The Government could be heading for a clash with Catholic-owned hospitals if it acts on proposals to extend the number of designated centres where terminations can be carried out in its planned abortion legislation.

The heads of the Protection of Life During Pregnancy Bill only specifically provides for terminations to be carried out in the 16 maternity units attached to general hospitals and the three Dublin maternity hospitals.

The proposals do not specifically provide for terminations to be carried out in large general hospitals which do not have maternity units.

However, the prospect of major Catholic-run hospitals such as St Vincent's or the Mater becoming designated centres for terminations in rare emergency cases could lead to a clash between the Government and the Catholic Hierarchy.

Three expert obstetricians from the Dublin maternity hospitals, speaking at last Friday's Oireachtas Health Committee hearings, called for the number of designated centres where terminations can be carried out to be extended to all general hospitals in the State.

This would allow terminations to be carried out in large general hospitals in Dublin, for example, where in emergency situations the mother might be transferred from a maternity hospital, or where in an emergency case a mother whose life is in danger may have to go directly to a large general hospital without a maternity unit.

It was pointed out at the Committee hearing that none of the three Dublin maternity hospitals has intensive care units, and already used the ICU facilities in general hospials for some patients.

The Catholic Bishops earlier this month, commenting on the draft abortion legislation, said imposing a duty on Catholic hospitals to provide abortion 'would be totally unacceptable and has serious implications for the existing legal and constitutional arrangements that respect the legitimate autonomy and religious ethos of faith-based institutions'.

The Bishops had particular concerns about the position of Catholic hospitals potentially being obliged to carry out terminations in emergency situations under the legislation.

None of the 19 maternity units designated in the draft legislation, with the exception of Holles Street, has any religious involvement in its governance.

And in Holles Street's case, although its Chairman is still the Catholic Archbishop of Dublin, his role is largely titular and the current Archbishop, Diarmuid Martin, has asked that this role should cease.

Former Holles Street Hospital Master Dr Peter Boylan told the Oireachtas Committee that because of the way things will happen in emergencies, all Government-approved hospitals in the State should be designated as termination centres rather than just the maternity hospitals or maternity units in general hospitals.

He said things can happen very fast and one cannot have a situation where a woman is going to die if she does not have a termination of pregnancy, but she is put in an ambulance in one hospital and dies on the way to a designated hospital.

Dr Boylan said Holles Street already transferred women to St. Vincent's Hospital when they were very ill and require intensive care. He said on occasion, babies were delivered at St Vincent's in emergency cases when the mother was believed to be at risk.

Holles Street Master Dr Rhona Mahony said sometimes they decided to deliver women in a general hospital because of the concurrent medical difficulty she might have.

"In addition, in an emergency, we cannot have a situation where we have to require to transfer a patient to an obstetric unit for determination of pregnancy. Therefore, it is very important that we include all Government-approved hospitals in this legislation."

Rotunda Hospital Master Dr Sam Coulter Smith also proposed the heads of bill must be broadened to include general hospitals.

Under the current heads of bill, the only hospitals specifically designated at termination centres are the 19 public maternity units, although the proposals do mention that in an emergency a termination can be carried out in a location other than a public obstetric unit.

Under Health Minister James Reilly's recently announced hospital reorganisation plans, hospitals are to be organised into six regional groups overseen by State-appointed boards. This may ultimately lead to a dilution of the role of Catholic orders that currently run hospitals such as the Mater and St Vincent's.

The hospital group plans may also provide for new governance arrangements for Holles Street Hospital that would end the tradition of the Catholic Archbishop chairing its board.

Under the plans, all hospital groups will eventually become independent trusts.

The Oireachtas Committee hearings on the abortion legislation are to continue today and tomorrow.

Church may lose hospitals role