Seanad debates

Wednesday, 12 October 2005

7:00 pm

Mary Henry (Independent)
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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.

Photo of Brian Lenihan JnrBrian Lenihan Jnr (Dublin West, Fianna Fail)
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I thank Senator Henry for raising this matter on the Adjournment. I had the honour of opening the schools of nursing at Dundalk Institute of Technology and Trinity College on behalf of the Tánaiste and Minister for Health and Children. They are the only two schools of nursing I have opened. I do not want to trespass too far into the issue raised by the Senator.

I am responding to Senator Henry on behalf of the Tánaiste and Minister for Health and Children. The Senator has asked for an update on the implementation of the recommendations of the expert group on midwifery and children's nursing education in relation to midwifery. The expert group, which presented its report to the Tánaiste in late December 2004, was established in September of that year to develop a comprehensive strategy for the future of midwifery and children's nursing. Its establishment followed the introduction in 2002 of a four-year undergraduate degree programme in general psychiatric and intellectual disability nursing. The report's major recommendation was for the introduction of a four-year undergraduate midwifery programme offering 140 places per annum. The report recommended that postgraduate courses for midwifery be transferred to the higher education institutions. When the Tánaiste welcomed the expert group's report, she made it clear that while it is intended that both programmes will commence in autumn 2006, she is concerned about the scale of the additional costs of the implementation of the two programmes, having regard to the significant resources in place to support nursing education.

The Government has provided for capital investment of over €240 million for the provision of purpose-built infrastructure for undergraduate nursing students, including state-of-the-art clinical skills and human science laboratories. Having seen the facilities at Trinity College, in the old gas company property, and at Dundalk Institute of Technology, I assure the House that they would repay visitation. The outstanding facilities in Dundalk include a simulated accident and emergency section. I appreciate that such facilities do not pertain to midwifery. The Department of Health and Children is in negotiations with the higher education institutions representing the universities and the institutes of technology about reducing the cost of the transfer of midwifery and children's nursing education to the third level sector. The Department has consulted the Department of Education and Science, the Higher Education Authority and the Health Service Executive about the issue.

I would like to give the House details of the developments which have taken place since it was given an update on the implementation of the recommendations in the expert group's report on 5 October last. Negotiations with the higher education institutes have progressed and are well advanced. The Tánaiste is not in a position to give the House further details, however, as the negotiations are ongoing. As she has said previously, she hopes that the negotiations will offer a way forward for the introduction of the direct entry midwifery and integrated children's general nursing degree programmes in the autumn of next year.

Mary Henry (Independent)
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This is all about costs.

Photo of Brian Lenihan JnrBrian Lenihan Jnr (Dublin West, Fianna Fail)
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Yes.

Mary Henry (Independent)
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It is outrageous, when one considers the Department of Health and Children's extraordinary waste of money on many different projects, that the training of midwives to help Irish women and women of other nationalities to deliver Irish babies may be hindered by cost issues. It is a sad day when cost considerations are of more importance in this country, which has prided itself on its maternity care, than the quality of the programmes to be introduced.