Maternity Services

[Speaking in the Seanad during Order of Business]

I would like clarification from the Deputy Leader on a few issues. They are really the same issue, but they have different ramifications. As Members may remember, I introduced legislation earlier in this term which would have prevented Government agencies suing anybody, presumably including each other, in defence of their good name. My own belief is that in a democracy, where they are answerable to the public, the reputation of Government agencies, public bodies, quangos, Departments and so on depends entirely on their effectiveness and the quality of the service they provide. It should not be something that hides behind either legal challenges or public relations companies. There should be no public relations professionals employed anywhere in the public service other than in technical areas where advertising is required. Public officials should be required, perhaps in rotation in their own Departments, to take the rostrum, as it were, and to answer questions from the public, through their representatives in the press, about their activities.

I was very disappointed to see the discussions which have come into the public domain between the HSE and HIQA on the issue of Portlaoise and other obstretrics services in the country. This was commented on earlier in the week, but unfortunately I could not be here at the time. I feel strongly on this issue. This is an area where a clear directive needs to be given by the Government to all public employees. I would like the Government to support my Bill and get it through its next couple of Stages. That would be the simplest thing to do, but we all know how difficult that can be with independent backbench legislation originating in the Seanad. However, an executive order could be given, certainly in the Department of Health, by the Minister, to all Department employees and agencies, the HSE, and all bodies funded by the Department that they simply are not to fall back on any kind of legal threat in an attempt to silence any kind of dissent, either from outside the State or from within it. I understand that people who work in State bodies have personal reputations that can be and need to be defended and they have a right to defend them. However, the entities themselves do not.

Two of the charges raised by the HSE in its correspondence with HIQA were that HIQA was suggesting that the HSE was guilty of reckless endangerment when it came to the provision of obstetrical services. I would like to ask the questions that would help me decide whether the HSE is guilty of reckless endangerment in maternity services right now. Could the Deputy Leader find out for us from the Minister, or the Minister himself could come in if he wishes, and answer the following questions? How many consultant obstetricians are there in this country? How many posts are there? How many of these posts are filled and how many are filled by locums, as opposed to people who are on permanent contracts? What is the typical tenure of a locum contract? How rapidly are locum staff actually rotating through? Similarly, what percentage of the deliveries that require some degree of medical assistance are being attended by consultants and how many by NCHDs? I mean no disrespect to any normal deliveries which are supervised very competently by a fine cohort of midwives, but sometimes a doctor needs to intervene and a doctor needs to assess everybody who is pregnant at some stage. What percentage of the NCHD jobs in obstetrics are currently occupied by locums? I believe we are right at the bottom of the international league tables for the number of obstetricians per head of population. If that is the case and if throughout the country people are experiencing sometimes adverse events in a service that generally provides very safe care to pregnant women and their children, is there any link between that and understaffing and not only understaffing, but also poor staffing, through a lack of appropriate forward planning and sufficient people in permanent posts?

I would also note in passing the final quote from the HSE to HIQA, which was that the apparent allegations which may or may not have been made by HIQA would have the appearance of shattering confidence in the ability of the HSE to deliver services. I certainly require a little reassurance on the competence of the HSE to deliver services.

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