Paudie Coffey (Waterford, Fine Gael) | Oireachtas source

I apologise to the Deputy for the unavoidable absence of the Minister for Health today. I wish to respond to this Topical Issue debate on his behalf. Premature birth is the largest cause of neonatal death worldwide. In Ireland, 6% of babies are born prematurely, a rate that is increasing for a variety of reasons, including assisted reproduction, higher rates of multiple births and increasing maternal age.

It is a sad fact that many families have been touched directly or indirectly by the consequences of premature birth.

Thankfully, however, there has been a dramatic fall in mortality and morbidity rates for newborn infants and 90% of infants born prematurely at 28 weeks now survive, whereas in the early 1980s, 90% of those babies unfortunately died. Clearly, neonatology is one of medicine's greatest success stories over the past 30 years. This success is not only because of scientific advances and the availability and application of new technology but also is due to the centralisation of complex cases in tertiary hospitals and the training of a highly skilled and specialised workforce.

The national clinical programme for paediatrics and neonatology was established in 2011 as a joint clinical initiative between the Health Service Executive, HSE, and the faculty of paediatrics in the Royal College of Physicians of Ireland, RCPI. The programme aims to provide high-quality care to more than 67,000 babies born in Ireland annually through effective screening, the provision of equal, rapid access to neonatal intensive care where and when required and the eradication of fragmentation and duplication of newborn specialist and intensive care services. High-quality care is vital for fragile infants and, together with good policies and well-planned programmes, the outcome for preterm infants is very positive.

It is recognised that the key to good neonatal services is to concentrate the care of preterm infants in a small number of centres where highly trained staff become experienced in managing the complex problems these high-risk infants develop. In this regard, there are 19 neonatal units and 300 special care baby unit cots across the State to care for preterm and sick newborn infants. The neonatal units provide differing levels of care depending on their size and medical and nursing numbers. Four tertiary units provide the most complex level of care and four secondary units provide an intermediate level of care, while the 11 remaining primary units provide routine newborn care and immediate resuscitation facilities. The process that integrates these neonatal units is the national neonatal transport service. This facilitates the rapid transfer of babies who need a higher level of clinical support. A specially equipped ambulance staffed by trained neonatal doctors and nurses travels from Dublin to the smaller hospitals to help with the transfer of the baby to the tertiary centre. These babies can be transported at short notice, day or night, seven days a week.

The Minister for Health also is delighted to mention today that last Monday, the HSE, working in close partnership with the RCPI, launched a new model of care for neonatal services in Ireland. This was developed following wide consultation with professional groups and parents. Importantly, the recommendations have been benchmarked against international standards. The model of care is intended to ensure sustainability in the neonatal services and has three core objectives, namely, improving safety and quality in the delivery of baby-centred care, improving access to the appropriate services and improving cost-effectiveness of services delivered. In conclusion, I assure the Deputy and Members that there is little need to discuss making prematurity and neonatal health a national health care and welfare policy priority, because it already is a priority.

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