It was the middle of the night in California, but Catherine Martin, who is there “on a week-long tourism and audiovisual trade mission,” didn’t want to miss the much-anticipated cabinet meeting to sign off on controversial plans for a new National Maternity Home (NMH).
Last Friday, the Arts Secretary announced that she would support the NMH’s controversial move from Holles Street to the campus of St Vincent’s Hospital in south Dublin, as she was the only remaining Cabinet Secretary not to support the deal up to that point.
However, some of today’s cabinet reports said the Green Party’s deputy leader, who appeared via video link, only agreed to back the move after Attorney General Paul Gallagher gave solid backing to the structures underpinning the deal at the morning meeting.
It was also said that Ms Martin was pushing for the new NMH to become a center of excellence in maternity care. The reality was a little different, according to a Cabinet source, who noted sharply, “She didn’t mention it in her comments live from California.”
Indeed, the memo that Stephen Donnelly presented to ministers spells out the vision for “a co-located center of excellence” and that the Health Secretary has committed to “ensuring that the new LMWH at Elm Park is supported as a center of excellence for maternity care”.
The difference between what Ms Martin actually says – or in some cases does not say – in Cabinet and what is told to the media about what she says in Cabinet is beginning to irk some of her fellow ministers. The Green Minister’s spokesman said he “cannot comment on confidential cabinet affairs”.
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After two weeks of intense debates over the airwaves, hours of Oireachtas committee hearings and the release of complex legal framework documents two weeks ago, the Cabinet memo approving the deal is just four pages, the last of which is mostly blank.
It was signed by ministers despite concerns from opponents of the plan that the failure to build a public hospital on public land leaves open the possibility that religious influence might mean abortions, gender-affirming care or fertility treatments not be allowed at the new hospital if it eventually does opening later this decade or more likely in the early 2030s.
The inclusion of the term “clinically appropriate and legally permissible” in legal documents has raised concerns, which the memo itself acknowledges, that some procedures may not be performed if a woman requests them.
However, ministers were told that this term corresponds to a definition proposed by the HSE Board, agreed by hospitals and used in all framework documents, reflecting that the hospital would not perform cardiac or orthopedic surgeries, for example.
This term, the memo argues, is also broad enough to encompass future improvements and innovations in healthcare. The protections in the new hospital’s constitution and associated legal documents are “broad and explicit and obligate” the hospital to “provide the full range of health services permitted by law, and to do so without religious ethos or ethnic or other distinctions.” These services include abortions. The minister also has the power to direct the board to ensure that all these services are provided “in the unlikely event that they are ever needed”.
Such assurances, detailed to ministers today, were not enough to persuade two Green Party TDs, Neasa Hourigan and Patrick Costello, to back the deal, with the latter saying the cabinet decision was “the wrong one”.
But the Cabinet moved to stave off a possible backbench revolt by also agreeing not to reject a Sinn Féin proposal calling for a public hospital to be built on public land. The private members’ motion is non-binding, legally meaningless and “designed to be divisive,” says a minister. Sinn Féin has criticized the government’s cynicism.
The cabinet meeting itself was “simple” according to one of those present, with Mr Gallagher, of the AG, keenly aware of the robustness of the legal agreement and the “unprecedented” level of protection the agreement affords in relation to the provision of all legally available services .
Social Protection Secretary Heather Humphreys said the decision was taken in an informed and transparent way, telling colleagues the feedback she is getting is that people want the government to go ahead and build the hospital.
In that vein, Public Expenditure Secretary Michael McGrath told the meeting that a tendering process – which has taken nearly two years for the National Children’s Hospital (NCH) – can be run in parallel with an “external assurances process” where an independent Expert that reviews business case for new NMH to identify project risks, feasibility of delivery and robustness of costing, governance and procurement. The Department of Public Expenditure’s Advisory Group on Major Projects (MPAG) will then review this report.
Mr McGrath reminded Cabinet of the lessons to be learned from a PWC report on the debacle that has become the NCH project – whose cost has risen to €2 billion.
Tánaiste Leo Varadkar told the meeting he plans to put a shovel in the ground next year and is believed to be frustrated by the delays that have delayed the hospital’s completion so far. “Delays add to costs and women and young children are waiting long enough,” a senior government source said.
The final verdict on whether the government was right to go ahead with this plan will only come when the hospital is built and operational, which is several years and many millions of euros away.
https://www.independent.ie/news/national-maternity-hospital-inside-the-cabinet-room-as-ministers-approve-controversial-move-41660209.html National Maternity Hospital: In the Cabinet Room as ministers agree on a controversial move