Professor Sean Daly:

I will answer the questions in reverse order. There are 70,000 births in Ireland each year and each scan takes about 30 minutes. That amounts to 35,000 hours of scanning.

Each midwife, sonographer and radiographer will do approximately 35 hours per week. As such, the numbers required will be significant. It is important to have scanning available when people go on holidays, etc. That is the type of personnel numbers that will need to be trained and in place before routine anomaly scans can be rolled out.

To back up these people, foetal medicine consultants are required. If someone scans and sees something, he or she will generally not make a diagnosis. Instead, that person will get someone like me to confirm or refute.

Regarding GP training, everyone should be trained. There are ultrasound training opportunities within UCD. It is the only third level college that offers them and they take approximately six months to do.

Medical indemnity and insurance comprise a significant issue. People who open up ultrasound facilities generally are not properly insured, so there is no comeback for the person who suffers as a result of inappropriate advice or a misdiagnosis. This is an important issue and there should be a regulatory body charged with overseeing all of these services.

As to the first question, it is not necessary to have a doctor always available where there is a trained person doing the ultrasound. In any hospital or clinic, sonographers or midwives function independently. The hope is that they will not inadvertently diagnose or reassure people. That is where the difficulty lies. If someone believes that there is a problem, explains it to a patient and makes a treatment or referral plan, that is probably okay. A situation in which a qualified radiologist or foetal medicine specialist is always available probably does not exist. Even in centres like St. James's, where the radiology service is very good, radiographers function independently and radiologists review images afterwards.