Dr. Mary McCaffrey:

We have never referred women because it is illegal to do so.

I find it difficult to see how the timeframe could be narrowed any further. A period of seven days is really tight. In an ideal world, one would try to get it as close as possible. A period of five days might be aspirational. There are weekends and panels have to be put together. It would be really difficult.

Merging the heads of the Bill in regard to medicine and psychiatry makes absolute sense.

On Senator Crown's comments, we may be very unlucky in smaller units, but cases always seem to happen on a Sunday afternoon and come out of nowhere.

People do present seriously ill with pre-eclampsia - fulminating pre-eclampsia - out of nowhere. Women do present with sepsis. I know of cases in which people have come in seriously ill. Antenatal care is all about trying to predict in advance the issues that might arise. Looking at the confidential inquiries from the United Kingdom, they are very much into educating primary caregivers to be more mindful of picking up on these issues at an early stage. Unfortunately, however, many of the situations we deal with happen very acutely. I do not believe that in any of those situations any obstetrician would conscientiously or otherwise do anything which would tend not to save that mother's life there and then. We do get people with seizures and bleeding, so that is not an issue. Deputy Denis Naughten asked about the neonatal transfer team. We might talk about that at another time, but it is not appropriate to discuss it under the heads of the Bill.

In regard to the screening of job applicants, interview processes should put the best candidates forward for the job. Providing for rare circumstances is one aspect of the care we provide. What one would want is to have people in these jobs who will ensure the safety and health of the mother. I worked in the United Kingdom for a number of years and one is not allowed at interview to ask questions such as those suggested. I recall only one interview at which I was asked a question like that. I did not get the job and I never knew whether it was because I said I would not do a termination of pregnancy. We would have to be careful of discriminating against people.

With regard to appropriate locations, what is outlined in the heads of the Bill needs to be extended to include general hospitals. Ironically, a woman presenting at Tralee would have access to a wider range of services than in some other places.

Fortunately, I have never seen a patient with suicidal ideation. I have certainly never seen a patient delivered early because of it. In fact, I am not aware of any instance in any unit where I have ever worked.