Fergus Finlay: As a HSE board member, I support the new maternity hospital plans

Tue, 10 May, 2022 - 11:00

THIS isn’t something I would normally do. As a member of the board of the HSE, I’m bound by normal confidentiality about the operations of the board, although of course all our minutes, and the minutes of committees, are regularly published. But the more I think about it the more I feel obliged to say something about the National Maternity Hospital.

The arrangements for the hospital are complicated and they have caused a lot of confusion and some distrust. I get that. There are people close to me, friends I respect, who believe that in some way we have sold the pass. That we’ve fallen under some malign influence or been codded up to the eyeballs by the Vatican and its secret service.

Here’s my bottom line. As a citizen, campaigner, and advocate; as a husband; as the father and grandfather of women and girls; there are simply no circumstances under which I would support the development of a new national maternity hospital in Ireland that was influenced by anything — anything — other than the public interest and the interests of women.

There are no circumstances — none — under which I would support a maternity hospital that was run on the basis of religious ethos or any other form of discrimination. I want to see a national maternity hospital that is open to every woman in Ireland, whatever her colour, ethnic origin, or income. And I want to see that hospital offer every single service that women need. I will never support anything less.

Prof Shane Higgins, Master of the National Maternity Hospital and Dr Cliona Murphy, chair of the Institute of Obstetricians and Gynaecologists, at a press conference at the Department of Health to answer questions on the National Maternity Hospital. Picture: Dominic McGrath/PA

The National Maternity Hospital in Holles St does all of that now, though in unacceptable and often Dickensian conditions. So do other maternity hospitals.

It is vital that when the National Maternity Hospital moves into new surroundings, the only thing that changes is that women have access to more comfort, more dignity, and more support, whatever their circumstances and whatever decisions face them.

For those reasons, not only do I support the decision that I hope will be made soon to proceed with the new hospital, but I am proud of it.

It would be impertinent for me to speak for every other member of the board. But I happen to believe that on this issue, we all share exactly the same determination — to secure a world-class maternity hospital that will never be controlled by a sectional interest and will operate only in the interests of the people it is intended to serve. None of my colleagues would accept anything less.

The board of the HSE has been in existence (after a long absence) for about three years. I’m a member because I applied in response to a public advertisement. It’s a small board, and for several reasons that makes it a very busy place to be. Luckily for me, I’m surrounded on the board by people of immense talent and quality. There’s none of them that I haven’t learned a lot from over the past three years.

Because Covid-19 invaded the world about eight months after the board was formed, the HSE, as you know, has been operating in a state of emergency, and grappling with huge issues day by day.

Cyberattack

All of that was compounded by a cyberattack about a year into the pandemic. We’ve watched and supported a senior management team working day after day — often weeks without a day off — to try to protect the people we serve.

Apart from the pandemic itself, almost no issue has taken more board and committee time than the National Maternity Hospital.

Under the rules by which we operate, the approval of a major capital project like that is called a “reserved function” of the board of the HSE. It cannot go ahead without the agreement of the board.

In this case, the board assigned responsibility in the first instance to its audit and risk committee, of which I’m also a member. We devoted many hours at that committee, under the leadership of a brilliant chair, over many months, to examining and analysing the huge set of documents that had been developed to give legal underpinning to the project. We worked with senior management colleagues and had the benefit of legal advice at every stage.

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Our job was a simple one. We had to provide the board with assurance that: (a) there was a strong business case for the new hospital, and (b) the structures surrounding it would guarantee that it served only the public interest.

And of course we knew from the very beginning that we wouldn’t be building this hospital on land we owned ourselves. That made it doubly important that all the legal arrangements were as watertight as we could make them.

Documents were sent back a number of times. Several times we indicated that couldn’t yet provide that assurance the board needed. But as we did our work, new approaches began to emerge. They were complicated in some respects, but they answered key questions.

At the end of the day, individually and collectively, we had to satisfy ourselves about a number of things before we could provide assurance to the board. For example:

Will the State own the hospital? Yes it will — it will be the national, state-owned hospital, built and funded by the State. The State will own it on a leasehold basis for the next 299 years.
Will the State own the land on which it is built? No, but there will be a 299-year lease at a rent of €10 a year. That rent can only be increased if the HSE tries to use the site for purposes other than healthcare.
Who will actually run the hospital? The hospital will be a charity, regulated under charity law, and managed by a board of trustees.
Nobody will have a controlling interest, and nobody will have a beneficial interest, except that the minister for health will have a “golden share” to protect the core values of the hospital.
What role will religion play? None whatsoever. The Sisters of Charity have left healthcare in
Ireland, and their shareholding in St Vincent’s has been transferred to another charity — not a private company, as some allege, but a charity, regulated by law. The constitution of that charity makes no reference whatever to religious ethos.
At the moment in Holles St, all obstetric, neonatal, and gynaecological care permissible within Irish law is available — and that includes abortion, tubal ligation, gender affirming surgery, and assisted reproduction. Will all that continue in the new hospital? The answer to that question is yes.

If we couldn’t answer those questions, we would not have made a positive recommendation to the board, and I don’t believe the board would have decided to proceed.

As everyone knows, two of our members, although they accepted the collective decision of the board, recorded their dissent from the decision in the published minutes. All of us utterly respect their viewpoint.

At the end of months of work by a lot of people, I honestly believe that we have put the best protections we can in place for a truly national maternity hospital that will never discriminate nor ever be controlled by any religious influence. I can’t wait for it to be built.

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