Mary Lou McDonald (Dublin Central, Sinn Fein) | Oireachtas source

I will begin by thanking and commending our colleague, Deputy Louise O'Reilly, for tabling this motion and for doing so at this time. I think we are in agreement, despite the fact that we have regularly commended ourselves for having the best maternity services in the world - it almost became like a catch-cry or a matter of national honour - that there are massive deficits and shortfalls within our service provision. This motion sets all of that out: the shortages in consultant obstetricians and other specialist staff; the operational deficits in midwifery staff; the operational deficit of a magnitude of 17% in the Dublin maternity hospitals; and the lack of fetal anomaly screening, which has been referred to. I also want to register and recognise the lack of perinatal psychiatrists. There are only four, as we know, to cater for the entire State. I believe there are part-time positions in addition to that.

We know from the statistics - though these are never just matters of statistics, these are pregnant women - that 16% of women attending maternity services are at probable risk of depression. These statistics are from the Well Before Birth study. We know that risk of depression increases as pregnancy advances. Some 12.9% of women are at risk in the first trimester, 13.8% are at risk in the second and 17.2% are at risk in the third. We know, of course, that for many women post partum after delivering their babies, it is not merely a case of the baby blues. We can have full-blown post-natal depression, which is a most debilitating condition.

I welcome the fact that the Minister has commended and extolled the virtues of the maternity services strategy. While we have a strategy, I want to reiterate that we had a strategy for mental health service provision way back when called A Vision for Change. The thing about these strategies is that they have to be resourced, driven and delivered. There is much work to do.

The motion makes reference to the really horrific circumstances of mother and child mortalities or injuries. It cites Portiuncula University Hospital, University Hospital Galway, Portlaoise, Cavan and Drogheda. There was a time when week on week and month on month one waited in the horrific expectation of another bad story from our maternity services for the women of Ireland.

These matters are matters of women's health. In very real terms, they are matters of life and death in many instances. They are also about choice. They are about women's choices, decisions, autonomy and capacity to make decisions for ourselves in partnership with medical practitioners. In that regard, I come to the issues of ownership of the new maternity hospital at St. Vincent's. It is entirely outrageous and unacceptable that the Minister would come to the floor of the Dáil in the year 2017 and make the statement he made earlier welcoming the confirmation by the board of St. Vincent's Healthcare Group that any medical procedure that is in accordance with the laws of this State would be carried out at the new hospital. The Minister might ask why I would cite that as outrageous. It is entirely unacceptable in this day and age and at this time that the Minister would require such a confirmation from the board of St. Vincent's Healthcare Group. It has to be taken as an absolute given that services in accordance with the law are provided in publicly-funded hospitals. Sin é.

There is a bigger question about divestment across the health services, but we need to start with this hospital. I have lost count of the number of women in particular who have asked me why in the name of God the Catholic Church would want to own, control or even influence a maternity hospital. That is the question out there. In addition, I have lost count of people who have said to us collectively as Members in this House to make sure that does not happen. The history of interference and of religious dogma blinding good medical practice is writ large. The cost of that policy was very high for women in this State. To this day, it remains a problem for us.

I welcome the fact that the Government is in fact withdrawing its amendment. I am very glad to hear that we will have cross-party agreement on this matter. If nothing else, we can credibly and collectively give a response to the public that we have heard what the public mood and view is. That is for first-class health care for our women without interference of ideology or dogma and for women to come first.

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