Ms Mary Leahy:

I will make two or three brief comments. The first relates to item No. 7 of the list of actions which were to have commenced by the first quarter of 2018. This was that "additional supports are provided to pregnant women from vulnerable, disadvantaged groups or ethnic minorities, and take account of the family's determinants of health, e.g. socioeconomic circumstances" and the action to be taken was to develop a plan to support vulnerable women and families antenatally and women, families and infants postnatally in conjunction with the local socio-economic inclusion team. Speaking as a practising public health nurse, we see more and more homeless pregnant women and mums. A lot of families are in hotels and we are noticing obvious negative health effects. New babies and toddlers are not achieving the milestones expected of their age because they are living in hotels and accommodation that is inappropriate for young families. This is a serious issue that is becoming commonplace and I do not see any actions in respect of it. I wanted to raise that issue.

I want to hone in on what Ms Phil Ní Shéaghdha stated. This strategy sought the recruitment of 96 midwives per year by five years but we are more than one year into it and not alone have we not recruited the 96 midwives but we have a deficit of 16, which could be interpreted as a deficit of 112. This strategy cannot be implemented without the recruitment of midwives. All of the Deputies and Senators raised the issue of why and we spoke about pay and other conditions, but it is a chicken-and-egg scenario. If we do not pay people properly, we will not recruit and if we do not recruit, the workload is phenomenal and there is a massive burnout and demoralisation in the workplace as a result.

Let me say to members, as politicians, that it is no longer possible to preside over a system which pays nurses and midwives between 12% and 20% less than every other four-year honours degree graduate. It is a disgrace. We ask if it is because we are predominantly female or that the Government has got away with it too long. We have asked so many questions but the time has come where this cannot be allowed to prevail. As a first step we are seeking parity with colleagues who at entry level have a four-year honours degree.

The issue of risk was mentioned as well. All of the international research shows that the risk of mortality and morbidity rises substantially for every one less nurse or midwife on a shift or ward. That in itself is a risk. We aspire to one midwife to every 29.5 births when we are nowhere near it. We are between 1:35 and 1:40. As a public health nurse in the community, I can tell members that we are severely short on public health nurses as well.

Finally, I will refer to my medical colleagues, the issue of goodwill and the fact that the unpaid-for hours is definitely an issue in medicine. It is a massive issue in nursing and midwifery as well. We have proved that through auditing our hours. We are giving massively of free hours in midwifery and nursing and that goodwill is not sustainable.