Joyce Fegan: The core issue at the heart of new maternity hospital, confusion

A model of the new National Maternity Hospital proposed for the St Vincent’s Hospital campus in Dublin 4. Picture: Gareth Chaney, Collins

WHEN it comes to women’s health, especially their reproductive health, Irish women are well used to playing the long game.

The women of Ireland waited 35 long years to receive the right to control their bodies. From 1983 to 2018, approximately 200,000 girls and women made the journey to Liverpool, Manchester, or London to terminate pregnancies they were legally mandated to carry against their will on home soil.

Women of Ireland do not rush; the long game is our mantra.

However, at the moment, there’s this urgent pressure to get a new maternity hospital deal over the line. I’m sure you’ve heard about it in one way or another over the past number of years, and especially months. Much has been written, and even more has been said. It’s so confusing.

This week, this six-year-in-the-making deal came to a head. Health Minister Stephen Donnelly brought it to Cabinet to be signed off on. Only it wasn’t. His colleagues got a little nervous it seems. Two weeks were given to allay any concerns.

Put simply, the deal involves building a new state-of-the-art maternity hospital on the grounds of St Vincent’s Hospital in Dublin 4. However, ever since this site was selected in 2016, there have been concerns.

Why?

The site the hospital will be built on is owned by the Religious Sisters of Charity. Critics have long been concerned that a Catholic ethos would leak its way into medical matters.

The concerns have been batted away as “misinformation”, “derailing” the project, “misleading”, “manifestly false”, and “ill-informed”.

We have a long history of not listening to women’s concerns when it comes to their health, especially their reproductive health, in this country. The State’s line always seems to be: “Nothing to see here, ladies.”

And is there nothing to see here? Is the deal “cast iron”? Is it absolutely guaranteed beyond all reasonable doubt that there will be no religious influence? Will all medical procedures be available?

The Cabinet have delayed deciding on the proposal to move the National Maternity Hospital to St Vincent's Campus. Picture: Leah Farrell / RollingNews.ie

There’s a real rush on.

There is absolutely an urgent need for a new maternity hospital. Anyone who has given birth or assisted in the delivery of a baby in Ireland knows this only too well. We’re told the deal will still go ahead after the two weeks of concern-allaying. This is six years in the making.

The lease for the land for the new hospital will, however, last 299 long years. Best to turn ASAP, as soon as possible, into as slow as possible to make sure things are “cast iron”. Right?

Instead of dismissing any concern as “ill-informed”, we should be listening closely and having a robust public debate, just like we did in the long, long lead up to repealing our country’s 35-year abortion ban.

The girls and women of Ireland were made to beg for a referendum on the issue. “Go easy,” they told us. “This is a sensitive issue,” They said. We were tone policed. Urged to speak and act with decorum. Slighted for being “obstreperous”. We marched for years. There were court cases, testing legal lines with human consequences. Still, we waited. For years. Then there was a Citizens’ Assembly. The assembly of 99 people recommended a referendum. But still, we waited. Patiently.

When a date for a vote was announced, we mobilised. We marched. We knocked on our neighbours’ doors to have hard conversations, decades in the waiting. We sat down at kitchen tables, for even harder conversations.

The result? Our people lifted the ban by a vote of 66.4% in favour. That was close on four years ago now. And still, we are waiting. We’re patient like that. Only 10 out of 19 hospitals that can provide abortion services do. And only one in 10 GPs provides the medical service.

Where’s the rush to remedy this?

The concerns

But back to this urgent hospital deal. And the confusion.

There have been talks of nuns. Talk of the Vatican. What will be allowed? What won’t be allowed? Words like co-location. Abbreviations like SVHG (St Vincent Hospital Group) and lingo like Elm Park (the name of the site at St Vincent’s Hospital in Dublin 4). Terms like mergers and acquisitions. Talk of transfer of shareholdings. Stuff about approval from the Holy See. Terms like “clinical appropriateness”. Talk of tubal litigation, emergency or elective. Agreements. Assurances. Opinions of the Attorney General. Codes of Canon Law cited — 638-639 and 1292-1294 to be observed specifically.

Confused anyone?

You would need cross qualifications in land law, canon law, obstetrics, urology, gynaecology, and corporate law to get anywhere near having a full and black-and-white understanding of the current state of affairs.

And yet concerns are “ill-informed”. Well not to state the obvious, but of course they are.

While many people want to get this deal over the line, it is the girls and women, and future girls and women of Ireland, who will have to walk the line.

Listen to our valid concerns and give us clear answers.

When it comes to women’s health in Ireland, there is no concern too small, too insignificant. But we’ve been nothing but gaslit our whole lives on this land when it comes to our bodies.

Symphysiotomies.

Magdalene laundries.

Contraceptive bans.

Abortion bans. Refusal to terminate pregnancies on medical grounds.

Cervical smear scandals.

And our people have paid with their lives.

For anyone wishing to rush this deal, this is the territory on which you thread. The women of Ireland have no reason to unquestioningly trust the State when it comes to their maternal and reproductive health.

This is a matter of trust.

And what are some of the concerns that people have?

The Department of Dermatology, the site of the new National Maternity Hospital on Sisters of Charity Land at St Vincent's University Hospital in Dublin. Picture: Collins Photos

Time to talk, time to listen

In the plainest of terms, there is first the issue of what treatments will be medically allowed on the site. We’re told everything, including “gender reassignment procedures”.

There are two matters to address here. Firstly, there are no gender reassignment surgeries available in Ireland at present. We currently refer our people to Britain.

And secondly, in a parliamentary question dated October 26, 2021, it was stated in black and white that “IVF treatment is not provided at St Vincent’s University Hospital”. In this same answer it was also stated that sterilisation procedures have been carried out at the hospital “when it is clinically required to do so”, but “not for the executive purpose of sterilisation”.

There is also this term “clinical appropriateness” doing the rounds. Will this term, and another person’s life, have to be “tested” in a court of law? Or is it robust enough to provide us the certainty we need to greenlight a much-needed hospital that comes with a 299-year lease?

Then there is the matter of personnel. Why is someone like UCC’s Professor Deirdre Madden, deputy chair of the HSE, not supporting the deal?

Her UCC bio reads: “I enjoy translating legal concepts into everyday familiar language that people can understand as I firmly believe that the law exists for all citizens and should be accessible and comprehensible to everyone.”

After the decades of patience that Irish women have shown the State, surely the politicians of the day can grant us the adequate time to make the terms of this deal “accessible and comprehensible to everyone”.

Is a bit of time and some room to talk, too much to ask for?

Festina lente as they’d say in Rome.