Colm Burke (Fine Gael) | Oireachtas source

I thank the witnesses for their presentation, which was circulated to members before the meeting.

I welcome the report on the national maternity strategy. My problem with reports is that in 2003, when there were between 90 and 100 consultants in obstetrics and gynaecology, the plan was that to have 180 by 2012. The report published last year showed that in 2014 there were 121 consultants. My understanding is that is that there are now approximately 130. The report states that over 100 additional consultants should be recruited. Can we make a time frame for the implementation of that recommendation? I know there is a difficulty in recruiting and retaining people but of the 130 some will retire in the next five years. Apart from additional recruitment, are we forward planning for these retirements? How many consultants will be recruited per annum during the next five years to implement that?

I understand that 13 director of midwifery positions were filled. Are those permanent appointments? I understood that there were to be 19 directors of midwifery appointed.

Has the bar been set too high for small units, thus making it difficult to get candidates? Has that been reviewed? The candidate has to have a certain level of experience and have worked in that area. People with a lot of maternity experience may have gone into other parts of a hospital for a period and now do not fit those criteria.

Deputy Sherlock mentioned the unit in Cork. When it opened, there were two theatres - one has never been opened and the other is open only 3.5 days a week. In order to open it for longer, more nurses would have to be recruited and that would take time. To open the second theatre would also require more nurses and beds. It has been proposed that the HSE rent space in another location, rather than using the National Treatment Purchase Fund, NTPF. The consultants are willing to go off site to carry out procedures - many of them are day procedures - where there is another location available. This might be a far cheaper way to deal with the problem. The patient would remain under the care of her own consultant who knows her history. Is that being considered?

In some units there is a lack of support for staff where there is an adverse outcome. While there is a huge trauma for a family there is also a trauma for staff which we sometimes forget. When there is an inquest or court case there is a lack of support for them. What new procedures will be put in place to ensure that? Where an adverse outcome arises there should be an independent review. I know of two cases where everyone agreed that there should be independent reviews. There was a decision about who should carry out the review but someone in administration decided that the person was not suitable - although the individual in question was very competent and had done previous reviews - and, 18 months later, that review has not been completed. Therefore, the people who have suffered as a result of the adverse outcome suspect that something is being hidden. When it is decided to hold an independent review, why can a timescale not be set down? That would help greatly in reducing concerns.