On 29th May 2017, it was announced that:
“The Religious Sisters Of Charity will end our involvement in the St Vincents Healthcare Group and will not be involved in the ownership or management of the new National Maternity Hospital.”Religious Sisters of Charity Statement
Sister Mary Christian, the Congregation Leader of the Religious Sisters Of Charity, went on to state that:
“Upon completion of this proposed transaction, the requirement set out in the SVHG Constitution, to conduct and maintain the SVHG facilities in accordance with The Religious Sisters of Charity Health Service Philosophy and Ethical Code, will be amended and replaced to reflect compliance with national and international best practice guidelines on medical ethics and the laws of the Republic of Ireland.”Religious Sisters of Charity Statement
However, while the “completion of this proposed transaction” had not taken place there were efforts made to obtain “The Religious Sisters of Charity Health Service Philosophy and Ethical Code”. Given that this document formed part of the negotiations around the proposed new National Maternity Hospital, it remains of significant public interest.
The efforts to access this document spanned a prolonged period. For example, on several occasions when the Joint Oireachtas Committee on Health sought the document, the St Vincent’s Healthcare Group “Ethical Framework” was provided instead. A copy of the St Vincent’s Healthcare Group Ethical Framework is available at the bottom of this page. Below is illustrated a letter from St Vincent’s Healthcare Group to the Joint Oireachtas Committee on Health, providing the Ethical Framework in place of the actual document requested. It is clear that this correspondence does not represent the first occasion on which a copy of The Religious Sisters of Charity Health Service Philosophy and Ethical Code was sought.
Obtaining a copy of The Religious Sisters of Charity Health Service Philosophy and Ethical Code, continued to be a matter of public interest.
On 4th January 2022 I sought a copy of The Religious Sisters of Charity Health Service Philosophy and Ethical Code from St Vincent’s University Hospital, under the terms of the Freedom Of Information Act. On 1st February 2022 I received the decision of the hospital, which was to refuse my request. A full copy of that decision letter is available at the bottom of this page, but the two reasons given for refusing my request can be quoted as follows:
“… the record in question has been superseded by the Ethical Framework … I am of the view that the release of a copy of the Religious Sisters of Charity Health Service Philosophy and Ethical Code and any suggestion that this code is still relevant to or guides the operations, objectives and initiatives of St Vincent’s University Hospital or the new National Maternity Hospital would be thoroughly misleading.”
“In my view, the release of the record in question could reasonably be expected to result in material financial loss or gain to St Vincent’s University Hospital and, furthermore, could prejudice the conduct or outcome of any negotiations and ongoing dealings with regard to the new National Maternity Hospital.”Quote from St Vincent’s University Hospital
I did not accept that either of these issues were valid reasons for refusing my Freedom Of Information request.
On 3rd February 2022 I sought an internal review of this decision by a more senior manager at St Vincent’s University Hospital, according to the terms of the Freedom Of Information Act. The result of that internal review was provided to me on 24th February 2022. The outcome upheld the original decision to refuse my request. A full copy of that internal review document is available at the bottom of this page.
The more senior representative within St Vincent’s University Hospital who conducted this review, agreed with the two reasons for refusing access to the document that were described within the initial decision letter.
On 25th February 2022 I appealed the outcome of this internal review to the Office Of The Information Commissioner (OIC). The content of my appeal included the following comments:
“I have made a FoI request to St Vincent’s University Hospital for a copy of the Religious Sisters of Charity Health Service Philosophy and Ethical Code. An internal review has upheld the original decision to refuse my request for two reasons, both of which I believe to be invalid.
St Vincent’s University Hospital has stated that the Religious Sisters of Charity Health Service Philosophy and Ethical Code has been “superseded by the Ethical Framework”. On this basis, they argue that sharing the original document out of context may cause the public to believe that the hospital operates on the basis of the old document rather than the new one. However, there is no derogation from the Act that allows public bodies to refuse records on the basis that they may be misinterpreted. For example, Case Number OIC-93830-Q3M0P1 states that:
‘This Office does not generally accept that the possibility that information once released will be misinterpreted is a good cause for refusing access to the information, nor is there any provisions in the Act to exempt the release of information on the grounds that it is factually inaccurate.’
St Vincent’s University Hospital has stated that releasing the Religious Sisters of Charity Health Service Philosophy and Ethical Code could cause them a financial loss and could prejudice ongoing negotiations. No basis has been provided to support such a contention. Moreover, if the requested document has been superseded and is no longer in effect, then it is inconceivable that sharing such an old deprecated document could prejudice currently ongoing negotiations, or cause a financial loss.”Quote from Appeal Submitted to the OIC
The OIC agreed to accept my request for an appeal.
On 23rd of August 2022, the OIC published their decision with respect to this issue. A full copy of their decision is available at the bottom of this page, which outlines all of the submissions they received and the detailed reasoning that supports their conclusions. The OIC found against St Vincent’s University Hospital. Interestingly, the Religious Sisters of Charity also made their own submission to the OIC, even though I had only ever corresponded with St Vincent’s University Hospital as a public body in relation to my FoI request. For example, the OIC decision stated as follows:
The Religious Sisters of Charity, in its submissions, objected to the release of the Code and made similar arguments to SVUH in relation to section 30(1)(b). It noted the vital public services provided by SVUH and to be provided by the new National Maternity Hospital and that disclosure of the outdated Code could have a damaging and misleading effect on these services and those providing the services.Quote from OIC Decision 120078
The rationale for the OIC decision was consistent with the submission that I had made to the appeal. The extract from the decision illustrated below, summarises the relevant issues.
Often, when the OIC finds against a public body, they will annul the original decision and then ask the public body to consider the FoI request afresh. In this case though, the OIC directed that The Religious Sisters of Charity Health Service Philosophy and Ethical Code, should be released to me in full. The conclusion of the decision is included in the extract illustrated below.
Following the publication of this OIC decision, there is now a four week period during which St Vincent’s University Hospital may appeal to the High Court. However, it is clear that the document should be released immediately, as it should have been when I made the original request in January 2022.
The reasons offered by the Religious Sisters of Charity and St Vincent’s University Hospital for keeping the document secret, are clearly contrived; inconsistent with the law; and contrary to the public interest. Publicly funded healthcare in Ireland should be informed by the best available medical evidence, and not by a catechism handed down to a religious order by a man in Rome. Where the latter has been the case, the Irish public are entitled to know the details.
I should note that I had help with this process from Ken Foxe, who is a leading expert on the Freedom Of Information Act. Anyone interested in training on how to make Freedom Of Information requests; on how to access environmental information; or on how to manage internal reviews and appeals; should consider working with Ken. Moreover, Ken is also involved with the Right To Know organisation. I am a supporter of that organisation and I would encourage others to consider offering them some support too.