Alan Kelly (Tipperary, Labour) | Oireachtas source

The witnesses are very welcome. I will not go over some of Deputy Kelleher's questions as they overlap with some of mine. I am a big supporter of the strategy. I have publicly stated that on numerous occasions and we have discussed it at length in the committee.

An organisational chart of the strategy showed the various directorships and positions there was a delay in filling initially. Have all the roles been filled and down to what level? We need an update on that. I understand that at the highest levels, the programme director, clinical director and director of midwifery have all been appointed but have all appointments been made?

There are big concerns about perinatal services. I keep raising the issue. Have there been any improvements since the witnesses were last with us? In relation to the services provided it is estimated that at least 10% of pregnant women have some form of mental health issues. There is a lack of psychiatric services. Are we going in the wrong direction? Is the system stalled or are we making progress?

I would like to hear the views of witnesses on staffing numbers across the various disciplines. I have taken on board what has been said about the mastership model. I think that is the right model. I would like to hear how it will be implemented across the board.

In terms of the announcement last week of the national development plan and the capital plan, we know that within the ten-year maternity strategy certain milestones have to be met. Will we make up the time we have lost given that a couple of years have been lost? I know the maternity facility in Limerick quite well. I came through it myself and I have experienced the fantastic service there but the physical infrastructure is not adequate. The sum of €3 million was required in order to even carry out the assessment and planning but that was not found so we have lost a couple of years. What are the views of witnesses in relation to that?

I am very much taken with community midwifery services. The midwife-to-birth ratio is deeply concerning. That is something we need to air here so that we can leverage the committee to address it.

The strategy envisages the doubling of consultant obstetricians over ten years. We are not achieving anywhere near that so how are we going to address the issue? Those numbers are required by the strategy.

An issue I raised previously with the witnesses is training in ultrasound. Have we made progress in that regard? It was outlined to us previously that the lack of progress in this area would hold up the services we need to provide to women and children.