Professor Michael Turner:

Yes. It is nothing to do with the HSE programme. We support having a comprehensive registry and it is of concern to me, as a clinician, that one in three births in the country is not covered by the HSE registers. It is those parts of the country, when we did the comprehensive audit, that had the highest number of neural tube defects that are not part of the registry. The numbers are higher in the midlands and in the Border counties and they are not being covered by our national register. We need to get accurate data. To return to Deputy Kelleher's point, in terms of the data collection, the data on termination are very difficult to collect in any country, irrespective of what the legislation provides, because a lot of terminations of pregnancy take place in a private health care facility where the information is not collected.

There is an issue around diagnosis and, in particular, the diagnosis of spina bifida, because most cases of spina bifida are diagnosed around 22 weeks gestation. We know that the ultrasound services for diagnostic purposes are far better in the big academic centres than in the 13 smaller units. This may be part of another discussion on the maternity services but the ultrasound services in the smaller hospitals are deficient. The committee has heard a lot of talk about this. It is related to the fact that Ireland has the lowest number of consultant obstetricians and gynaecologists in the European Union. We need to do something about that in terms of improving pre-natal diagnosis.

There are huge advantages to the couple if the diagnosis is made at 22 weeks because they can then plan the rest of the pregnancy, including where the baby is to be delivered and if it is going to be in larger maternity unit where there are foetal maternal specialists. There is a major national issue when it comes to the provision of ultrasound services.