Niamh Griffin: State ownership of healthcare should allow for full transparency

Calls to end the involvement of the Catholic Church have put massive pressure on the State to step up
Niamh Griffin: State ownership of healthcare should allow for full transparency

Protesters campaigning against Catholic Church ownership of the new National Maternity Hospital outside Leinster House. 

Calls to end the involvement of the Catholic Church in healthcare have put massive pressure on the State to step up, and the consequences of this are only starting to be understood.

The current row over the location of the National Maternity Hospital is just one front in this cultural shift, although by far the most bitterly-fought to date.

The State has for decades abrogated its responsibility for the health and education of its citizens to the Church. 

While this is not historically unique in Europe, the long-standing nature of the arrangement surprises many new migrants to these shores.

In 2017, former health minister Simon Harris reassured the public the new Children’s Hospital Ireland (CHI) will be “a secular hospital, underpinned by legislation”.

This needed to be said because of the type of hospitals being amalgamated. Temple Street hospital was run by the Irish Sisters of Charity since 1876 when the secular founders gave it to them.

Crumlin hospital is more properly known as Our Lady’s Hospital in Crumlin, founded by the Archbishop of Dublin in the 1950s.

Only Tallaght Children’s Hospital had a secular and voluntary history.

But, perhaps surprisingly, while much criticism was and continues to be levelled at this new build, the focus is on the geographical location and rapidly spiralling costs rather than ethos.

“The three children's hospitals and their boards have voluntarily agreed to come together as part of a new single entity,”  CHI chief executive Eilish Hardiman told the Oireachtas health committee in 2017. 

“This new single entity on commencement will take over the governance and management of services currently provided by these three hospitals, and the rights and liabilities of the three hospitals will transfer into it.” 

One of the two new national trauma centres will sit on the campus of the Mater Misericordiae University Hospital, founded by the Congregation of the Sisters of Mercy in Dublin.

Again, a disputed location, but this time on medical grounds by neurologists at the National Referral Centre for Neurosurgery and Neurology.

The second will be at Cork University Hospital.

Outside of hospitals, the State through the HSE is being pushed into services also once dominated by religious orders.

St John of God (SJOG) is one of the biggest providers of disability services. It is currently in such financial disarray that it is planned for the HSE to take over in September. However, in May the Department of Health said they are now seeking to hear about “a pathway to financial and operational sustainability” for the services.

Interestingly, and in contrast to fears around the maternity hospital, many families with relatives in SJOG want to keep the State out.

The Brothers of Charity warned in 2019 of financial difficulty and resource shortages. They noted the impact of “historical funding cuts” on their ability to provide services in the annual report.

Some other services either have religious involvement or historical ties. Is the State ready to step in for any of these? Do we want them to?

It is worth remembering State involvement in healthcare is not always a guarantee of safe services. But it does mean external independent inquiries are more likely.

One of the most distressing episodes in the maternity services is the tragic loss which Róisín and Mark Molloy endured at Midlands Regional Hospital Portlaoise in 2012, leading to a Hiqa report on up to 30 infant deaths.

There were no nuns, no priests, no dispute about land, but Hiqa found the HSE and hospital “were aware for many years of numerous patient safety risks in the hospital but failed to act decisively to reduce these risks.” 

Another inquiry took place at Portiuncula Hospital pushed by the O’ Reilly family.

It was reported the HSE inquiry into the Aras Attracta scandal involving abuse of people with intellectual disabilities cost over €3m to the end of last year, and was not yet formally concluded.

Meanwhile, almost two and a half years since the termination of pregnancy act was signed into law, nine of the 19 units — all HSE hospitals — do not offer this service.

Some, including University Hospital Kerry, only offer a referral pathway to larger hospitals.

This week, Dr Peter Boylan, who advised the HSE on implementation of the service, said he visited all units in 2017 and found high levels of personal conscientious objection in hospitals that choose not to sign-up.

Cork GP Dr Trish Horgan, on the Southern Taskgroup on Abortion and Reproductive Topics, has said lack of hospital provision limits the ability of local GPs to offer the early termination service.

The State seems powerless to overcome the obstacles.

So if the Government does decide to act on growing calls to somehow purchase the site for the National Maternity Hospital despite clear opposition from St Vincent’s Healthcare Group, what then?

State ownership of healthcare brings with it state responsibility for patients and families.

And it should bring open disclosure, transparency, the ability to set in place an independent external inquiry should negligence occur and a financial commitment to safe levels of staffing.

It is no small thing, but the momentum towards this only continues to grow.

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