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

I wish to especially welcome Dr. Fitzpatrick and apologise to him for the poor attendance at this point in time. We have been in session since 9.30 a.m. and unfortunately we have lost some colleagues for this later session. However, it is important that Dr. Fitzpatrick knows that the content of his contribution and the engagement that we will have will be recorded and noted by all of the members. His contribution does matter and I wanted to reassure him about that.

I thank Dr. Fitzpatrick for his opening remarks. They reflect on some of what we have already discussed here this morning. He said that decisions made on prioritisation and funding at the highest levels of political authority have had a significant impact on clinical outcomes in hospitals. He also briefly referred to the Flory report which is very much a focus of this morning's newspaper reports. I note that he referred to Mr. Paul Cullen, who wrote a front page report on the Flory report for this morning's edition of The Irish Times, a newspaper that I am happy to purchase every day. I would like to say for Mr. Cullen's benefit that if I were a Dublin Deputy speaking about maternity services in Dublin, the matter would never be referred to as a parochial issue. As I am a Cavan-Monaghan Deputy referring to Cavan-Monaghan maternity issues it is no more a parochial issue. From Mr. Cullen's tweets, I am sure that he will note my comment.

Dr. Fitzpatrick said that during the boom years, there was little, if any, investment directed into maternity services. That is absolutely the case. This is an historic problem that dates back a critical number of years. It is not only reflective of the cuts that have only added even deeper to the problems that existed historically. The maternity services were exposed to systematic cutbacks. That is a fact of life that has been borne out again in the Flory report and other reports and it concerns the under-provision of staffing. The Portlaoise report very definitely exposed the fact that there was serious and significant under-provision of staffing for maternity services at Portlaoise where Dr. Fitzpatrick has a particular interest because of the connection now between the Coombe and Portlaoise.

Dr. Fitzpatrick spoke about the current maternity strategy. We do not have one and that is the nub of the problem. We need a new maternity strategy to be fast-tracked. The absence of same is giving rise to a significant lack of confidence and certainty. It has also impacted on the staff at many of the smaller entities rather than at the major Dublin based maternity units. Many of the staff at the other smaller entities, which are spread across the 19 maternity settings located across the country, are fearful for their futures because there is no certainty. We have encouraged and urged the Minister and his Department to move towards the delivery of a national maternity strategy that will give us certainty going forward.

I ask Dr. Fitzpatrick to elaborate what he meant when he said that he believes the Minister for Health should establish a national women and infants programme in order to drive change and clinical excellence. Where would a national women and infants programme fit into the jigsaw of the overall governance of health care delivery in this country? How does Dr. Fitzpatrick envisage its make-up in terms of personnel and accountability? To whom would it report? I ask him to give us a sense of his vision for such a structure and to outline where it would fit into the overall circumstance today.

I have a few questions for Dr. Fitzpatrick that relate to his time as master of the Coombe. Had there been, traditionally, a relationship between the Coombe and any of the other maternity settings across the country? Did he feel, in his role as master, that he was listened to when he brought forward particular proposals and points of relevance? Did he feel that his expertise and knowledge was properly acknowledged and respected? In terms of the system - I refer not only to the political system but also the permanent government in terms of the Civil Service - was he given an ear? Was there follow-through in terms of actions on the recommendations made by him during his years of service in that post?

I thank Dr. Fitzpatrick again for his contribution and I look forward to his responses.