David Cullinane (Waterford, Sinn Fein) | Oireachtas source

First, I wish to thank the Independents who have brought forward this motion. I wish to commend the motion and its three main demands, namely, that there must be an immediate step change in the implementation of the national maternity strategy, including a comprehensive, time-bound, fully resourced implementation plan for full implementation by 2026; that immediate action is taken on the eight recommendations from HIQA's overview report of its monitoring programme against the new standards for safer, better maternity services; and absolute iron-clad assurance that the new national maternity hospital will be publicly-owned and operated, with absolutely no room for error or mistakes.

Women's healthcare is not something in respect of which this State has a good reputation. The history of the State's attitude towards women's healthcare is not one we can be proud of - from the avoidable deaths of several babies in the years prior to the strategy, consistent negative international comparisons of the performance of maternity units, the CervicalCheck scandal, the vaginal mesh implant scandal, and the historical wrongs committed against women and their children. We need a women-centred approach to women's healthcare to be adopted very rapidly.

CervicalCheck campaigners continue to face barriers to justice with the CervicalCheck tribunal still not hearing the number of claims that would have been anticipated. It does not seem to be fit for purpose. There is little trust between women and the Irish healthcare system.

The national maternity strategy was supposed to be part of the answer, but the fact is that it was never properly resourced. The resources committed in the last budget to the national maternity strategy was a start, but it was a start after many years of underinvestment or very little investment. Several maternity hospitals have significant infrastructural deficits. HIQA has recommended that all maternity units are reviewed.

I have visited the Rotunda Hospital a number of times. I am sure the Minister is aware of how cramped conditions are and how difficult it is for staff who are trying to provide the very best maternity care in that hospital. They need capital investment to ensure that they can expand and provide a much higher standard of maternity care in a much safer way. That is the bottom line. That is only one maternity unit. There are many more.

It is highly concerning to hear that not all clinical staff involved in the management of obstetric emergencies have received the necessary multidisciplinary training. The lack of a standardised national approach and provision of training for obstetric emergencies is a huge failing in respect of mothers and their babies. There are also significant protocol deficits. There is a lack of transfer protocols to the most appropriate care settings for women and newborns and a lack of a shared learning from reviews of clinical incidents across maternity units.

Covid-19 has been blamed for the strategy falling behind, but if we are honest, it was never at the races to start with. Funding was made available for 23 consultant roles but they are not filled by permanent staff. Consultant working conditions are preventing recruitment for those roles because Government has refused to address the recruitment and retention crisis in our hospitals, and indeed, the two-tier consultant pay issue which still exists and prevails.

Talking about new public-only contracts sounds great, and that is something that I obviously support, but we have to deliver. It also has to be agreed with the Irish Medical Organisation and the Irish Hospital Consultants Organisation. We need to win support from hospital consultants and their representative groups for new contracts, so that we can attract the highest quality consultants into maternity services and other areas like cancer care, as we heard at the meeting of the Joint Committee on Health this morning.

We are meant to have a community midwife-led service in all of our maternity hospitals, but five years on, only two hospitals have this service and have considered closing it. In our manifesto, Sinn Féin committed to providing an additional €70 million to fund and implement the national maternity hospital. That is the level of investment which is necessary.

I wish to finish by stating that we need an absolute commitment that the national maternity hospital will remain completely in public ownership. Why we had to go down the route of establishing a company to manage the land and the hospital, is beyond me. Surely, the land should have been gifted to the State? That is what should have happened. It should have been transferred or gifted to the State, then the national maternity hospital would be fully owned by the State. The land would be owned and managed by the HSE as opposed to being managed by others on a board. We must look at this issue. I commend the motion on highlighting the issue and seeking clarity on it.

I listened to what the Minister said earlier. He has provided some clarity, but there are still questions outstanding in relation to how it would all work in practice. The only way forward is for the land to be gifted to the State and for the hospital to be in full public ownership.

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