Thomas Pringle (Donegal, Independent) | Oireachtas source

I thank the Acting Chair for the opportunity to contribute on our motion on national maternity services and I would like to commend my colleague, Deputy Catherine Connolly, and her staff Béibhinn and Rachel, on their work on the motion. I was very happy to put my name to the motion to call on the Government to publish a time-bound and comprehensive implementation plan for the remaining years of the 2016-26 strategy.

It is 2021, three years since we voted to repeal the eighth amendment and nine years since Savita Halappanavar tragically lost her life. There have been many other unspeakable tragedies in maternity hospitals across the country. Our first national maternity strategy was published in 2016 and was to run until 2026. There are now five years left in this strategy and it is time for the Government and HSE to be held accountable for the commitments made. Women are consistently being let down by the State. It must be exhausting. Front-line staff in maternity services and midwifery staff are overworked, undervalued and working in physical environments with infrastructure that is not fit for purpose. I welcome that HIQA’s report of early 2020 focused its recommendations on the HSE and the Government.

Covid has meant that pregnant people have been attending prenatal appointments alone. I have made regular representations regarding Letterkenny University Hospital and support for pregnant people during Covid. I understand that there must be additional restrictions to ensure that Covid is kept out of hospitals, but there are pregnant people receiving devastating news alone and partners missing out on wonderful moments of hearing heartbeats on ultrasounds.

Just this week, on Monday, 31 May, I was informed that birthing partners are allowed a 30-minute visit each day to the maternity department in Letterkenny University Hospital after the birth of a baby. Even when everything goes perfectly there is still a need to check in on the person giving birth. We all know that there are many stories and incidents of traumatic births which may not begin to be processed until weeks or even months after the birth.

I have been told that from this week birthing partners in Letterkenny can accompany pregnant people to dating and anomaly scans. Letterkenny is now allowing the birthing partners of people in labour to attend. Partners can also attend a caesarean section done under regional anaesthesia. In those cases, partners must be screened and wear PPE - in fairness I think they are usually in scrubs when attending caesarean sections.

The spokesperson for the hospital said that if a partner has Covid-19 symptoms, is awaiting a Covid-19 test or test result or has had a positive test within the last 14 days he or she must not come to the hospital, and in this event an alternative birth partner may attend. So far, so good, but the spokesperson went on to state that partners must wear a face mask at all times, maintain social distancing and use the available hand gel to clean their hands regularly. From whom are they to maintain social distancing? Is it from the staff or the person giving birth? If they live together, why would they have to socially distance during the birth process? In cases where a baby is in the neonatal unit, just one parent at a time may visit.

On 7 and 8 August 2019, HIQA visited Letterkenny University Hospital unannounced. I welcome that the inspection report found that all standards bar one were compliant or substantially compliant. I particularly welcome that Letterkenny has a formalised process for people who have used the maternity services. It was standard 2.7 where Letterkenny Hospital was found to be non-compliant. HIQA found that the infrastructure in the maternity ward and assessment room was outdated and that infrastructure was listed as a risk on the risk register. HIQA inspectors were informed that there was no funding available to address the infrastructural deficits. The key finding included that the obstetric operating theatre for emergency cases was not adjacent to the labour ward, but is instead three floors above. There was an operating theatre there at the time but it did not have any staff.

Our motion calls for the eight HIQA recommendations to be implemented but, more importantly, that there are clear actions and timeframes for implementation and completion. As with all areas of government, progressive strategies are not worth the expensive paper they are printed on if the recommendations and changes are not put into practice.

Another example of the Government's lip service to issues of public importance is that of the ownership of the National Maternity Hospital. I fully support the campaign against church ownership of women's healthcare regarding the proposed new maternity hospital at Elm Park. For years now, activists have raised the issue of Catholic ethos practices in maternity, gynaecology and women’s health services. Particularly since we repealed the eighth amendment and abortion services were rolled out across our 19 maternity hospitals, the possibility of the Catholic ethos overriding legislation is hugely concerning.

In our motion we call for legally guaranteed independence from all non-medical influence in the hospital's clinical operations within the laws of the State. However, campaigners are concerned that this is the language being used by independent legal experts advising on public engagement. Campaigners have provided documents showing that such guarantees cannot be provided within the terms of the largely private ownership and full private operational control demanded by the Religious Sisters of Charity and its company, St. Vincent's Healthcare Group. The Minister might consider raising this aspect with the relevant parties. Only full public ownership and full public governance can guarantee a full service in reproductive health.

Conversations around the need to co-locate maternity hospitals with acute general hospitals began in 2008, following a KPMG recommendation that timely access to complicated care should be readily available when needed. The National Maternity Hospital’s Holles Street campus was found to be dilapidated and the need for change urgent. As per the usual pace of government change, it was 2013 before the then Minister for Health, James Reilly, announced the chosen site of Elm Park to co-locate with St. Vincent’s Hospital for the National Maternity Hospital.

Three years later, in 2016, a dispute emerged over the governance and ethos of the National Maternity Hospital. It was agreed a new company with clinical and operational independence should be established. This brought us St. Vincent’s Healthcare Group, of which the Religious Sisters of Charity was the shareholder. Not only that, but it was also revealed that the State would gift the hospital to the group. Therefore, not only were we allowing nuns and the Catholic church to run a national maternity hospital, but we were also going to hand over ownership. It really beggars belief. I must commend the campaigners and the vocal repeal campaigners who have been keeping this issue in the media for years. In 2018, 66.4% of the electorate voted to repeal the dangerous eighth amendment, yet there were still conversations that abortion care could not take place at our new and improved national maternity hospital. Dr. Peter Boylan resigned from the executive board of the National Maternity Hospital, saying it was “blind to the consequences” of transferring ownership of the hospital to the group.

Various taoisigh have stood up in Dáil Éireann and given official State apologies to the vast numbers of people who have been hurt by the Catholic church, and indeed the State, in the past. We talk about our dark history but there are people around us for whom this history is very, very present. There are families trying to be reunited, having had babies forcibly taken from them. There were illegal adoptions and illegal birth registrations and survivors are still not being heard. How can we atone as a country for the State’s part in all this trauma without acknowledging the need to now separate the church and the State? How can we keep saying we must change our patriarchal system of delivering healthcare when we do not prioritise women’s health?

There are larger conversations around the suitability of those who are accessing fertility treatment or experiencing miscarriage having to sit in waiting rooms with heavily pregnant people and joyful scenes. There are huge issues around the diagnosis and treatment of endometriosis and many other gynaecological issues. I say to the Minister that we all know that if men suffered through women’s health issues, complications, and other traumas, the services would be completely different and would respond to our needs. That is what we need to do, to respond to the needs of women.

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