Geraldine Feeney (Fianna Fail)

I thank the Cathaoirleach for allowing me to raise this important issue and I thank the Minister for agreeing to take the Adjournment debate. The matter I want to raise relates to expectant mothers, and the case I will deal with is in the Galway area. An expectant mother cannot avail of private accommodation in a public hospital unless she has made a private contractual arrangement with a consultant obstetrician, even though she has private health insurance. I use the phrase "expectant mother" rather than "patient" because pregnancy is not an illness. Everybody will agree it is a confinement, if we want to have a term for it. It has been brought to my attention that obstetrician-gynaecologists in the Galway area, and further afield, charge a fee of between €2,000 and €3,000 to deliver a baby - it may be even more in Dublin. That must be paid by the mother although she pays her private health insurance. If she does not enter into an arrangement with the obstetrician to deliver her baby, she cannot avail of the private room.

A survey reported that 50% of expectant mothers would prefer their babies to be delivered by a midwife but avail of a private room after having their babies. This pilot scheme was carried out in Cavan and Drogheda. Some 50% of eligible women would choose a midwifery-led service rather than a consultant-led service - there is a consultant-led service in place. Similar initiatives in Cork and Dublin also demonstrated a strong demand. There is evidence in these surveys that 50% of women would prefer their babies to be delivered by a midwife rather than an obstetrician-gynaecologist.

I am familiar with the Health Act and because of its age it might be a little antiquated in that it did not allow for a public patient to have a private room. Matters have moved on and women no longer stay in hospital as long after childbirth. I know of a baby who was born in the Minister's constituency last Saturday and the mother and baby were out of hospital on Sunday. If one had a normal delivery, one would stay three days in hospital but if one had a caesarian section, one would perhaps stay five days.

An expectant mother should have a choice. She should be able to decide that she wants a midwife to deliver her baby and to avail of a private room or that she wants an obstetrician-gynaecologist to deliver her baby and to avail of a private room. It should not be one or the other. It is a bit much for consultants to demand that their services should be used in order for a woman to avail of a private room.