Marie Sherlock (Labour) | Oireachtas source

I thank the Minister for coming into the House. I will confine my comments to the women's health action plan. I have made my views on the maternity hospital very clear. I warmly welcome the women's health action plan. There are a lot of very good people behind it. I refer to the women's health task force. Services that have long been fought for are now committed to in this plan.

I am struck by the theme running through the document and mentioned on the cover, which is "Listen. Invest. Deliver". That is what Government and politics are about, are they not? They are about listening, investing and delivering. I want to ask the Minister about the particular issue of delivery. On 11 May last year, 55 weeks ago now, the Minister made an announcement after listening to those of us who have been campaigning for breastfeeding supports for many years and listening to people within his own party and Government colleagues. Bainne Beatha, Cuidiú, La Leche and other groups have also been campaigning for breastfeeding supports. The Minister announced 24 new lactation consultant posts. I absolutely welcome that. That would be progress. It is still far off what we need, but it is progress.

However, as of 18 May this year, recruitment was only commencing for these posts. I do not know if I misheard the Minister's statement when he seemed to convey that these consultants are in place but, from the reply to a Commencement matter I put down here just two weeks ago, it was very clear that despite being halfway into the year, recruitment was only commencing for these posts. We really have no idea as to whether they are going to be filled. If we look at the 2020 commitment, we would not exactly be filled with hope that the 2021 will be realised and delivered upon because, in 2020, 10.5 lactation consultant posts were approved under the national maternity strategy but, two years later, only eight have been filled while two and a half posts remain open. We welcome the commitments but ultimately we can only judge them based on delivery and, to date, we are not seeing that.

I welcome the commitment to embedding perinatal mental health services within all maternity units. We know that postnatal depression and other mental health issues relating to pregnancy and postpartum have been very much the poor relation in maternity services over many years. Provision has been very patchy across many maternity services. I respectfully suggest that the Department might start by reviewing all partner restrictions across maternity units because, as I understand it, partner restrictions remain in place across the majority of maternity units. I know Holles Street has lifted its restrictions but many others have not. We have heard from the Better Maternity Care campaign and psychologists with expertise in the area that the environment and conditions in which a baby is born can have a significant impact on a mother's mental health. I ask the Minister to engage with the maternity units and ensure that those restrictions can be reviewed and, indeed, lifted as soon as possible.

The GP lead on women's health is another important introduction. I ask that the Minister ensure that, when that person is appointed, he or she has a specific remit to look at migrant women's health issues because I know from talking to AkiDwA, the organisation representing many African people and people with African descent in this country, that knowledge and expertise in dealing with African people's issues among GPs in this country is very patchy, disappointing and insufficient in many parts. Again, I ask that the GP lead look at that.

I will refer to something that is not referenced in the document. There is nothing with regard to home births. There is a long-standing issue in that the HSE has effectively failed to properly provide for the second midwife in a home birth situation. They are only paid €160 and are not paid if the woman is transferred to hospital. I ask the Minister to do something about this.

In the last few seconds available to me, I will mention that we have had a commitment to a Bill on assisted human reproduction for many years now. There is a commitment in this document as well. Many of us are waiting for this Bill, all for our own individual reasons, political and personal. We know that the Bill has been delayed for an unacceptable length of time. The Minister has to progress this Bill and he has to ensure recognition and legal certainty for the parents of the babies born via surrogacy. Any provision put into this legislation must have retrospective application because it is simply not good enough that there are babies who were born via surrogacy whose parents will not have legal recognition in this country.

The last thing I will say is that none of this matters unless the staffing is in place. The Minister knows better than the rest of us here the staffing shortages that exist right across the country. There are shortages among medical scientists, in the therapies and in the children's disability network teams, CDNTs. Children are waiting three years or longer to get a diagnosis within the CDNTs. Their only option is to go private. People are being approved for home support hours but simply cannot get them because the staff are not there. What is the Department doing with regard to workforce planning? We are at a really critical point now. People are not being paid enough to do the jobs that are vitally necessary. We need a comprehensive response from the Department with regard to the shortages right across the health system.