John Moloney (Laois-Offaly, Fianna Fail)

I would like to express my sincere sympathy to all the women and their families who have been affected by these incidents.

I wish I had the time to respond to some of the queries put to me that fall outside the realm of the specific subject of this motion. I will respond briefly to a number of them. I advise Deputy Burke that I am not in a position to give a commitment regarding the retention of services at Portiuncula Hospital. I have not seen the report commissioned but when I have I might have an opportunity to speak to the Deputy next week. I am not trying to evade the Deputy's question, but I am not in a position to answer it.

I support Deputy Neville's call for a debate on the increase in the incidence of suicide and I will take up his request and see if I can be assistance in that regard. I note the issues he has raised and I recognise his commitment to this issue over many years.

Deputy Ring called for an independent inquiry into this matter. The chairperson of the miscarriage misdiagnosis review team is an independent expert in obstetrics and gynaecology, Professor William Ledger, and that in itself lends to the review having a layer of independence.

In the few minutes I have available, I will speak about the issue of patient safety. The priority at present is to ensure that the concerns of women who may have been affected are addressed comprehensively. I welcome this opportunity to state that the Government also recognises the concerns raised in the motion.

It is important to point out that the HSE has been working with all 19 maternity facilities nationwide to ensure that women with concerns about their care or treatment have access to information, reassurance and that appropriate follow-up support is provided. A commitment on that was given by the Minister yesterday evening.

I welcome the involvement of HIQA. I also welcome the instruction that issued to all public and private obstetrics facilities advising them to put in place immediate measures to ensure that the decision to use drugs or surgical intervention in women who have had a miscarriage diagnosed must be approved by a consultant obstetrician. This should provide clinical assurance to women in regard to any follow-up actions, where necessary, and ensure the safe management of early pregnancy loss across the country.

With regard to the composition of the miscarriage misdiagnosis review team, it is chaired by an independent expert in obstetrics and gynaecology, Professor William Ledger, Vice President of the Royal College of Obstetrics in the UK, and he is joined by Professor Michael Turner, the national clinical lead of the HSE's obstetrics programme.

The information gathered from the review, the subsequent report and recommendations can inform the standards national guidelines for obstetrics - which are currently being developed by Professor Turner - which will provide essential evidence-based good practice guidelines which can be implemented and audited to ultimately improve patient care in the future. I am confident that these guidelines will go a long way to help prevent incidents such as those that have occurred and which are the subject of this debate.

It is also important to point out that careful attention will be given by the Department of Health and Children and the HSE to promoting learning from these incidents to improve patient experiences and outcomes.

Improving the safety and quality of care for all patients has been to the forefront of health initiatives introduced by the Minister. She has been criticised for not showing a lead in this particular area. It is important to note her involvement in the establishment of the Commission on Patient Safety and Quality Assurance, the establishment of the Health Information and Quality Authority, and legislative proposals for standards-based licensing of public and private health care providers.

It is important to acknowledge the fact that HIQA is a key driver of patient safety and quality care in the health system. It continues to enhance its role through its work in setting standards that will drive the quality of care into the future. The soon to be launched draft standards on quality and safety for all health care providers will be a fundamental building block for a safer health system delivering consistently higher quality care.

HIQA is an organisation fundamentally centred on the patient and its work is key in advocating on behalf of patients. All its work in standard setting and monitoring performance against standards is designed to improve the patient experience. It involves patient representatives in all the work it does, both in developing the standards and in ensuring they are implemented.

There are many challenges facing the health services, as has been acknowledged throughout the debate. The Minister, Deputy Harney, is facing up to these challenges with determination and resolve. Ireland can be justifiably proud of its maternity services. As was said yesterday, and it is worth repeating, maternal mortality, perinatal mortality and infant mortality are all low by comparison to other jurisdictions. Women can be confident and satisfied as they come to use maternity services in this country.

In response to points raised by Deputy Neville, I advise that the number of child and adolescent mental health beds have increased from 20, some four years ago, to 55. The issue of misappropriate placements of individuals in psychiatric hospitals is an issue of great concern in terms of patient safety. The Deputy is concerned about that issue but I wish to confirm that by the end of 2011 there will be no further such placements of people under the age of 18. That is a move forward and it enhances patient safety.

I thank the Ceann Comhairle for this opportunity to contribute to the debate.

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