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Dáil Éireann debate -
Tuesday, 15 Apr 2003

Vol. 565 No. 3

Written Answers. - Maternity Services.

John Gormley

Question:

305 Mr. Gormley asked the Minister for Health and Children the reason the home birth scheme in Galway was axed only days after he praised the home birth scheme in Dublin and said that similar schemes should be rolled out nationwide; and if he proposes to take steps to save the Galway scheme rather than starting from scratch again at a future date. [10771/03]

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 by the Western Health Board 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 have been accepted on to the scheme since 6 March last. 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.

I understand Western Health Board officials hope to meet the Parents for Choice group tomorrow to discuss the issues involved. 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; a DOMINO/outreach project – domiciliary care in and out of hospital – based at the National Maternity Hospital, Holles Street.
On 12 March last, I launched the evaluation of the National Maternity Hospital's domino/home birth scheme. I was happy to endorse a project that has proven itself to be successful from the perspective of both service users and providers. Dr. Harold Brenner, who was commissioned by the ERHA to carry out this evaluation, stated in his report that, on the basis of the very high levels of client satisfaction and the excellent clinical outcomes, a strong case could be made for the development of a similar service within the catchment areas of other maternity hospitals and units throughout the country.
At the request of my Department, the chief executive officers group has established a domiciliary births group with the following terms of reference: to 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 11 February 2003, and expects to make recommendations to the chief executive officer group before the end of this year. These recommendations will inform the development of future national policies, procedures and protocols for domiciliary births.
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