Professor Louise Kenny:

I thank the Chairman and committee for this opportunity. I echo what my colleagues have said. We must accept the fact that the woman is at the heart of everything we are addressing today. We must not lose sight of that. Notwithstanding that, my colleagues and I at the Institute of Obstetricians and Gynaecologists welcome the national maternity strategy and sincerely hope it will be adequately resourced and fully implemented without further delay.

There are fundamental inequities in the provision of women’s health care in Ireland in 2017. First, Ireland has the lowest number of obstetricians and gynaecologists among the OECD countries, at a rate of just 3.95 per 1,000 live births. This is just over half the comparative number in the UK for the same number of births. Despite this, clinical outcomes for mothers and infants are comparable with the best internationally. We urgently need to recruit a minimum of 100 extra consultants. This will require remedial steps to retain our senior trainee specialists who are currently discouraged from remaining in Ireland by poor working conditions, the perception of a hostile media and gross inequality of remuneration and contracted hours that has been brought about by the introduction of the divisive 2012 consultant contract.

Second, we reiterate the need for equal access for all women to standardised ultrasound services. Neither specialist ultrasound nor foetal medicine services are available to all pregnant women in the Republic of Ireland. Even in CUMH, where I work, a tertiary level referral unit where more than 8,000 infants are born every year, we cannot provide second-trimester foetal anomaly scanning for the majority of pregnant women attending for antenatal care. This issue remains unresolved in 2017 and exposes pregnant women attending CUMH, and their health care providers, to an unacceptable level of risk.

Finally, the single most important step to safeguard the success of the national maternity strategy is to ensure the governance of women’s health services is robust, independent and secure. International experience demonstrates that women’s health services are always the first to be cut when they are not protected by independent governance and a ring-fenced budget. Closer to home, the well-documented issues with the provision of gynaecology services in CUMH, which have led to unprecedented and dangerously long waiting times for outpatient and surgical treatment, further illustrate this point. We believe that in keeping with the national maternity strategy, maternity services within the Irish hospital system need to be led by a single accountable individual with both clinical and executive authority.

I thank the committee again for the opportunity to be here today.