Back in 2013 it was announced that a new National Maternity Hospital would be built on the site of St Vincent's Hospital in Elm Park in Dublin.

Eight years on and the development has not yet got the green light as it remains mired in questions about its independence. At issue is the ownership of the land where the new hospital will be built and its operating structure.

But the critical point for campaigners is whether the complicated ownership structure is designed to mask a Catholic ethos. This would be anathema in a healthcare facility for women and babies in post-Repeal Ireland.

So why has it been impossible to progress a development which everyone agrees is desperately needed?

Tánaiste Leo Varadkar told the Dáil this week that all procedures currently offered at Holles Street will be offered by the new hospital including terminations, sterilisations and abortions. He said this would be guaranteed by its governing documents.

But he said there were two problems holding up its progress - the ownership of the land and the governance of the hospital.

The Religious Sisters of Charity own the land and say they are gifting it to the Irish people. However, it is not that straightforward, as the land is being transferred to a new private charity, the St Vincent's Holding CLG. The land will be leased to the State for 99 years at a nominal rent.

The individual directors and members of St Vincent's Holdings CLG are the shareholders of St Vincent's Healthcare Group. And the Religious Sisters of Charity are currently the sole shareholders in St Vincent's Healthcare Group.

Critics including a former Master of Holles Street Hospital, Dr Peter Boylan, say this means that a religious order will ultimately be in control of the new hospital, compromising its independence.

He said yesterday that the core values of the new hospital would be Catholic and it would be "a Catholic organisation".

The nuns insist they will have no day-to-day involvement in running the hospital, pointing out that they no longer sit on the board of St Vincent's Hospital and decided in 2017 to withdraw from the St Vincent's Healthcare Group.

They also say they will have no role in the appointment of directors to St Vincent's Holdings CLG.

But this has not satisfied campaigners or the officials in the Department of Health, who are not yet convinced that sufficient safeguards are in place to ensure the independence of the new hospital.

Social Democrats co-leader Róisín Shortall has repeatedly raised this issue in the Dáil. She says the onus is on the Religious Sisters of Charity to give this land to the people - meaning full public ownership.

"We absolutely have to ensure that this major public investment is protected and that there is a secular ethos in the new National Maternity Hospital. Nothing less is acceptable. That cannot happen with the current proposals."

The Department of Health also says it has made several attempts to buy the land outright dating back to Simon Harris' time as Minister for Health in 2017. These were rebuffed, as were suggestions of a 999-year lease and a mortgage in favour of the HSE.

However, yesterday, both the Religious Sisters of Charity and the St Vincent's Healthcare Group disputed that they have been approached to sell the land.

Taoiseach Micheál Martin also weighed in yesterday insisting the new hospital should be owned by the public and built on public land. He pointed out that nothing has been signed off yet and said that given the enormous taxpayer funding involved, the taxpayer should own the facility.

In 2016, troubleshooter Kieran Mulvey was drafted in by Mr Harris to broker a deal between St Vincent's Hospital and the National Maternity Hospital on the corporate structure of the new facility.

It was agreed that a new operating company would be set up with four directors from St Vincent's, four from the National Maternity Hospital and one nominated by the Minister for Health. The minister would also have a golden share to protect the public interest.

But while the Department of Health says the report remains the basis for further agreement, one politician, speaking privately yesterday, said that they felt it was not possible to square the circle given that officials have been working for years on the legal framework without success.

All Opposition parties have highlighted concerns. People Before Profit’s Bríd Smith said yesterday that while there is no indication that certain procedures will not be available, the fact remained that the Board of Directors was appointed by the order who will employ staff.

She stopped short of calling for the entire plan to be scrapped, saying the State should attempt a Compulsory Purchase Order for the site.

This is being considered by Government, but it is viewed as a measure of last resort and one that would be fraught with legal difficulties.

Instead, Minister for Health Stephen Donnelly is understood to be considering a proposal to extend the 99-year lease by another 50 years. The logic here is that the building would be obsolete by then and would have to be replaced anyway. However, this suggestion is unlike to be enough to ease concerns.

The bind for the Government is that it wants to get this much-needed project over the line but not at any cost. The problem lies on the desk of the Fianna Fáil Minister for Health, but other politicians were keen to highlight that Fine Gael ministers have had a lot of earlier involvement.

The coalition appears to be aiming to apply political pressure to encourage the order to transfer the site to public ownership.

But pressure will also be maintained on the Government to broker a solution with a Social Democrats motion due in the Dáil next week calling for full public ownership and control of the new hospital. Campaigners also plan a protest next weekend.

For now, nobody wants to contemplate the alternative of scrapping a project several years in the planning and going back to the drawing board.