Tuesday 17 September 2019

Dr Ciara Kelly: 'Religious beliefs spell trouble for healthcare'

'No obstacle should stand in the way of a woman receiving care'
'No obstacle should stand in the way of a woman receiving care'

Ciara Kelly

This week several things happened in women's health. Legislation was passed that finally allows abortion to be rolled out in this country. Heated debate happened among healthcare professionals about the difficulties they foresee with delivering the services by January.

And very quietly a commencement order was signed by the HSE for building to start on the new National Maternity Hospital (NMH) on the St Vincent's Hospital campus.

It's this I want to discuss.

The NMH is currently located on Holles Street in an old Victorian building that's simply not fit for purpose. It's not big enough or designed to deliver the types of services required in a modern maternity hospital. So a new hospital is vitally important for women's health. Building it on a site adjacent to a general hospital makes infinite sense so women who are pregnant with complex medical needs can draw on the expertise of consultants in different specialities and have access to the facilities available in the separate hospital.

St Vincent's ticks all these boxes. So far so good.

What St Vincent's also has on site, is a strong Catholic ethos. It is owned by the Sisters of Charity who run it in accordance with their religious values. So doctors will anecdotally tell you that there are things you don't refer patients to St Vincent's for - like sterilisations for example. This was never expressed to me officially as a GP, it was just known.

The difficulty now, is we are locating the biggest woman's health facility in the country right there in the middle of it - straight after we have repealed the Eighth Amendment. And if you think the nuns aren't keen on sterilisation, just think how they'll feel about abortion, contraception, assisted reproduction or gender reassignment.

But we're being told that the Sisters of Charity are now pulling back from St Vincent's! Well that makes little difference in effect when they are handing over the running of the campus to the St Vincent's Healthcare Group (SVHG) - which will continue to run it in accordance with the ethos of the Sisters and their founder Sr Mary Aikenhead.

Religious orders still run schools and hospitals around the country with barely a nun or a brother between them but they remain religious in their culture.

Ownership and governance are key in the running of a hospital. Religiously owned institutions have constitutional rights to control them in line with their values. And under current proposals the hospital will be owned by the SVHG. So you have to ask yourself - do you believe our NMH is going to be the first Catholic hospital in the world to allow procedures to be carried out on its premises that are contrary to Catholic teaching? Or is it more likely we will run into difficulties?

You also have to ask yourself why an order which is so fundamentally and ideologically opposed to the provision of things like abortion would ever want to stand aside and facilitate those things happening on its campus? It simply isn't credible.

Which brings me back to the commencement order. The NMH project, which has this inherent conflict between ethos and the services it's supposed to provide, now has a start date. Is that just putting the cart before the horse? Or is it the case that there may be some who would like to see momentum behind the NMH now before the issues of ownership and governance are ironed out?

Why else push ahead with the building before the issues are resolved? Are we really going to spend €350m on a hospital and end up neither owning it nor being able to decide what procedures can be carried out there? Until we have clarity here it seems to me entirely possible that we are. But make no mistake this cannot be allowed to stand. There will only be one NMH built for future generations of Irish women. We need to make sure there are no obstacles to them receiving the care they are entitled to there. If there's any suggestion they won't I'll see you in front of the diggers.

@ciarakellydoc Ciara presents 'Lunchtime Live' on Newstalk, weekdays 12-2

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