Dáil Éireann debate -
Tuesday, 25 Mar 2003

Vol. 563 No. 4

Written Answers - Maternity Services.

Paul Connaughton

Question:

407 Mr. Connaughton asked the Minister for Health and Children if his attention has been drawn to the fact that pilot projects concerning the provision of specifically trained midwives to oversee and assist on the occasion of home births, with particular reference to the DOMINO programme, are now being concluded; if such programmes will be extended to meet the demand for such services nationally; if the results of the pilot projects will be made public; and if he will make a statement on the matter. [7756/03]

Minister for Health and Children (Mr. Martin)

I am aware that the home birth pilot project in University College Hospital, Galway, has been suspended by the Western Health Board. There are no plans to curtail the projects in Cork and Dublin.

The number of births in University College Hospital, Galway, rose from 2,830 in 2000 to 3,218 in 2002, with births to non-nationals increasing from 2% to 11.5% over the same period. The home birth pilot project was introduced in 1999 and provided six home births and 21 DOMINO births in year one; 8 home births and 100 DOMINO births in year two; 15 home births and 143 DOMINO births in year three.

The service plan adopted by the Western Health Board for 2003 agreed the need to appoint a consultant neonatologist and an additional consultant obstetrician to meet both the volume and complexity of cases presenting at University College Hospital, Galway. The service plan approved the transfer of funding from domiciliary home care services to support this priority development. The home birth scheme was suspended on this basis. The current caseload of patients who have booked for home births will have their service completed and these commitments will be fulfilled. No new patients are being accepted on to the scheme at this time. I am advised that the board's obstetric services will be further reviewed on the appointment of the consultant neonatologist within the framework of priority service objectives and national policy.

The home birth pilot projects have their origin in the report of the maternity and infant care scheme review group which was published in 1994. Following the publication of this report, the chief executive officers of the health boards established an expert group to consider approaches to providing a home birth service as suggested by the review group.

The expert group recommended the following three pilot projects which were subsequently established and funded by my Department: a community midwifery service, to be conducted in Cork by the Southern Health Board; a hospital outreach approach to be conducted by the Western Health Board and based at the University College Hospital, Galway; and a DOMINO/outreach project domiciliary care in and out of hospital, based at the National Maternity Hospital, Holles Street.

At the request of my Department, the chief executive officers group has now established a domiciliary births group with the following terms of reference: prepare an up to date progress report on the implementation of the recommendations from the expert group on domiciliary births 1997; to make recommendations on the long-term approach, arising from the outcome of the pilot schemes, and to establish protocols and procedures; to commission an external evaluation of the three pilot home birth projects.

The group met for the first time on Tuesday, 11 February 2003. The tendering process for the external evaluation of the three pilot home birth projects is currently under way. The group expects to make its recommendations to the chief executive officer group towards the end of this year and no later than early 2004. These recommendations will inform the development of future national policies, procedures and protocols for domiciliary births.