The decision by the government to gift the new National Maternity Hospital it plans to build to an order of nuns has been causing waves of outrage here for the past few weeks. And much of this outrage, particularly from those who support a liberal, secular Ireland, has included demonizing the unfortunate nuns involved.
But however unwise the government's decision was (and it was extremely stupid), much of this criticism has been lazy and facile. The truth is that this situation is not particularly the fault of the nuns.
Our politicians are much more to blame. It's the way things have been done here for so long, with the state abdicating responsibility for running large parts of our health and education services to religious orders.
It has suited the state to do this for decades, in fact ever since the foundation of the Irish Republic. It has been a handy way for the state to avoid providing and paying for the services, which was helpful in the cash-strapped newly independent Ireland. It also fitted in with the beliefs of so many of our politicians who regarded the Catholic ethos as an essential part of these services and, indeed, of the new state itself.
That background probably explains how the government blithely blundered into this situation without foreseeing the difficulty it would cause. It's the way things were always done here, after all.
Of course these days we are in a new, modern Ireland and the Catholic Church has lost the esteem it once enjoyed. But even being aware of this, the outrage caused by the decision seems to have come as a surprise to the politicians.
The decision probably had looked like a practical, sensible solution. The existing 200-year-old National Maternity Hospital in the center of Dublin, where over 9,000 babies are born annually, has barely been coping for a long time.
Apart from chronic overcrowding, the old building is unsuitable for a modern maternity service. A new maternity hospital is needed, one co-located with an existing general hospital so that wider medical services are available when required in complicated cases.
Co-location is regarded internationally as best practice these days, and that requirement narrowed down the number of possible sites for the new maternity hospital. So when the Sisters of Charity, who own and run St. Vincent's Hospital on the south side of Dublin, offered a site on their complex it seemed to make sense. St. Vincent's is one of the major teaching hospitals in Ireland and has a high reputation for the quality of care it provides.
The nuns would provide the site. The state would build the maternity hospital. What could be wrong with that?
Well, for a start it is going to cost the state at least €300 million to build the new hospital, and because the nuns would retain ownership of the site the hospital would have to be given to them.
Giving away that much state money to a religious order was bad enough, critics said. Even more worrying was that nuns controlling the new hospital could mean a continuation of the old Catholic ethos, which would mean that some services that modern maternity hospitals provide would not be allowed.
At present, even vasectomies and female sterilization are not carried out in St. Vincent’s. Would those basic services, as well as legal abortion, IVF or gender realignment, all of which are contrary to the nuns’ beliefs and those of the Catholic Church, be provided in the new maternity hospital?
Although the proposed board of the new hospital would be only 50 percent nominated by the nuns and the government was going to have a so-called "golden share" to retain control, no one could say for certain what the day to day situation would be.
The board of the existing National Maternity Hospital strongly supports the move with the master, Dr. Rhona Mahony, saying the new hospital would be independent and would provide all services and that the proposed structure gives a triple lock to allow this.
But the former master, Dr. Peter Boylan, is so worried about the structure that he has publicly opposed what is being done. He was supported by a former master of The Coombe, another major maternity hospital in Dublin, who said that the National Maternity Hospital move would inevitably lead to conflicts between doctors and the Catholic Church. To have one leading obstetrician opposing the move was bad enough; two was a disaster.
As public opposition mounted and became more vitriolic and derisive, particularly in relation to the nuns, the government scrambled to rescue the plan. The young Minister for Health Simon Harris, looking more out of his depth than ever, has made reassuring noises and appealed for calm while he considers how he can guarantee absolute medical independence in the new hospital.
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And that's where we are now, although no one seems to have much confidence that he can do so this under the proposed deal. The situation has not been helped by the nuns who have said they cannot make a judgment now on concerns about how their ownership of the hospital might influence the medical care provided in the future.
Even more unhelpful was the statement by a Catholic bishop who flatly insisted that, like anywhere else around the world, any clinical practices that would take place in a facility on land owned by the Catholic Church would be subject to Canon law as well as state law relating to modern maternity practices.
Boylan, probably the most highly regarded obstetrician in the country, agreed. He said that if the guarantees of independence given so far were accurate, the new hospital would be the only one in the world owned by a Catholic order and run by a Catholic order that allowed IVF, abortion, sterilization and gender realignment.
“It would be unique in the world if that happened,” Boylan said.
Among the solutions to this mess proposed by the government are that the nuns should either gift ownership of that section of the St. Vincent's campus to the state, or that the state should take a very long lease on the site. But it has now emerged that both of these options may be legally impossible because the nuns mortgaged the entire complex when they built the St. Vincent's private hospital beside the big public hospital there some years ago.
That debt probably would have to be paid off before the nuns can gift or lease the site, assuming they wanted to do so. Which brings us back to the whole question of money, something that has been at the root of this mess from the beginning.
Getting a suitable site from the nuns for free was no doubt part of the government's thinking. Having the nuns involved and having the new hospital run partly on a charitable basis also reduces running costs to the state, even if the state builds the hospital.
As we said above, it's all part of the system we developed here over decades which allowed the state to reduce the direct cost of providing services, particularly in health and education. We now know that this came at a terrible price, having learned about what went on here in orphanages, mother and baby homes, Magdalene laundries and industrial schools (reformatories) which were run by religious orders on behalf of the state.
We also know, of course, that Irish society in general was complicit in this shameful history, banishing pregnant daughters and hiding away other problems.
The Sisters of Charity, who own the St. Vincent's complex, have a record in this that is just as bad as that of other religious orders. They ran some of the notorious Magdalene laundries and other institutions.
And so far they have failed to come up with €3 million of the €5 million they agreed to pay 10 years ago under the redress scheme for victims of institutional child abuse. The fact that there are not much more than a hundred Sisters of Charity left, and most of them are elderly, may have something to do with it.
You would imagine that this situation gives them the perfect opportunity to pay this debt by gifting the site to the state, but as explained above it's not as simple as that.
In fairness, it has to be said that the nuns do not deserve all the vitriol that has been poured on them in recent weeks. Like other religious orders here, the Sisters of Charity made an immense contribution to the country over many years, with their selfless hard work. Despite the abuse that was perpetrated by some sisters in some places decades ago, that remains true for the majority of the sisters over the years.
It is also true that in a republic like Ireland the religious beliefs of all must be protected, and that includes Catholics. Similarly, Catholics should have the right to run their own schools and hospitals and other institutions, if they want to and can fund it themselves.
But in any republic worth the name, there has to be a complete separation between church and state.
In the peculiar republic that was created after Irish independence, of course, that was never the case. The Catholic Church was given a favored position and our politicians were forever falling to their knees before the Catholic bishops and asking for their guidance on legislation.
We're supposed to be way past all that now. But this clash over the new National Maternity Hospital would make you wonder. Unraveling the legacy of the past is far from easy.
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