Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I thank the witnesses for their attendance and their comprehensive presentations. I have a number of questions. The first is for Ms Leahy. She mentioned community midwifery services in her presentation. I am specifically interested in knowing how geared up are the primary care centres at present. I suspect I know the answer to this question but will ask it anyway. How geared up are they to lead on those community-based maternity services? Second, what will we need to do to ensure they are geared up and can meet those demands? Ms Leahy also mentioned the issues of recruitment and retention and the need for, at a minimum, an additional 100 midwifery posts. Will Ms Leahy elaborate for the committee on what will be needed? Recruitment is important but is no use without retention. Ms Leahy should address those two elements.

Dr. Boylan spoke about the need to have a master in the maternity units. Some of those units are much bigger than others. Does Dr. Boylan envisage any scenario whereby they would be amalgamated to get the critical mass that would necessitate a master or is he specifically talking about the need to ring-fence budgets with some person who has ultimate financial responsibility and ultimately the capacity to hold on to that money? As Professor Kenny said, when things get a little bit rough, it is very often the first place that gets cut.

Dr. Boylan and Professor Kenny spoke about the need for ultrasound services and scans. I asked the HSE about the availability of the 20-week scan and it advised me initially that 20-week to 22-week scans are available to patients and it listed a number of hospitals. It initially advised me they were routinely offered and provided. This is not the case. I know it is not the case because the HSE revised its response to me and told me then that they are available. I would like to hear from both Dr. Boylan and Professor Kenny on what exactly is meant by "available". I do not believe they are available. I certainly do not believe they are offered as a matter of routine but perhaps the witnesses could enlighten the committee as to how women can access these services. A person in my family was told that if a woman is medically indicated for it, she will get it. That is anecdotal but I thought that one would need it to know. The witnesses' expertise on this is vital.

There are no gynaecological services mentioned in the maternity strategy. I speak as a lay person, albeit one who has availed of the maternity services. I would have thought the two must be connected and that if they are not, somehow we are missing a big chunk of the picture. Are the witnesses aware of plans to develop a similar strategy? Perhaps they might be able to tell us why the HSE or the Department of Health left out this very vital service.

Ms Leahy spoke about the need for ratios. It is in the strategy and that is to be welcomed but perhaps we are far from having the personnel to populate the ratios. Does Ms Leahy see a need for those ratios to have some sort of legislative underpinning? Does she believe a guideline would be enough? Can we trust the workforce planners, the HSE and the Department of Health to put in place the necessary numbers or do we need something stronger in terms of legislation?