Denis Naughten (Roscommon-South Leitrim, Independent) | Oireachtas source

I refer to Dr. Gerard Burke's evidence. He flagged an issue flagged in January, which is how to define a real and substantial risk. He referred to it on a number of occasions. Last January, Dr. Rhona Mahony, master of the National Maternity Hospital, raised the specific concern of whether a real and substantial risk is 10%, 50%, 80% or 1%. Interestingly, the evidence of Dr. Gerard Burke contradicts the evidence of Dr. Rhona Mahony earlier. She believes the legislation provides clarity. I do not believe there is but Dr. Gerard Burke could comment on her evidence.

In Dr. Tony Holohan's evidence, he said that there may have been women who had early deliveries due to suicidal ideation. Although two of the witnesses were asked twice, they did not answer that question. I ask the four witnesses whether they have experience of early delivery based on suicidal ideation. Has it happened within their facilities?

We are anxious to have smaller units present to indicate whether there are different implications for smaller units in respect of this legislation. Subhead 1 defines the appropriate location. With regard to Dr. John Monaghan and Portiuncula Hospital, the facility must provide obstetric and mental health services. That is quite close at the moment, with Portiuncula and an acute unit in St. Brigid's Hospital in Ballinasloe. There are two acute psychiatric units in the Roscommon-Galway services, one in Ballinasloe and one in Roscommon. One of these will close in the not-too-distant future. If the one in Ballinasloe closed, would that have implications on the delivery of the service? I ask the speakers from smaller hospitals if they have specific concerns regarding the implementation of the legislation and the definition of appropriate location when they consider the traditional agenda within the HSE to remove the smaller units. A HIQA investigation is ongoing and we do not know what recommendations are going to come of it. Have the witnesses any fear the legislation could be a Trojan horse?

There are normally three consultants in smaller units. Do the witnesses fear that if the three consultants had a conscientious objection to carrying out procedures and one was to retire, there would be an agenda to ensure a new consultant does not have a conscientious objection and would be recruited on that basis?

Are the witnesses satisfied with the neonatal emergency transport service available to them? Will that be adequate in future? Are the witnesses satisfied with the existing level of psychiatric support for pregnant women?