The Contribution of Religious to Irish Healthcare

Abstract

The Contribution of Religious to Irish Healthcare Tim O’Sullivan A recent Studies special issue, ‘The Nuns’ Story: Writing the Record’, included a comment by Deirdre Raftery that ‘Irish women religious have left a vast, and largely undocumented, legacy to healthcare and education’.1 This comment could be extended to male religious as well in healthcare, in areas such as intellectual disability and mental health services. Growing appreciation of the neglect of the contribution of religious has led to significant work on religious congregations in recent years, such as that reported on in Studies by Raftery and others. In the field of social policy, there has been considerable analysis of the historical importance of Catholic health care providers in Irish social services, but relatively little coverage ‘from within’ of Catholic non-profit providers in Ireland – partly perhaps because of their own reticence or their pragmatic focus on progressing the job at hand rather than in theorising about it.2 Many analyses set out statecentred narratives that view the involvement in social provision of non-profit providers, and particularly those with a religious motivation, as anomalous and distracting from the responsibility of the State to provide basic social services.3 . Interest in the perspectives of religious has also clearly suffered because of their declining numbers and relative importance in Irish social services and because of grave concerns about the historical abuses in residential child care services run by religious orders.4 As a result, although Catholic providers have been a very significant stakeholder in Irish social services, their perspectives on these services have arguably received limited coverage in the social policy literature. Nevertheless, as the Studies authors suggested, there is a strong case today for a more balanced reflection on the contribution of the religious. This contribution is not just an historical one, even if the religious orders delivering healthcare are in significant decline in Ireland. An important recent report chaired by Catherine Day on the role of voluntary organisations in publicly funded health and personal social services made it clear that the Tim O’Sullivan Studies • volume 108 • number 431 288 Studies_layout_AUTUMN-2019.indd 56 21/08/2019 09:14 faith-based contribution to Irish healthcare remains substantial.5 This article seeks to reflect on the contribution of the religious in healthcare, while taking account of their own perspectives. It offers some thoughts on the Day report and draws on a 2013 study of my own, which incorporated interviews with representatives of significant Catholic healthcare providers.6 Substantial presence of religious in Irish healthcare The Day report listed seven Catholic hospitals that are still under religious ownership: the Mater Misericordiae University Hospital, St Vincent’s University Hospital and Temple Street Children’s University Hospital in Dublin; Mercy University Hospital, Cork; Cappagh National Orthopaedic Hospital, Dublin; St Michael’s Hospital, Dun Laoghaire and St John’s Hospital, Limerick. It also noted that there was a faith-based element in the governance arrangements of several additional hospitals. It referred to the planned withdrawal of the Sisters of Charity from St Vincent’s and added that the number of voluntary acute hospitals owned by religious orders may be reduced to four in the coming years: Cappagh, the Mater, the Mercy and St John’s (par. 3.3). In the same paragraph, the report stated that two thirds of all disability services are still provided directly by the voluntary sector, including eighty per cent of residential places. A number of large disability service providers are faith-based, for example: Brothers of Charity Services Ireland, Carriglea Cairde Services, Daughters of Charity Disability Support Services, Saint John of God Community Services. These organisations, the review group stated, account for approximately fifty-eight per cent of the funding allocated to disability service providers under the ‘Section 38’ funding system. A somewhat State-centred distinction is drawn at times in the Irish policy literature between large non-profit bodies that provide services ‘on behalf of’ a statutory body and community and voluntary organizations that provide other services and undertake developmental activities to meet social need without being delivery agencies on behalf of a statutory agency.7 . In legal terms, this distinction is reflected in the 2004 Health Act...