Mary Harney (Dublin Mid West, Progressive Democrats)

I certainly hope it will be enacted because otherwise it will fall. A huge effort is being made in the Department of Health and Children to try to make sure we have modern and robust legislation enacted with great speed.

Clearly, there are deficiencies in the 1978 legislation. We need more modern and robust legislation but, notwithstanding the deficiencies, that is no excuse for what happened in the maternity unit of Our Lady of Lourdes Hospital for 25 years. To be quite frank, if it were not for that brave midwife and the response of both Ambrose McLoughlin at the time and Mr. Lennon we might never have got to the stage of finding out what happened there. Notwithstanding the legislation or the deficiencies in it, many things could have been reported that were not reported and we need to learn from that. Everybody has responsibilities in regard to this issue.

Specifically on competence assurance, in medicine in particular, but more and more in other professions, continuing professional development is an important prerequisite for maintaining one's skill base. That will become mandatory in the new legislation. We need to ensure that those who are on the register, the specialists in our health care system, are involved in a process where the patients can be reassured that they are competent to do the job they originally qualified to do. I know most progressive doctors feel very strongly about this as well.

The Lourdes hospital report also raised issues for the college of obstetrics, the Royal College of Surgeons and others, as well as for hospital management. That is why we want to have clinical directors in the context of a new consultants' contract. Currently in the health care system consultants are independent contractors. They are not required to work as part of a team. Each person is his or her own boss, as it were. I know some doctors are critical of this but the best health care systems in the world are ones where people work as a team and there is a clinical director with specific responsibilities. Generally, the chairperson of the medical board of a hospital does this on a pro bono basis and maybe in some places they might get a session or something in lieu of the work they put in. We have to take this issue more seriously and see this role as a job in itself where people are hopefully appointed to the position based on their expertise and competence. They would then be responsible for the team with which they work. That is when we would get the best results.

Clearly, there has to be a national audit. As Members are aware, we have given resources to Cork University Hospital to establish an audit in regard to maternity issues. Professor John Higgins from Cork is the person who put the idea to me. It is borne out of something he had seen elsewhere. I am happy to say we have provided the funding to get that up and running so that details in regard to all births nationwide will be fed into a central unit at Cork University Hospital. I hope it will be possible to detect something like what was happening in the maternity unit in Our Lady of Lourdes Hospital much earlier because it should be evident if the pattern in one hospital is very different from the pattern in some of the other hospitals in the country.

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