Ms Mary Leahy:

I will give the example of what happened during the moratorium. In Galway, most of the neonatal intensive care midwives were incentivised to retire. Once they had left, the HSE realised that their expertise was lost to retirement. I had to re-recruit them as retirees, which is not ideal. Mary Gorman can correct me if I am wrong but I believe there are very few places on the neonatal intensive care course. One might even have to go abroad to study for that course. It is something that must be harvested. We have an older maternal population and an increased incidence of early births of low birth weight babies. An increasing number of babies are going into the neonatal intensive care unit, NICU, so that must be addressed as well. I do not wish to over-beat up the HSE, but it was dreadful how it let that expertise go. It was uncontrolled and unmanaged.

There is a huge emphasis on lactation support, in midwifery initially and then in the community from the point of view of the early discharges, the midwives who are coming out and the public health nurse. Unfortunately, our rates have improved but they are still quite low. We have an initiation rate in breastfeeding of approximately 48% to 50%. We carry out a three month development assessment of all neonates and when we bring the mothers back it has dropped to approximately 38% at that stage. We have examined this and there is a great deal of research on it, but our most recent anecdotal information from speaking to many colleagues and midwives is that it is due to the pressure on mothers to return to work. A cultural sea change is needed in that area as well. There are many Polish women in our communities and Polish and eastern European women will automatically breastfeed. Their rate is approximately 98% and our indigenous population levels are being pushed up because of the eastern European women and women of other nationalities who are now living among us.

Deputy Sherlock mentioned governance. I will not respond to that question as it is not in my area. Have I dealt with everything?