National Maternity Services: Motion (Resumed) [Private Members]

The following motion was moved by Deputy Stephen Donnelly on Wednesday, 19 June 2019:
That Dáil Éireann:
recognises:
- the need for Ireland’s maternity services to be as safe as possible for women and babies, including the need for women to be listened to and respected;
- the hard work, skill and dedication of all staff across Ireland who provide maternity services;
- the growing crisis in maternity care for reasons including:
- outdated and inadequate hospitals;
- limited diagnostics;
- poor staffing ratios;
- insufficient parental supports;
- wide geographic variations; and
- lack of community-based options for mothers;
- the deep concern these pressures are resulting in for current and expectant mothers and fathers; and
- the increased burn-out and stress for clinicians, together with a retention and recruitment crisis and chronic staff shortages;
notes:
- that the 2008 KPMG Independent Review of Maternity and Gynaecology Services in the Greater Dublin Area identified the need for maternity services to be co-located with adult acute services;
- the repeated announcements from 2013 onwards, including in the Capital Plan 2016-2021 and the National Maternity Strategy 2016-2026, that Dublin’s three maternity hospitals and Limerick’s would be relocated, with:
- the National Maternity Hospital to St. Vincent’s University Hospital campus;
- the Coombe Women and Infants University Hospital to the St. James’s campus (to happen in parallel with and be tri-located with the National Children’s Hospital);
- the Rotunda Hospital to the Connolly Hospital campus at Blanchardstown; and
- Limerick Maternity Hospital to the University Hospital Limerick campus;
- the lack of progress on these essential projects, including:
- on-going delays regarding the National Maternity Hospital; and
- no progress and no budget allocation to begin the relocation process for the other maternity hospitals;
further notes:
- the numerous reports into localised maternity care issues in recent years, including Portlaoise and Portiuncula hospitals;
- the lack of progress in implementing various recommendations from these reports;
- the clinical, patient and political buy-in to the National Maternity Strategy 2016-2026, and the lack of implementation of that strategy, with no new development funding for it in 2019;
- the lack of progress on numerous issues raised in recent years by midwives, including staffing ratios, working conditions and pay inequalities, with:
- just two midwifery-led units in place; and
- a shortfall of 200 midwives below the recommended safety-levels in the National Maternity Strategy 2016-2026;
- Ireland’s low-rate of obstetricians per capita, being the third lowest in the Organisation for Economic Cooperation and Development, and being further exacerbated by a high-level of unfilled posts; and
- the rise in State payments in compensation for incidents in maternity units, up from €4 million in 2007 to almost €120 million in 2017; and
calls for:
- a definitive time frame and funding deployment for the relocation of the stand-alone maternity hospitals;
- progress to start in 2019 on all projects not yet commenced;
- a guarantee from Government that new public maternity hospitals will not have separate external or internal entrances, nor separate facilities within the hospitals, for private patients;
- funding and a task force to implement the National Maternity Strategy 2016-2026, including choice around birth, types of antenatal care, access to anomaly scanning, breast-feeding, counselling services, public health, domestic violence supports and
appropriate staffing levels;
- an active clinical programme for the development and review of clinical guidelines for maternity services;
- an immediate statement of maternity services available at all sites, including prenatal screening, access to foetal medicine, counselling, genetic testing and laboratories being used;
- investment in community-based pathways to ensure choice for mothers;
— indemnity to cover practice nurses who give antenatal care;
- measures to address the chronic staff shortages, including ending pay disparity; and
- investment in a national foetal magnetic resonance imaging (MRI) programme and bereavement care.
Debate resumed on amendment No. 1:
To delete all words after “Dáil Éireann:” and substitute the following:
“recognises:
— the need for Ireland’s maternity services to be as safe as possible for women and babies, including the need for women to be listened to and respected;
— the hard work, skill and dedication of all staff across Ireland who provide maternity services;
— the growing crisis in maternity care for reasons including:
— outdated and inadequate hospitals;
— limited diagnostics;
— poor staffing ratios;
— insufficient parental supports;
— wide geographic variations; and
— lack of community-based options for mothers;
— the deep concern these pressures are resulting in for current and expectant mothers and fathers; and
— the increased burn-out and stress for clinicians, together with a retention and recruitment crisis and chronic staff shortages;
notes:
— the publication of the National Maternity Strategy 2016-2026, Palliative Care for Children with Life-Limiting Conditions in Ireland – A National Policy by the Department of Health, the Health Service Executive’s (HSE) National Standards for Bereavement Care following Pregnancy Loss and Perinatal Death, and the 2014 Report on End-of-Life and Palliative Care in Ireland by the Joint Committee on Health and Children;
— the submission of the National Standards for Safer Better Maternity Services by the Health Information and Quality Authority (HIQA) to the Minister for Health;
— that the 2008 KPMG Independent Review of Maternity and Gynaecology Services in the Greater Dublin Area identified the need for maternity services to be co-located with adult acute services;
— the repeated announcements from 2013 onwards, including in the Capital Plan 2016-2021 and the National Maternity Strategy 2016-2026, that Dublin’s three maternity hospitals and Limerick’s would be relocated, with:
— the National Maternity Hospital to St. Vincent’s University Hospital campus;
— the Coombe Women and Infants University Hospital to the St. James’s campus (to happen in parallel with and be tri-located with the National Children’s Hospital);
— the Rotunda Hospital to the Connolly Hospital campus at Blanchardstown; and
— Limerick Maternity Hospital to the University Hospital Limerick campus;
— the lack of progress on these essential projects, including:
— on-going delays regarding the National Maternity Hospital; and
— no progress and no budget allocation to begin the relocation process for the other maternity hospitals;
further notes:
— the numerous reports into localised maternity care issues in recent years, including Portlaoise, Portiuncula, University Hospital Galway, Cavan, and Drogheda hospitals;
— the lack of progress in implementing various recommendations from these reports;
— the clinical, patient and political buy-in to the National Maternity Strategy 2016-2026, and the lack of implementation of that strategy, with no new development funding for it in 2019;
— the serious inequalities and absence of resources which exist within the HSE to provide services to children with life-limiting and complex medical needs, and to those under palliative care;
— that new-born screening services in this State only screen new-born babies for 8 conditions, whereas Britain screens for 9, Switzerland 13, Sweden 24, Portugal 25, and Italy 40;
— the lack of progress on numerous issues raised in recent years by midwives, including staffing ratios, working conditions and pay inequalities, with:
— just two midwifery-led units in place; and
— a shortfall of 200 midwives below the recommended safety-levels in the National Maternity Strategy 2016-2026;
— Ireland’s low-rate of obstetricians per capita, being the third lowest in the Organisation for Economic Cooperation and Development, and being further exacerbated by a high-level of unfilled posts; and
— the rise in State payments in compensation for incidents in maternity units, up from €4 million in 2007 to almost €120 million in 2017;
and calls for:
— a definitive timeframe and funding deployment for the relocation of the standalone maternity hospitals;
— progress to start in 2019 on all projects not yet commenced;
— a guarantee from Government that new public maternity hospitals will not have separate external or internal entrances, nor separate facilities within the hospitals, for private patients;
— the Government to ensure that the new National Maternity Hospital is built on the St. Vincent’s Hospital campus as quickly as possible, remains entirely within public ownership and has legally guaranteed independence from all non-medical influence in its clinical operations within the laws of the State;
— funding and a taskforce to implement the National Maternity Strategy 2016-2026, including choice around birth, types of antenatal care, access to anomaly scanning, breastfeeding, counselling services, public health, domestic violence supports and appropriate staffing levels;
— swift approval, dissemination and implementation of the National Maternity Standards for Safer Better Maternity Services;
— an active clinical programme for the development and review of clinical guidelines for maternity services;
— expansion of the new-born screening programme and guarantee that every child born in this State has the right to be screened at birth for any disease for which there is a viable treatment;
— an immediate statement of maternity services available at all sites, including prenatal screening, access to foetal medicine, counselling, genetic testing and laboratories being used;
— all maternity hospitals to have access to foetal anomaly screening, with the requisite staff and equipment;
— investment in community-based pathways to ensure choice for mothers;
— indemnity to cover practice nurses who give antenatal care;
— measures to address the chronic staff shortages, including ending pay disparity;
— the Government to work with nursing and medical unions in the recruitment and retention of medical staff so that all maternity hospitals meet the Birthrate Plus standard for midwifery staffing, as well as international standards for consultant obstetricians and gynaecologists;
— the implementation of the recommendations of the 2014 Report on End-of-Life and Palliative Care in Ireland by the Joint Committee on Health and Children, prioritising those parts relating to care for children with life limiting conditions; and
— investment in a national foetal magnetic resonance imaging (MRI) programme and bereavement care.”
- (Deputy Louise O'Reilly)
Amendment put and agreed to.
Motion, as amended, agreed to.
Sitting suspended at 1.30 p.m. and resumed at 2.10 p.m.