Jan O'Sullivan (Limerick East, Labour)
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Question 119: To ask the Minister for Health and Children the progress that has been made in discussions aimed at including independent midwives in the State's insurance package; and if she will make a statement on the matter. [45823/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Historically the Irish Nurses Organisation has facilitated a certain level of insurance cover to independent self-employed community midwives who were members of that organisation. As and from 30th September it withdrew this facility. I would like to emphasise that I support choice for women in childbirth. However, the option of domiciliary births must only be provided in a safe and secure manner. This was the key finding of the Expert Group on Domiciliary Births which reported in 2004. The Health Service Executive established a National Implementation Committee, representative of all the stakeholders involved, to implement the recommendations of the report.

Following extensive consultations, agreement has been reached for the extension of the HSE's cover, under the State's Clinical Indemnity Scheme, to include self-employed community midwives. This is subject to the signing by the individual midwife of a Memorandum of Understanding (MOU) with the Health Service Executive (HSE). The MOU is constructed on the basis of appropriate forms of governance, clinical supervision, clinical care pathway, performance management and audit frameworks being in place to ensure a safe system for home births.

The new arrangements came into operation on 1st October 2008. These arrangements cover those midwives who have signed the MOU with the HSE and provide a robust national clinical governance framework which ensures that self-employed community midwives work closely with the HSE, the HSE maternity services and voluntary maternity hospitals.