Niamh Smyth (Cavan-Monaghan, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I welcome the opportunity to raise this very important issue regarding the 20-week anomaly scan at Cavan General Hospital. I have submitted numerous parliamentary questions in the past eight months and I have been getting mixed messages from the Health Service Executive, HSE, on this issue. I was first led to believe that it had been actively worked on for Cavan General Hospital and that it was the aim of the HSE to provide this essential scan to pregnant women in Cavan, Monaghan and across the region. We then heard that the equipment was in place in the hospital but that the management is unable to fill the vacancies with the required expertise. I have now been informed that scans will be provided for within the RCSI hospital group because staffing cannot be secured to have them carried out at Cavan General Hospital. That is cold comfort to expectant mothers in Cavan and Monaghan.

The hiring of professionals across all Departments within the HSE appears to be a recurring problem. One must ask why that is the case. Is it just an excuse to get out of the original commitments to provide this anomaly scan in Cavan General Hospital and force pregnant women to travel up to two hours away to have the scan they need? Why should women in Cavan and Monaghan, and across the general area, not have this scan made available to them? I have to say they are being treated differently and discriminated against, and we are back to the same old story of only looking after those living in the big cities.

Unfortunately, too many harrowing cases have been reported in recent years regarding these scans. We had one only this week in County Cork. I do not know the reason the HSE is not listening to the women who have been crying and concerned about this issue. Why will it not accept and implement the recommendations of previous cases taken against the HSE? When something goes wrong during pregnancy or, even worse, when there is a fatality, it has a devastating impact on the families involved and on the staff in hospitals. To hear that this anomaly scan, if available, could prevent and change the outcome in some way adds further insult to injury. To the families that have been bereaved, it is incomprehensible.

Having a scan available to expectant mothers at any other site apart from Cavan General Hospital is not good enough. It is not enough to cherry-pick certain areas and only provide in the big cities. To further compound the families' grief, misinformation has been given to the media by the professionals leading the public, and me, to believe that the scan would be made available in the hospital. That is simply not true.

I requested a meeting with the Minister, Deputy Harris, regarding one particular family, the Whelans, who have suffered terribly. In requesting the meeting for the Whelan family, the Minister's answer, which I will paraphrase, was that it would be better for them to meet the HSE. That is not what the Whelan family want to hear. They want to meet with the Minister to express their concerns and to ensure that this is implemented in Cavan General Hospital.

When and why has the plan changed from providing the scan at the hospital to providing a regional maternal foetal medicine service with the RCSI group? Why does the HSE think this model would give greater recruitment success? Why has the HSE given up so easily on requiring the staff of the hospital to provide the scan, particularly when we believe all the equipment necessary for the scan is in the hospital?

Will the Minister of State outline what are the long-term plans of the Department and the HSE for the unit in Cavan General Hospital? It is a fabulous department which just requires this one scan, which has been recommended.

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I apologise for arriving late and delaying proceedings. Unfortunately, the Minister, Deputy Harris, cannot be here. I thank Deputy Smyth for raising this matter and giving me the opportunity to update the House on the position on foetal anomaly scanning at Cavan General Hospital. The Minister, Deputy Harris, is advised that while the provision of routine foetal anomaly scanning for all pregnant women has been a key target for Cavan General Hospital, despite every effort having been made the hospital has not been successful, to date, in recruiting the necessary specialists required to provide a routine 20-week anomaly scanning service. However, the Minister is advised that those maternity hospitals and units currently providing anomaly scans will accept referrals from other maternity units, if requested. This occurs where the medical team in the referring maternity unit considers that an anomaly scan is clinically indicated.

The Minister, Deputy Harris, accepts that the provision of anomaly scanning is not uniform throughout the country but we are working to address this. The national maternity strategy is very clear that all women must have equal access to standardised ultrasound services. The strategy will be implemented on a phased basis over the coming years and this work will be led by the HSE national women and infants health programme. The programme was recently established, and the Minister anticipates it will drive improvements in maternity service delivery. On behalf of the Minister, I am pleased to confirm a programme director was seconded into position on 3 January. A clinical director has recently been appointed and will take up position on 1 March.

The Minister has been assured the issue of anomaly scanning is a priority for the programme. As a first step, clinical guidance on routine detailed scans at 20 weeks will be developed. In the meantime, the programme will continue to work with the hospital groups to assist in increasing access to anomaly scans for those units with limited availability. Of course, one of the current challenges to increase access to anomaly scans is the recruitment of ultrasonographers. In this context, it is expected the establishment of maternity networks across hospital groups will assist in the development of a sustainable service model that ensures that all women in each hospital group can access anomaly scans.

The maternity strategy recognises that smaller maternity services cannot, and should not, operate in isolation as stand-alone entities. Those units cannot sustain the breadth and depth of clinical services that the populations they serve require without formal links to larger units. Accordingly, maternity networks are being established across hospital groups. The Deputy can be assured the Government is fully committed to the progressive development of our maternity services. Last year saw the publication of Ireland's first ever national maternity strategy as well as the HSE's national standards for bereavement care following pregnancy loss and perinatal death and HIQA's national standards for safer better maternity services. In addition, each of our 19 maternity units now publishes a maternity patient safety statement on a monthly basis. I am sure the House will agree these developments represent key building blocks to enable us to provide a consistently safe and high quality maternity service.

Niamh Smyth (Cavan-Monaghan, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

It is a fundamental piece of equipment and a fundamental service in any maternity ward. I am really not sure from the Minister of State's reply whether she has stated staff will circulate between various hospitals or there will be a designated 20-week anomaly scan in Cavan General Hospital and patients will not just be referred to the Rotunda or other hospitals.

I wrote to the Minister, Deputy Harris, to ask him whether he would meet the Whelan family. At the inquest into Conor Whelan's death, it was part of the recommendations the 20-week anomaly scan would be provided in the hospital so any fatal foetal abnormalities and any abnormalities in an unborn child would be recognised in the early days. Is the Minister agreeable to meeting the Whelan family? Is the Minister of State telling me we will have a designated 20-week anomaly scan in Cavan General Hospital?

Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I acknowledge the concerns the Deputy has raised. As I stated, despite every effort being made, the hospital has not been successful to date in recruiting the necessary specialist required to provide a routine 20-week anomaly scan service. I will certainly bring back the Deputy's concerns about this. I will also bring back her concerns in regard to the Minister meeting the Whelan family. As a mother and grandmother, I know pregnancy is a very stressful time for the woman and the man in such cases and a 20-week scan gives some assurance to expectant parents that everything is okay. It is unfortunate the problem seems very much to be finding the proper specialist to provide the anomaly scan service. I will bring the Deputy's concerns to the Minister, particularly in regard to meeting the Whelan family.

Niamh Smyth (Cavan-Monaghan, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I really appreciate that.