Dr. Peter Boylan:

The timeline is undoubtedly challenging but what needs to happen is for all of the relevant stakeholders, including the HSE, the Department of Health, the GP representative bodies, the family planning clinics, doctors who work in providing women's health care outside of those arenas and the institute and so on all need to sit down and work out the pathways of care that need to be implemented and get the patient journey clarified for doctors, both in hospital and in the community. That needs to happen soon so that we can get a clear picture of what the requirements are in infrastructural deficits that need to be addressed.

On the MRI, in reality it is only used in cases of foetal abnormality in order to clarify what the diagnosis is so it is only relevant in those particular circumstances. An MRI is not needed in every hospital. There is only one in a maternity unit at the moment, in the National Maternity Hospital but that is the consequence of a very generous grant from an individual.

Other scans or MRIs are done in Temple Street Children's University Hospital but that machine has effectively reached the end of its life and needs to be replaced.

There are challenges in that respect. The MRI machine in the National Maternity Hospital, with some jiggling around, could possibly be a national centre for referral to clarify the diagnosis for women and pregnancies where there are foetal abnormalities. The consequences of getting it wrong are serious. We could end up with a termination done for a condition that is not fatal or vice versa. It is not an issue at the moment because women have to travel abroad and in many circumstances, or most, when they go abroad, they will have an MRI before having a termination of pregnancy. That is something that has not been relevant in this country and it will not be until legislation is introduced and practice is changed. That would require some investment but it is not madly expensive. It just requires a jiggling around of consultant sessions, etc.

On ultrasound, there clearly are capacity constraints and we are all aware of those so that needs to be addressed. It may be better to let Dr. Murphy address the other capacity constraints as she is more on the front line than I am at the moment.