Catholic involvement in maternity hospital

Sir, – In response to widespread public outrage over the proposals of the November 2016 Mulvey Report on the future operation of the new National Maternity Hospital (NMH) at Elm Park DAC, the Religious Sisters of Charity (SOC) announced on May 29th, 2017 that they were ending their involvement with St Vincent’s Healthcare Group (SVHG) and transferring ownership of SVHG to a new company with charitable status which would be called St Vincent’s. The move was intended to allay fears of any possible religious influence on the ownership and governance structure of the new publicly-funded €300 million NMH, in recognition of the incompatibility of Catholic ethos with the full range of women’s reproductive healthcare. This issue is especially relevant following the referendum to repeal the Eighth Amendment.

Marie O’Connor (Letters, August 13th) is correct to ask whether or not this new company will be incorporated as a Public Juridical Person, and therefore answerable to the Catholic Church and not the State. There are numerous examples of this sort of structure in Catholic healthcare facilities globally, including Mercy Care South in Ireland.

I see also that despite the Sisters of Charity's announcement in May 2017, a note in the annual accounts of SVHG published in November 2017 states that future directors of St Vincent's will be obliged to uphold the "values and vision" of Mother Mary Aikenhead, founder of the Religious Sisters of Charity (ie Catholic ethos). Prof Vincent Twomey told the Sunday Times on April 29th, 2018 that the Aikenhead commitment would require compliance with Catholic medical ethics. As of today, the new company has yet to be incorporated.

In the meantime, earlier this year the Irish Catholic Bishops’ Conference published their “Code of Ethical Standards for Healthcare”. The bishops state “there may be specific procedures which a Catholic healthcare facility cannot provide, by virtue of its ethos . . .” In the section entitled “Specific Issues”, the code explicitly states that the following procedures cannot be provided by Catholic facilities: any form of artificial contraception, provision of the morning after pill, any form of assisted fertility treatment, surrogacy, abortion, referral elsewhere for abortion, sterilisation, and gender reassignment surgery.

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The code is also concerned with governance and management, insisting that “[w]here the ministry of a diocese or religious congregation has been incorporated as a limited company, the board of that company is to act in accordance with its mandate from the diocese or congregation” and that “[c]are must always be taken to ensure that arrangements deriving from contracts with other parties are in accord with Catholic moral and social teaching”. The code binds board members to educate themselves in and regularly reflect on “the mission and values of their organisation”.

Under "Respect for the Rule of Law", the code states that "[i]f a particular law conflicts with the fundamental and inalienable rights of the human person, however, it conflicts with the common good and with reason and does not command obedience". (My italics).

To date, SVHG has failed to clarify their new ownership structure as well as how it proposes to resolve the inevitable ethical conflicts that will arise from its ownership of a maternity hospital. Over a year ago, I asked to be provided with a single example anywhere in the world of a hospital operating under Catholic ethos which provides the full range of women’s healthcare. I am still waiting.

Nicholas Kearns, Deputy Chairman of the National Maternity Hospital states once again (Letters, August 14th) that the 2016 Mulvey agreement on the proposed move of the NMH “guarantees the new hospital clinical and operational independence”. However, under the Mulvey agreement (presumably to be updated when St Vincent’s is incorporated) the new NMH is to be a 100 per cent subsidiary of St Vincent’s, the chair of the board of the New NMH is to be from St Vincent’s on a three-year rotating basis, and the Master is to report to the clinical director of St Vincent’s and the board of the NMH. I cannot understand how Mr Kearns persists in his belief that this represents clinical and operational independence.

The new National Maternity Hospital can either be Catholic under the ownership and governance of SVHG or its successors, or independent under an ownership and governance structure yet to be determined, but certainly not that of the Mulvey Report. In my view, in an independent Republic, a publicly-funded maternity hospital should be fully independent. – Yours, etc,

Dr PETER BOYLAN,

Dublin 6