The National Maternity Hospital

Sir, – My colleague Roger McMorrow makes an excellent broad point about voluntary and HSE hospitals ("Public ownership is not the crux of abortion access", Opinion & Analysis, May 11th).

The tone pervading most of the recent debate around the National Maternity Hospital assumes that State ownership and management grant ready access to all legal treatment options.

Meanwhile, in the real world, half of HSE hospitals fail to provide full termination of pregnancy services while all of the large, voluntary maternity centres do so. It is remarkable that this topic, in contrast to the NMH move, receives so little attention. It’s worth asking obstacles to change exist.

The Irish people voted by about a two-to-one majority to legalize abortion. The views of medical practitioners are relevant to its provision, of course. A study of Irish anaesthesia doctors (of which I was a co-author) found that only a quarter of those responding would conscientiously object to providing such services. And just 16 per cent had voted in opposition to the constitutional amendment (British Journal of Anaesthesia, 2020).

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Our findings were very similar to those of the Irish College of General Practitioners, whose data found that 26 per cent of GPs would conscientiously object.

Thus medical providers seem even more “liberal” than the population of this, a very liberal society, and in essence, respectful of conscientious objection but unwilling to allow it to prevent public expectations being met.

Since patients or voters demand this service, and doctors are at least willing to respect that fact, it is hard to understand why State hospitals do not do so too. But I don’t think our religious orders are in any way responsible for the current reality. I wonder who is? – Yours, etc,

BRIAN O’BRIEN,

Kinsale,

Co Cork.

Sir, – On the very day that Minister for Children Roderic O’Gorman was apologising in the Seanad for “the historic wrong and deep and enduring impacts” caused by illegal birth registrations done in St Patrick’s Guild which was run by the Religious Sisters of Charity, Taoiseach Micheál Martin was in the Dáil defending the Government’s total acceptance of the decision of the Religious Sisters of Charity not to have gifted or sold the land to the State for the new National Maternity Hospital (transferred instead to St Vincent’s Holdings CLG).

Like many, I remain unconvinced, despite the genuine assurances given, that the convoluted arrangements chosen by the Religious Sisters of Charity to make the site available will safeguard clinical independence in the new hospital.

The Government needs to join up its own dots; in the interests of women, the State should own the site. – Yours, etc,

CHRIS FITZPATRICK,

(Former member of the

National Maternity

Hospital–St Vincent’s

University Hospital

Co-location Project Board),

Dublin 6.

Sir, – Miriam Lord, in her recent Dáil Sketch (May 11th), has suggested that the ongoing debate about the new National Maternity Hospital features many of the elements of Irish drama namely religion, land, money, nuns, childbirth, politics, law and strong women.

However, it would seem one predominant feature of Irish drama was overlooked – farce. – Yours, etc,

PAUL WALSH,

Skerries,

Co Dublin.

Sir, – Discussion about the New National Maternity Hospital continues after nine years. The Minister of Health stated this week that transferring the hospital to a new site would delay the project by between 10 and 15 years.

I can understand this statement if the State continues to plan, develop and commission new hospitals under its current method.

This is no longer acceptable to us as taxpayers.

As I understand plans for the new hospital are already complete, there is no reason why it could not be developed and commissioned within a two-year period on a greenfield site, such as co-located with Connolly Hospital on the adjacent 50 acres which are State owned.

As many of our hospitals are long past their sell-by date, it is time that we replace them in an efficient, timely and cost-effective way. To continue as we are is unacceptable. – Yours, etc,

JAMES M

SHEEHAN, FRCSI

(Developer of the

Blackrock, Galway

and Hermitage Clinics),

Blackrock, Co Dublin.

Sir, – We represent the large majority of trainees in obstetrics and gynaecology in Ireland and are deeply concerned about recent political actions which are serving to delay the development of the new National Maternity Hospital (NMH), co-located on the St Vincent’s University Hospital (SVUH) site.

At the NMH and SVUH, there is no impediment to abortion care, contraceptive use, sterilisation procedures or fertility assessments, irrespective of clinicians’, midwives’ and ancillary staff’s private views.

We know this first-hand because we work on the ground in both of these institutions.

We are very satisfied that the present, excellent provision of abortion care will continue at the newly built NMH and believe strongly that the current political furore with regard to governance and clinical freedoms to be just that: a political football.

The wording of “clinically appropriate” procedures in the legal framework is being openly debated in the media and political circles.

Let it be absolutely clear, this phrasing is not and will not be an impediment to the services provided to women at the NMH. This term serves to protect the provision of those “clinically appropriate” services in a maternity hospital.

This will avoid the replication of what we witness daily in the general hospital settings where women’s health procedures are often cancelled to prioritise other specialities.

Simply put, St Vincent’s University Hospital patients will not be transferred into the maternity hospital to facilitate hip replacements, bowel surgeries, etc, due to bed or staff shortages in our neighbouring hospital.

The omission of an exhaustive list of “clinically appropriate” services that may or may not be provided also future-proofs the hospital and enables it to deliver any newly discovered medications, surgical techniques or imaging methods without requiring a lengthy amendment to the legal framework.

We want to work in a fit-for-purpose, co-located hospital, where we can provide the highest level of care for obstetric and gynaecology patients. Currently, only one of Ireland’s four tertiary maternity units is co-located with an adult hospital in keeping with international best practice. We believe the clinicians working at the NMH and we support them wholeheartedly in their endeavour to realise this new iteration of the NMH. We know that the care provided will be unconstrained by any religious beliefs. – Yours, etc,

Dr CATHY MONTEITH,

Dr CIARA NOLAN,

Dr MEI YEE NG,

Dr OLADAYO ODUOLA,

Dr EIBHLÍN HEALY,

Dr GILLIAN CORBETT,

Dr NAUREEN YASIR,

Dr MAEVE WHITE,

Dr LUCY BOLGER,

Dr AMY WORRALL,

Dr ALICE O’NEILL,

Dr ELZAHRA IBRAHIM,

Dr DIVYA GAUTAM,

Dr FIONA O’TOOLE,

Dr KATE SEXTON,

Dr LUCY BOLGER,

Dr RACHEL O’KEEFE,

Dr RÓISÍN GRYSON,

Dr SARAH MURPHY,

Junior Obstetrics

and Gynaecology Society,

Dublin 2.

Sir, – If the new children’s hospital is anything to go by, the new maternity hospital might need all those 299 years on the lease before it’s open for patients. And so it goes. – Yours, etc,

KEVIN DEVITTE,

Westport,

Co Mayo.