Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I hope the Chairman has not yet started the clock. I will prioritise a number of areas, focusing initially on maternity policy in the Health Service Executive. In the reply to my question for this quarterly meeting the Minister indicated that the Department and the Health Service Executive were working on a new maternity strategy. The Department commissioned a review of national and international literature on the issue, which has been completed and is informing the development of a maternity services policy paper. The reply indicates that the Minister will establish a high level working group to assist in finalising the strategy. When will the working group be established and when will the strategy be finalised? Is this a priority for the Department? If, as I hope, it is, will he indicate when he expects the strategy to be published?

I also note that, as part of the outworking of this process, interviews and discussions will take place with staff across maternity services units, of which there are 19 in the State. A range of site visits is also planned. Will, as I hope, all obstetric units be visited or will only some of them be visited? If the latter is the case, which units will be visited? Will nurses and midwives in each obstetric setting visited be included in the engagement on the new maternity strategy?

The Minister stated the Health Service Executive continued to implement all recommendations in both the HIQA Galway report and the HSE Galway report. All of the obstetric units were invited to self-assess against the recommendations contained in the HIQA reports. The self-assessment has been completed and the HSE will shortly survey all hospitals to review progress made in responding to the initial self-assessment, which will be evaluated against the recommendations contained in both reports that followed the death of Savita Halappanavar.

When will the surveying of all hospital sites get under way? Is there a timeframe for its completion?
As we have heard, the Health Service Executive is continuing to implement all of the recommendations made in the two Galway reports. I submitted a question about the recommendations made in the report on the tragic loss of baby Jamie Flynn who was born in Cavan General Hospital in November 2012. The response I have been given indicates that the Cavan-Monaghan hospital management team is in the process of commissioning a new external review team. How long will it take before this new team is put in place to carry out a second investigation into this tragedy? I have been told that family members are being kept updated. That may well be the case, but I know that they are deeply distressed. I have been given a list of measures being taken at Cavan General Hospital's obstetric unit. It appears that five of them will address potential delays in accessing the theatre for emergency Caesarean sections and that three of them will strengthen clinical governance arrangements for women's and children's services. Given that we had two further tragic outcomes in April this year, surely every identified improvement in systems and practices must be introduced. Surely we do not have to wait for another report to be presented. I seek clarity on the listed eight measures being introduced. Are they reflective of the recommendations contained in the first report which was suppressed as a result of High Court action? Regardless of the decision to suppress the first report, if the recommendations made in that report stand on merit and are self-evidently needed, I hope they will be implemented without question or delay. A further report should not be needed to ensure these actions are taken. I ask the Minister to expand on the position outlned in the response he has given. Many women who are expecting and others who are planning to have children in the future are very concerned. We have had three tragic outcomes, but we have had no public presentation of a report or recommendations. We simply do not know what, if any, actions have been taken as a result of the recommendations contained in the first report.
I would like to move on to the issue of mental health services. With the Minister of State, Deputy Kathleen Lynch, we met representatives of Mental Health Reform earlier today. I have commended the contribution of that organisation which has highlighted a number of serious deficiencies in mental health services. Even though the programme for Government contains a commitment to "ring fence €35m annually from within the health budget to develop community mental health teams and services as outlined in A Vision for Change", just €20 million was provided this year. As I recall, it was previously indicated that this year's €15 million shortfall would be added to the 2015 funding of €35 million. It has not been indicated or stated anywhere more recently that this will be done for the coming year. I would like the position to be clarified. Is it the case that the additional money promised in the previous commitment will not now be forthcoming? We have been told that the €20 million provided for the current year has not been and, most likely, will not be fully expended before the end of the year in the recruitment of the essential staff needed.
I would like to make a final point about maternity services. I wanted to ask several other questions. The Minister gave me a response yesterday on the midwifery practice of a named, very well known and highly respected midwife. I am not referring to her specific case. I have received four e-mails this morning from some of the 29 women who have yet to have a midwife allocated to them to fill the vacancy created by the removal of cover from their first-choice midwife. The pregnancies of some of these women is advanced and they are extremely concerned. With respect, I do not think the suggestion made in the Minister's letter that the matter is receiving attention is enough. The women concerned need to be advised about the availability of replacement midwives as a matter of extreme urgency. I, therefore, ask the Minister to commit here this morning that this will be done. There should be no further delay in having that need met.