Tuesday 22 October 2019

Revealed: Read the full agreement between St Vincent's Healthcare Group and the National Maternity Hospital

Simon Harris with a model of the new maternity hospital (left), and the Sisters of Charity
Simon Harris with a model of the new maternity hospital (left), and the Sisters of Charity

Maeve Sheehan and Catherine Devine

The Minister for Health, Simon Harris, has released the full agreement between St Vincent's Healthcare Group and the National Maternity Hospital.

The full statement can be found here .

Details of the agreement were first revealed in the Sunday Independent.

The agreement between the two hospitals spells out how the independence of the maternity hospital will be protected through a new Designated Activity Company providing maternity services.

The company will be a 100pc subsidary of St Vincent’s Healthcare Group. However the group's ownership is conditional on allowing the State a ‘golden share’ in the company to protect its independence, and a ‘lien’, so that it cannot be used as collateral against loans or sold.

The document states that both hospitals "will benefit significantly by this re-location" and outlines the details of the arrangement.

It says:

• The new company’s memorandum and articles to provide for “reserved powers” and a “golden share” — effectively a ministerial veto — to protect the autonomy of the board.

An excerpt from the agreement detailing the Corporate Governance Structure for the hospital campus
An excerpt from the agreement detailing the Corporate Governance Structure for the hospital campus

• The “agreed reserve powers” are “to be exercised in an undiluted manner by all of the directors” and include specific reference to the hospital’s “clinical and operational independence” in providing maternity services “without religious, ethnic or other distinction”.

• The “reserve powers” also refer to budgetary control, the retention of the master role and “the retention and utilisation” of any donations, gifts or bequests to the maternity hospital”.

• The “reserved powers” cannot be amended “save with the prior written and unanimous approval of all the directors of the board and with the consent of the Minister for Health”.

• Either group can consult the Minister for Health on any matter relating to the reserved powers “on which they may feel aggrieved”.

• Under the heading “Ownership”, the document says St Vincent’s Healthcare Group will be the sole owner of the new company “subject to” two conditions: that the Minister for Health holding a Golden Share with powers that protect the “reserved powers”, “constitution” and “board composition” and that “the State will require a “lien” on the hospital.

• The master will also have a group role, as clinical director for obstetrics and gynaecology, and will report to the group clinical director and the group medical board, under “an agreed system of clinical governance” with St Vincent’s Health Care Group. 

• The hospitals also agreed to share information on “private clinical practice” arrangements of their consultants, to provide for transparency on their “specific roles and purpose” and their relationship with the public hospital.

• The maternity hospital will be “physically connected” to St Vincent’s University Hospital, so that consultants and staff can move freely from one to the other.

• Patients will transfer “seamlessly” from one hospital to another, to protect patient care. 

• SVHG made “the valid point” that it has overall responsibility for the operation of the campus and needed to “retain a corporate unitary oversight of all campus utilities and services”.

• Some corporate “oversight” or “integration” was not “unreasonable” and two NMH nominee would sit on the board of SVHG.

• The “compromise” of equal representation of St Vincent’s Healthcare Group and National Maternity Hospital on the board “as a fair balance between the corporate hospital interests of both entities”; a ninth director to be an independent expert on obstetrics chosen jointly. The first chair to be a NMH director.

• The memorandum and articles of the new company will also ensure services provided by the new hospital will be “in succession to the objectives and services” provided at Holles Street.

The Health Minister also welcomed the confirmation by the Board of St Vincent’s Healthcare Group that any medical procedure which is in accordance with the laws of this State will be carried out at the new hospital.

He said that he and his officials will arrange meetings with the two hospitals shortly.

In a statement, Mr Harris also repeated his request that some time be allowed for the detailed work that is necessary.

The agreement states that the "provision of care to Obstetrics and Gynaecology patients by the two hospitals will be seamless".

"The Consultant with primary responsibility for care of the patient will decide what care services are required and in which location these services should be provided.

"There will be no contractual or administrative requirement for the patient to be “transferred” from the care of one hospital to another in order for care to proceed as decided," the agreement states.

The document also provides for how instances of liability related to sub standard care:

"If any elements of service standard fall short of required levels then any questions of liability will be decided based on the performance of individual members of the care team," the document reads.

Earlier on Tuesday the board of St Vincent's released a statement to clarify that all medical procedures allowed under law will be carried out in the Maternity Hospital.

The controversy around the planned hospital continues this week with Dr Peter Boylan, who sits on the board of the current National Maternity Hospital, refusing to resign his board seat.

He had been asked to do so during an exchange of text messages between him and two other board members.

Dr Boylan has been among the most vocal critics of the move and has stated his opposition to the plan in the national media.

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