Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I welcome the witnesses and thank them for their presentations. The national maternity strategy was launched some time ago and our role is to see how much has been implemented and whether resources have been made available to same to ensure we have safe and uniform maternity services across the country. In that context, one of the important issues that has been consistently raised is the lack of uniformity in terms of services available to women. One area would be the issue of scans. For example, in Dublin, most women would be able to receive a scan, but in other parts of the country it would only be if there was a high risk, or if they were identified as having potential problems. In that context, how much progress have we made in the area of making a scan available to every woman at 12 weeks and at around 20 weeks? Is that something that needs an awful lot more infrastructure or is it personnel? What are the delays in rolling out that uniform service across the country?

Another area highlighted in the report is that due to a variety of contributing factors, including demographic, lifestyle medical co-morbidities, maternity care in Ireland has become more complex but despite this, perinatal and maternal mortality rates remain low. However, challenges remain and the proportion of complex pregnancies is increasing. Caesarian sections are increasing, the proportion of low birth weight babies and pre-term babies are increasing and breast feeding still remains very low. While we have, and it is acknowledged as such, a fairly safe system in terms of mortality rates, there are huge challenges in terms of outcomes. What are the main reasons behind these issues regarding the complexities, the co-morbidities and the low birth weights? Is there anything in the strategy to address that in terms of trying to identify early on and deal with the underlying demographics, the underlying societal problems and the underlying health problems in advance of even pregnancy - in other words, educating people well in advance of pregnancy?

There are 19 maternity centres.

Can they all remain as is? Does there need to be realignment or reconfiguration or even amalgamations? A key component of the maternity strategy is to have birth centres alongside delivery wards. How far advanced are we in rolling out birth centres across the 19 maternity units?

In terms of personnel and recruitment of consultant obstetricians and midwives, the Public Service Pay Commission is looking at pay rates but are there more fundamental, underlying problems affecting recruitment such as the pressure the system is under and the potential problems for indivdiuals if things go wrong? I refer to law suits and culpability and other such issues.