Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I welcome the Minister of State. While I am sorry the Minister for Health, Deputy Leo Varadkar, is not present, I understand the reason for his absence.

It is very regrettable that I have to raise this issue and I know that the Minister of State agrees with me when I say that. The death of another newborn child in Cavan General Hospital yesterday is a very serious and troubling matter. This is the fourth newborn child to be lost in the maternity unit at the hospital in the past 30 months, within which time we have yet to see findings or recommendations in respect of any of the previous tragic outcomes. That is compounding the serious impact all of these outcomes on the confidence of a dependent community in Cavan, Monaghan and neighbouring counties. It is absolutely imperative that the Minister and his Department intervene immediately to ensure the reports under preparation following the conclusion of the investigations of those given the responsibility to carry them out are brought forward with all due speed and published. In that way, people will have the opportunity to see the findings and recommendations made and very quickly thereafter the implementation of same. It is very reasonable and understandable that many people in the constituency in which I live and I am honoured to represent believe because of the absence of findings and recommendations, including in the very first case, that of baby Jamie Flynn in November 2012, that the subsequent tragic outcomes could have been avoided if the full gamut of information had been available and the necessary steps taken. Sadly, there was yet another case yesterday.

I ask the Minister of State and the senior Minister to intervene with Dr. Peter McKenna, Professor Tom Mathews, Ms Dawn Johnson and Ms Margaret McGarry to encourage the employment of the maximum number of hours available to them and more, if possible, to expedite the conclusion of their investigations. Let us not forget that this is the second investigation into this matter, as the report on the first investigation was suppressed by a decision of the High Court following a case taken by one of the practitioners directly involved.

I am also anxious to establish the nature of the engagement by the former Minister for Health, Deputy James Reilly, with HIQA when he announced publicly in Cavan that he would secure HIIQA's attention for the cases in Cavan, in association with the authority's investigation into and report on the tragic outcomes at the Midland Regional Hospital in Portlaoise. It appears from the information to hand that no such direct order was issued by the former Minister, despite his public commentary, and that HIQA has not carried out any investigation or paid any "particular attention," to use his words, to the cases in Cavan in the intervening period. I ask the Minister of State to shed light and offer clarity on the issue.

What is the most up-to-date assessment of when the second investigation into the death of baby Jamie Flynn is likely to be concluded?

Kathleen Lynch (Cork North Central, Labour)
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I should clarify for the House that the Minister for Health is not present to deal with this Topical Issue because he is meeting the families involved in the aforementioned tragedies at the Midland Regional Hospital in Portlaoise. I am sure the Deputy will agree that the Minister is right to meet them.

I thank the Deputy for raising this issue and affording me the opportunity to offer my sincerest sympathies to the family at the centre of this sad incident. I am very conscious of their personal tragedy, and do not, in any way, want to intrude on their privacy. It is important at this time that we give the family the space to grieve and I am sure they are grieving.

Of course, the HSE will undertake a review of the circumstances of the case and in so doing will follow the HSE incident management policy. Pending the outcome of that review, it is not appropriate for me to make any further comments on the specific incident. HIQA will conduct a focused programme of monitoring of compliance with the National Standards for Safer Better Healthcare across maternity services nationally. This programme will include the maternity unit at Cavan General Hospital and will be undertaken this year.

Concerns were raised regarding maternity services in Cavan following the deaths of three babies between 2012 and 2014. Following the death of the third baby in May 2014, the previous Minister for Health, Deputy Reilly, wrote to HIQA requesting that priority be given to a review of the maternity services in Cavan General Hospital against the national standards. I understand that HIQA has made contact with the HSE and details of the three incidents have been furnished to the authority.

With regard to the specific infant death referred to by the Deputy, the investigation into this tragic incident is still under way. I can make no further comment at this time. We are, of course, all too painfully aware of the events detailed in the HIQA report into maternity services at Portlaoise hospital. The Minister, Deputy Varadkar, briefed this House on the findings of that report yesterday and Deputies will be aware of his views on the failings in our services as detailed in the report.

I assure the House that action is being taken to address the serious concerns raised in the HIQA Portlaoise report. The Minister, Deputy Varadkar, has decided to establish a national women and infants health programme to address and improve maternity services across the country. The programme will provide the cross-sectoral framework and the necessary governance, integration and leadership to drive reform and standardise care across all 19 maternity units.

One of the Minister's priorities for 2015 is the publication of the national maternity strategy. The strategy will provide the policy to underpin the women and infants health programme. The steering group to advise on the strategy met for the first time last week and had a very useful engagement. The group is expected to report to the Minister before the end of the year. I believe it is expected in October.

I wish to clarify one other issue before the Deputy stands up because I do not want him to be wasting his time. I have a copy of a letter from the previous Minister for Health to Mr. Brian McEnery, the chairperson of HIQA. It outlines the concerns over Cavan General Hospital's maternity unit and the events there. In his letter the Minister requested HIQA to prioritise the monitoring of the maternity unit at Cavan General Hospital. Unfortunately, that request, as far as I know, has not been carried out, but it would be re-emphasised at this time.

Again not to have the Deputy wasting his time when he stands up for his second intervention let me also say that there is a very delicate balance over what Ministers can say to HIQA while not having that seen as an intrusion on its statutory and separated powers from Government. That is a line we all tread every day.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I assure the Minister of State that I never waste my time when I get the opportunity to speak in this House. I will have the opportunity to query the address of the Minister to HIQA in a few moments when I return to the Joint Committee on Health and Children before which Mr. Phelim Quinn is appearing this afternoon. However, I understand that the request does not equate with an order and there seems to be some differential between the two. This is most unfortunate and needs to be properly addressed.

I note the Minister of State's inability in her reply to refer to the second investigation. I named the make-up of that team in my first contribution. Irrespective of what restrictions may exist, I ask the Minister of State in her further reply to indicate that she and the Minister would urge the participants, Dr. McKenna et al., to increase focus in terms of the utilisation of their time, accepting that they are all already very busy people in other areas but recognising that we cannot afford to wait for the third anniversary of the tragic loss of baby Jamie Flynn by November of this year before we are to see even the publication of the report never mind the implementation of its recommendations.

Among a significant catchment of this country, pregnant women presenting for obstetric maternity services are deeply concerned. Staff in the maternity unit in Cavan General Hospital are also deeply concerned at the absence of any report findings and recommendations. I have no question as to the integrity and commitment of the maternity staff, the nurses and midwives, at Cavan General Hospital. They are understandably anxious to have this matter expedited. It is imperative that particular action is taken and that we have the required closure in terms of those findings and recommendations at the earliest possible time. I thank the Minister of State for her co-operation on that.

Kathleen Lynch (Cork North Central, Labour)
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I share the Deputy's frustration over the inability to publish certain reports. We must find a way of on the one hand allowing people named in reports to have due process if that is what they want but on the other hand being able to publish the relevant information in order for us to take the necessary steps. The non-publication of the report does not mean that the necessary steps cannot be taken, because clearly it is seen by the people in the system.

However, in the instance that has brought us here today, an investigation team is already being set up. It is just over 24 hours since that baby died. A serious reportable event report is being prepared by the hospital. The case is logged in the incident investigation and management system, and is being escalated. An investigation team has already been established. The coroner has been contacted and the appropriate paperwork is being completed.

The HSE is not currently aware of any wider patient safety concerns arising from this case. That is important because we are talking about people who are at their most vulnerable. For a pregnant woman, going into labour is probably the most vulnerable time in her life. The necessary steps are being taken over that incident.

There is a wider issue with maternity services across the country, and not just in Cavan and Portlaoise. We need to determine what we need to do in order to restore trust and give women the reassurance they need regarding maternity services. The group appointed to prepare the maternity strategy will do that for us. However, the things that need to be done regarding Cavan General Hospital are already in train.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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The thoughts and prayers of the entire community are with the couple concerned and their families at this very sad time.

Kathleen Lynch (Cork North Central, Labour)
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I say this on behalf of everyone. It is a difficult enough time for any family to find themselves in this position. Even when it is unavoidable, it is a difficult time. It must be doubly difficult when they have the spotlight of the nation on them.

Olivia Mitchell (Dublin South, Fine Gael)
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That is appreciated.