The Supreme Court has dismissed an appeal over the North Eastern Health Board’s power to discontinue maternity services at Monaghan General Hospital, ruling that section 38 of the Health Act 1970 regulates hospital premises rather than services provided there.
The appeal was brought by Shauna Tierney, Maura Sherlock, Brenda McAnespie and Sharon O’Neill after the High Court refused their judicial review application in July 2004. They argued that the Board lacked statutory authority to suspend or discontinue maternity services at Monaghan and that the legislation required services already provided by a hospital to continue there.
The Board submitted that the service had not been discontinued, arguing that full maternity services were available at Cavan and that Monaghan’s services had been temporarily suspended before a midwife-led service was established in 2005. It also argued that section 38 concerned the provision and maintenance of premises, not the closure of a hospital department. For the purpose of deciding the legal question, the Supreme Court assumed that maternity services at Monaghan had been discontinued. It did not decide whether Cavan and Monaghan constituted one hospital or two.
Delivering judgment on 9 July 2010, Denham J said the appeal raised a discrete question of statutory construction. The Court distinguished the Health Act provisions requiring health boards to make inpatient and maternity services available from section 38, which sets out powers concerning premises. The Court held that section 38 did not prevent a health board from closing a department within a hospital.
The judgment said the Board had a general duty to provide services, including maternity services, but the legislation did not prescribe where they must be provided. The Board could meet that duty by providing services elsewhere in its region. The Court concluded that the Board had power to close a hospital department and had not acted ultra vires.
The Supreme Court dismissed the appeal and ordered that the case title be amended to name the Health Service Executive as respondent. The judgment did not determine the merits of the Board’s service arrangements or make a finding about the quality or safety of services at either hospital.