Time for the church to move out of healthcare?

  • Niall Hunter, Editor

Oh the sisters of mercy, they are not departed or gone - Leonard Cohen

The Sisters of Mercy, it was announced last week, are to contribute property and cash to the value of €128 million in reparation for the suffering of children who were in industrial schools run by the order.

The Sisters of Mercy ran a number of these schools including the notorious Goldenbridge. Another religious order, the Sisters of Charity, were involved in a number of industrial schools.

The institutions run by both of these orders featured in the Ryan Commission report on institutional child abuse published earlier this year.

The Sisters of Charity, for their part, last month agreed to contribute €5 million to a trust fund being set up for the benefit of former residents of institutions. They said they genuinely regretted any suffering experienced by former residents while in institutions under their care.

The week before last, people were reeling again yet another abuse report, from the Murphy Commission, in which we read of horrific abuse of children by priests and a massive cover-up by those running the Dublin Diocese.

In the face of such a horrific history and all it tells us about Irish society, many would be tempted to say all of these awful events happened in the past and belonged to a time when the clergy and religious orders exercised as almost hypnotic and in many ways inexplicable level of influence on our daily lives.

And yet, if we look at some of our healthcare institutions, we see that despite their inglorious records in looking after many of the people who were under their care, the same largely unaccountable power elites are still owning and running many of our major publicly-funded hospitals.

And they can still wield not insignificant influence on how these institutions are run.

The Sisters of Mercy and Sisters of Charity still own two of Dublin, and Ireland's, biggest hospitals, the Mater and St Vincent's respectively.

Other healthcare institutions owned by The Sisters of Mercy include Temple Street Children's Hospital and National Rehabilitation Hospital in Dun Laoghaire. The Sisters of Charity also own St Michael's Hospital in Dun Laoghaire as well as other healthcare centres.

A look at the the Mater Hospital's website shows us how firm a grip the Catholic church still has on hospiutal governance. It tells us that the Mater Misericordiae University Hospital is single member company; a subsidiary of the Mater Misericordiae and the Children's University Hospitals (Temple St) Ltd.

"The majority of the members of the parent company are Sisters of Mercy and the remaining members represent the Catholic Archdiocese of Dublin, the Catholic Nurses Guild of Ireland, the Society of St Vincent de Paul and the Medical Consultants of Mater Misericordiae University Hospital and the Children's University Hospital."

This statement reads like a historical document from the 1950s, rather than a description of how many would now feel a modern, almost wholly state-funded hospital should be run.

A further reading of the mission statements of the Mater and St Vincent's refer to their devotion for caring for the sick and concern at all times for the welfare of the patient. They also refer to upholding the spirit and ethos of the religious orders who own and run them.

And it is not just religious orders that still have a strong influence on healthcare provision. The Catholic Archbishop of Dublin is still Chairman of Crumlin Children's Hospital and Holles Street National Maternity Hospital. The recent Murphy report showed us how two appalling cases of abuse by two priests working at Crumlin hospital were neglected and covered up by predecessors of the current Archbishop.

A glance at the list of governors at Holles Street shows us that not only is the Archbishop Chairman, but three other local parish priests are on the board. These are all "ex-officio" governors, who automatically get onto the board because of the positions they hold.

The Ryan and Murphy reports have demonstrated gross abuses of power and of people by religious orders and the clergy.

Notwithstanding the good work many in both religious groupings still do, the recent revelations about child abuse and how it was neglected and covered up by the Church must inevitably lead to a questioning of its continuing role in the ownership and running of major hospitals .

If one even looks at the 'optics' of the current situation, is it appropriate to have the Sisters of Mercy owning a children's hospital (Temple Street) given the order's controversial history in the area of child welfare? This is course not to deny the excellent standard of care provided by staff at Temple Street. The new Children's hospital to replace the existing three Dublin hospitals will be built on the Mater site. It will be a HSE-owned hospital but will be linked to a major hospital still run by the Sisters of Mercy.

In the same vein, is it appropriate that the Archbishop of Dublin (however decent the current incumbent may be) should have a major say in running Crumlin and Holles Street Hospitals. Should the Hierarchy have any say any more in the provision of child health or women's health services?

The appropriateness of the continuing role of the Church in healthcare role can be questioned on a number of levels.

1. Accountability.

Hundreds of million of taxpayers' euros are spent on running Catholic hospitals each year. The State provides the vast bulk of the funding for these hospitals, and has paid, over the years for developments at these institutions. Yet much of the ownership and governance of these hospitals is still vested in religious orders or members of a clergy who have a less than glorious recent history in catering for the needs of the vulnerable in our society, in particular to the needs of children. In this respect, their moral authority to own and run hospitals must be questioned. Even if one were to set aside the issue of child abuse for a moment, how appropriate is it today for major hospitals funded almost completely by the State to be run by private groups or companies? Ownership of Our Lady of Lourdes Hospital in Drogheda was transferred from a religious order to the State in the 1990s - surely the same can be done in respect of other religious-run hospitals funded by the State.

2. Societal/cultural.

We live in an increasingly secular and multicultural world in which excessive religious influence on State-funded healthcare is now surely an anachronism. Surely good healthcare within the principles of humanism and justice can be delivered of a similar standard to the care ethos of the major religious orders without having to invoke Jesus or the Virgin Mary or only bring Catholic teaching to bear on how care is provided.

3. Damaged Goods?

Surely evidence of past (and some in the fairly recent past) abuses of power and people by the Church severely diminishes any remaining authority the Church has in terms of running institutions that care for sick and vulnerable people.

4. Influence on hospital policy

As recently as 2005, a trial of a cancer drug was delayed while a committee of the Mater Hospital deliberated over the fact that women who could get pregnant might have to take contraception while getting the drug to avoid fetal damage. Up until quite recently, women sometimes had to pay a heavy price for being treated in a Catholic hospital. The controversial practice of symphysiotomy, a surgical procedure to widen the pelvis which had serious after-effects, was practised in one Catholic hospital as recently as the early 1980s. One of the reasons given for this practice was that women subjected to the alternative of repeated Caesareans might be tempted to use birth control. Again, until recently the Catholic ethos of state-funded hospitals has sought to prevent or actively prevented procedures such as female strerilisation taking place, even though such procedures were legal and available in other hospitals. Such influence on hospital policy which can restrict patient choice of treatment is still potentially there. This is surely not appropriate in 2009.

Obviously, given the recent revelations and growing hostility to Church institutions, it is easy to descend into simple anti-clericalism, or 'priest-bashing'.

However we must start thinking about having a truly State-run health service. It is the State and the taxpayer, not priests, bishops or nuns who are paying for it and should be allowed run it without potential interference.

See also "Romantic Ireland's well and truly dead and gone"

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