Ms Angela Dunne:

In respect of the competency of a particular midwife, some would take longer to adapt and others a shorter period. With regard to the recruitment of midwives, the committee members will be very aware that public confidence in the maternity services is poor. That is something we have to work on. If we do not start regaining that confidence, we are not going to retain our midwives. It is a huge part of our role.

We have had our midwives leaving the country because they want to practice normal midwifery. They want to get experience in supportive pathways of care. We need to start implementing our supportive pathways of care. One of our actions for 2018 is that 20% of women in all maternity units will be offered a supportive care pathway. That is the first step.

We also need to look at the career pathways of our midwives. We have in place a number of clinical midwifery specialist posts in bereavement, sonography and perinatal mental health. We are also putting in place the advanced midwifery practitioners posts, which will be another career pathway for our midwives. There are also the managerial roles such as shift leaders and clinical nurse manager 3, CNM 3, posts.

The directors of midwifery have really made a huge change on the ground in the 19 maternity units. The tertiary hospitals did have directors of midwifery. I have seen a huge change in the last year in this regard. They are the catalysts for change on the ground. They are addressing the issues. They are the advocates for resources, staff and the implementation of the maternity strategy. There is a hunger for this model of care. I am not just referring to the supportive model. As Dr Boylan said, we work very well as teams on the ground and do not want to break that. The strategy is about the three models of care. It is about continuity of midwifery care through the three pathways.