, but we will see how things develop between now and then.

Above all, we should not lose sight of what we are trying to achieve here. This is the biggest single investment in women's health in Ireland since the foundation of the State. It is part of an overall strategy to improve women's health, maternity care and neonatal care, including improvements at the Rotunda, the new Coombe hospital, a new hospital in Limerick, a new unit in Galway as well as community units. We want to achieve a world-class maternity hospital. I worked in Holles Street hospital and I know it well. It is a great hospital but it has conditions and infrastructure that are from 50 or 100 years ago.

In the new facility, every woman will have a single room en suite with the dignity that comes with that. In addition, there will be much better infection control. There will be a state-of-the-art newborn intensive care unit, NICU, for those little babies born prematurely who are most vulnerable. There will be five theatres instead of two. Think what that will do for gynaecology waiting lists. It will co-locate with a major adult teaching hospital, St. Vincent's. That means if something goes wrong, such as a woman having a major haemorrhage, cardiac arrest or stroke, within 20 minutes she can be in the ICU or in theatre in the adult hospital with all those specialists around her. At the moment women need to be transferred into an ambulance, through the streets of Dublin, out of the ambulance and into St. Vincent's Hospital. That is very much suboptimal. That is the prize. If we go for the plan in front of us, we can have that new hospital under construction as early as next year or, if not, the year after.

The CPO approach Deputy Bacik proposes does not give us that guarantee. The difficulty with the CPO, which was considered by the Government, is that we would not have the co-operation of St. Vincent's when it comes to that CPO. It would need to be a compulsory purchase, not a voluntary purchase. That would definitely mean additional costs and additional delays. At the end of it, the CPO might be refused because we would need to prove to An Bord Pleanála and to the courts that the CPO is necessary. We are being offered a 300-year lease. Deputy Bacik is a lawyer and she will know that a 300-year lease is considered to be secure title. That would make it very hard to give the women of Ireland any assurance or guarantee that the CPO would be successful. The alternative the Deputy is proposing - I understand the purity and rationale behind it - would definitely involve higher costs and further delays, and it might actually fail in the end.

Ivana Bacik TD

We are convinced of the clinical need for the new maternity hospital; I think all of us are. All of us want the same outcome, which is a state-of-the-art, fit-for-purpose new national maternity hospital for women's healthcare in Ireland. We have heard why that should be at the St. Vincent's site. However, it is time to call the bluff of the owners of that site. It is time to call them out. While a 299-year lease is certainly better than the previous alternative that was offered of a 99-year lease, it still remains different from freehold. It still remains conditional ownership and not outright ownership in perpetuity. That is the difficulty we have. We believe it is time to call the bluff of the owners of the site and to say that we, as a State, wish to take ownership in perpetuity of the land on which the new national maternity hospital is to be built, to put beyond doubt the future ownership and future availability right into the next century of all necessary maternity and reproductive healthcare services for women. For too long women in this country have been failed by the State and by the church authorities, often working in tandem. We need to call them out on it now.

An Tánaiste Leo Varadkar

As the Deputy knows, the entire St. Vincent's campus is owned by a secular non-profit company, a charity. It has been very clear with us that it does not wish to sell the site. If the site were at the edge of the campus, like the BreastCheck building, it might sell the site as it did in the case of BreastCheck. It is very clear that this site is in the middle of its campus and it does not want to sell it. That would mean we would need to go down the route of a CPO.

It would mean they would withdraw co-operation from this project. They would cease to be partners in the project. That would absolutely mean additional cost. I cannot quantify what the additional cost would be but it would certainly be tens of millions, if not more. It would absolutely mean further delay. Instead of the hospital being under construction next year or the year after, it definitely would not be. Even at that point, the compulsory purchase order might fail, and then we would be back to square one with no hospital at all.

I appreciate the Deputy is being honest and is putting forward an alternative but I do not think it is a good alternative and I could not recommend that to the women of Ireland.