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Rolling back the Eighth Amendment: the Church’s power grab for the new national maternity hospital­­ — backed by government. By Marie O’Connor.

Church and State have worked together for almost a decade to advance a deal that threatens Repeal. Legal safeguards, apparently approved at the highest level by Church authorities in the Vatican and in Ireland, are set to ensure the ethos of the Religious Sisters of Charity will govern the new maternity hospital if the government persists with its plan to gift the facility to the nuns.

The big day.

The sun shone, marquees fluttered, caterers bustled. Everybody who was anybody was there, ‘old boys’, former nurses, family friends. The No 1 Army band heralded the arrival of the Archbishop of Dublin; His G33race was followed five minutes later by the Tánaiste and Mrs Childers. The Archbishop said Mass for some 1200 people after leading a procession to bless ‘the new Vincent’s’, also known as the Mary Aikenhead School of Nursing. After the speeches came a two-tier lunch, turkey in the cafeteria for staff, cold meats, salads, wines and coffee for distinguished guests.

Marie O’Connor is an author, broadcaster, journalist, health activist and advocate for Survivors of Symphysiotomy.

Acquisitions

The following year, the Religious Sisters of Charity acquired St Michael’s Hospital, Dun Laoghaire, from the Sisters of Mercy. Thirty years later, in 2001, they established St Vincent’s Healthcare Group to own and manage their hospitals. In 2010, the RSC expanded their portfolio again, mortgaging a publicly-funded asset, St Vincent’s University Hospital, to fund the building of their new private hospital at Elm Park. A decade later, the congregation is poised to acquire a new multi-million maternity facility — set to be one of the biggest in Europe — built and maintained from the public purse.

Archbishop John Charles McQuaid arriving to open the ‘new’ St Vincent’s at Elm Park in 1970.

Succession

The key RSC objective today is to guarantee that their ethos will continue to determine care in their facilities. The congregation is dying out, so succession problems arise, as they do for religious worldwide, the dwindling owners of hospitals, schools and other non-profit enterprises. The order, which comprises some 250 members in all, mainly in their 70s and 80s, is headquartered in Dublin. Controversially, the congregation refused to pay its agreed €3 million share for victims of institutional child abuse in 2012, following the publication of the Ryan Report into industrial and reform schools. The order subsequently declined to compensate the Magdalene women, having netted €45 million in 2001 from the sale of its land at Donnybrook, Dublin, site of a laundry it ran for over 150 years. The flouting of public-pay policy by the Vincent’s Group was also widely censured. 

Vincent’s and Holles Street

Vincent’s has always had a special relationship with the National Maternity Hospital, Holles Street, a privately owned-corporation under the aegis of the Catholic Archdioceses. For decades, the NMH led the way in symphysiotomy, an operation that unhinged a woman’s pelvis, performed in lieu of Caesarean section by doctors who disapproved of birth control.  Today a much more liberal regime prevails.

As Tony Farmar’s centenary history of Holles Street shows, medical consultants practised privately in both hospitals from the 1890s. Archbishop John Charles McQuaid was the National Maternity Hospital’s (NMH) all powerful chairman when he performed the opening ceremony at Elm Park in 1970. Today, around 40 per cent of NMH consultants work in the RSC’s hospitals despite the religious restrictions imposed on their practices.

Archbishop McQuaid inspecting Knights of Malta at Elm Park.

A power grab

In 2013, Minister for Health James Reilly announced the building of ‘the new NMH’ — then set to cost €150 million — at Elm Park. KPMG had recommended that Dublin’s three private maternity hospitals be co-located with acute general hospitals in 2008. Co-located single-speciality hospitals offer ready access to wider specialist care: hospitals retain their independence while sharing ancillary services. Initial agreement between Vincent’s and the NMH on co-location broke down. In or around September 2014, under a new chairman, James Menton, a former KPMG partner, the nun’s company made a takeover bid for the NMH, reportedly delaying the planning process until Holles Street caved in.

The Mulvey report

Dr Rhona Mahony

Incoming Minister for Health Simon Harris appointed Kieran Mulvey to broker an agreement between the two warring private entities in May 2016. Four months later, the then deputy chair of the NMH, Nicholas Kearns, and the hospital’s then Master, Dr Rhona Mahony, now a director of the Group, reportedly informed Mulvey that they were willing to dissolve the NMH charter to become a wholly-owned subsidiary of the nuns’ company. This offer was made without consulting either the NMH board or the governors, according to former master and former board member Peter Boylan, a strong opponent of the takeover by the nuns’ company.

St Vincent’s Healthcare Group, the company founded by the order in 2001, was now set to own and control the new maternity hospital company, which is to be a wholly-owned subsidiary of the Group. Mulvey had no public-interest mandate. The report set out detailed proposals for the takeover: it did not question it, nor did it consider who should own the land underneath the new hospital. Simon Harris welcomed the publication of the Mulvey report in April 2017, in a U-turn from the government’s previous support for NMH independence from Vincent’s, expressed by his predecessor Leo Varadkar in May 2016. It was a watershed for the congregation’s plans.

Protest in April 2017 at the Department of Health, organised by Cllr Eilis Ryan, Workers’ Party

Pushback

Public opposition grew. A mass demonstration took place at Leinster House, one of many, and over 100,000 signed a petition against the government’s proposal to gift the new facility to the RSC. Peter Boylan publicly expressed his concern that certain procedures would not be available in the new hospital because of its Catholic ethos. Responding on 25 April 2017, the chair of the Group, James Menton asserted that “in line with current policies and procedures at SVHG [the nuns’ company], any medical procedure which is in accordance with the laws of the Republic of Ireland will be carried out at the new hospital”. This is a remarkable claim— later repeated — that gives the impression that abortion and other procedures banned by the Catholic Church were, and would continue to be, provided at Vincent’s hospitals.

The Irish Catholic Bishops’ Conference healthcare code

The Irish Catholic Bishops’ Conference issued its ‘Code of Ethical Standards in Healthcare’ in 2018. Abortion is permitted only as a lifesaving  procedure.  Under all other circumstances, such as rape, the threat of suicide or the diagnosis of a fatal foetal abnormality, abortion is prohibited. Referral for abortion is also banned, because it  constitutes “formal co-operation with wrongdoing”, which is “never morally permissible”.

Other prohibited practices include artificial contraception, IVF, surrogacy and sterilisation on request.

The code is premised on the right of Catholic healthcare providers to refuse to supply services they feel in conscience unable to provide.

The bishops’ view is that laws that conflict with “the fundamental and inalienable rights of the human person” do not “command obedience”.  Catholic providers are expressly forbidden from entering into any contract with other parties “with the intention providing some services prohibited by Catholic teaching”.

The pushback from the public also forced a change of tack from the congregation. By then, securing ownership of the new maternity facility had become critically important. The movement to repeal the Eighth Amendment to the Constitution was under way. On 29 May 2017, Sr Mary Christian announced that the RSC were ending their involvement in their company. In a volte face from the arrangement laid out in Mulvey, she stated that a new company to be called ‘St Vincent’s’ (later incorporated as ‘St Vincent’s Holdings CLG’) would be formed to take ownership of the Group’s hospitals and associated lands, and that the two members of the congregation on the board of the nuns’ company would resign “with immediate effect”. This reinforced the impression that the congregation would “not be involved in the ownership or management of the new National Maternity Hospital”.

The Aikenhead values

However, the congregational leader did emphasise the primacy and indissolubility of the values ascribed to Mary Aikenhead. The RSC remained “dedicated to preserving the legacy of Mary Aikenhead”; the Group would “continue to provide healthcare services that foster Mary Aikenhead’s values”; and the directors of St Vincent’s Holdings would “be true to the values of our Foundress”. The Aikenhead values have the power to define Catholic medical practice. After the congregation had transferred their assets, the duty of the Group to adhere to the “Religious Sisters of Charity Health Service Philosophy and Ethical Code” would morph into an obligation to comply with “national and international best practice guidelines on medical ethics”.

The chair of the nuns’ company, James Menton, simultaneously issued a statement confirming that “the Board, management and 4,000 staff of SVHG are also absolutely committed to upholding the vision and values of Mary Aikenhead — namely dignity, compassion, justice, quality and advocacy”. He, too, affirmed that the Group would “always be true to the values of its Foundress”. This combined media initiative by the congregation and its company succeeded in garnering the approval of both government and media. The contradiction between the Group’s fidelity to the Aikenhead values and the suggestion that procedures banned by the Catholic Church were, and would continue to be, carried out in Vincent’s hospitals was left unexplored.

That these values are Catholic is indisputable. As a 2019 job description for a staff nurse at St Vincent’s University Hospital showed, to be true to the Aikenhead values is to be faithful to the ethos of the congregation. The document opens with the statement that “the philosophy of St Vincent’s Healthcare Group is based on that of the Religious Sisters of Charity”. Under ‘Mission’, the Group states: “the values underlying the philosophy of St Vincent’s Healthcare Group in relation to our care of patients and staff are those of human dignity, compassion, justice, quality and advocacy, which are based on the mission and philosophy of the Religious Sisters of Charity”. The company then affirms that it “will continue to develop the Healthcare Group in line with the above principles”. A 2020 job specification for a radiology aide at St Michael’s, also issued by the Group, translates the Aikenhead values into Irish. The first, “human dignity”, is translated as “comh mheas” or parity of esteem; the second, “compassion”, is “comh bhá” or parity of sympathy; while the third, “justice”, is rendered as “comh phártíocht” or parity of partnership. These unusual translations, taken together, point unambiguously to the pro-life dimension of the Aikenhead values. (The final two values are “quality” and “advocacy” — speaking for ‘the voiceless’––both translated as ‘comhoibriú’ or cooperation.)

The first, “human dignity”, is translated as “comh mheas” or parity of esteem; the second, “compassion”, is “comh bhá” or parity of sympathy; while the third, “justice”, is rendered as “comh phártíocht” or parity of partnership. These unusual translations, taken together, point unambiguously to the pro-life dimension of the Aikenhead values. (The final two values are “quality” and “advocacy” — speaking for ‘the voiceless’––both translated as ‘comhoibriú’ or cooperation.)

As a Catholic congregation, the RSC required  permission from the Vatican to transfer the property held by the Group to the new holding company. The nuns’ assets were, and remain, Church property in Church law. Their transfer — and future management — are subject to Church law. The assets in question are considerable. The RSC’s shareholding in the Group was valued at €661 million in 2018. This shareholding includes the land the congregation intends to lease to the State (on condition it builds the new facility). This made the land, and its future use, the activities in the new maternity hospital, for example, a subject of interest in Rome. The leasing of any Church property with a value in excess of €4.3 million requires the express consent of the Holy See. With an estimated market value of €50-60 million, the leasing of the intended 29-acre hospital site was set to be examined through the lens of canon law. The order duly petitioned the Pope to begin the transfer process.

The Pope visiting a maternity hospital

Ignoring the statements issued by the nuns’ company to the effect that services banned by Rome would be carried out in the new facility, the Vatican authorised the RSC’s plans. In a letter from canon lawyers to the Religious Sisters of Charity in March 2020, the Congregation for Institutes of Consecrated Life and Societies of Apostolic Life consented to the congregation’s plans. This consent was, and remains, conditional on the observance by the order of certain canon laws. One of the canons referenced in the letter from Rome requires “precautions” to be taken “to avoid harm to the Church”. The definition of harm in Church law expressly includes “activity which gives rise to grave harm to ecclesiastical teaching”.

Among the ecclesiastical authorities consulted by the Holy See were Archbishop Eamon Martin, President of the Irish Catholic Bishops’ Conference, Archbishop Diarmuid Martin, then Primate of Ireland, and Archbishop Jude Okolo, the Papal Nuncio to Ireland. Speaking post-Repeal on 15 June 2020, Archbishop Eamon Martin, an avowed opponent of abortion, told a Catholic news outlet that he supported the RSC’s request and had relayed to the Vatican that there was “a serious need for a proper National Maternity Hospital” in “contemporary Ireland”. In his correspondence to the Vatican on the subject, the Archbishop pointed out that the work of a maternity hospital ought by definition to be pro-life and emphasised that the carrying out of abortions or morally illicit medical procedures at the maternity hospital would be “repugnant to clearly enunciated Catholic moral teaching”.

Archbishop Eamon Martin

Two months after receiving the letter from Rome, on 8 May 2020, the nuns announced the Vatican’s decision, in a piece they headlined, ‘Religious Sisters of Charity to gift to people of Ireland lands at St Vincent’s Healthcare Group to the value of €200 million’. Sr Patricia Lenihan emphasised that “the final steps” towards the RSC’s departure from the company they founded were now being formalised. Echoing her predecessor, Sr Mary Christian, she expressed confidence that “St Vincent’s Healthcare Group Board, management and staff” would “continue to provide acute healthcare services that foster Mary Aikenhead’s mission and core values”; and underlined that the RSC would “not be involved in St Vincent’s Healthcare Group going forward”. Sections of the mainstream media unreservedly welcomed the congregation’s announcement.

Government’s response

Gliding over the marked emphasis on the Catholic Aikenhead values, Minister Simon Harris responded by saying: “today’s announcement by the Sisters will remove any remaining concerns that a religious influence might be brought to bear on the governance of the new National Maternity Hospital at Elm Park”. Referencing Mulvey, he continued: “the [RSC’s] announcement will also pave the way for the finalisation of the legal framework which will protect the State’s investment in the new hospital and ensure that the new National Maternity Hospital will have clinical and operational, as well as financial and budgetary independence in the provision of maternity, gynaecology and neonatal services”.

Dáil opposition

Strong opposition to the government’s plan to gift the new facility to the congregation was voiced in Leinster House. A well-attended briefing on 26 April 2021 organised by Deputy Roisin Shortall led to the formation of an all-party group. Deputies on all sides of the House engaged with the fundamental question: “should the new maternity hospital be secular and public or Catholic and private?”. The day before a Dáil debate on the issue on 23 June, the nuns’ company issued a statement baldly claiming that “all medical procedures” were “available in SVHG hospitals, including pregnancy termination, tubal ligation and gender reassignment procedures”.

Roisin Shortall TD

These extraordinary claims fly in the face of the Vatican’s conditional consent, the Church’s teaching on healthcare, the Irish bishops’ healthcare code and the congregation’s Aikenhead values. The Group is legally bound to uphold the pro-life philosophy of the RSC, which stipulates that “the sanctity of life belongs to all persons from conception to their natural end”. Responding to the company’s claims in thejournal.ie, Peter Boylan quoted the RSC’s healthcare code:

Religious Sisters of Charity ‘Health Service Philosophy and Ethical Code’

Direct abortion is never permitted since it constitutes the intentional killing of the unborn. Also any procedures, the direct purpose of which is to destroy the embryo at any stage of its development, whether by preventing it from implantation, or removing it from the womb before it is viable, or by any other procedure is not permitted… Direct sterilisation of either men or women is not permitted in our healthcare services when its sole immediate object is to prevent or eliminate fertility. Extracorporeal conception as it is attained, for example, in the process of in-vitro fertilisation, bypasses the marital act, and is not permissible in our healthcare services.

 

The claims made by the Group were, and are, improbable. The statement that abortions are “available” in Vincent’s hospitals can only be true in the rare event that the procedure is necessary to save a woman’s life. Other assertions defy credibility. Requests for tubal ligations have never been granted in Vincent’s hospitals, according to consultant obstetricians and representative groups. The further claim that gender reassignment procedures — banned by Rome — are available in these facilities is belied by the fact that such surgery is not carried out anywhere in Ireland.

Unconvinced by the Group’s assertions, the Dáil unanimously passed a motion on 23 June 2021 calling for the new maternity hospital to be fully owned and governed by the State.

Unconvinced by the Group’s assertions, the Dáil unanimously passed a motion on 23 June 2021 calling for the new maternity hospital to be fully owned and governed by the State.

Catholic lay trusts

Behind the corporate claims lies the legal reality of Catholic lay trusts. Church lawyers in both the Vatican and Ireland have evidently satisfied themselves that, from a canon law perspective, the companies set to acquire the nuns’ assets are successor bodies to the RSC. This is a tried and tested model that has been used for decades by religious congregations worldwide to resolve succession issues. Proofs that both St Vincent’s Holdings and St Vincent’s Healthcare Group are Catholic lay trusts, not unlike the Edmund Rice Trust, lie in the incoming constitutions of both companies.

Vatican lawyers with the Pope

St Vincent’s Holdings

The first feature of note in the constitution of this company, whose formation was announced by Sr Mary Christian, is how the RSC’s new ownership vehicle is joined at the hip to St Vincent’s Healthcare Group. The holding company’s main object is “to advance healthcare in Ireland … through the S. Vincent’s Healthcare Group and to reflect compliance with national and international best practice guidelines on medical ethics”. It is clear that all roads, however dimly lit, lead back to the congregation. The Aikenhead values are cited, verbatim, as the holding company’s “core values”. Its directors are obliged to “be true” to these Aikenhead values, an obligation that binds them to the ethos of the Religious Sisters of Charity. Ethical compliance may be enforced through employment contracts and leasing arrangements.

Its directors are obliged to “be true” to these Aikenhead values, an obligation that binds them to the ethos of the Religious Sisters of Charity. Ethical compliance may be enforced through employment contracts and leasing arrangements.

St Vincent’s Healthcare Group

Underneath St Vincent’s Holdings in the corporate pyramid sits St Vincent’s Healthcare Group. The revised constitution of the Group dovetails seamlessly with that of the holding company. The Group’s current legal duty (“to conduct and maintain the Facilities in accordance with the Health Care Philosophy and Ethical Code of the Religious Sisters of Charity”) now appears in its new guise as a legal obligation ‘”to conduct and maintain the Facilities in compliance with national and international best practice guidelines on medical ethics”, the wording used by Sr Mary Christian in 2017. Mary Aikenhead is name-checked. Behind the mantra of best-practice guidelines on medical ethics stands the Foundress of the congregation. The constitution even references her mission: the Group professes “in the continuation of the fulfilment of this [Aikenhead] mission’ to ‘be true” to these Catholic values, an undertaking that binds the company to the ethos of the RSC.

The constitution even references her mission: the Group professes “in the continuation of the fulfilment of this [Aikenhead] mission’ to ‘be true” to these Catholic values, an undertaking that binds the company to the ethos of the RSC.

National Maternity Hospital at Elm Park DAC

Elm Park

The revised constitution of the latter company treats the National Maternity Hospital at Elm Park DAC as just another facility: there is no derogation here for the new Elm Park entity.

If the congregation acquires the planned maternity hospital, the new hospital company, the ‘National Maternity Hospital at Elm Park DAC’, will be just another Vincent’s facility at the bottom of the corporate hierarchy, wholly controlled by its corporate owners, St Vincent’s Holdings and St Vincent’s Healthcare Group. The revised constitution of the latter company treats the National Maternity Hospital at Elm Park DAC as just another facility: there is no derogation here for the new Elm Park entity. On the contrary, the Group retains for itself the power to draw up overall policies, including on healthcare, for the maternity facility; to lay down plans, procedures, requirements, rules and regulations, including for discipline, staffing, teaching, patient care, and ‘research, medical, nursing and surgical services and treatment of all kinds’.  In further contravention of the ‘clinical and operational, as well as financial and budgetary independence’ promised by successive ministers for health, the Group is to act as the maternity hospital’s ‘supervisory body’ and is even empowered ‘to appoint or direct the appointment of the Medical Consultant personnel/staff and Medical personnel/staff’.

In further contravention of the ‘clinical and operational, as well as financial and budgetary independence’ promised by successive ministers for health, the Group is to act as the maternity hospital’s ‘supervisory body’ and is even empowered ‘to appoint or direct the appointment of the Medical Consultant personnel/staff and Medical personnel/staff’.

The “licence arrangement”

These extensive controls over the new facility did not go far enough for the company. Refusing to relinquish the freehold ownership of the land, the Group demanded an operating licence to run the new hospital as a fundamental condition of the lease it proposed to grant the State. The nuns’ company had repeatedly refused to hand over the land on which the hospital was to be built. In May 2017, the Group informed the Department of Health that they would not “countenance any sale” of the land or “any separate ownership of a hospital on site”. The company’s brief, issued on 22 June 2021, talked again about “seamless care pathways”, “transfer protocols”, and “increased risk to patients”.

Jack Lynch at the opening of St Vincent’s in 1970

These reasons are entirely at variance with what the HSE risk and audit committee heard on 10 May 2020. Board members were informed that the “legal framework” under discussion with the State was “developed in circumstances where, at the outset, the Group indicated that it was only agreeable to providing a site for the hospital by way of a licence arrangement [emphasis added]”. This was agreed by the Department of Health as far back as June 2017.

The ‘licence arrangement’, the HSE committee was informed, would grant the National Maternity Hospital at Elm Park DAC “full rights to carry out and provide health services in the NMH areas of the building”. This is belied by the Group’s revised constitution, which does not envisage any such spatial distribution of powers. On the contrary, the powers to be exercised by the nuns’ company over the new maternity hospital company are without limitation.

The “legal framework”

The objective of the “legal framework”, as successive ministers have repeatedly stated, is to “protect the State’s investment in the new hospital and ensure that the new National Maternity Hospital will have clinical and operational, as well as financial and budgetary independence”, a mantra that now looks hollow.

HSE minutes show that the legal framework consists of just two substantive documents, the lease and the licence, both evidently drawn up by St Vincent’s Healthcare Group to protect its own interest and that of the congregation. The other documents in the bundle are a grant agreement authorising the release of monies for a pharmacy at St Vincent’s University Hospital (already completed); the extension of a for-profit car-park owned by the RSC (nearing completion); and two option agreements (covering improbable circumstances). Missing from the legal framework are the constitutions of the RSC’s successor companies. These, the only documents in the public domain that set out the legal realities behind the corporate spin, did not form part of the file presented to the HSE committee.

HSE minutes show that the legal framework consists of just two substantive documents, the lease and the licence, both evidently drawn up by St Vincent’s Healthcare Group to protect its own interest and that of the congregation.

HSE consent required  

The risk and audit committee has yet to satisfy itself in relation to such questions as to how the State’s investment in the new hospital will be protected, as well as even more intractable issues of ethos, services and governance. Stephen Dodd, SC, whose opinion was sought by a lobby group in relation to the possible compulsory purchase of the Elm Park site by the State, recently described the Vincent’s proposals under consideration as “byzantine in their complexity, almost Kafkaesque, from which it is difficult to clearly ascertain with certainty key matters of ownership, control and governance”. Holles Street applied to the HSE for consent to the proposed transfer of ownership from itself to the nuns’ companies in September 2020. This consent, a reserved function of the board, is critical. The NMH is under contract to the HSE to provide a wide range of obstetric and gynaecological services that today include abortion. Not unlike the Vatican, the HSE must satisfy itself that there will be no adverse effects on service provision arising from the takeover by the nuns’ companies.

Holles Street

On 25 June 2021, the HSE board discussed “significant concerns” about the level of assurance provided by the “legal framework”. The HSE’s concerns, flagged by the risk and audit committee, relate to “the proposed ethos of the hospital and the services it will provide”; the protection of ‘the State’s financial investment (both capital assets and revenue funding)’; and, “in particular, the appropriateness of the proposed ‘governance arrangements”. These concerns are to be addressed through “a number of amendments” to the legal framework. This thinking might change if board members had sight of the incoming constitutions.

The HSE would do well to remember that the State is powerless to direct the activities of private providers. Simon Harris, when Minister for Health, was blocked from mounting an independent inquiry into patient health and welfare at Holles Street In 2018, following the tragic death of a young woman at the hospital two years earlier. She lost her life as a result of what the High Court heard was “a cascade of negligence”, after her aorta had been accidentally torn during routine surgery for an ectopic pregnancy.

Minister Simon Harris

The ship sails on

Although the latest proposals from the Group change nothing, magical thinking prevails around the legal framework. While the nuns’ company recently proposed to extend the number of public interest representatives on the board of the National Maternity Hospital at Elm Park DAC, the new entity is set to be wholly under the ownership and control of two Catholic lay trusts. Nor will the doubling of the terms of the lease enable the government to take control of the hospital site, as claimed by sections of the media. The licence supinely agreed by the Department of Health, which grants the Group operational control over the new facility, strips away many of the characteristics of ownership that would otherwise reside in the lease proposed to the State. So, whether the lease runs for 99 years or 999 hardly matters.

The ship sails on, albeit under the lodestar of canon law. The RSC still intend to divest themselves of their assets after — but not before — they have acquired the new hospital entity. The State is still intent on gifting the new facility to the congregation, the government still bent on building the facility on Church-owned land.

Only the numbers have changed.

The new build is now set to cost in excess of €800 million, an estimate (June 2021) now outdated due to the rise in building costs. Despite this, only the shell of the building is to be publicly-owned. If the deal goes through, the hospital company will be owned by the congregation, and by their Catholic successor companies. Hapless taxpayers will also be forced to pay, in perpetuity, the running costs of the new hospital, some €60 million annually (NMH’s current funding), in addition to the €320-odd million (the Group’s present allocation).

Irreconcileables  

The order’s statement in 2017 that it was “ending” its involvement in St Vincent’s Healthcare Group doesn’t bear scrutiny. The congregation still owns its hospitals and associated lands, and, as sole shareholder, it still nominates Group directors. Secondly, take the assertion that the RSC would ‘not be involved in the ownership or management of the new National Maternity Hospital’. While this may well be true in a limited corporeal sense, this is as far as it goes. The company that the nuns founded, St Vincent’s Healthcare Group, whose directors they have nominated for the past twenty years, will continue to run the show after the congregation leaves the pitch. The claims made for the “independence” of the new holding company don’t stand up, either. There is, as Stephen Dodd, put it, “an ongoing chain of connection” between RSC appointments and St Vincent’s Holdings. This is an entity that was formed by the Group’s directors: the holding company’s board currently consists of three directors of the Group, one of whom is its chair. The holding company is to nominate the board of the Group from here on in, so it looks to be an enduring self appointing circle.

The company that the nuns founded, St Vincent’s Healthcare Group, whose directors they have nominated for the past twenty years, will continue to run the show after the congregation leaves the pitch.

Eamon De Valera and Lynch at St. Vincent’s 1970 with Mother M. Canisius

The central claims made by St Vincent’s Healthcare Group in June 2021 lack all credibility. Take one, that ‘the new National Maternity Hospital will be clinically independent’. This is belied by the sweeping powers — reinforced by the operating licence — to be exercised by the Group over “the Facilities”. No derogation for the new Maternity Hospital at Elm Park DAC is provided for in the revised constitution of the Group.

The endlessly repeated claim that ‘all medical procedures, in accordance with the laws of the land, are available in SVHG hospitals, including pregnancy termination, tubal ligation and gender reassignment procedures’ is baseless. The code of the Religious Sisters of Charity quoted earlier prohibits “direct abortion” and “direct sterilisation”. St Vincent’s Healthcare Group is a self-declared Catholic healthcare provider, whose current constitution binds it to adhere to the RSC code. Gender reassignment surgery is not performed in the State.

The claim that “that there will be no religious or Vatican influence” goes to the heart of the controversy surrounding the new maternity hospital.  This claim is embedded in a deeply disingenuous assertion, that “the SVHG values of dignity, compassion, justice, quality and advocacy are not owned by any religious or secular organisation”. This is an extraordinary disavowal: it ignores the way in which the Aikenhead values have been used repeatedly both by the nuns and by the Group itself to reference the ethos of the congregation. As the Group states in 2019, the philosophy of the company is “based on that of the Religious Sisters of Charity”; and “the values underlying the philosophy … are those of human dignity, compassion, justice, quality and advocacy”. These, the Aikenhead values, “are based on the mission and philosophy of the Religious Sisters of Charity”. Nothing could be clearer. In the revised constitution, the Group undertakes to continue Mary Aikenhead’s evidently religious mission. How can the company now suggest that the Aikenhead values are not Catholic?

In the revised constitution, the Group undertakes to continue Mary Aikenhead’s evidently religious mission. How can the company now suggest that the Aikenhead values are not Catholic?

The nuns can hardly be comfortable with the assertions made by St Vincent’s Healthcare Group in June 2021, which still appear on its web-site. These have the potential to jeopardise a key RSC objective: the canonisation of Mary Aikenhead, a project begun by the nuns a hundred years ago, in 1921. Why has the congregation allowed the Group’s claims to stand? And why have Church authorities turned a blind eye?

Catholic lay trusts

Dr Harold Quinlan receives a commemorative medal for medical services from Archbishop McQuaid at Elm Park.

The reason is not difficult to fathom: Church authorities have satisfied themselves that St Vincent’s Holdings and St Vincent’s Healthcare Group are both Catholic entities. It follows that if the Aikenhead values are Catholic, then so are the companies that profess to be true to them. The Vatican would never have countenanced the transfer of a €660 million Catholic healthcare enterprise to a non-Catholic company, nor would the Church authorities in Ireland have permitted it. The proofs given by the congregation to the Vatican in or around 2019 demonstrating that no abortions or other banned activities will take place in the new facility have evidently been found to be satisfactory. Canon lawyers in both the Vatican and Ireland are clear in their determination that the Aikenhead values reference Catholic doctrine, and that they underpin the “best practice guidelines on medical ethics” set to govern all activities in Vincent’s facilities.

The will of the people

For the government to look to the so-called “legal framework” to resolve these contradictions is to ignore the fundamental principle unanimously affirmed by the Dáil on 23 June 2021: any hospital built and maintained by the State should be fully owned and governed by the State. It is now blindingly clear that the nuns’ ethos will endure through their successor companies. Only a publicly-owned hospital can guarantee a secular ethos.

Set beside the legal realities of the incoming constitutions, the claims made for the  clinical, operational, financial and budgetary independence of the new hospital company are groundless. Multiple layers of control — reinforced by the operating license given to the Group over the National Maternity Hospital at Elm Park DAC — have been built into these constitutions. No amount of tinkering with the legal framework will change this. Further, the State is powerless to direct any Catholic entity to provide services that it declines to provide, such is the power of private ownership.

Savita Halappanavar

Leading members of the Coalition strongly supported the repeal of the Eighth Amendment. The tragic death of Savita Halappanavar still casts a long shadow. The question for the government is: will it risk alienating the 66 per cent of the electorate who voted to repeal the Eighth by persisting in its plans to build the new facility on the nuns’ land? Gifting the new facility to the Religious Sisters of Charity could lose them the next election. It would also pave the way for the ‘culture wars’ — and the courtroom battles they give rise to — now being played out in the United States’ Supreme Court over abortion.

This picture shows the bottom of page 16 and the top of page 17 of the 1971 St Vincent’s annual