Michael Fitzmaurice (Roscommon-Galway, Independent)
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It has emerged in the past week from minutes of meetings of the executive of the Saolta group that consideration is being given to merging the maternity services at Ballinasloe and Galway. Eoghan Murphy of Shannonside Radio obtained the minutes of recent meetings by way of a freedom of information request. The information has caused concern in County Roscommon and north Galway because the maternity service at Portiuncula Hospital in Ballinasloe is a very valuable asset. Is a downgrading of maternity services at the hospital envisaged? What is the status of the services and what does the reference to a merger in the minutes actually mean?

Finian McGrath (Dublin Bay North, Independent)
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I thank the Deputy for raising this very important issue. I know that he cares passionately about health service provision and the delivery of maternity services, in particular, in counties Galway and Roscommon.

The ongoing, progressive development of maternity services is an important part of the development of the health service and something to which the Government remains committed. As the House is aware, Ireland’s first national maternity strategy, Creating a Better Future Together, 2016 to 2026, was published in 2016 and is being implemented on a phased basis by the national women's and infants' health programme in the HSE. Realising the vision of the strategy requires a fundamental restructuring of maternity service delivery, as well as significant investment over the lifetime of the strategy. A detailed implementation plan for the strategy was published in October 2017. It provides a clear roadmap for the development of maternity services into the future.

This year the Government provided additional development funding of €4.55 million to progress implementation of the strategy and improve waiting times for gynaecological services around the country. In 2014, the chief medical officer’s report on perinatal deaths at the Midland Regional Hospital, Portlaoise, recommended that managed clinical maternity networks be established within each hospital group. That report recognised that smaller maternity units should not operate in isolation as stand-alone entities and should instead be supported through formal links to larger units. The establishment of maternity networks within hospital groups and the sharing of expertise within and across those networks will improve the operational resilience of smaller units and support those units to provide safe, quality services.

The establishment of a maternity network across the SaoIta hospital care group was further recommended in the clinical review of the maternity services at Portiuncula Hospital, conducted by Professor Walker and published earlier this year. That report also concluded that a maternity network is a requirement to ensure the delivery of high quality, safe and standardised maternity care across the entire hospital group. It is prudent therefore to remind the House that the establishment of maternity networks across our hospital groups represents Government policy and, as such, is a key priority for the Minister for Health. However, to be clear, the development of the Saolta maternity network, and the other maternity networks across our services, does not represent a plan to close any services. Maternity networks are about supporting smaller units to deliver their services in a more standardised and safer manner. The establishment of a maternity network is being progressed within the Saolta hospital group and, as a first step, that network will initially comprise University Hospital Galway and Portiuncula University Hospital. These new governance structures will provide the framework for the delivery of maternity services in the Saolta hospital group to ensure that the needs of women, their babies and their partners are being met, and that a consistently safe and high quality standardised maternity service is delivered across the group.

Michael Fitzmaurice (Roscommon-Galway, Independent)
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On the face of it, I welcome what the Minister of State said. He clearly stated there is no intention to close any services but that services will work together. I would like him to state there is no intention, over the coming years, to downgrade any services.

It needs to be understood that Portiuncula Hospital, Ballinasloe, is a valuable hospital for maternity services for north Galway and Roscommon. Everyone agrees on the importance of hospitals working together to ensure the best outcomes are achieved for expecting mothers and best practice is always adhered to.

In light of the way it was worded in the minutes of the meeting, there was much uncertainty and uneasiness in the area in case there was something going on behind the scenes without the people in the area knowing it.

I welcome the Minister of State's comments that Galway and Portiuncula hospitals will work together and Portiuncula hospital's maternity services will continue to be available in Ballinasloe and nothing will be downgraded. Will the Minister of State confirm that no service will be downgraded?

Finian McGrath (Dublin Bay North, Independent)
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I again thank the Deputy for bringing this important issue to the attention of the House. I will bring his concerns to the Minister for Health, Deputy Harris. I also accept his point on uncertainty, which we cannot have with regard to maternity services. The establishment of maternity networks is a central tenet of the national maternity strategy, being key to progressive development of maternity services in the future. Their establishment across the hospital groups is Government policy and is a key priority for the Minister for Health. The full establishment of maternity networks, not just in Saolta but across all hospital groups, will build on the substantial good work already under way in the development of maternity services and will underpin Government arrangements by providing quality assurance and ensuring equity of access to maternity services for women. The key phrases here are "quality assurance" and "equity of access to maternity services for women".

Any other concerns Deputy Fitzmaurice has will be raised with the Minister for Health.