We are a little behind schedule, so I ask for full co-operation, on every side, regarding the time limits. I call Deputy McDonald.

Yesterday, I raised with the Taoiseach the real and serious concerns held by many regarding the ownership of the new national maternity hospital. The Taoiseach dismissed these concerns again and doubled down on his characterisation of this issue as a "red herring". However, last night in a letter to the Oireachtas Joint Committee on Health, two HSE board members, Professor Deirdre Madden and Dr. Sarah McLoughlin, restated their strong opposition to the ownership deal. In the letter, they describe the ownership deal as "unsatisfactory" and state:

While the shares have since been transferred from the [...] Sisters of Charity to a new company, St Vincent's Holding CLG, we believe that in the interest of the public trust and confidence in this new project, there should be absolute clarity on the separation of Church and State.

They go on to observe that the necessary public trust and confidence "would be better achieved if the State owned the land on which the hospital [will be] built". Now that comes from two eminently qualified professionals who were centrally involved in planning for the new maternity hospital. Their concerns, it must be said, mirror those held by many of us on the Opposition benches and, indeed, by many Deputies on the Government benches, as well as by people right across society.

I put it to the Taoiseach that the best way to allay fears and to resolve this problem is for the Government to secure full public ownership of the land and for us to have a clear transaction in which the St. Vincent's Healthcare Group, SVHG, transfers the land directly to the State. That after all, was the initial promise or undertaking from the Sisters of Charity. This would provide absolute, airtight clarity. It would ensure the best protection of the State's interest in what will be a very expensive project. Additionally, it would ensure it is the State’s health authorities that set the range of and the clinical governance for services provided at the hospital.

I think this is just a matter of common sense, but the Taoiseach has pushed back against this common sense in claiming that the current labyrinthine arrangements amount to public ownership. They do not. Repeating the refrain of a "tenner a year" does not change that reality. There is no doubt in my mind that the St. Vincent’s Healthcare Group has to move. It must step up to find a resolution to this issue, but this Government must also step up. Through inaction, the Government will be acquiescing to and colluding in a deal and an arrangement that does not fully protect the public interest.

Tá bunús maith leis an imní maidir leis an ospidéal máithreachais nua. Léiríonn na saincheisteanna tromchúiseacha a léirigh an tOllamh Madden agus an Dr. McLoughlin go bhfuil an imní chéanna ar dhaoine ar fud na tíre. Is é an bealach is fearr chun an fhadhb seo a réiteach ná don Rialtas úinéireacht Stáit ar an talamh a aimsiú. We all want to see this hospital built and built quickly. It can and must represent a huge step forward for the modern, progressive healthcare that women in Ireland deserve. Therefore, I put this proposition to the Taoiseach again in the hope, more than the expectation, that I will get a clear answer. Will he, the Tánaiste and the Minister for Health get around the table with representatives of the SVHG and convince them to transfer that land directly to the State?

Ar dtús báire, tá na geallúintí dleathacha ann ionas go mbeidh gach seirbhís atá dleathach sa tír seo faoi láthair agus sa todhchaí ar fáil san ospidéal nua. Níl aon amhras faoi sin agus tá comhairle dhleathach faighte agam féin agus ag an Rialtas gur sin an scéal. Is turas fada a bhí ann go dtí an lá seo. Caithfidh mé é sin a rá. The 300-year lease at €10 a year is effective ownership. I have received legal advice to that effect. It is ownership. Deputy McDonald may disagree, and it is her entitlement to disagree. I have read the letter from Professor Madden and Dr. McLoughlin. They make the point that at the time of the HSE board's decision on 14 March 2022, the transfer of shares in SVHG from the Religious Sisters of Charity had not occurred "and we held concerns regarding realisation of that transfer". They go on to state:

While the shares have since been transferred from the [Religious Sisters of Charity] to a new company, St. Vincent's Holding CLG, we believe that in the interest of the public trust and confidence in this new project, there should be absolute clarity on the separation of Church and State.

Now there is absolute clarity on the separation of church and State, and that is contained in the constitution of the new hospital, which has reserved powers. Those make it very clear that there can be no "religious ethos or any ethnic" or other consideration in the deliberations of the hospital. That is clear in the reserved powers in the constitution of the hospital. The Minister's golden share gives him or her the power to enforce and to oblige the directors to follow through on those reserved powers and implement them. Additionally, the operating licence given by the HSE to the new hospital board also puts that obligation in place.

What I do not get, and what no one has answered to date, and I asked this last week as well, is how there is differentiation in the context of a 300-year lease at €10 a year and ownership.

I have the conditions here, so let us not pretend it is €850,000; it is not. If you read any of the conditions on the lease, they are normal conditions that would apply to everybody. The tenant with prime responsibility for the funding of public hospitals remains the tenant under the lease. That is not an imposition. There is no change to the permitted use without the consent. That is not an imposition.

Read the definition-----

I am not talking to you, Deputy. It is going to be built as a hospital. I have read it all. There are no impositions in this. It is basically saying "Go and build a maternity hospital". Let us for the sake of clarity accept that. Let us not try to cloud in terms of the conditions of this. None of these are an imposition on the maternity hospital. In fact, it is a co-location. The question I want to put to the Deputy is that nobody has explained to me how the difference between a 300-year lease at €10 per year and outright freehold ownership materially affects the governance or the clinical, operational or financial independence of the hospital. Nobody has actually explained the how of that to me. People might not be happy. They might want freehold versus leasehold but there is no clear indication, following the articulation of that view, as to how that materially impacts, in real terms, on the operational, clinical or financial independence of the new maternity hospital. Yesterday, I quoted a letter from the ten directors of midwifery services and assistant directors. The Minister has also received correspondence from a very significant number of midwives - all the directors of midwifery in all of Ireland's maternity hospitals - and they are unanimous in their support for the move of the national maternity hospital from its current inner-city location to a new purpose-built world-class facility on the campus of St. Vincent's University Hospital, Elm Park.

As the Taoiseach knows, for a very long time, midwives, clinicians and all concerned - and women of course - have been very much in favour of a new maternity hospital and proper investment in maternity services. That should not surprise any of us. The Taoiseach said there is an unanswered question. Let me put this to him. He says that €10 a year for 299 or 300 years is effective public ownership. The question is this. That being the case, why is it that there has not simply been a clean transaction and a transfer of this land to the State? That is actually the question. If the Taoiseach is saying that it is public ownership in all but name, why is it not full public ownership? That is the first question. The second question is this. Given that the State is the key anchor of the voluntary hospitals, including St. Vincent's University Hospital, which receives substantial State money, the Government has a very powerful hand to play. Why is it that the Taoiseach is resisting my very reasonable request-----

Time is up, Deputy.

-----that he, the Tánaiste and the Minister for Health lead from the front and resolve this issue?

I thank the Deputy and call the Taoiseach.

Why not make public ownership in all but name actual, legally certain public ownership of this land? That is actually the question.

I have led from the front on this. I have asked the Minister for Health over the last year to get this issue resolved once and for all because it has been going on since 2013. The previous Minister for Health, Deputy Harris, brought in Kieran Mulvey, for example, to bring all the parties together. Let us not pretend there has not been detailed, exhaustive engagement between all parties to this over the past nine years. We have led on this and I am determined that we get something done and get the hospital built for the benefit of women and newborns.

In relation to the Deputy's question, there is an argument in terms of the integration of a massive tertiary hospital that is currently on the site. This is going to be a campus, including the existing tertiary hospital and the maternity hospital. It needs to work. I can understand where the St. Vincent's Healthcare Group is coming from on that point. I might not agree with it but I can understand. I do not see a big mystery or conspiracy there. I genuinely do not.

I am not arguing there is a conspiracy; I am arguing for public ownership.

Some are. What is the issue then if the Deputy is not arguing there is a conspiracy?

I thank the Taoiseach.

At some stage, we have to take people at good faith in regard to this.

Táimid ag bogadh ar aghaidh go dtí an chéad cheist eile.

Otherwise, we will never get movement on it.

It should be a public hospital.