Michael Kitt (Galway East, Fianna Fail) | Oireachtas source

I commend Deputy Billy Kelleher on tabling this motion. It is important and gives us an opportunity to discuss a very serious matter. I extend sympathy to the families who lost babies at Midland Regional Hospital, Portlaoise. I deplore the manner in which the families were treated by the HSE in the aftermath of their loss. There was certainly a lack of decency and compassion for the families.

The HSE must act swiftly to implement the recommendations of the HIQA investigation into services at Portlaoise hospital. I am not one to expect a Minister to micro-manage every hospital but I believe the current Minister should outline practical policies and fight for a good budget. I was heartened to hear that Mr. Tony O'Brien, the director general of the HSE, commented that he would be negotiating a good budget. He talked about conducting business in a different way and about taking a much more robust approach. That is important because we are talking about a level 3 hospital for which sufficient resources are not available.

If we really believe in the importance of the patient and patient safety, we should have a patient safety authority established. This has been long promised. It is important to have HIQA incorporated into any new structure. There has been talk of a patient safety agency or patient advocacy agency. Irrespective of which, we are told it will not be in the service plan. If, as we all agree, patient safety is important, we must reflect on the fact that it will be another year before we have a body that will deal with it.

We have an opportunity for public consultation. I would like to see public consultation on the provision of maternity services right across the country. The west-north hospital group has ongoing reviews. These are important because they afford an opportunity to determine the conditions in the maternity units.

We are waiting for the review of maternity units at Portiuncula Hospital in Ballinasloe which is an excellent hospital and one I know well, Castlebar, Sligo Letterkenny and Galway. University College Hospital, Galway is a level 4 hospital and a centre of excellence. However, many members of staff talk about the workload, while constituents talk about the extent of the inadequacies in the public health care system because of the shortage of staff. I refer, in particular, to the stroke unit at University College Hospital, Galway where there is difficulty with the level of nursing care because of the shortage of staff. The Minister of State knows that nursing staff in the psychiatric unit in the hospital have threatened industrial action. This is a level 4 hospital and it is certainly time resources were also made available there.

Both the Midland Regional Hospital and Portiuncula Hospital serve the midlands. Portiuncula Hospital also serves the west and the mid-west. Some of the challenges in it are similar to those faced by the Midland Regional Hospital, particularly the issue of resources, replacing staff, the need for extra staff and buildings. I can tell the Minister of State that the last official opening of a building I attended in Portiuncula Hospital was when Mary Harney as Minister for Health opened a special baby care unit. The hospital has made submissions for buildings and I hope they will be looked on favourably by the HSE and the Department. I know that there are other concerns about the recommendations in respect of maternity services in other locations such as Tralee, Cavan, Clonmel, Kilkenny, Monaghan, Wexford, Portlaoise and Drogheda. That is why public consultation is important. We need to have that process completed before any action is taken. The HSE should outline the real agenda in the health service. I have seen reports that reviews are being carried out at 19 maternity units across the country in order to provide assurance that the recommendations made in a number of recent high profile reports are being fully implemented. This is the important point. We know that corrective measures to address quality of care issues should be implemented, but it is important that implementation is ongoing. Similarly, I have also seen reports that additional training has been provided for all maternity staff and additional senior supervision has been provided for for both medical and midwifery staff. However, I have not seen any reports stating extra staff will be provided, particularly in areas in which there are significant pressures.

I would like to have a full debate on the infrastructure of maternity services, particularly the infrastructure we need to meet the needs of the country in the coming years. In particular, I would like to have a discussion about the greater role community midwifery services could play and the urgent need for greater numbers of consultant obstetricians. If we had obstetricians who led services as a priority in maternity hospitals, we would be doing a very good day's work. We know that there are proposals in Dublin to relocate maternity hospitals to more suitable locations, but let us also look at the people who live outside Dublin because we must provide high quality health and maternity services for them. If we ensure current maternity services are protected, we will be doing a good job, but we should enhance rather than downgrade them. It is a very important issue around the country, as the Minister knows. I hope we can investigate those areas that are doing well and provide the investment needed to support them. It is true to say we have very good staff in hospitals who work very hard, but there are huge pressures, as the Minister knows. This is the area in which I would like to see him lay down his overall policy and, in conjunction with the HSE, fight for a good budget in order that the resources required can be made available.

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