Dara Calleary (Mayo, Fianna Fail)
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I thank the Ceann Comhairle for allowing me to raise this matter, as well as thanking the Minister for Health for coming in to reply. According to The Connaught Telegraph, a report commissioned by the HSE conducted by the Dublin-based firm, Health Partnership, is examining maternity services in the west-northwest hospitals group. The initial first draft of the report is recommending closure of the units at Castlebar, Sligo and Roscommon, and the centralisation of maternity services into University Hospital Galway and Letterkenny General Hospital. As the Minister can imagine, that has caused considerable distress so the matter needs to be clarified urgently.

The HSE has confirmed that the review is under way but has still not made any report. The HSE subsequently said that there was a preliminary report. The HSE has issued a number of different press statements, so maybe that can be clarified. There was a preliminary report but this recommendation was not included in it.

I am asking the Minister to clarify a number of issues. In 2012, the last year for which I have full figures, Mayo General Hospital had 1,788 births. It is a busy maternity unit. The Minister knows the geography of Mayo well and his roots are there. A round trip to Galway from Belmullet or Erris is over 300 miles. Some weeks ago, somebody travelling from Achill experienced a difficulty and had to go to their local GP who, luckily enough, had the skills to deliver a child in Mulranny. The geographic difficulties are significant in the area and there is a need for access to maternity services. Mayo General Hospital provides a quality service in its busy maternity unit. The staff in the unit are renowned for their excellent work. They are deeply caring and there is a huge level of community trust in their abilities, as there is in the other hospitals.

How many reports are there and will the Minister publish the preliminary report? What are the terms of reference for the overall examination and will the Minister publish them? What level of public consultation will there be with GPs and local representatives? What is the date for this report to be delivered?

John O'Mahony (Mayo, Fine Gael)
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I thank the Ceann Comhairle for selecting this matter for debate and also thank the Minister for his attendance. The worst thing one can have is speculation started by leaks, which is suddenly taken as being the truth. I firmly believe that is the case here. The suggestion that Mayo General Hospital, Portiuncula and Sligo will have their maternity units closed is totally off the wall. I have spoken to many people who have attended those maternity units and they have nothing but praise for the care and attention they received from staff.

As Deputy Calleary has said, there were over 1,700 births in Mayo General Hospital in 2012 - a figure that has grown from 1,200 at the turn of the millennium. The size of County Mayo is relevant also. In recent times we have centralised many services at Mayo General Hospital, including the renal dialysis unit, which means that patients can be treated in Castlebar rather than having to travel to Galway.

I presume that there is absolutely no truth in the latest report but it needs to be nailed now. We have heard a lot of good stories about Mayo General Hospital, including treatment for renal dialysis and cystic fibrosis. In addition, there are plans for palliative care between the Mayo-Roscommon hospice in conjunction with the HSE. Only yesterday, the hospital was named as one of the top performers in meeting targets for treating people in accident and emergency within nine hours. This is despite the fact that the hospital has taken extra patients as a result of the accident and emergency unit closing down in Roscommon. By any measure, Mayo General Hospital has performed well. It is important, however, that this matter is not made into a political football. We do need these matters to be clarified.

James Reilly (Dublin North, Fine Gael)
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I welcome the opportunity to provide reassurance regarding the future delivery of high quality and safe maternity services in the west of Ireland. I thank both Deputies for having raised this issue.

Recent reports appear to suggest that some hospitals within the west-northwest group, including Mayo General Hospital, are to lose their maternity services. These reports are purely speculative and, as such, unhelpful. I fully recognise that such unsubstantiated reports are a cause for concern for patients and staff, and I regret any upset which may have been caused.

Maternity services in the west-northwest hospitals group are under review but, let me be clear, no decisions on reconfiguration will be taken in that context. The position is that the review arises from the implementation of the recommendations of the HIQA report into the death of Savita Halappanavar.

In addition, the Higgins report on the establishment of hospital groups, requires that each hospital group prepare a strategic plan for service configuration, consistent with national objectives for the delivery of patient services. These reports provide the backdrop for the review currently under way in each hospital in the west-northwest hospitals group, including the maternity units at Mayo General Hospital, University Hospital Galway, Portiuncula Hospital Ballinasloe, Sligo Regional Hospital and Letterkenny General Hospital. The review is in the early stages and will take some months to complete.

Maternity services in all parts of the country will be subject to review and evaluation this year as part of the development by my Department of a new national maternity strategy. The development of this strategy is currently under way and will determine the optimal configuration of maternity services to ensure that women in Ireland have access to safe, high quality maternity care in a setting most appropriate to their needs. It is the intention to publish the strategy this year.

Deputies can be assured that any decision on maternity service reconfiguration will be considered in the context of the national strategy and, therefore, on a national rather than a local basis. No decisions on service reconfiguration will be implemented without the agreement of my Department and certainly not in advance of the publication of the proposed national maternity strategy.

Developing the strategy will provide us with the opportunity to take stock of current services and identify how we can improve the quality and safety of care provided to women and their babies. The strategy will ensure that our services are fit for purpose and in accordance with best available national and international evidence well into the future.

Dara Calleary (Mayo, Fianna Fail)
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I thank the Minister for his reply. I accept that no decision on reconfiguration will be taken in a regional context, but the Minister is opening up the reconfiguration issue in a national context. What stage is this national maternity review at and what is the timeline? Will it be delivered in the Minister's time in office? What are its terms of reference?

The Minister of State, Deputy Ring, said that on his watch, and that of the Taoiseach, nothing will happen to maternity services at Mayo General Hospital. Given the strong track record, level of throughput and excellence of care both there, in Sligo and in the other hospitals concerned, can the Minister give a guarantee on maternity services in the context of this review?

John O'Mahony (Mayo, Fine Gael)
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I welcome the assurances given by the Minister but I wish to reiterate that all this speculation is unfair. I welcome any reviews that will increase or improve on the already great care that is provided in Mayo General Hospital. I have seen at first hand the wonderful care that is given. Unless we nail it now, this kind of scaremongering is damaging for staff morale as well as causing worry for expectant mothers. It is totally at odds with what we are hearing on the ground from our constituents about the care that is provided.

A family member of mine who is working abroad will be flying back to Ireland to have her baby at Mayo General Hospital in the next few months. We need to ensure that maternity services will continue at that hospital.

James Reilly (Dublin North, Fine Gael)
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I wish to reiterate that the HIQA report into the care and treatment provided to the late Savita Halappanavar recommended that as a priority maternity services should be reviewed, and a national maternity services strategy should be developed and implemented.

I have accepted that recommendation. The proposed national maternity strategy will determine the optimal configuration of maternity services to ensure women in Ireland have access to safe, high-quality maternity care in a setting most appropriate to their needs. The Department will oversee the development of the strategy, which will be informed by our national expertise as well as international expertise and analysis of maternity and gynaecological service configurations. The project is currently being scoped and it is expected to be published later this year.

Dara Calleary (Mayo, Fianna Fail)
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Is that the full report?

James Reilly (Dublin North, Fine Gael)
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Yes. In December 2011, I announced new management arrangements for two groups of hospitals in the west and midwest, Galway University Hospital, incorporating Merlin Park, and Portiuncula, Ballinasloe and Roscommon hospitals, were placed within a single management structure led by a single chief executive officer, Mr. Bill Maher, who is responsible for group performance. The hospital group has a single clinical governance model, one budget and one employment ceiling. We are trying to devolve as much authority as possible locally in respect of budgets, staffing and recruitment. However, no local review will supplant the national maternity review and no local decisions can be in conflict with national policy. National policy will determine matters. Mayo General Hospital joined this group.

I agree with Deputy John O'Mahony that this scaremongering is unhelpful and undermines confidence in the hospital and the staff. A great service is available in Mayo General Hospital, in particular, and in the other hospitals and it is one they have every right to be proud of. I am here to reassure people that there is no plan to close maternity hospitals.

Denis Naughten (Roscommon-South Leitrim, Independent)
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The report is before the board today.