Bernard Durkan (Kildare North, Fine Gael) | Oireachtas source

Never. Like others, I welcome the witnesses and I thank them for their interesting address. Regarding the deficiencies in the postgraduate and undergraduate courses and the location of adequate encouragements, for want of a better description, to ensure the people who embark on those courses have a place to go and are sure of where they want to go at the end of them, to what extent do the witnesses bring that to the attention of the authorities?

I am a great believer in the chain of command, and I am sorry about the director who, unfortunately, must take responsibility for all of these things as it is a difficult position, presuming the director has a full and total free hand in delivering the services we are speaking about. It is a two-way process. How does it work? What happens when the director responds to the queries coming from the ground? Does anything happen? Is it slow? Is there a possible resolution? If not, why not?

With regard to the risk factors, and looking at a number of cases that have come up in recent times, I feel very sorry for the professional people involved. I have to say I am equally sorry for the unfortunate victims in those circumstances. No matter how sorry one is for the victims, it does not replace the person who has gone, whether it is the mother or the child. Something has to be done about bank holiday weekend cover. We need to do something about it as a matter of some urgency. There are no circumstances in my opinion where a woman going in for a crisis pregnancy or a normal pregnancy should be in a situation where her consultant is missing and cannot be there. In the event of an emergency arising it is a very daunting and lonely place for her to be. I note what Dr. Boylan said on overtime and the on-call system, but some means has to be found to protect the lives of those who may be at risk in those circumstances. Quite frankly I do not care what has to be done but it is time to do it. There is no time for discussion afterwards. There is no sense going into court afterwards and stating something went wrong and people are sorry it happened. Of course we are all sorry it happened, but it is a sad thing that it goes to court.

I am only a simple member of the male population but problems with the provision of oxygen during birth seems to occur more than occasionally. I do not know why this is. There must be somebody who knows and who is familiar with the procedures who should be asking questions as to why it happens. We are told all of the time that we have one of the safest systems in the world. If that is so, why should this occur? Should a different procedure be followed at an earlier stage to prevent it happening? Who makes the decisions? Who is the decision maker? Is advice available to the person on the ground on his or her own who may be making a very serious decision in a very short space of time? Can that person refer to anybody further up the line? With modern technology, or whatever the case may be, is it possible to do so? If not, why not? It is totally unfair to have a situation whereby the person in the ward at the time of the emerging crisis is left alone to make a decision or has insufficient authority to make a decision. I know about the clash between doctors and midwives and I am not referring to this. There needs to be more than one person involved in making that crucial decision. It is crucial from the point of view of the professionals and, more especially, crucial for the woman and the baby.

Does the director have adequate resources in respect of maternity services? I know what the answer to that is. Does the director have adequate authority to make the decisions that are required to be made in a short space of time to ensure the best possible quality and standard of service is made available to those directly involved, by which I mean the mother, the baby and the staff on the spot in the maternity hospital? They are the people in the eye of the storm. They are the people who will be in the eye of the storm afterwards in the event of litigation.

It is much better to put in place corrective measures than to spend time defending in court what appears to be the indefensible. It may not be the indefensible, and there will always be accidents and we accept this. We cannot prevent accidents happening. However, a certain amount of accidents can be prevented and it is these we need to zoom in on and try to come to a decision on them and provide knowledge back up.

The retention of staff at all levels comes up again and again. It will become more difficult. Way back some years ago benchmarking was introduced. Nobody ever admitted this, but while the cost of living was given as the reason this was not the case. It was the cost of housing that drove it mad. The cost of renting a house and the cost of taking out of mortgage has nearly doubled. Rent has definitely doubled and more than doubled over the past five or six years. This obviously will be a disincentive for anybody, particularly a young person going to work in the health services, or in any service for that matter. I make this as a passing point because we may have to find a way or means to do something about it. I am not saying we should go back to benchmarking, because we paid the price for that previously. It was the identification of the problem that was wrong and not the benchmarking. It was identification of the underlying problem, which was the inability of professionals to take out a mortgage or rent a house at any particular time.