The service plan adopted by the board for 2003 stated the need to appoint a consultant neonatologist to meet the volume and complexity of cases presenting at UCHG. The plan approved the transfer of funding from domiciliary home care services to support this priority development. The home birth scheme was suspended by the board on this basis. The current caseload of patients who have booked home births will have their service completed by the end of September and no further patients are being accepted.
The board is awaiting completion of an internal evaluation of the project by the steering committee. The impact and future organisation of the Domino service and the provision of midwifery led services is being examined by management and clinical staff at UCHG.
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 its publication 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 group.
The 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 UCHG; 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 officer group 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; and to commission an external evaluation of the three pilot home birth projects.
