Mary Henry (Independent)

I thank the Minister of State for again coming before the House to discuss the issue of direct entry into midwifery courses at third level, a matter we discussed when he was here last week. A few hours before our discussion, a meeting had taken place between interested parties and officials from the Department of Health and Children. They discussed the negotiations regarding the involvement of the third level sector which the Minister said would take place "to reduce the costs being sought by the higher education institutions for the transfer of midwifery and children's nursing education to the third level sector". The Minister of State also said last week that the Tánaiste was committed to bringing forward the recommendations of the commission on this issue. He may remember that the commission recommended entry into universities.

The Department of Health and Children is, of course, consulting with the Department of Education and Science, the Higher Education Authority and the Health Service Executive. At the meeting that took place last week, which was attended by some members of the Conference of Heads of Irish Universities, there were developments that were alarming from the point of view of Trinity College school of nursing. Those present were told that the Dundalk Institute of Technology was to institute a course on direct entry into midwifery, with Our Lady of Lourdes Hospital in Drogheda being the relevant health facility, and that this was to begin next September.

When Trinity College was asked by the Department of Health and Children in the year 2000 to set up a pilot project for direct entry into midwifery, the Drogheda hospital and the Rotunda were to be the health facilities used. A relationship has been built up between Drogheda and Trinity College and some important research is being carried out by them. A randomised control trial was established to see if the outcome of midwifery-led services were better, worse or equal to consultant-led care. This is of great interest because it is the only research taking place in this area on a world basis. It is very important this initiative should carry on.

There has also been an overarching development between Trinity College's department of health science and the HSE north eastern area, which, as the Minister of State knows, has had serious problems in the recent past. Judge Harding Clark, who is carrying out an investigation into obstetric practice in the area following the unfortunate cases dealt with by Doctor Neary in the Drogheda hospital, has said that association with Trinity College has been most helpful in encouraging audit and the development of evidence based procedures. There is general agreement in this regard.

The Trinity pilot programme for direct entry is to be the template for courses that are set up throughout the country. The institutions that were recommended in the report were universities. While all the third level institutions have their place, I would be sorry to think that the recommendations of the commission would be disallowed because of a cheaper course being put forward by the Dundalk institute. The Minister of State has said that cost benefits are important. Of course they are but so is the quality of the courses being brought forward.

We are trying desperately to get people to enter midwifery courses. It is disappointing, in a profession which brings such joy to so many people, that we have such trouble but this is an international problem. We have a commission which has made its best effort to recommend what should be done to encourage people into direct entry but, unfortunately, we now have one of the most serious recommendations of the commission apparently being disregarded by the Tánaiste and Minister for Health and Children in that the recommended institutions will not be those in which the courses will be brought forward.