Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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That is helpful. Mr. Molloy made the point that it had become apparent to him at an early stage that his was not the only family whose healthy child had died in similar circumstances. How did it become apparent? From what engagement did it become apparent? How did it come to his attention?

Mr. Molloy made a point about each new level of management as he progressed from local and regional to national level and said it was clear to him and Ms Molloy that they appeared to be totally unaware of the serious patient safety issues involved. Did he believe that that was the case? Were they being less than upfront and honest or does he believe, therefore, that there was a suppression of the facts and the information at a level closer to the hospital and that it was not making its way up through the structures?

I refer to the point made about the engagement in October 2013 and I am conscious in referring to it that the experience of Mr. Kelly and Ms Delahunt happened earlier that year when they lost Mary Kate in May, a full 15 months following Mr. Molloy's tragic loss. There was the further case of the Redington couple and that of another couple. Apart from the known number of losses, there were a multiple of cases in which bad outcomes were a reality. While I do not in any way seek to reduce attention on the fact that five babies were lost, lives were also seriously impaired in a significant number of cases. Can he shed further light on this?

Mr. Molloy's decision to go to "Prime Time" was triggered by a meeting with the HSE national director for quality and patient safety and the HSE national director for patient advocacy. Can he identify whom he met? If he cannot, I will understand, but the two positions were national director for quality and patient safety and national director for patient advocacy. Despite the fact that the purpose of the meeting was to discuss implementation of the 43 recommendations contained in Mr. Molloy's report, all they had to say to him was that they were there to listen to him. That is not a discussion. That was totally and absolutely outrageous. In some way, their almost monkey-like see, hear, speak, know, etc. approach has done us all a service because it was the trigger that directed him in his frustration to go on the national airwaves, for which I thank him sincerely.

Mr. Molloy's closing comment about an attempt at both local and national level to suppress repeated known red flags is a very serious matter. Many of us are parents and have gone through the experience of childbirth either as the woman or as a partner in support. This is of major importance to each and every one of us and for our children, who may become parents in their own time. It is very important that the learning takes place.

I refer to what Ms Delahunt said, which was very important, about the extent of funding being directed to legal voices to limit inquests scopes and, most importantly, therefore any derived learning. I am making the link between both points by Mr. Molloy and Ms Delahunt because it is the learning that needs to happen. It needs to inform a system that is clearly deficient in so many ways.

That is not to take away from the many excellent people who work in maternity units throughout the country and are giving a first-class service, but there are deficiencies. There are clearly deficiencies within the reporting process and the address of these exposed deficient practices by virtue of the fact that there is no learning taking place. The sad reality is that any of the witnesses' experiences could be repeated today in any number of settings as a consequence. Therefore all the more important it is-----