The Irish Times view on the National Maternity Hospital: a symptom of a bigger problem

It's now eight years since the current plan for the National Maternity Hospital project was announced. Building work on the site at the St Vincent's campus in south Dublin is still at the preliminary stage. Meanwhile, each year more than 8,000 women continue to give birth in wholly ill-suited, crowded conditions in a Victorian-era building at Holles Street. And all the while politicians rehearse the same arguments that have beset the project from the beginning.

Under a plan that is at once a statement about the State’s ambitions for modern healthcare and a messy compromise rooted in a century of official neglect in the same area, the Government will build an €800 million hospital on grounds owned by the Religious Sisters of Charity. The nuns are transferring the land to a new entity, St Vincent’s Holdings, which will in turn lease it to the State. The religious order says it will have no involvement in the running of the hospital, but some campaigners say the land ownership structure may curtail the provision of services such as abortion or IVF.

The Government appears satisfied that all legal procedures will be carried out in the hospital. But suddenly last week Tánaiste Leo Varadkar revived the controversy when he said he had concerns over some outstanding elements of the lease deal and governance. The Government has said it would like to buy the site outright for the State, though both the order and the hospital group say they never received an offer. Even if the State had indications that the land-owners would not sell, it seems careless at best not to have tested their resolve. If there is any way of buying the land, even at this late stage, it should be done.

The State is content to outsource public health services, including entire hospitals, to religious and other private outfits

The political context is worth noting. St Vincent's and a large part of its catchment area are located in the Dublin Bay South constituency, where the Government parties desperately need victory in a byelection next month. For weeks, moreover, there have been stirrings of internal dispute over funding of the project, with Minister for Public Expenditure Michael McGrath last month rejecting a request from Minister for Health Stephen Donnelly to exempt the development of the hospital from official rules governing spending on large capital projects.

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Ultimately, the row over the maternity hospital is a symptom of a much bigger issue, which is that the State is content to outsource public health services, including entire hospitals, to religious and other private outfits. The Government quite reasonably seeks the right to board representation at the new maternity hospital, but it is happy to forego significant input in other hospitals it funds but does not run. It’s disingenuous for a Government that presides over these contradictions to dismiss concerns about the maternity hospital as ideological. As if maintaining the status quo is not in itself an ideological stance.