I am very happy to outline, for the Deputy, the significant progress which has been made to implement the Healthy Ireland Framework and the National Maternity Strategy.
Healthy Ireland, A Framework for Improved Health and Wellbeing 2013-2025, is the national framework for action to improve the health and wellbeing of Ireland. The Framework is now past the mid-way point for implementation.
Since publication in 2013, there has been significant progress in implementation. This has included:
- A focus on building an enabling environment for cross-sectoral and collaborative action, supported by a stakeholder engagement and communications strategy.
- Significant cross government and intersectoral partnerships and working has been created by the Framework.
- A suite of national policies and plans to address risk factors such as obesity, tobacco and physical inactivity have been published, and policy direction across areas such as cancer, maternity care, drugs and mental health has been informed and influenced by Healthy Ireland.
Notwithstanding the progress to date, there is an urgent need to scale and expand the activity across all strands of the work, from Government to local level, to support effective implementation, and to capitalise on further opportunities to involve more sectors in implementation.
In late 2019, the Health and Wellbeing Unit in my Department commenced the development of a Strategic Action Plan for the next phase of the Healthy Ireland Framework. Despite the challenges caused by Covid-19, which has caused some delays to the original timeline for this process, significant progress on the development of the Strategic Action Plan for Healthy Ireland has been made. To date the process has already completed a rapid review of previous progress, extensive stakeholder engagement, a desktop review of other jurisdictions for best practice, and a review of goals for alignment with the Sustainable Development Goals and the Programme for Government.
Presently a set of emerging priorities is being considered in partnership with other Government Departments and internally in the Department of Health. The Healthy Ireland Strategic Action Plan is expected to be finalised in early 2021, for agreement across Government and subsequent publication.
National Maternity Strategy
The Programme for Government commits to 'Promoting Women’s Health' and Budget 2021 provides a very significant investment to deliver on this commitment. This includes funding of €12m to ensure a continued impetus to the implementation of the National Maternity Strategy and to improve gynaecology services. In addition, building on the work of the Women’s Health Taskforce, a €5m Women’s Health Fund was allocated in Budget 2021 to improve women’s health outcomes and experiences of healthcare.
As the Deputy is aware, the National Maternity Strategy was published in 2016. The Strategy aims to ensure that appropriate care pathways are in place in order that mothers, babies and families get the right care, at the right time, from the right team and in the right place. Similarly, the Strategy aims to increase choice for women whilst ensuring that services are safe, standardised and of the highest quality. It recognises that, while all pregnant women need a certain level of support, some will require more specialised care. Accordingly, at the Strategy’s core is an integrated model that delivers care at the lowest level of complexity and encompasses all the necessary safety nets in line with patient safety principles.
The phased implementation of the Strategy is being led by the National Women & Infants Health Programme (NWIHP). Development funding provided to the NWIHP in 2021 to progress the Strategy’s implementation will serve to:
- further develop community-based midwifery services;
- address deficits identified in HIQA inspection reports;
- improve access to specialist and allied health professional services and supports;
- strengthen training and education supports (e.g. CTG training).
- Further progress the roll out of the Maternal and Newborn Clinical Management System, which supports better, safer clinical decision-making and a more connected and integrated health service delivering improved health outcomes.
Notwithstanding the impact of COVID 19, work continued in 2020 to implement the Strategy and to further develop and expand community midwifery services, to facilitate the roll-out of the Supported Care Pathway and to enable women to avail of maternity care at the lowest level of complexity. In addition, the first National Maternity Experience Survey, a key recommendation of the Strategy, was conducted in 2020. The survey reports, published in October, were largely positive, and provide tangible evidence and rich qualitative information about what matters to women and their partners, and identifies, from their perspective, what areas require further focus and improvement.
Through the implementation of the National Maternity Strategy the quality and safety of our maternity services has improved. The Deputy can be assured that our maternity services are developing progressively and the benefits are being experienced by almost 80,000 families who access such services each year. Development funding has been provided for additional midwives, consultants, theatre staff, ultrasonographers and quality and safety managers; increasingly women have more choice in the service they receive with the development of community midwifery services and the availability of home from home birthing options; access to routine anomaly scanning has increased; Bereavement Teams are in place in every maternity unit; the perinatal mental health model of care is being implemented; all maternity hospitals/units now publish a Maternity Safety Statement on a monthly basis; and phase 1 of the roll-out of the Maternal and Newborn Clinical Management System has been completed.
The Strategy Implementation Plan is currently being reviewed by the NWIHP with a view to assessing the overall status of implementation and to provide up-to-date timelines for the individual recommendations. My Department will continue to work with the NWIHP in 2021 to support ongoing implementation of the Strategy.