The decision to overturn planning permission for a new critical care wing at the Rotunda Maternity Hospital is deeply disappointing. The staff there provide exceptional care to women and babies. However, the building is failing them. The Rotunda is the busiest maternity hospital in Ireland and one of the busiest in Europe. Yet, vulnerable premature babies are being treated in facilities that are simply not fit for purpose and healthcare workers tell us that space constraints are already impacting on care.

We all know we have a shameful history in this country on women’s healthcare. The legacy of the draconian eighth amendment, the bans on contraception and the barbaric practice of symphysiotomy all cast a shadow over our recent memories. The fight for better healthcare is not over for women, however. Even since 2018, women still face patronising delays and unnecessary restrictions when accessing abortion services. Now, Victorian infrastructure and, indeed, Georgian architecture, it seems, are impeding the provision of decent maternity care.

I respect An Coimisiún Pleanála, of course, but we need to build critical healthcare capacity. It is welcome that the Dublin Civic Trust has said it will not go to court if a judicial review is sought against the decision. However, it is really disappointing and frustrating for all those working in and relying on the Rotunda that so-called heritage concerns have outweighed the urgent need for decent healthcare facilities. In its decision, An Coimisiún Pleanála referenced a decade-old proposal to move the Rotunda to Connolly hospital, a plan that has not proceeded to date and, sensibly, as we know, the Rotunda has instead built clinical links with the Mater. As recently as last year, however, the Government was continuing to suggest that the move could still go ahead. It was entirely foreseeable that unless Government clearly ruled out relocation plans, such plans could be used as a stick to beat maternity care with in the planning process. That is the reality, no matter how much the Minister for Health tried to downplay it on the radio this morning.

Therefore, can the Taoiseach say with clarity if, in fact, the Government has abandoned plans to move the Rotunda? As Deputy Sherlock has asked, if that is the case, why did the Minister for Health not spend €50 to let An Coimisiún Pleanála know that as part of the appeal in the planning process? I remind the Taoiseach that the Government introduced the very planning procedures now blocking this development. The Minister spent the interview this morning on RTÉ lamenting a planning process the Government helped to create. It speaks to a long-standing lack of vision and lack of ambition for critical infrastructure. The Government is legislating around planning constraints for gas reserves and airport capacity because of ineffective planning laws. Now, a €100 million investment in neonatal care is stalled. As a Government, we are cash rich but as a people, we know we are asset poor. Creaking infrastructure is causing suffering. It is causing flaws and inadequacies in care and the Government carries the responsibility for closing the gaps. It is not good enough to give out about An Taisce or Dublin Civic Trust or anyone else on the radio, especially not with this continued equivocation. The Government is not a bystander. Its Ministers are not bystanders. What is going to happen now with the Rotunda? What will the Taoiseach do to ensure women and babies get the medical care they deserve?

First of all, the Minister for Health has expressed her deep disappointment-----

Oh, no.

-----at the decision of An Coimisiún Pleanála to overturn the position of Dublin City Council and, indeed, its own recommendation from its own planning inspector who recommended that the proposed critical care wing at the Rotunda should go ahead. I would add that it is deeply disappointing. The Minister this morning met with the regional clinical director and also the regional executive officer. The HSE will be meeting with the master of the Rotunda to review the next steps and all the plans pertaining to the Rotunda, the Mater and, of course, Connolly hospital.

The Deputy is correct. The interview this morning with the person who objected on behalf of Dublin Civic Trust was interesting. When they were pressed on whether they would object again if that particular dimension - the 2016 strategy - was removed, there was no commitment not to object again. There are no guarantees either way because other factors were taken into account.

The issue from a planning perspective is that irrespective of what happens in the long term, the critical care unit is needed now.

It is an immediate need for babies who require intensive care of that kind. About 20% of specialised neonatal care is in the Rotunda, so it is a national facility. It is not just a regional facility from that perspective. Huge numbers of women go to the Rotunda, so it is a critical resource for us.

There is an issue in terms of the prioritisation of the protection of human life over the heritage considerations. Invariably what tends to happen is that people try to marry, and do the very best they can to harmonise, developments like this. Let us not forget the Rotunda is part of the heritage as well. Are we suggesting it stands still as a building or never moves in any direction or never gets expanded? We recently opened Hampson House. I presume Deputy Bacik is familiar with that outpatient facility near O'Connell Street. It is a fantastic facility. This facilitated and opened up the opportunity to do this development. There were people working where space has now been created for the critical care wing, or part of it anyway. From our perspective, the Minister will work with all involved. The master did seek to engage with people on the ground and with Dublin Civic Trust and others. That was not, to my understanding, taken up at that particular time.

In terms of maternity development more generally, there are a number of maternity hospitals in Dublin and it is a fact that over the past 30 years or longer, we have not managed, through institutional and other issues, to get maternity hospitals located in one given site. Holles Street hospital is now moving to St. Vincent's hospital after a long row in here and argy-bargy about this, that and the other, a lot of it in my view not of substance and, quite frankly, it did not put women first. People were more worried about conspiracies in the Vatican, in my view, than women's health but there we are. Cork managed to do it. We should review the Rotunda in terms of what should happen there in the long term as well. That is something the Minister will deal with fairly quickly.

I listened carefully to the Taoiseach's response and it is more of the same. It is Government as bystander and that is not good enough. It is not good enough for the Taoiseach or for the health Minister to say how disappointed they are with a decision of an entity created by the Government. It is simply not good enough either for the Taoiseach or the health Minister-----

What entity?

You are critical of planning decisions.

What entity created by the Government?

Sorry, I did not interrupt you.

I did not get that bit.

As I have said, and I hope I get more time, it is not good enough for the Taoiseach to govern as a bystander because he is in government and, indeed, he was in the previous Government. The planning process was established by Government. It is now up to the Government to do something about this decision. What I did not hear from the Taoiseach was any clarity about the long-term plans for the Rotunda. An Coimisiún Pleanála referred to a prospective move of the Rotunda. That has not been ruled out by either the Taoiseach or the health Minister. Women and their families deserve clarity on what the plan for the Rotunda is. Is it going to stay on site? The Taoiseach referred to Holles Street hospital. Holles Street hospital has not moved yet either. We have seen very little progress on that. I have stood in the Rotunda and met the staff. I have heard from them their extreme frustration at the lack of space and the constraints in the facilities. Anyone who has been in there as a patient or who has visited people will know exactly the constraints the Rotunda is under. It is up to the Taoiseach to do something about it. He is in government and he is not a bystander.

It is a good catchy soundbite but-----

It is not a soundbite.

-----I interrupted Deputy Bacik to get clarity from her because of the outrageous, disingenuous suggestion that the Government established An Coimisiún Pleanála when the Oireachtas, through legislation, voted for its establishment.

Proposed by the Government.

Deputy Bacik knows that as a legislator and as a person with legal background. It is a creature of the Oireachtas. Yes, the Government proposed reforms but it is a creature of the Oireachtas and Deputy Bacik knows that.

The Taoiseach is deflecting.

She would be the very first person calling on a Minister to resign if that Minister tried to interfere in an independent planning process.

You had one job to do and you did not do it.

It is utter hypocrisy of Deputy Bacik to call us bystanders because we did not interfere and tell An Comisiún Pleanála that, no matter what its views are, it is to pass that along and rubberstamp it because that is what the Government wants.

That is what Deputy Bacik is saying.

Order, please.

It is disrespect to the Rotunda.

That is what the Deputy is saying.

That is not what we are saying.

All of us have met the Rotunda. All of us support the Rotunda. I have met the master and the people involved, and so has the Minister for Health.

Where is the clarity?

Deputy Bacik.

The clarity is that An Coimisiún Pleanála has made a decision. We now have to deal with that decision and we will.

It was within your power to do something about it and you did not do it.

Anois, Deputy Holly Cairns.

One in six babies in this State is born in the Rotunda. It is the busiest maternity hospital in the country by some distance and it is also the oldest maternity hospital in the world, and in many ways it feels like it. I was there yesterday to speak to the team after the devastating news that the planning permission for their long-awaited and desperately needed extension had been overturned. On Friday, as the news filtered through the hospital corridors, staff were in shock. One told me they burst into tears. They literally could not believe it because they could not comprehend how anyone could walk into that neonatal intensive care unit and deny that those babies needed more space.

I visited the neonatal intensive care unit yesterday to see the conditions myself. It is not a large room and it is stuffed full of equipment that overflows into the surrounding corridors. Right now there are seven babies in incubators in that room. Their machines are practically on top of each other and their mothers and nurses are squeezed into the spaces in between. One mum with her tiny, gorgeous baby on her chest was afraid to lean too far back in her chair in case she hit another incubator. There is no privacy, no dignity and no proper protection from hospital-acquired infections. There is about a meter between each incubator, to fit parents, nurses and equipment.

The team in the Rotunda hoped that would change when a critical care extension was built onto the hospital. That extension would have included a 20-bed neonatal intensive care unit and a 25-bed special care baby unit, as well as new labour and postnatal wards and 80 additional hospital bedrooms - a game-changer for the care of women and babies. Unbelievably, however, planning permission for this extension was revoked by An Coimisiún Pleanála. An appeals board said the extension did not represent an overwhelming public benefit "sufficient to justify the degree of heritage harm identified". On what planet is the treatment of premature babies not an overwhelming public benefit? The mind boggles.

The absurdity of that decision makes at least some sense when we realise that An Coimisiún Pleanála partially based this decision on Government policy to co-locate the Rotunda with Connolly Hospital. Listening to the Minister for Health this morning and visiting the hospital yesterday, it is clear that is not the case any more. This decision, as well as being completely mad, it is partially based on outdated information. We all agree that co-location is best practice for any maternity hospital, but it is abundantly clear to everyone that the Rotunda is not going to be co-located with Connolly. It already works alongside the Mater and that relationship should be formalised in the upcoming national maternity strategy.

Will the Taoiseach now confirm that plans to co-locate the Rotunda with Connolly Hospital will not go ahead? Will he explain why this announcement was not made before the planning decision was made? What is the Government going to do now to get this urgent project over the line and how will it do that quickly?

I believe this project is in the overwhelming public interest and that there is an overwhelming public benefit. That is why we funded about €16 million into Hampson House to facilitate decanting but also provision of a first-class service now in terms of outpatient facilities, antenatal clinics and all of that. The Government is 100% behind this project but An Coimisiún Pleanála is independent, as all TDs would want. In this House no one has ever suggested it should not be. However, I hope the Deputy will back us now when we bring forward a critical infrastructure Bill. I hope we get the House's agreement that, certainly in health, there are exceptional projects that need to bypass the planning process altogether and just get it done-----

Hear, hear.

----- in the interest of public health. Deputy Cairns has summed up the neonatal intensive care unit correctly. I do not argue with her summation of the conditions there.

Those who objected to this vital project should have taken up the invitation of the master of the Rotunda. They should have visited the neonatal intensive care unit and they should have then weighed up what they are objecting to. They have their commitments - the civic trust and others - but everybody has to weigh up the pros and cons of any given decision. In my view, in objecting to this facility, they very significantly got it wrong.

In terms of previous strategies and recommendations that were made, I do not want to invent new national maternity strategies on a whim. There is a successor to the current one. However, I know the Minister is meeting with the master. The Minister will come back to Government fairly quickly in terms of a statement in respect of how we see this now proceeding. The colocation is there in essence between the Rotunda and the Mater level 4 hospital. There is a blue light corridor there that facilitates urgent transfers and so on. In essence, it is very important we have colocation for women's health. It is absolutely an imperative. There has been a very significant and impressive development of a strong relationship between the Rotunda and the Mater. They work very closely together.

As I said, there is a protective blue light corridor to provide adults with acute services when needed. The Minister has already had meetings today on the range of issues involved and how we move this forward. The Minister will be meeting with the master, Professor Sean Daly, shortly. I am working with the Minister and Government. The Minister will come back to Government with proposals in this regard. In my view, we will have to look at all options here to get this critical care wing built at the Rotunda because there is no other immediate prospect or any short- to medium-term prospect of anything else happening, other than the critical wing being established on this site.

The Taoiseach says colocation between the Rotunda and the Mater is there in essence. Yes, I agree with him and everyone can see that. The problem the Taoiseach is talking around is that it is not there in reality in the Government's maternity strategy and An Coimisiún Pleanála brought that into its decision-making process. Part of the reason it gave when balancing it with the cultural heritage of the area was that this was not the long-term plan. However, the long-term plan has changed. The Government failed to acknowledge that, even five months ago when the appeal was put in. The Minister came out on the radio this morning and basically clarified that situation five months later.

Now, the decision has been made. There will be a massive delay in this extension happening no matter what and the Government now needs to at least take responsibility for that and admit it was the Government's strategy that misled An Coimisiún Pleanála into making this decision. That is the very least the Government could do when the delay is considered.

At the moment - I do not know how to emphasise this enough - there are 22 postnatal women sharing one bathroom. There is one bathroom between 22 women who have just given birth. All of those intensive care units for tiny premature babies are jammed into a room. There is not room for the two parents to go into see their baby at one time. This will go on even longer because the Government did not inform An Coimisiún Pleanála that the plan to colocate has changed.

The Deputy has omitted the fact that Dublin City Council approved this planning and the inspector at An Coimisiún Pleanála recommended and approved the decision of Dublin City Council. There was no expectation-----

Has the Taoiseach read An Coimisiún Pleanála's-----

Sorry, now. I know it is the job of the Opposition to blame the Government all of the time. An Coimisiún Pleanála took a decision which obviously went against the Dublin City Council decision and the recommendation of the board's own inspector, I am informed.

Has the Taoiseach read the decision?

It was a split decision as well.

There was a split decision as well but that can happen. In fairness, I do not believe in microscopic examination. People make decisions in their own right as officers of An Coimisiún Pleanála. In my view, it is the wrong decision. In my view-----

They cited the colocation with Connolly Hospital.

Allow the Taoiseach to respond, Deputy.

Anyone who knows anything about this and sought to know anything about it would know that this critical care wing is needed now. It is not needed in five, ten, 15 or 20 years' time.

It is needed now, as Deputy Cairns has articulated, because we are all aware of-----

It was needed five years ago, or ten years ago.

Do not be interfering with the Social Democrats' time, please. You tend to want to monopolise the Opposition a lot. I know that but you should not be trying to do it on Leaders' Questions.

Anyway, that is-----

I have no tolerance for waffle.

The time has concluded on this question.

The critical care wing is needed now. An Coimisiún Pleanála knows that. Dublin City Council was clear, that it was okay and it approved it, and so was the inspector.

I call Deputy Ward.

You should read the An Coimisiún Pleanála reason.

We did read it.

It said it was because of colocation.

It did not say that.

That was taken into consideration.

It does say that.

Deputy Ward, please.

It does not say that.

It does.

Please, Deputy Ward.