Dr. Peter Boylan:

Ten new consultants per year need to be appointed for the next ten years, in addition to the replacement of retirees. Retirements are entirely predictable, as the age of all consultants is known and they currently have to retire at the age of 65, although some have continued on beyond that.

There are enough trainees coming through, but the jobs are not attractive enough to them. Making our jobs attractive enough for consultants to apply for them is one of the major hurdles that we face in the Irish health care system. When I addressed the committee previously, I pointed out two jobs which were illustrative of this. The first was a job between the Rotunda Hospital and Drogheda, which would be a very attractive job as a consultant. There were no applicants for that job, which is astonishing. The second example is a job between the National Maternity Hospital and Mullingar. It also would normally be regarded as a very attractive proposition. There was one applicant from Lithuania and she withdrew before the interview. That job has not been re-advertised. That is the reality. Something needs to be done to make those jobs more attractive. The contractual issue is the major one, as well as working conditions, infrastructural deficits, working hours and so on.

There are only three part-time peri-natal psychiatrists in Ireland and they are all based in Dublin. That is just not acceptable in 2016. There are no mother and baby units in Ireland for women who have breakdowns or who become severely distressed or depressed after delivery. Those women's recovery would be much better were they in a mother and baby unit, of which there are about 20 in the UK. Those are two deficiencies which can be addressed.

There is only one clinic in the public hospital system offering assisted fertility techniques such as IVF. The other clinics are either private or have been bought by international IVF organisations, or businesses, basically. They are in it for the business. That needs to be addressed. For a couple having difficulty in achieving a family, the transformation when assisted is quite dramatic.

Professor Kenny has addressed the 20-week scan. I do not think ethos is a barrier but, as Professor Kenny said, first trimester scanning and the routine offering of screening may cause difficulty for some working in the Irish health service. However, this service should certainly be available.