Wednesday, 13 March 2019
Independent Clinical Review of Maternity Services at Portiuncula University Hospital: Statements (Resumed)
In regard to this matter, I seek some answers as to whether these 35 recommendations have been implemented. This report was published in May 2018. Where are we with regard to these recommendations? When the Minister spoke in June 2018, all of the recommendations had not been implemented. Second, he pointed out that the maternity strategy was very welcome, and I certainly agree with him. He pointed out that it was unbelievable that we did not have a strategy before now, on which I also agree with him also.
The national maternity strategy was brought into being to cover the period from 2016 to 2026. There are many recommendations in the strategy but I do not know if they have been implemented. For example, I understand there are midwifery vacancies in more than one area. I will not use the few minutes remaining to me to outline this issue but when a strategy is produced, there is a duty on the Government and on the Minister, when he speaks in the Dáil, to clarify precisely what has and has not been implemented and where we are going in regard to it. We must bear in mind that the national maternity strategy arose from the basic problems identified arising from the Portiuncula inquiry and, in terms of my own city, from the death of Savita Halappanavar, where a strong recommendation, among many other recommendations, was to have a maternity strategy. I welcome that and the fact that it will be woman and child-centred. There is a very good opening statement by the chair, whose name I have just forgotten, in which she refers to making the woman the centre of the process, as well as giving choices to women regarding where they give birth. She also refers to not medicalising something that is extremely normal, which is set out in the strategy, that having a baby is normal and that there should be a pathway of choices in that regard. Where are we in that regard? I have read the strategy to try to see where it has been implemented.
This is particularly poignant given that the independent midwife, Philomena Canning, is currently facing death, as she said herself. She is an independent midwife who fought bravely to bring choice to women in terms of where they would give birth. Her indemnity was withdrawn in 2014 by the Health Service Executive. As a midwife she delivered 500 babies. We know that; this is all factual. She had planned to set up a home centre in Ireland, which is what many women, including myself, would love to see, but her indemnity was withdrawn. Unfortunately, we did not have the national maternity strategy at that time, which sets out that aim as one of the ambitions to have in Ireland. That indemnity was subsequently restored to her but it was too late.
I am highlighting her case briefly because the woman is facing death. I do not want to dwell on it except to highlight that she and very many similar independent midwives have struggled to tell us there is a better way to allow a woman give birth than the medicalisation of that whole process. That was one of the key recommendations in the report we are talking about tonight. I refer to the patriarchal, hierarchal nature of the relationship between doctors and nurses in the hospital. Many times the midwives themselves reported that there was a lack of staff during that critical period and no action was taken on it.
I will conclude because I have to. That is not the Acting Chairman's fault but it has been difficult to follow the time in order that I could work my thoughts around what I was saying.