Gavan Reilly: Some NMH facts to help you make up your own mind

Who to believe in the row over the National Maternity Hospital? Even as an (intended) purveyor of facts I’m not sure who to believe, or which of several contradictory factors might prevail over the others.

The arcane arrangement of the State engineering a collaboration between two voluntary hospitals, Holles St and St Vincent’s, only further complicates things. But here are some factual statements which might help readers to make up their own minds.

The plan is to form a new company, ‘National Maternity Hospital at Elm Park DAC’, which will run the hospital. This DAC will have nine directors – four drawn from the previous Holles St, four from the current St Vincent’s group, and one outside obstetrician who is appointed by a sub-committee with a St Vincent’s majority. While the State will not appoint a director, the Minister for Health will be given a ‘golden share’ which effectively means no major change in corporate structure or governance can go ahead without the Minister’s permission.

That DAC – which has not yet been officially formed – is to have a corporate constitution giving ‘reserved powers’ to its nine directors. Those powers are to include “clinical and operational independence in the provision of maternity, gynaecology, obstetrics and neonatal services (without religious, ethnic or other distinction)”.

The original plan was for this DAC to be fully owned by an entity called the St Vincent’s Healthcare Group, which refers in its own constitution to the values of Mother Mary Aikenhead and the Religious Sisters of Charity.

This group intends to change its constitution to include a reference to procedures which are valid under Irish law, but only slightly dilute the existing references (there is still a reference to its ‘core values’, borrowed from those of the Sisters, including a plan to “speak for the voiceless”). After the public pushback, St Vincent’s now intends to have all of its assets instead vested in a new company, St Vincent’s Holdings, whose constitution mentions Irish law, and not Aikenhead, but still contains similar wording around ‘core values’.

Ultimately it is up to readers to decide their own stance: do the explicit mentions of Irish law trump the inferred references to ‘values’? If the new hospital is to be operationally independent, why do St Vincent’s need four members on its board and the effective right to appoint a fifth?

Does this stacking of the board mean that the new hospital’s ‘independence’ is actually independence from the Government, rather than independence from St Vincent’s? And when the land is merely leased from St Vincent’s, can the landlords have any influence? Only when all those questions are ironed out will ‘truth’ emerge.