Will State receive money from sale of hospital sites?

There is now major uncertainty over whether the State – which is planning to spend in the region of €1.3 bn on building the new maternity and the new children’s hospital and its satellite units – will receive any money from the multi million sale of the existing hospital sites at Crumlin, Temple Street and Holles Street. Maureen Browne reports.

It could have been expected that the money from the sale of the Holles Street site would go towards funding the new National Maternity Hospital on the St. Vincent’s campus, particularly since under the current agreement, it is to be owned by the St. Vincent’s Healthcare Group.

Equally it could have been expected that the money from the sale of the Crumlin and Temple Street sites would go towards the new children’s hospital on the St. James’s campus.

The site of the children’s hospital in Tallaght is already vested in the Minister for Health.

There has been little or no public discussion as to the contribution to be made by the owners of Holles Street, Crumlin or Temple Street to the new hospitals from the proceeds of the sale of their existing hospitals.

A major uncertainty has also emerged over whether the State will receive any money from the multi million sale of the existing hospital sites at Crumlin, Temple Street and Holles Street.

There appears to have been a tacit understanding in some quarters that the sale money would go towards the new developments.   Indeed in 2013 it was reported that when the new maternity hospital was built, the authorities at Holles Street would cede ownership of its current building to the state.

However, when asked if the proceeds of the sale of Holles Street would go towards funding the new hospital, a spokesperson for the Department of Health was unable to clarify this, saying it was a matter for Holles Street.

A spokesperson for Our Lady’s Hospital in Crumlin said that no decision had been taken regarding the future of the hospital. It is understood that the ownership of both Holles Street and Crumlin are vested in a Board of Directors, chaired by the Archbishop of Dublin.

The Temple Street Children’s University Hospital buildings and site are owned by the Mater Misericordiae University Hospital (MMUH). A spokesperson for the hospital said no decision had been taken as to what the current Temple Street Children’s University Hospital buildings and site would be used for when the staff of Temple Street moved to the new children’s hospital on the St. James Hospital site in 2022.

History shows a reluctance by the owners of voluntary hospitals to pass money from the sale of their hospitals directly to the state when the services of these hospitals are transferred elsewhere.

The public anxiety regarding the ownership of the new NMH has also sparked a conversation regarding the future ownership of voluntary hospitals which are funded by the State.

When the services of the Adelaide, Meath and the National Children’s Hospitals were transferred to the new Tallaght Hospital almost 20 years ago, the three hospitals set up Foundations, where the money would be used to support healthcare, research and education and would claim that they have made major contributions to the health service. For example, since 2002 alone, the Meath Foundation has awarded 98 research and education grants totalling €3.8m to Tallaght Hospital staff and has recently completed a major upgrading of the Meath Foundation Research Laboratory in the hospital.

It now seems on the cards that the authorities of Crumlin, Temple Street and Holles Street may be contemplating similar ideas.

In the meantime we are awaiting the further detail promised within the next few days by Health Minister, Simon Harris, on how he plans to address issues of public concern regarding the new NMH to be sited on the campus of the St. Vincent’s Healthcare Group in Elm Park.

Officials of the Department of Health have been working with the authorities at the St. Vincent’s Healthcare Group and the National Maternity Hospital in Holles Street for the last few weeks to try and come up with a solution which would allay public concern over the clinical independence and ownership of the maternity hospital.

While the authorities at Holles Street are satisfied that the current agreement, worked out under the chairmanship of Mr. Kieran Mulvey, guarantees the clinical independence of the new national maternity hospital into the future, this is not accepted by some leading clinicians and there is also serious public opposition to the new hospital being vested in the ownership of the Sisters of Charity, the ultimate owners of the St. Vincent’s Healthcare Group.

Many of the public believe that while the extremely valuable site is being provided free of charge by the St. Vincent’s Group, the State, which is ploughing in the €300 million build costs, should retain ownership.

There is also public anxiety that the religious ethos of the St. Vincent’s Group may impinge on the maternity hospital’s clinical independence in the future, particularly if the State introduces legislation on abortion.  This is despite the fact that the Board of the St. Vincent’s Group has publicly reaffirmed the clinical independence of the NMH.

The agreement also has robust measures to protect the State’s investment, in line with well established practice, and a new role for the Health Minister of the day in terms of a “golden share” – something which he said that in his view is an improvement on the current reality in maternity services.

Mr. Harris said the agreement reached between the hospitals recognised that the State would require a “lien” on the new facility in accordance with whatever funding agreements were in place by the State for such capital projects. He said different options had been used in the past in doing this and he believed there was potential to devise creative and acceptable solutions ‎that would provide further reassurance regarding the ownership of these facilities which would be paid for by the State.

The public anxiety regarding the ownership of the new NMH has also sparked a conversation regarding the future ownership of voluntary hospitals which are funded by the State.

The Minister has said that this was a good thing and he wanted to separately put in place a process to facilitate that broader conversation “which is long overdue and which will, rightfully, take some time.” ‎

This process can be expected to raise a broad range of complex policy issues that will need to be addressed on a general basis within the health service into the future.

The matter is further complicated by uncertainty as to whether Minister Simon Harris – who has publicly supported Simon Coveney as the future leader of Fine Gael – will retain the Health portfolio in the event of Leo Varadkar defeating Coveney for the leadership.