Denis Naughten
Question:233 Mr. Naughten asked the Minister for Health and Children his plans to develop midwifery services here; and if he will make a statement on the matter. [30418/01]
Written Answers. - Maternity Services.
One of the objectives of the new health strategy is to develop a system which has the capacity to deliver timely and appropriate services. Under this heading, action 58 of the strategy outlines plans to provide responsive and high-quality maternity care. Models of maternity care are changing with increasing demands for choice with regard to type of care and location of birth. In recognition of the changing needs and pressures on existing services, a working party will be established to prepare a plan for the future development of the maternity services. The objective will be to ensure that maternity care in Ireland is: woman-centred; equitable across different parts of the country; accessible to all; safe; accountable. The target date for the establishment of the working group is 2002, and it is expected to submit its report by the end of 2003.
A strategy for nursing and midwifery in the community is being developed at present under the auspices of the primary care strategy. This will address the deficits in the current system by providing a plan for the integration of nursing and midwifery services within primary care. This strategy will build on the existing diversity of nursing and midwifery competencies, currently provided by public health nurses, practice nurses, general nurses, midwives, community mental health nurses and others. The strategy will seek to maximise the use of nursing-midwifery competencies in the provision of a needs-led, high-quality and sustainable primary care service.
It will also consider the potential for the role of the clinical nurse specialist-clinical midwife specialist and advanced nurse practitioners-advanced midwife practitioners as members of the primary care team, in line with the guidelines developed by the National Council for the Professional Development of Nursing and Midwifery. The target date for publication of the strategy for nursing and midwifery in the community is the end of 2002.
Denis Naughten
Question:234 Mr. Naughten asked the Minister for Health and Children his plans to address the litigation problems associated with maternity hospitals and the midwifery profession; and if he will make a statement on the matter. [30419/01]
My Department's plans to introduce enterprise liability as the basis for providing professional indemnity cover for doctors and insurance cover for health boards and hospitals in July 2002 should address the issue of meeting the cost of claims arising from litigation. The "no fault" advisory group is also examining the possibility of introducing a "no fault" compensation scheme for infants who suffer brain damage at, or close to, the time of birth. This small group of claims generates the high cost settlements which are pushing up indemnity and insurance costs. Action is also being taken to deal with the underlying incidents which give rise to claims. Most health boards and hospitals have appointed risk managers who help identify and reduce the risk factors which contribute to the occurrence of adverse events. Several hospitals have appointed specialist risk managers to their maternity units.
Denis Naughten
Question:235 Mr. Naughten asked the Minister for Health and Children the plans being proposed at EU level which may have a direct impact on the provision of midwifery services and the management of maternity hospitals; and if he will make a statement on the matter. [30420/01]
Inquiries have been made from the European Commission and it is not aware of any plans being proposed at EU level which may have a direct impact on the provision of midwifery services and the management of maternity hospitals.
However, I have been informed of proposed changes to the EU directive governing the education and training of general nurses and midwives. The current sectoral directive prescribes three methods for the training of midwives within the European Union. It stipulates the hours of theory and clinical practice necessary for mobility within the European Union.
Under the proposed changes, a general systems directive would place the onus on the individual member states to ensure that midwives entering their jurisdiction have qualifications comparable to those trained domestically. In effect, there would be a requirement on the national administrations to set the minimum standards for the practice of midwifery in their area. In the long-term, these proposals could conceivably have implications for the recruitment of midwives from abroad. However, it must be stressed that the changes are presently up for discussion in the member states and that An Bord Altranais has indicated its opposition to them.