Yesterday in Questions on Promised Legislation, the Taoiseach stated the issue should have been raised in Leaders' Questions. He is getting those questions today because he still has not clarified his position on the new national maternity hospital. The decision to locate a State-built and funded, much-needed, modern national maternity hospital without clear clarification as to ownership of the site or governance and ethos of the hospital has resulted in the present mess. That mess has developed - and here I disagree with the Taoiseach - over the last century because of the role of the State and of vested interests in the way our hospital and health services are run. Regarding the new national maternity hospital, we face, because of the role of the church and through the Religious Sisters of Charity, what is called a very complex situation. It has developed into a complex situation and it is an issue we must deal with.

The situation in relation to the new national maternity hospital is a test for the Government and for the people, particularly women, of Ireland. Are we to have high quality, free to use public services as a right for all in a modern secular republic? Alternatively, will we have a shabby compromise with the State spending at least €800 million to build a hospital on land we do not own, funding 100% of the cost of staff, the board of governors nominated by a private charity and no certainty that all medical procedures legal in the State will be provided to women who need them? Rights are exerted, charity is bestowed. We must move away from this. I heard what the Taoiseach said before but this is the line we have to get it over.

I know what the preference of the Taoiseach and the Minister, Deputy Stephen Donnelly, is, but the stance the St. Vincent’s Healthcare Group outlined yesterday was that it must retain the land to have control of clinical governance for operational reasons, including the provision of a safe, integrated system of care for patients. If that is the case, the Taoiseach must prepare for CPO of the land. If he thinks that cannot take place because of cost, length of time or whatever, he must be prepared to move away from that site. He must make that clear to the Religious Sisters of Charity who he is negotiating with over the coming days. Seemingly, they have been out of the system since 2017 but now are a key part of it again.

The key motivating factors behind the decision to co-locate the National Maternity Hospital, Holles Street, with St. Vincent’s were safety, optimal healthcare and outcomes for women and babies plus the deteriorating conditions in the existing physical facility of Holles Street. Those were the key motivating factors in the decision, eventually announced in 2013 after ongoing discussions between the two voluntary hospitals, to co-locate the new national maternity hospital on the St. Vincent's site.

The expert medical view and all international research says that maternity should not be stand-alone. It is a feature of the improvements in our health service that we locate a maternity hospital adjacent to and integrated with a major national tertiary facility so that if women become ill, have certain conditions and so on, the expertise is on-site to intervene quickly to save lives. The fundamental motivating public interest in this is to save lies and have better outcomes in circumstances where risks are present. That does not happen across the vast majority of maternity care but the informed advice and recommendations to successive governments has been to co-locate maternity and neonatals in tertiary hospital settings. That will apply to Limerick, is in Galway and will have to apply to the Coombe and the Rotunda hospitals as well.

The difficulty here was that this location was on a private hospital group owned by a religious order. That issue has dragged on since 2013. First, there was a dispute between the two hospitals as they endeavoured to reach an agreement. Kieran Mulvey mediated between them and produced a report in 2016. In 2018, planning permission for a new hospital was secured. Enabling works were completed thereafter, in terms of a pharmacy and car park. That is where we are now.

A CPO is easily called for but, coming back to the original objective, if we move off-site, what tertiary hospital do we suggest it should go to? If we CPO, is everybody in the House prepared to say we will wait another number of years as conditions deteriorate? These obvious questions arise in the event of a CPO. We know how long CPOs go on.

That said, the three fundamental points I mentioned that have to be addressed relate to ownership, governance and, without question, the fact that there can be no religious involvement, good, bad or indifferent, in the running of the hospital or in what is allowed there.

We all want a safe modern national maternity hospital. No one challenges that. No one challenges the preference that it be co-located. The KPMG report in 2008 indicated that and the Government went by that report. However, eight years on from 2013 and 13 years on from that report, we are in a situation where the Religious Sisters of Charity still have control over this hospital being built.

The St. Vincent’s Healthcare Group said it must retain ownership of the lands for clinical governance and operational reasons, including the provision of a safe, integrated system of care for patients between the hospitals. The group has said “No”. What is the Government prepared to do? We back the Taoiseach on this. Everybody outside this building supports this being owned by the State and Government for the people of Ireland.

I thank the Deputy for her contribution. I do not accept the argument the hospital group has put forward that the ownership of the site is essential for the safe, integrated system of care. One can deploy many mechanisms to ensure safe integrated systems of care between two hospitals. The ownership of the site is not critical to that. Given the hospital, in terms of the negotiations that are under way, is in the ownership of the State in any event, I do not think that argument stacks up at all. The St. Vincent’s hospital board will have to reflect on the consensus here and on the public interest. It has to understand the public interest. There has been enormous investment in the existing St. Vincent’s hospital, both capital and current.

The State is building a new maternity hospital and the hospital will have to clear up that point.

I thank the Taoiseach. The time is up now.

They told the previous Minister for Health, Deputy Harris, that they were not going to sell the land.