Kate O'Connell (Dublin Bay South, Fine Gael) | Oireachtas source

I wish to follow on from Senator Burke's comments. My understanding is that in Portiuncula there is no proper 3-D scanning unit, or whatever it is called. I refer to the fancy scan a woman gets at 20 or 22 weeks. About a year ago this committee heard from Professor Louise Kenny from University College Cork. She outlined that the anomalies pop up in the population group where one would not expect them. From memory, I think she said they emerge at a rate of about one a week. Conditions that one would not associate with a 28-year-old mother, for example, happen at about that rate. There is no way of detecting them if there are no machines to do so. Do the witnesses get what I am saying? I would like to make that point. If a woman is never scanned, she will never know, and it is only when the baby starts coming out that the doctor realises the problem.

While I am commenting on Portiuncula, I note that the report is shocking. I am not too shocked by it, because I know of a number of cases in that part of the country. I would like to ask whoever is in charge, perhaps Mr. Sullivan at this moment, if they would be happy for any member of their family to have a baby in Portiuncula hospital. The impact of catastrophic events at birth extend a long way beyond the impact on the baby. There tends to be an emergency section. There tend not to be ideal circumstances for a section to be carried out. It tends to be a large section; it tends to have repercussions when it comes to women's health thereafter, including both forms of incontinence, adhesions, and impacts on people's personal lives, sex lives and relationships. I have not read the report yet because I have been too busy with other things. However, I have heard statements here this morning. Looking at it as a woman who has been engaged in the maternity services for the last ten years, I am concerned about any babies being born under these circumstances and any woman presenting themselves. I wonder if Mr. Sullivan or whoever would be happy for somebody belonging to them to be born there.

I know that Mr. O'Brien has left now, but when he came before the committee he mentioned difficulties with one person being at the head of the service. I do not want to misquote him. He did not think it was possible, or thought that people would not apply for the job. My understanding is that Mr. O'Brien has been in that job for six years. I am wondering if the Department has any correspondence from Mr. O'Brien, or if anybody has such correspondence, where he indicated that he did not think it was possible for one person to do the job. It seems to me that we heard that today, in light of all that has come out, but he did apply for a job that he deemed himself qualified for. Somebody gave him the job. I do not want to misquote him, and we can go back and check the record. However, what I took from what he said was that this is too big a job for one person. When he referred to what a big job it is for one person, was he referring to the management of the organisational structure of the HSE, or is he talking about the population it is in charge of? I would like to remind Mr. Sullivan that the population of Ireland is comparable with that of Manchester. How could anyone say that it is too big to manage when it happens in other countries? I am quite concerned about those statements this morning, in light of Mr. O'Brien's six years in the job. If someone came into a job said that it was too much after six months, I could understand it. However, it seems a bit confusing at this point in the conversation.

I wish to return to the issue of open disclosure, with reference to the cervical screening situation. Mr. O'Brien referred to the open disclosure practice of the HSE non-clinical staff. Is there any letter or any record of any non-clinical staff member being told that open disclosure would apply to them? Regarding the health administrator role being subject to regulation, which I spoke about in my first contribution, has this just started today, or is it in train? I refer to health administrators or whatever we want to call them, non-clinical people who are in a position of authority. Is it envisaged that the regulation would be on a statutory footing? Doctors very much do not like going in front of the Medical Council. It tends to be quite complex and can be very difficult for people. If we are going to make people accountable, are they actually going to be properly accountable? Will it be on a statutory footing, and will it have real teeth?

Regarding the terms of reference, I refer to part f. I went through these in detail last night. Term f. seems to have an awful lot of stuff shoved into one term of reference. It deals with tendering, contracting, operation, conflict of interest arrangements, performance information, performance management, accreditation and quality assurance. An awful lot seems to be contained in term f. To me, it is really important going forward, as opposed to looking back, that the data we are getting back from places is of value to us when we are studying our population data.

Finally I wish to raise the plan for human papillomavirus, HPV, testing that the HSE already had before this happened. Will the HSE now look at the HPV plan with a new lens in light of what has happened? Are we now looking at a new way of going about this, and when will we have a picture of what sort of plan that will be?