Privatisation and hospital lease
Deputy Pringle criticises the Taoiseach's record on privatisation and argues the maternity hospital lease is being dressed up as public ownership. The Taoiseach defends leasehold as common, rejects any privatisation characterisation, and says the legal documents and guarantees ensure lawful services and public ownership.
Deputy Naughten is next on my list but he is not here. Does somebody else from the Regional Independent Group want to take his slot? No. That is odd. We will proceed to the Independent Group. I call Deputy Pringle.
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I sat in the Taoiseach's office in 2016 following a general election as he was making his first attempt to ascend to the position he now holds. We talked at some length about privatisation within healthcare. I remember he used the private Bon Secours hospital in Cork as an example of private healthcare's over-reliance on the public system and the public purse to prop up its operations. He told me he was committed to the public provision of healthcare. Perhaps as a former leader of the Labour Party said, "Isn't that what you do during an election?" The Taoiseach's actions today speak volumes and tell me that his words to me on that day were not what he believes.
The spin machine has been working overtime this morning. The Taoiseach has been quoted as saying he has "no doubt that all the guarantees are there". The Minister for Health, Deputy Donnelly, said, "There will never be any religious influence on the services." The Minister for Justice said she is confident that the hospital will be secular. The Minister for Children, Equality, Disability, Integration and Youth, Deputy O'Gorman, said that the past two weeks have provided absolute clarity on the secular status of the new hospital. The women of Ireland know that talk is cheap, particularly talk from Fianna Fáil, Fine Gael and the Green Party. Over the course of the hearings held during the past two weeks, a number of questions, including questions I tabled to the Minister for Health last Thursday, remain unanswered despite the Minister's promise that answers would be forthcoming.
The recurring issue has been the unexplained term that appears like a rash throughout the various contracts, licences, constitutions, leases, fact sheets and option agreements. That phrase is "clinically appropriate". The Minister, Deputy Donnelly, initially explained that the term needed to be included to prevent St. Vincent's from turning the place into a drive-through McDonald's or the likes. That explanation holds no water and no better explanation has been put forward since. The National Maternity Hospital, Holles Street did not put that phrase there. St. Vincent's Hospital holding company, or whatever you are having yourself, said it did not put it there. The representatives put forward by those organisations at the committee meeting last week said they were happy for it to be removed and yet it is still there. Why? Its removal would go a long way to removing the ambiguity that the spider's web of corporate structures has created. It does not need to be clarified; it needs to be removed.
We all agree that the hospital should be a public hospital on public land. The Government even supported Deputy Joan Collins's Private Members' motion in that regard. As the Government appears to be hell-bent on ploughing on with a second-rate option, will it commit to the removal of the term "clinically appropriate" from all documentation relating to the development of the new maternity hospital? That is within the control of the Taoiseach and it emanated from a Government Department.
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I will respond to the Deputy's comments and remarks. On the issue of ownership, I must be strong because this debate is focused on the nature of leasehold versus freehold ownership.
Leasehold ownership is very common across the State. It is not some new concept. It has been clarified that leasehold ownership is common-----
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I did not ask that question. I did not ask about ownership.
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The Deputy talked about State ownership and said that I had no commitment to State ownership.
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My question was not about ownership.
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I will come back to the Deputy's question. I have three minutes but I am entitled to refer to points that the Deputy made, in terms of the ownership question. This is a publicly-owned hospital. That is the point. I am not going to allow people to stand up and say that it is not a publicly-owned hospital, that there is somehow a private agenda. It is anything but a privatised agenda.
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It is a publicly-owned hospital and given the way healthcare is evolving, there will be more of this. Healthcare has evolved over the last 100 years through different methods, in all countries, with non-religious voluntary hospitals like St. James's Hospital, which have their own independent governance mechanisms, and voluntary hospitals like St. Vincent's hospital. We have to deal with where we are and move on and co-location was the origins of this.
In terms of the issues in relation to lawfully and legally permissible, all of the legal documentation is there and all of the guarantees are there in terms of legally permissible and lawfully permissible services. The HSE put in the term "clinically appropriate" - not the other interest, but the HSE - to protect the maternity hospital and to ensure that it would provide maternity facilities and services, gynaecological services and the full range of clinically appropriate activity that happens in maternity hospitals, as opposed other uses being made of the maternity hospital or of facilities within the hospital. The lease is clear on that as well, that it has to be used as a maternity hospital.
Attempts have been made to conjure up the idea that there is some conspiracy behind the utilisation of that language but there simply is not. Stating that there is does not make it a reality. There simply is not and time will prove this. Time will prove it but if the Deputy does not want to take my word for it, the clinicians in Holles Street are very clear about this. They provide all legally permissible services now, from termination right through. There is no issue in the hospital at the moment and there will be no issue in terms of the new hospital either. That is the reality. This has been debated now for seven years or nine years and it needs to be brought to a conclusion. There are three contracting parties to it, namely, the HSE representing the State, St. Vincent's Holdings and the National Maternity Hospital. There has to be a partnership arrangement on the site because it is a very expansive medical and hospital campus. That is the objective and the rationale is a bone fide, noble one.
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The problem is that the term "clinically appropriate" is not accepted because nobody really knows what it means. The Taoiseach has had to give lots of convoluted explanations today as to what it means to try to get it over the line. Why is the Government so hung up on it when everybody agrees that if those two words were removed from the lease, it would be acceptable? Indeed, even at the meeting of the Joint Oireachtas Committee on Health last Thursday evening Professor Peter Boylan and Mr. Simon McGarr, who were there to object to the lease, said that as a best case, if those words were removed it would be a reasonably acceptable lease. Why is the Government still hanging on to it? That is the question that must be asked and answered. Unfortunately, the Taoiseach is not going to answer it. If the Government removes those two words, it would solve the problem. The problem would go away but the Government is not willing to do it. Why?
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If that is the case then why, for the last two weeks, have we been arguing about ownership? Now the Deputy is saying to me that last night that all disappeared.
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Did the Taoiseach not watch the committee?
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The Taoiseach obviously was not watching the committee-----
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What I am saying is that over the last fortnight, or for the first week or ten days of this debate, from all sides of the Opposition, it was all about ownership. In other words, this keeps shifting and the goalposts keep changing. There is an element of that but what we must do is address the real concerns people have in terms of what can happen in the hospital and what services can be permitted. The Government received very strong legal advice, the strongest of legal advice, that the legal guarantees mean that all services which are lawful in this State not only will be, but have to be, permitted.
The directors of the hospital are obliged to ensure the provision of all legally permissible services. That is the point. The legal guarantees have been given and address all of the issues raised by people genuinely.