Mr. Kilian McGrane:

I thank Deputy Durkan for clarifying the question. As I just stated a moment ago, it is important to state that the programme is not clinically responsible for the delivery of the service in any individual unit. It would not be feasible or practical. Our role is in monitoring, oversight and design of the system. It is slightly different from the normal chain of command. If something does not happen in an individual institution, it is a matter for the master of a maternity hospital or the general manager or the CEO of a general hospital.

If we were to separate them, we would make it impossible to deliver quality services. My two colleagues who have worked as masters would also say this and I have been the CEO of a hospital. If somebody sitting outside the institution was to take accountability, the system would break down. However, it is exactly as has been said and we must be notified when issues emerge. We can add real value when the design of the maternity networks means that individual units no longer just look at their own practice; it is looked at in the context of others. If we take a hospital group such as Saolta which has five units, it compares data across the five units. We then meet it and compare its data with those for the other five maternity networks in the system. In that way we hope to start to identify an emerging trend because it may not be a trend in an individual unit or even a group but it may be across the country. That is where we come in. It is the ability to provide scrutiny at local, network, group and national level that will provide a different approach to how the service is managed. That is what is set out from a governance and leadership perspective in the maternity strategy and it is what we aspire to do. We have to have real-time information to be able to provide it.