It was a bombshell alright, when the news emerged last week that the Sisters of Charity would wholly own the proposed new National Maternity Hospital, co-located with St. Vincent’s Hospital on the south side of Dublin.
It wasn’t just about ownership: the nuns had also been given the power to appoint four members of the nine-person board of directors, that would control the hospital into the future. All of this, despite the fact that the State would have to fund the building of the hospital to the tune of an estimated €300 million (and doubtless more when the inevitable budget over-runs happen). It had all the hallmarks of a stitch-up. And that’s exactly what it is.
The news sparked widespread anger. The question was asked over and over again: why would the nuns, or any religious order for that matter, want to own a maternity hospital? The answer isn’t simple. Where vested religious interests are concerned the answers never are.
TRANSFERRED OWNERSHIP
The first reason has to do with vast sums of money. Once you scratch the surface, the major religious orders, here in Ireland and elsewhere, are all about money now: making it and hoarding it and in particular finding ways of protecting it against the threat arising from historic abuse cases and other claims for damages and redress. Collectively, the orders are sitting on enormous tracts of land and other properties worth billions. They are also surrounded by advisers and other well upholstered burghers who (a) are in the business of getting those assets off balance sheet; and (b) often benefit themselves from financial manoeuvres of this kind.
The usual mechanism is to transfer the orders’ assets into a web of trusts and companies. These separate corporate entities then apply for planning permission – for apartments, nursing homes and private hospitals – on lands owned by the orders. In the case of St. Vincent’s Hospital, according to reports, they went as far as mortgaging the public hospital under their control to fund the building of St. Vincent’s Private Hospital on the same site, out of which they aim to make millions.
Is their use of the public hospital as an asset to be mortgaged legal, given that the operations of that hospital are fully funded by the State? Were the relevant authorities in the HSE and the Department of Health informed? And if they were, was this brought to the attention of the Minister for Health at the time? And was it approved? And if so was this ever published?
Meanwhile, there is an issue about the money owed by the Sisters of Charity under the redress scheme and a €3 million tab for their legal costs, for the Ryan Tribunal, that is apparently being picked up by the State. And there is a wider issue about the enormous shortfall in the contributions made to date by religious orders towards the total cost of the Redress Scheme, with some reports suggesting that they have paid less than €200 million of the €760 million they owe under the agreement. Against that background, while still considerably behind on their payments, we know that the Christian Brothers moved to transfer the ownership of school playing fields to the newly minted Edmund Rice Trust. Do these trusts, and the way in which assets have been transferred to them, really stand up to legal scrutiny? Is it right that they can get away with this financial sophistry? It is a question that needs to be answered. But we will come back to money later.
CLINICAL INDEPENDENCE – NOT
The second reason for the nuns’ interest in ownership of the National Maternity Hospital is the more obvious one. The Sisters of Charity, and the Roman Catholic burghers who advise them, want to control the National Maternity Hospital because it will give them the potential to have a say in how the hospital is run. And where maternity services are concerned, that will inevitably lead to conflicts in relation to abortion – when it is permissible, and on what basis it can be carried out, if any, in the National Maternity Hospital.
The deal to merge the hospitals was done by the current Master of the National Maternity Hospital, Rhona Mahony. That there is a pressing need for a new hospital is not in doubt: the existing NMH in Holles Street is no longer fit for purpose.
But even the urgent requirement for a new hospital building does not, and cannot, justify handing over what is or should be a State asset to a private company. Nor can it ever be an excuse for allowing, in any shape or form, the possibility that the Roman Catholic ethics of the proposed owners of the hospital might be imposed now, or at any time in the future, on the operations of the National Maternity Hospital, which should be absolutely free of any religious, ethnic, racial or political bias.
We are told that, in the deal between the two hospitals, brokered by the former head of the Workplace Relations Commission, Kieran Mulvey, the hospital’s notional independence from religious interference is guaranteed by a ‘golden share’, held by the Minister for Health, as well as by commitments made by representatives of St. Vincent’s. This too is sophistry.
In relation to any promises made by the nuns or by people acting on their behalf, two words say it all: “mental reservation.” This is the precept that allows members of the Roman Catholic hierarchy and religious orders to lie brazenly if they believe that the greater moral good – in their narrow, prejudiced definition – is achieved by doing so.
The truth is that in relation to something as serious as abortion, nothing that the nuns or any other religious interests say about refraining from interfering can be trusted. They will happily dissemble to achieve a position where they, or their appointees, can affect the decisions made in relation to terminations. And they will pursue the ideology of the Roman Catholic Church in any way they can.
The Bishop of Elphin, Kevin Doran, confirmed that this is what they should do, in an interview with the Sunday Times. Well, there is no excuse whatsoever for allowing this to happen.
In relation to the so called ‘golden share’, what happens if a man or woman is appointed as Minister for Health who holds dogmatic Roman Catholic views on abortion? The current Minister may see himself as ‘sound’ on the issue of freedom from religious interference, but there is no knowing that this will be true of Ministers in the future. The mechanism is only as good as the Minister of the day, which means that it is no good at all.
The inescapable truth is that the whole exercise is a typical Irish solution to an Irish problem. It is, to put it kindly, a complete shambles. The former Master of the National Maternity Hospital, Peter Boylan offered a devastating assessment of the decision in an article written for the Irish Times.
“Modern maternity and gynaecological care encompasses contraception, sterilisation, IVF, gender reassignment surgery and abortion, as well as the usual day-to-day activities of a busy maternity hospital.
“Are we seriously expected to believe,” he asked, “that if the hospital goes ahead according to the proposed arrangement it will be the only maternity hospital in the world owned by the Catholic Church, and run by a company owned by the Catholic Church, that will allow these procedures? This stretches credibility to breaking point…
“The proposed structure means that the four directors nominated by St Vincent’s Healthcare Group will have fundamental religious objections to a significant part of the clinical work of the hospital.
“In a power struggle who is more likely to win? Is it likely to be the owners of the hospital and the company tasked with running it? Who is the ninth member more likely to support?
“The ‘golden share’ held by the Minister for Health is supposed to be the ultimate protection. Ministers for health come and go and will inevitably hold differing views.
“Indeed, if the safeguards for true clinical independence are as robust as is currently claimed, why is there any need for the Minister to hold a ‘golden share’?”
To which we can only say “Amen.” Peter Boylan might have added that the Roman Catholic Archbishop of Dublin has a say in the running of the National Maternity Hospital as it currently exists. There is no guaranteeing that even the four representatives from that body would support the provision of abortion, as allowed under any future, more liberal law of the land.
Indeed at the first test, one of the nuns who is a director of the St. Vincent’s Healthcare Group, Sr. Agnes Reynolds, refused to acknowledge even the promise of freedom from religious interference. Asked to confirm that the religious beliefs of the Sisters of Charity would not influence medical care in the proposed new hospital, what she said was: “I can’t make a judgement on that.”
RELIGIOUS VESTED INTERESTS
It is the definition of an unholy mess. And it might seem like one that is difficult to untangle. But I am not so sure. The impression has been given that all of the aces in the negotiations were held by the owners of St. Vincent’s Hospital. But this is not necessarily true.
It has been suggested that the State might use a Compulsory Purchase Order to secure the land. The mechanism is used all the time in relation to building roads and other infrastructural needs. Well, building a National Maternity Hospital has to rank ahead of the construction of roads in terms of its importance.
But that is a relatively blunt if potentially useful instrument. There is another that should be considered.
Even if this controversy had not arisen, we need to take a completely fresh look at the ‘charitable’ status of religious orders and related companies and institutions. For example the Sisters of Charity and the Bon Secours nuns, are both involved in the multi-million euro business of supplying private medical services.
This is a hugely lucrative industry. According to reports, St. Vincent’s Healthcare Trust pay €1.2 million a year to the Sisters of Charity. What tax arrangements are in place in relation to this? Furthermore, why should religious-run private hospitals have any competitive advantage over hospitals set up by private citizens? Why should religious landlords have a competitive advantage over landlords in general? They shouldn’t.
There is a strong argument that even the money that is collected in churches on a Sunday should be seen as income and taxed accordingly. What is the basis for doing otherwise? The truth is that – from root to leaf – religion is a big business. And the Roman Catholic Church in Ireland is sitting on a vast mountain of wealth and property accumulated without paying taxes on its income in the way that private citizens and businesses do as a matter of course.
What justification is there for this? None. Which begs another question. Why are those religious orders who are in default on their payments under the Redress Scheme not charged interest on what they owe, at the same rate that those who owe the State in unpaid taxes are?
The starting point for any discussion with religious orders about the future ownership of assets like the Natonal Maternity Hospital and schools. therefore. should be that the State is going to carry out a review of the arrangements under which the Church and its activites are treated as tax free. In the meantime, a deal might be done to extend that extraordinary privilege for an agreed period – but only if the ownership of schools, hospitals and other State-funded assets is transferred to the people of Ireland.
The issue of the ownership of the new National Maternity Hospital has brought the extraordinary financial privileges afforded to the Roman Catholic Church – and other churches too, though I doubt that the Scientologists and the Moonies are treated equally in the way that they should be – fully into focus. It is time for our politicians to do what is right for the citizens of Ireland. And that means facing down the religious vested interests that have tried to maintain a stranglehold on health and education in Ireland, in order to sustain their position of influence and control into the future.
Citizens’ Assembly Declares In Favour Of Abortion Rights
There was nothing predictable about the outcome of the deliberations of the Citizen’s Assembly on the 8th Amendment. The question now is: will Irish politicians face up to their responsibilities and make the necessary changes to our abortion regime?
Ireland’s laws on abortion should be hugely liberalised. That was the overwhelming verdict delivered by the Citizens’ Assembly, set up by the Government, which concluded its deliberations over the weekend, in Malahide, Co. Dublin.
There was some confusion along the way, in what proved to be a day of high drama, when a ballot of the 89 members present decided by a 50 to 39 margin that Article 40.3.3 of the constitution should be reformed rather than repealed.
This caused initial consternation among pro-Choice activists and supporters of the Repeal The 8th campaign. However, it emerged that this vote had come about directly as a result of advice, given to the assembly by the Chair of the Assembly, Justice Mary Laffoy, that a straightforward decision to repeal might give rise to legal uncertainty, and that decisions taken by the Oireachtas might then be challenged by anti-Choice groups.
In fact, the Citizens’ Assembly decided to go one further, declaring that the 8th Amendment should be replaced by a constitutional provision which would explicitly authorise the Oireachtas “to legislate to address termination of pregnancy, and any rights of the unborn and any rights of the pregnant woman.”
That particular nuance proved to be just a jumping-off point for a series of recommendations which have rocked the political establishment.
The most far reaching recommendation is that 64% of the members voted in favour of allowing abortion in Ireland “with no restrictions as to reason.” Access to abortion purely on the basis of socio-economic circumstances was supported by 72%. And 78% supported the right to abortion in the case of a risk to either the physical health, or the mental health, of the woman.
In a resounding call for radical change, 89% of members supported abortion rights in the case of fatal foetal abnormalities. The Assembly also strongly supported the view that abortion should be legalised, when the unborn child has a significant foetal abnormality – even if that abnormality is not likely to result in the death of the child.
While elements in the political establishment are stunned by the outcome, these results confirm two things: that people who are well informed on the issue of abortion are far more likely to support a woman’s right to choose, subject only to certain time limits; and also that the Irish people are far ahead of the politicians on issues of this kind.
The Assembly Chair, Ms Justice Mary Laffoy, now has the responsibility of delivering the Citizens’ Assembly report on the 8th Amendment to the Constitution to a Joint Oireachtas Committee, within a deadline of 10 weeks. The process then requires the Oireachtas Committee to inform the Dáil and Seanad of its verdict on the recommendations within three months of convening.
In effect the politicians on that committee have been given a powerful mandate for change by the Citizens’ Assembly. They now need to face up to their responsibilities and set out a timeline to bring the proposed changes into law. Nothing less will do.