Eilish O'Regan: 'Ethics, power and a tangle of influences surrounding the new maternity hospital'
The proposed opening date for the new National Maternity Hospital - originally due to be ready in 2018 - has now been pushed back to 2024, it has been confirmed.
But even that may be optimistic given the construction of the project has yet to go to tender and the current price tag of around €300m is likely to escalate.
There are also lingering questions about how it will be run, who will own it, its clinical independence and how it will sit in the location of the campus of St Vincent's Hospital in Dublin 4.
Reassurances have been given around all of these fractious issues which in recent years led to unfortunate delays in its progress and left it stalled. But so far there is a lack of published finalised documents to satisfy the sceptics.
It emerged this week that a revised constitution which "reflects the departure of the Religious Sisters of Charity from the St Vincent's Healthcare Group" has been drawn up and is awaiting official approval.
Two years ago the Sisters of Charity, which owned St Vincent's Healthcare Group, announced it would step away.
The St Vincent's Healthcare Group - which oversees the public and private hospitals - said its revised constitution is with the Charities Regulator.
Until it is approved, it follows the ethical code of the Sisters of Charity.
As if the matters of power and ethical influence are not enough, there is also the tangle of public and private services for maternity patients which exists in its current location in Holles Street to be worked out in the new hospital.
The plans for the new hospital show 244 single-occupancy rooms with en suites.
Currently the Merrion Fetal Clinic is based near the main public hospital.
It provides services to private patients, such as scans and tests for pregnant women including for fatal foetal abnormality in an unborn baby. It operates on a partnership basis between five specialists, including the former master Dr Rhona Mahony.
Instead of fees going to each individual consultant, they are pooled and at the end of the year divided between them.
At this point there are no plans to move this private clinic to the new hospital.
However, there is space in the new hospital for a reproductive medicine facility.
This is likely to accommodate the Merrion Fertility Clinic, which is also linked to the existing Holles Street hospital.
It caters for public and private patients and pays rent to the National Maternity Hospital.
There will also be five consulting rooms where consultants can see patients privately.
The consultants will pay rent for the dedicated rooms, as they currently do at Holles Street.
The appointment of Dr Mahony to the board of St Vincent's Healthcare Group this week is seen as helping to put some momentum into the project.
She is resigning from the board of the National Maternity Hospital.
Sources said there is no conflict of interest in her new role and her investment in the private Merrion Fetal Clinic which will not be part of the new hospital.
The building of the hospital is being handled by HSE Estates and the hope is that construction will be put to out to tender in the coming months.
Lessons will obviously have been learned from the ill-starred National Children's Hospital, which ballooned in cost to €1.7bn.
It is still unclear if it will repeat the same two-stage procurement process in the construction of the maternity hospital.
The HSE was unable to indicate yesterday when the tender for the maternity hospital will be submitted.
Work is currently under way on the car park, but the new 2024 timeline for the main building's completion may end up being stretched again unless some sense of urgency is seen.