Thursday, 5 May 2022
Nithe i dtosach suíonna - Commencement Matters
I thank the Minister of State for coming to the Chamber. I understand the average daily rate for Covid-19 has dropped to under 1,000 over the past 14 days. Concerns remain about future variants and the direction of the trend but we are almost three months into the Government decision to lift almost all restrictions across society and the economy. Yet, across most of the 19 maternity units, the policy restricting partners from attending some appointments remains in place. I ask the Minister of State to provide us with an urgent update on that policy. As recently as yesterday, the National Maternity Hospital announced that partners are now welcome to attend all appointments. That is very welcome.
Women have been telling us stories, particularly in recent weeks, and there is a degree of shock when people learn the restrictions are still in place. In recent weeks, we have heard of the experiences of people attending the Rotunda and Coombe hospitals, where partners were prevented from attending certain scans and appointments. One woman was told her partner could not even wait outside. In another case, a partner was prevented from attending a foetal anomaly clinic. Receptionists and sonographers are conveying different messages about whether a partner can attend at different appointments. One woman received bad news alone. Over the past two years, and up to last week, one hospital has been issuing a note to every woman coming into antenatal classes telling them they cannot communicate directly with the medical professionals or that they may not be guaranteed individual access to a medical professional. That has created all sorts of needless distress and confusion.
It is almost 12 months to the day since the Minister for Health announced that all Covid maternity restrictions would be lifted, on 11 May last year. That did not happen. Over the past two years, the Better Maternity Care campaign has very powerfully highlighted the stress and trauma associated with some of the restrictions that were put in place. It has shone a light on the restrictions that remain in place to this day. This group has been seeking a meeting with the HSE since the new year and that has not happened. There was engagement between the HSE and the campaign last year but that has fallen away since the new year.
It is important to acknowledge that many maternity units are often operating under difficult conditions, and flexibility has been afforded to some in high-risk pregnancies, but the reality is there is no clear message and there is inconsistency between one hospital and the next. While we accept that hospitals have a right to have individual visitor and infection control policies, partners are not visitors. Partners are a vital support to women when they are going through pregnancy and childbirth. I want a firm commitment from the Minister of State that, over the next fortnight, the HSE will update its partner restriction policy across the 19 maternity units and restrictions will be lifted, unless there is strong and very clear clinical evidence to the contrary.
I thank Senator Sherlock for raising an issue that has been of significant concern for women and their partners. I fully appreciate that limitations on partners accessing maternity services have been very difficult for women and their families during the Covid-19 pandemic. The current version of the HSE guidance on access to acute hospitals for nominated support partners in maternity services was implemented on 21 February 2022. The guidance recognises the central role the nominated support partner plays in supporting and advocating for a woman engaging with our maternity services. It recognises that such a support person also has a right to be present and participate in the care process to the greatest practical degree.
Maternity services are focused on maximising access for nominated support partners in the context of the current guidance. The objective of the guidance is to keep maternity services safe, support the woman and facilitate access for the nominated support partner. The clinical advice has always been focused on the potential for Covid-19 to spread in maternity services, and the highest priority is protecting the health and safety of the women and babies in our care. While guidance remains in place, it is important to recognise that it is a very different situation now from the position in the early stages of the Covid-19 pandemic. The HSE's guidance has significantly reduced limitations on access for nominated support partners.
The latest guidance again sets out that controls on access for support partners should be the minimum required to manage infection prevention and control risks, and any limitations on access must be clearly explained and should be applied with consideration for individual circumstances and needs. The guidance specifics that once a woman reaches her bed space or room, the nominated partner should have open access between 8 a.m. and 9 p.m. The guidance is quite broad in its scope, facilitating access for partners where women are attending antenatal scans, during labour and childbirth, during postnatal care and on arrival for labour or induction of labour during the initial assessment process. I am happy to inform the Senator that the HSE is currently reviewing the clinical guidance on the remaining access limitations as the recent surge in cases shows signs of reducing.
The HSE has advised that every possible effort continues to be made to provide maximum access for nominated support partners in maternity settings. Women are encouraged to raise any concerns pertaining to partner access and every effort is being made to address those concerns. Information on websites is reviewed and updated regularly to reflect any adjustments in access, and risk assessments are undertaken in circumstances where it is not possible to comply with the current guidance.
I assure the Senator that the decisions to restrict attendance in maternity hospitals were not taken lightly. The HSE has assured the Department that every effort continues to be made to maximise access for partners in maternity services and the guidance on remaining access limitations is currently under review.
I had a sense of déjà vuwhen listening to the Minister of State's response. We have been here before listening to a communication from the Department of Health setting out what the restrictions or policy should be, when we know the reality on the ground is quite different. Based on the stories women have told me or communicated to others and the Better Maternity Care campaign, we know the reality is different from what the Minister of State has set out. I ask that the clinical lead within the HSE for women's healthcare and Dr. Colm Henry now engage both with the Department of Health and those advocating on women's behalf on the ground to ensure, first, that what the Minister of State has set out is being implemented and, second, that there is further progress in lifting those restrictions. There is an issue as to whether the Department can stand over the guidance that has been issued.I say that because what I have heard on the ground, compared with what the Minister of State has relayed here from the Department, is very different from what happens for a number of women in certain hospitals.
I acknowledge the difficulties and the impact that access limitations in maternity services have had on women and their partners during the Covid-19 pandemic.
While I appreciate that the support of a partner is vitally important to expectant mothers, I remind the House that maternity hospitals and units introduced these measures to protect the well-being of the vulnerable women and babies in their care. It is worth noting that maternity services have performed very well in this respect and have continued to provide quality maternity care during what has been a very challenging time.
The Senator has asked that the clinical lead in the HSE would engage, on behalf of the Department, with people who advocate in regard to these very difficult and important issues. I will convey that to the Department.
We are now at a point where access for partners has been greatly increased. Notwithstanding this, the HSE is currently reviewing the clinical guidance on any remaining access limitations in view of the recent surge in Covid-19. I hope that in the coming weeks these issues and difficulties will be ironed out. I very much welcome these advocates and assure them and the Senator that these difficulties will be raised at the highest possible level.