Marc MacSharry (Fianna Fail)
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Following the Minister's statement in the Dáil yesterday and the real concerns of the people of the north west, I have some specific questions to which I would like specific answers.

What the Minister said yesterday led me to tabling today's motion, which asks him to confirm or deny the existence of a preliminary report on maternity services in the HSE west and north-west hospital grouping area, as prepared by the Health Partnership consultancy. I would like the Minister to outline the terms of reference provided for the preparation of this report. I want him to outline the report's draft recommendations, specifically in terms of the number and location of maternity service centres in the region, and to clarify the Government's position on the matter.

I have reason to believe that the draft preliminary report specifically states that two maternity services are to be maintained, one in Galway and one in Donegal. I know that no decision has been made, but I want to get to the bottom of this preliminary report, and I hope that the Minister can answer those questions. First, does a preliminary report exist? Second, what were its terms of reference? Third, what did the draft recommendations state?

I tried to contact this company, Health Partnership, which has a virtual office on Trinity Street. I spoke to a lady there today, who directed me to the CEO of the HSE to answer any of my questions. I do not know anything about this organisation. If we look up its website, it does not state that any personnel work there. The lady to whom I spoke said four people worked there.

The commitments given yesterday by the Minister had a very worrying end, because he said that a national review was taking place and that this would be determined by national and not local concerns. The Minister will understand that the people of the north west have an issue with the Minister and the Government on the basis that they were lied to in the past in respect of Roscommon General Hospital. They were lied to by the Tánaiste in respect of cancer centres of excellence. They were lied to by the Taoiseach in respect of Roscommon General Hospital as well.

James Reilly (Dublin North, Fine Gael)
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I thought we had rules about using words like "lies" and so on.

Catherine Noone (Fine Gael)
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You probably need to temper that language, Senator.

Marc MacSharry (Fianna Fail)
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I do not need to temper it. I am taking advantage of what is called parliamentary privilege to tell the truth. I am not abusing privilege, but I am using it to say that the Minister lied to the people of Sligo, the Taoiseach lied to the people of Sligo, and the Tánaiste lied to the people of Sligo and the people of Roscommon. I have an issue with the commitment given by the Minister yesterday being truthful. I do not accept it as being enough.

I want the detail of the preliminary report. I want the terms of reference given to Health Partnership and I want to know what are its draft recommendations. The people of Ireland and the people of the north-west region are entitled to know, if Fine Gael and the Labour Party are secretly intending to dismantle the maternity services of the north west, what are the terms of reference to do so. For example, the first term of reference that ought to be given to any consultancy group for the delivery of any health service in this country is that services are delivered on a geographical quality basis. That has not happened in the past, in spite of the Minister's lies on cancer services. I understand that I am using parliamentary privilege, but I am most certainly not abusing it-----

Catherine Noone (Fine Gael)
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That is not the idea of parliamentary privilege.

Marc MacSharry (Fianna Fail)
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-----because I must put on the record the fact that the Minister told lies in that respect.

Catherine Noone (Fine Gael)
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I must ask the Senator to conclude.

Marc MacSharry (Fianna Fail)
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As a result, we have grave concerns about the Minister's commitment yesterday. He did not issue denials that a preliminary report exists. He did not deny that the preliminary report's recommendations sought to shut down three of five services in the north west of the country. As a result, we need to see terms of reference. This group with a virtual office on Trinity Street needs to make available to us the preliminary report, and the terms of reference under which it drew up that report.

James Reilly (Dublin North, Fine Gael)
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I have a written response, but that was before the Senator got up and made these outrageous statements about lies. The people of this country know who told them lies. The Senator's Government brought this country to its knees, so I am not going to sit here and take a lecture from him.

Marc MacSharry (Fianna Fail)
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I do not want him to sit here. I want him to answer the question.

Catherine Noone (Fine Gael)
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The Minister, without interruption.

James Reilly (Dublin North, Fine Gael)
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I heard reports of the Senator's performance earlier today, and clearly he is still in the same form.

Marc MacSharry (Fianna Fail)
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I am interested in the people. I am interested in getting the answers.

Catherine Noone (Fine Gael)
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The Minister, without interruption.

James Reilly (Dublin North, Fine Gael)
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If I were given an opportunity to answer, I would.

Marc MacSharry (Fianna Fail)
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The Minister wants to give a lecture on the last Government. The people voted on that. The Minster is in the seat now and he should answer the question.

Catherine Noone (Fine Gael)
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Senator, you have already spoken. I must ask you not to interrupt the Minister.

Marc MacSharry (Fianna Fail)
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I would like you to direct the Minister to answer the question. I do not need a lecture from the Minister on why the people voted the way they did. I know, pal, and you know.

Catherine Noone (Fine Gael)
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You have had the opportunity to speak.

James Reilly (Dublin North, Fine Gael)
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The Upper House is not usually associated with people calling one another "pal", but however-----

Marc MacSharry (Fianna Fail)
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Welcome to the real world. Answer the question.

Catherine Noone (Fine Gael)
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You are going to have to let him answer the question.

James Reilly (Dublin North, Fine Gael)
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The first part of getting an answer is to be able to listen, rather than continually interrupting.

There have been media reports suggesting that some hospitals within the west and north-west group were to lose their maternity services. These reports are purely speculative and have no basis in fact. I fully recognise that such unsubstantiated reports are a cause for concern for patients and staff, and I very much regret any upset which may have been caused to staff or patients in the region. It is not helped, of course, that they are further undermined by the likes of Senator MacSharry stirring it up into a sense of hysteria.

Marc MacSharry (Fianna Fail)
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So says the king.

James Reilly (Dublin North, Fine Gael)
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The position is that in the context of the implementation of the HIQA report into the death of Savita Halappanavar and the Higgins report on the establishment of hospital groups, the west and north-west hospital group is currently undertaking a review of maternity services within the group. This review includes the maternity units at Mayo General Hospital, University Hospital Galway, Portiuncula Hospital in Ballinasloe, Sligo Regional Hospital and Letterkenny General Hospital. The review is in the very early stages and will take some months to complete.

I am informed that a draft report exists. I am further informed that it makes no recommendations on the closure of any of the five maternity units within the hospital group. The House can be assured that any decision on maternity service reconfiguration will be considered in the context of the development of a new national strategy for maternity services. No decisions on service reconfiguration will be implemented without the agreement of my Department, and certainly not in advance of the publication of the proposed national maternity strategy.

The development of this strategy is currently under way and it will determine the optimal configuration of maternity services to ensure that women in Ireland have access to safe, high quality maternity care in a setting most appropriate to their needs. It is my intention to publish the strategy later this year. As part of the development of the strategy, maternity services in all parts of the country, and not just the west, will be reviewed and evaluated. The House may recall that one of the recommendations of the HIQA report into the death of Savita Halappanavar called for a review of maternity services nationally. I accept that report. In addition, the Higgins report on the establishment of hospital groups requires that each hospital group prepare a strategic plan for service configuration, consistent with national objectives, for the delivery of patient services.

We should welcome the review and look forward to similar reviews throughout the country. Such reviews will inform the national maternity strategy and help us identify how we can improve the quality and safety of care we provide to women and their babies, ensuring best outcomes for women and their babies.

Marc MacSharry (Fianna Fail)
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The Minister has confirmed that there is a draft report. He has not confirmed the terms of reference. If it is as benign as he claims, why not publish the terms of reference that were given to the Health Partnership group to put the minds of those people at ease, and publish the preliminary report as well? The people of Ireland can then get a taste of what their future holds in respect of the maternity health services provided to them.

James Reilly (Dublin North, Fine Gael)
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I have met the two chairpersons of two of the new hospital groups. They are acutely aware of the need to make sure that services are delivered as near to home as possible, in the most cost-effective fashion, but that the services are also safe. That will be a benefit of these groups, because they will allow for a "buddy up" of services.

Rather than services closing, smaller units will have the support of the bigger unit in the hospital group to ensure that they can deliver a standard of care that is safe, efficient and will deliver best outcomes for patients, mothers and babies.