David Cullinane (Waterford, Sinn Fein)
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I was contacted by a constituent both of mine and the Minister of State named Natasha and she asked me to read into the record her experience. She states:

I want to tell you my story and I hope that the Government will soon reverse the decisions it has made to underestimate the need for women to have some support during their pregnancy. I have two gorgeous little boys. I surprisingly fell pregnant for the fourth time. My partner and I lost our first baby to a miscarriage in 2016.

I am sure you can imagine the first few weeks after finding out we were expecting again were pretty stressful and filled with anxiety and fear over having a 13-month-old and newborn. But then as the weeks went on that fear turned into hope and love for another beautiful perfect little bundle of joy that would complete our family.

Eight weeks into the pregnancy I started to bleed. I was called to University Hospital Waterford. I got to the hospital and had to make my way in alone. I waited in the corridor alone. I was seen by a lovely doctor and midwife, who checked me out and found a polyp. When the doctor started scanning me I could see her face change. She explained she was going to see her senior doctor, who would come to check as she had more experience, and left me in the room alone. I cried when I found out that I had lost the baby and I had to experience this on my own. The only person who was there to hug me was a doctor, not my partner.

Natasha is not alone and the Minister of State knows many women are in a similar position. I ask her to look at this compassionately to ensure such scenarios do not happen again.

Violet-Anne Wynne (Clare, Sinn Fein)
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We all appreciate that Covid-19 has thrown up some unprecedented challenges for our health service and staff and it most certainly did so for our patients in vulnerable positions and their families. Covid-19 arriving on this island has seen great demands on our people, including behavioural and habitual changes to what we have long been accustomed. That should be recognised by this House.

I will focus on the discontinuing of all visitors to our hospitals, including maternity hospitals, and nursing homes or care facilities. In Clare and across the State we have heard heartbreaking stories of loved ones facing difficult information or diagnoses, including diagnoses of cancer, on their own, not having their family with them for support or even as another ear to receive the difficult information.

People with disabilities are living in nursing homes where they should not be but they cannot receive visitors. Visitation could be facilitated and we could allow these visits on compassionate and critical grounds with proper planning, personal protective equipment and procedures in place. This cannot be a blanket decision and one size will not fit all when we are dealing with people's health and care.

Darren O'Rourke (Meath East, Sinn Fein)
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I will address this matter in the context of maternity services and appointments. Speaking on my own behalf, I am very happy to say my wife is 40 weeks pregnant plus one week and her due date was yesterday. We have lived with these restrictions in place at the Rotunda hospital just like everybody else. We would rather if it was different.

I am grateful that the pregnancy is progressing well. Deputy Cullinane can speak about the other side of this issue. I am also grateful that this is not our first child. People's first experience of pregnancy, especially of a difficult pregnancy, is very difficult. We have heard that from "Liveline" with Joe Duffy and we read it in our local newspapers. Things are really difficult for people in those situations. I am not speaking on my own behalf but on behalf of people facing additional challenges, risks, anxiety or other strains. Any measure that can be taken on compassionate grounds on a case-by-case basis is very important.

Mary Butler (Waterford, Fianna Fail)
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I thank Deputies O'Rourke, Wynne and Cullinane for raising this really serious issue. I was under the impression that I was coming to the House to discuss issues concerning visitations to nursing homes, but I will address both issues.

This was raised in the Dáil a couple of weeks ago by a Sinn Féin Deputy from Cork. I know it is a very challenging issue. I am a mother of three and I brought either my mother or my husband to every single appointment I ever had when I was pregnant. I want to congratulate Deputy O'Rourke on the baby who will be born very soon. It is a magical time but I know how challenging it is. It is very hard for an expectant mother to face these visits on her own. What Deputy Cullinane read out was devastating. It is absolutely devastating for any woman to be unsure of where to go in a clinic and to get bad news.

When I stood here to discuss this previously, we were told that the reasons for the policy were purely to do with the prevention and control of infection and the need to limit footfall in hospitals. Very young and premature babies and new mothers are very vulnerable, but obviously partners want to be involved. Though it varies from constituency to constituency and from hospital to hospital, I understand that the majority of hospitals allow partners to be present during the birth, including in the case of a Caesarean section. The main issue is that partners are not allowed to attend a 20-week scan. That scan comes at a very important time during a pregnancy, when parents are able to see how their baby is developing. This restriction is very difficult, as a mother could receive very bad news at this appointment.

This was raised with the Taoiseach in the Dáil last week. He said he would discuss the matter with the acting Chief Medical Officer to see if any compassionate grounds would be allowed. I imagine this will be extremely difficult in counties where restrictions are at level 3, such as Dublin and now Donegal. I have raised this with the Minister for Health, Deputy Stephen Donnelly, and I will certainly do so again. This is an extremely difficult situation. A mother is likely to feel emotional, vulnerable, tired and stressed at that time in her life. She is looking forward to the birth of her new baby, but it is very difficult to face that alone. Everybody needs support.

Deputy Wynne spoke about visitations to other facilities. Unprecedented challenges have arisen throughout our health services, and nowhere more so than in the area of older persons' services. As we all know, nursing homes closed down in early March and family members were unable to visit for almost six months. That was really trying, and I think we have learned that it is not the correct approach. We need to reduce footfall in nursing homes as much as possible and we have to protect our older and vulnerable people, but they are lonely and afraid and want to see their loved ones as well.

Violet-Anne Wynne (Clare, Sinn Fein)
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I appreciate the Minister of State's presence here. The Minister for Health, Deputy Stephen Donnelly, needs to look into this matter personally. We need to end the blanket ban on visitors in our hospitals and other care facilities. We need more humanity, more leadership and more solutions. Warm winter gardens could be considered for nursing homes. We are social creatures after all, and we need our families and loved ones when we are at our most vulnerable.

David Cullinane (Waterford, Sinn Fein)
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I thank the Minister of State for her compassionate response and her understanding of this issue. I raised this issue with the acting Chief Medical Officer myself at a meeting earlier this week. I completely understand the infection control measures that are in place in hospitals and the need to maintain social distancing and keep people away from hospitals to protect newborns and pregnant women. We all accept that this is a very challenging time.

At the same time, we need to consider allowing critical and compassionate access for visitors to residents of nursing homes and the partners of pregnant women. I do not believe that any resident of a nursing home should have to die alone. My own mother died several years ago. I would never allow it to happen if it was my mother, and the same is true for the vast majority of people. When I met the acting Chief Medical Officer he said that two reports were making their way to his desk. One concerned critical and compassionate access for visitors to the residents of nursing homes, and one was on the issue of access to maternity hospitals for partners. Perhaps the Minister of State could find out the status of those reports, the recommendations that have been made and the changes that can be implemented to support Natasha and many others.

Mary Butler (Waterford, Fianna Fail)
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The Covid-19 guidance on visitations to residential care facilities has been developed and is reviewed and revised on an ongoing basis in consultation with key national stakeholders. This is an important document that provides a pathway for safe visiting. Any updates are expected to encompass recent developments in the response. As I stated, however, the existing guidance is not without consideration for visiting on compassionate grounds. That is allowed. It behoves all providers of long-term residential care to balance their responsibility to ensure their residents' autonomy and right to have visitors with the need to ensure that visitations do not compromise overall residential care.

Visitation was suspended in all nursing homes when Dublin went to level 3. However, a situation arose where window visits were stopped completely. I wish to state on the record that this was not a recommendation of the National Public Health Emergency Team, NPHET. The onus is on each nursing homes to set out its own guidelines. I appeal to all nursing homes to allow window visits at a minimum. This does not entail contact between a visitor and his or her loved one, but a visitor can at least see in the window, wave and perhaps have a conversation, especially if a mobile phone can be used.

I will certainly raise the matter referred to by Deputy Cullinane with the Minister again. I have been contacted by many very distressed pregnant women from all over the country. This situation is very fluid and as we have seen today, it is changing by the day, but I will certainly raise it with the Minister again.