Dáil debates

Tuesday, 21 September 2021

Saincheisteanna Tráthúla - Topical Issue Debate

Hospital Services

10:45 pm

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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The second matter I have selected is from Deputies Niamh Smyth and Holly Cairns who wish to discuss when the current restrictions will be lifted so that partners can accompany women to maternity care appointments. The Minister of State, Deputy Anne Rabbitte, will respond to the matter. The Deputies have two minutes each.

Photo of Niamh SmythNiamh Smyth (Cavan-Monaghan, Fianna Fail)
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I am delighted the Minister of State has stayed until this hour of the night to respond to the matter. I am sure that I do not need to convince her of the importance of this debate and this argument. It is pitiful that 18 or 19 months on, we are still having this discussion about women and basic healthcare in maternity services around the country.

There are 19 maternity services around the country. It has to be said at the outset that not every maternity service within a hospital is restrictive, draconian or dogmatic in terms of the restrictions imposed. It is important to state that they are imposing these on women. The clear message that has to come from the debate tonight is that we, as women in the Oireachtas, are calling for a return to pre-pandemic access for women. They should be allowed to be accompanied by one partner when accessing maternity services and wards, and as they go through this critical, crucial and emotional journey through our hospital services.

There have been 96,000 births since the beginning of Covid-19. That number does not include the thousands of women who have suffered pregnancy loss. We, as Oireachtas Members, have had the privilege of listening to the women leading the campaign for better maternity care for women. Some of those women have relayed heart-breaking stories of being through their second and third pregnancy journeys during the pandemic, as well as the impact that is having on them. There are no happy stories coming from women who have been through the journey.

As I said, it is important to note that not every hospital is draconian in its measures. The point that I am trying to make is that 90% of our population has now been vaccinated. We are now back to being able to converse and to have a debate in the Dáil, and there are 40,000 allowed into Croke Park. We want to go back to pre-pandemic access to maternity services for women and partners.

Photo of Holly CairnsHolly Cairns (Cork South West, Social Democrats)
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Deputy Smyth articulated that perfectly. All of the women in the Oireachtas are calling for this. It was all well said by Deputy Smyth. I first raised this issue more than a year ago. Since then, there have been considerable changes. We are close to most of the restrictions across all of society being eased. More than 90% of over 16-year-olds are fully vaccinated, yet, restrictions still remain in accompanying people to maternity hospitals. Despite the opening of pubs, sports, offices, bingo and almost everything, women are still expected to endure prolonged labour and to care for their new born alone. This is not to mention the partners who have at times received the most difficult and tragic news on their own in hospital car parks.

There is deep frustration and anger, not only about this issue, but about the inconsistencies from the Government and HSE. If one goes onto the HSE webpage for hospital visiting restrictions, one will find a significant difference in the restrictions between maternity hospitals and units. Over the last year, I have raised the kind of post code lottery in relation to this. The goal posts have shifted every time I raised this issue. It has shifted from being a HSE issue, to a local hospital group issue, to waiting for vaccine roll-out, to cramped conditions in our older hospitals.

The Rotunda Hospital was insistent on its restrictions until the outrage at the filming of the television series. This was filmed at a time when partners were not allowed in. Once that pressure came, it miraculously eased restrictions. Back in May, as we all know, the Chief Medical Officer, Dr. Tony Holohan, said that there was no good reason in public health terms for maternity hospitals to restrict visits from partners. Then in June, the Minister for Health, Deputy Stephen Donnelly, said that all of the State’s maternity units will be following the same visiting guidelines for patients' partners.

However, we are now at the stage where some women, as Deputy Smyth said, are going through their second birth alone during the pandemic. The approach taken over the past 12 months has not worked. I am asking if the Government can please gather all the heads together to try to address the situation once and for all.

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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It is fair to say that the female Oireachtas Members have the total support of the male Members in their demands.

Photo of Holly CairnsHolly Cairns (Cork South West, Social Democrats)
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It must be confusing for people watching to hear that all of the female and male Members want this, yet it still has not happened. Why is that the case?

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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I am sure the Minister of State will cast some light on that now.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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I get all the good ones, a Cheann Comhairle.

I am taking this matter on behalf of the Minister, Deputy Donnelly. While I will deliver his script, I have my own opinion as well, which I would be happy to share with the Deputies.

Photo of Holly CairnsHolly Cairns (Cork South West, Social Democrats)
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Can you skip to that bit?

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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I want to thank the Deputies for raising this important issue. I welcome the opportunity to discuss the topic on the floor of the House. It is not the first time that I have responded to this matter. I think it might be the third time. I think I responded to Deputy Neale Richmond as well as to Deputy Cairns previously. This is my third time to respond to this matter.

I assure the House and the Deputies present that I completely understand and recognise the concerns and anxiety that the restrictions have caused to women and their partners over the course of this pandemic. The importance of partners attending with women at maternity appointments is well recognised, including by everyone working in the provision of maternity care. At the same time, the advice is that the potential for Covid-19 to spread maternity services continues to be very real. The highest priority must be given to protecting the health and the safety of the women and the babies in our care. The HSE guidance on attendance at maternity hospitals aims to manage that balance, while reflecting its commitment to providing increased access for nominated support partners. I am heartened to see that many restrictions have now been reduced and that there is now greater access for partners of women accessing maternity care. The clinical guidance has allowed for a broadening of that access, while at the same time ensuring that maternity services continue to provide care safely and protect women and their pregnancies from Covid-19.

The latest guidance of 3 September sets out that controls on access for partners should be the minimum required to manage infection prevention and control risks, and that any restrictions must be clearly explained and should be applied with consideration for individual circumstances and needs. No matter where the hospital or what the outbreak, that individual need should be taken seriously into consideration. The updated guidance deals with facilitating access for nominated support partners where women are attending for antenatal care, during labour and childbirth and in relation to postnatal care.

If a hospital places any additional limitations on partner access, the guidance stipulates that those restrictions should be based on a documented risk assessment that is reviewed regularly and is readily available, for example on the hospital’s website. There should be no contradictory evidence between the Department of Health and any of the 19 maternity hospitals around the country. If there is an outbreak of Covid, the Department would need to be notified and be aware of it, but it cannot be done on an ad hoc basis to suit whatever political agenda there may be in any particular maternity hospital.

To ensure that the current situation is clearly communicated, the HSE has advised that hospital groups continue to update their websites to reflect the current position and that it is now publishing the guidance on its website. In addition, arrangements are in place for each hospital group director of nursing and midwifery to monitor compliance so that access for partners to maternity services is facilitated and consistent with the guidance.

I indicated to the Department that I might have to move a little off-script as it would be unforgivable of me to stand here tonight without recognising the fact that a particular hospital allowed a TV company in to film while partners sat outside in their cars waiting to see how their partner was progressing in labour or, worse, finding themselves in the horrific position where there was no delivery, but they were after losing a child. It is time for the 19 maternity hospitals to show leadership on this. We need the hospital midwifery sections, which are normally led by women, to stand up and take ownership of the matter by coming forward and bringing maternity services into line with how we are doing infection protection and prevention in all other parts of the health system. Maternity should not be left behind.

10:55 pm

Photo of Niamh SmythNiamh Smyth (Cavan-Monaghan, Fianna Fail)
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I know the Minister of State is very passionate about this. Both the Taoiseach and the Minister have stood up and said this is not on. They have called on the hospital directors and masters of the maternity units to get on with lifting those restrictions and allowing partners in. It would be remiss of me not to say that my own hospital, Cavan General Hospital - and not everyone is lucky enough to have a maternity unit - is letting partners in. One of my own staff who is going through that journey is having a lovely experience and her partner has been allowed in with her. There is a midwifery-led unit there. They could come up with loads of reasons they would not allow a partner in but that is not the case and they are. Every hospital should be working in the same vein and allowing partners in with the mothers. It is not just a women's issue; it is a family issue. The Ceann Comhairle has rightly pointed out that the men or partners left out in the car park are equally upset about this. Their voices have to be heard in this debate as well.

I also want to make the point that there is an opportunity here. There has been an explosion in home births. A cousin who went through this chose, because of Covid, to have a home birth. There is huge leniency towards that. There is an opportunity with the Department, the HSE and maternity services to embrace that, to nurture it and to allow women to have that choice and make it more readily available.

Photo of Holly CairnsHolly Cairns (Cork South West, Social Democrats)
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I thank the Minister of State for her response. We all appreciate the complexity of the situation. We understand that nobody has the interests of the newborn more at heart than the expectant or new parents. They deserve as much certainty and clear guidance as possible and support from a partner through all stages of the journey, and that has to happen immediately.

We hear that the Minister has called for this and the Taoiseach has called for that, but the statement the Minister of State read on behalf of them includes stipulations. I reiterate what I said earlier: the CMO has said there is no good reason in public health terms for these restrictions. It cannot be a bit of both. We must be firm on this because it has gone on for so long. There are people going in for a second time.

Last December, the HSE reclassified partners as essential accompanying persons for the purpose of the 20-week scan. Maybe we could reclassify partners as essential accompanying persons for the entire maternity journey so that no matter how restrictions are looked at or revised, that remains the same. We are talking about giving rise to risk. We have had this conversation before but if a partner has brought the mother to the hospital in the car, they are arguably already a close contact. We should also consider the percentage of vaccinated people. I encourage the Minister to look into reclassifying partners on a permanent basis for the entire maternity journey.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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I am aware that Senator Doherty is having a meeting with the HSE tomorrow. All female Members, including the two Ministers of State in the Department of Health and all other female Ministers, have signed a supporting document. I call on the HSE to meet with the female Members of the Oireachtas tomorrow evening, to take on board all the suggestions and to show leniency, tolerance and empathy to the women coming into their maternity wards.

Photo of Jennifer Carroll MacNeillJennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I wish to put on notice that in addition, the women of the Oireachtas have agreed to bring this up at every opportunity until it is agreed. We brought it up at the Committee on Public Accounts last week, during Questions on Promised Legislation today and again this evening. We will bring it up every day.

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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I will facilitate you raising it here as often as you like.

Photo of Niamh SmythNiamh Smyth (Cavan-Monaghan, Fianna Fail)
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And the same in the Seanad.

Photo of Holly CairnsHolly Cairns (Cork South West, Social Democrats)
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The same in the Seanad.