A key stepping stone to the introduction of Universal Health Insurance will be to develop independent not-for-profit hospital trusts in which all hospitals will function as part of an integrated group. As a first step on that journey, hospitals will be aligned within groups on an administrative basis. The rationale behind the establishment of hospital groups and trusts is to support increased operational autonomy and accountability for hospital services in a way that will drive the service reforms and provide the maximum possible benefit to patients.
It is well recognised that the Rotunda Hospital provides leadership in maternity services obstetrics, midwifery, neonatology and gynaecology services to all of north Dublin and the northeast. Strong clinical links with the Mater Misericordiae University Hospital, including joint consultant appointments, are a fundamental support to the work of the Rotunda, and this will continue in any configuration in which the Rotunda is required to operate. It is neither intended nor anticipated that the Rotunda will be constrained by being positioned within a particular group. As well as its long standing links with the Mater, which can and should be retained, it would also be appropriate for the Rotunda to establish links with other hospitals to meet its future aspirations for sub-specialty development and to expand and consolidate the links which currently exist.
With regard to the framework within which maternity services are delivered, the Deputy refers to the KPMG Independent Review of Maternity and Gynaecology Services in the Greater Dublin Area and to a review of maternity models of care. The KPMG report, which was completed in 2008, noted that Dublin’s model of stand alone maternity hospitals is not the norm internationally and recommended that the Dublin maternity hospitals should be co-located with adult acute services and that one of the three new Dublin maternity facilities should be built on the site of the new national paediatric hospital. In regard to the review of maternity models of care referred to by the Deputy, work is currently ongoing in the HSE's Clinical Programme for Obstetrics and Gynaecology on the development of models of care for maternity services, which includes a review of current models with the development of a proposal for future developments. Both the KPMG report and the review to be carried out by the Clinical Programme will inform the delivery of maternity services in Dublin and nationally, as appropriate.