Dr. Peter McKenna:

Can I make one or two comments before the director answers for himself? I thank Deputy Durkan for his question and his incisive observation about the recurrent problem of the deprivation of oxygen. We hear that the maternity services - benign gynaecology - consume between 2% and 3% of the health care resources of this country. On the other hand, we contribute to 60% of the payouts from the courts as regards medical negligence and compensation. There is a huge disparity between the resources we have to work with and the justifiable expectations of patients as regards adverse outcomes. Without commenting on the generosity of the awards, I will say that the courts will only award money in the event of what they perceive as being negligence. These are preventable, or potentially preventable, issues. We have set this as one of our targets for reduction in the coming years. It is estimated that it is possible that 50% or more of the more tragic cases could have been avoided with different action. I thank the Deputy for drawing attention to this area, which we are very conscious of trying to rectify.

Deputy O'Connell asked about benign gynaecology. We recently visited Castlebar, which is one of the more difficult places to get to for those who are based in Dublin. We were phenomenally impressed by the quality of the gynaecological service there. The gynaecological clinic there has all the facilities needed for it to run on the spot. Ultrasound is available in the clinic, which means one does not need to make an appointment to go to have an ultrasound and then come back. Hysteroscopy is available there on the spot. One can have a hysteroscopy and possibly have some endometrial pathology removed if one needs it. This is possible for two reasons, the first of which is the availability of the medical champions who want to do it and the second of which is the presence of an administration that prioritises it and allows it to be done. That is what I mean by an imaginative approach.