This section briefly outlines the legal and operational governance of The National Maternity Hospital (NMH).
NMH was established through charitable donations in 1894 and, in 1903 the NMH received its Charter from the Crown. The legal status of the NMH emanates from the Charter and subsequent legislation and in that respect is along the same lines as the other two major Dublin maternity hospitals.
Under the Charter, before its amendment, the control of NMH rested with a Board of Governors numbering up to 65 but the day to day operational control rested with the Master, an obstetrician and gynaecologist elected by the Governors.
NMH was rebuilt in 1930s and this opportunity was taken to amend the Charter by the National Maternity Hospital, Dublin (Charter Amendment) Act 1936 (the “Act”). The Act increased the number of Governors up to 100. The Governors are essentially, in modern corporate language, the shareholders of the NMH. Their principal duties are to elect the ordinary members of the Board at each Annual General Meeting and to elect the Master once every seven years.
The Act devolved the management and operational control of the NMH to an Executive Committee which in modern language is the Board. The Act was ahead of its time in introducing a gender quota and diversity on the Board. In line with a number of other hospitals and in the context of the Act being enacted not long after the Eucharistic Congress the chair of the Board is His Grace the Catholic Archbishop of Dublin. The Archbishop has not been actively involved although is informed of significant developments. Also on the Board is Dublin’s first citizen, the Lord Mayor, who in recent years has taken an interest in the NMH and attended board meetings. The effective chair of the Board is the person, officially known as the Deputy Chair,who is elected at the first Board meeting following the Annual General Meeting in each year.
Certain board members are specified in the Act namely, in addition to the Master, the parish priest of Westland Row (in the 1930s the overwhelming majority of the mothers delivering babies would have been Roman Catholic); the public interest is represented by two nominations from Dublin Corporation (currently these are from the Green and Sinn Fein parties) and the Government’s interest is represented through the ability of the Minister for Health to appoint two nominees (these are currently in place). There are two officers namely, the Honorary Treasurer and the Honorary Secretary. Of the others, the Act provides that there shall be not less than six women. In practice the 21 ordinary members of the Board, who are subject to annual election, are split equally between medical clinicians practicing in the NMH, seven lay men and seven lay women. Thus the Board, consistent with modern day corporate governance, has a majority of non-executives currently drawn with a background of SME business, IT, financial (accountants, actuaries, brokering) and legal. The clinicians drawn from different medical divisions operating in the NMH provide the appropriate experience in the relevant fields of medicine necessary to the Board in its determinations. The Board meets monthly and considers issues raised by the Finance Committee, the House Committee and other Committees as well as legal issues including any cases taken against the NMH. Reports are given at the monthly Board meeting by the Master and the Director of Midwifery and Nursing, and regular presentations are given to the Board from units of the NMH so the Board has a full understanding of the working of the NMH which informs the Board when making decisions on all aspects of the NMH.
The Act maintains the successful system of the Mastership (a seven year term which cannot be renewed by the incumbent or a former Master) without which the NMH could not be run in the safe manner in which it currently operates for the annual delivery of over 9,000 new lives. The Master is ably assisted by the Director of Midwifery and Nursing, the Secretary & General Manager and the Financial Controller.
NMH's equivalent to a company's articles of association are its Rules and Bye-laws introduced in 1955 which have been amended on a number of occasions since. Under the Rules there are five sub-committees of the Board namely a Finance Committee, a Risk Committee, an Ethics Committee, a House Committee and a Nominations Committee.
The Finance Committee consists of the Executive Management Team of NMH, namely the Master (effectively the CEO), the Secretary & General Manager (effectively the COO), the Director of Midwifery and Nursing and the Financial Controller together with four lay representatives, namely the Deputy Chairman, the Honorary Treasurer, the Honorary Secretary and a member of the House Committee. The Finance Committee meets monthly dealing principally with financial matters which effectively covers all matters pertaining to the continual management of the NMH, accounts, income, expenditure both current and capital, budgets, retirements, resignations and replacements, insurance, procurement and correspondence with the HSE and Ireland East Hospitals Group. It reports to the Board monthly and in addition it effectively acts as an audit committee.
A long standing committee is the House Committee which meets regularly. Its primary activity is monthly inspections of the NMH. The NMH building having been built in the 1930s is in constant need of maintenance and the regular inspections highlight these needs which are brought to the attention of the Board (several members of the House Committee are on the Board) and, subject to available funds, appropriate repairs are directed by the Board to be carried out.
The other three committees meet regularly. The Nominations Committee assesses the suitability of persons to be nominated for election as Governors or as board members.