Header Item School Completion Programme (Continued)
 Header Item Maternity Services

Tuesday, 30 September 2014

Dáil Éireann Debate
Vol. 852 No. 1

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  6 o’clock

(Speaker Continuing)

[Deputy Seán Crowe: Information on Seán Crowe Zoom on Seán Crowe] Ultimately, we need to send to those communities a positive message that education is the way forward, that it is not set aside for a small elite in society and that there is a place for every child if he or she wants to proceed to further education. We genuinely believe in the concept of lifelong learning, but the children in question are only at the beginning and need the required supports. Will the Minister, in his new position, commit to championing the cause of those children who have been left behind and are disadvantaged through no fault of their own? Many come from a background in which we failed their families and parents. This is a challenge for the Minister and his new Department, but it is one he should take up.

Deputy James Reilly: Information on Dr. James Reilly Zoom on Dr. James Reilly I am sure the Deputy will agree that we all want to see all children reach their full potential. We want those who are particularly vulnerable and at risk of losing out through leaving education early in life to be supported in the best way possible. The schools inclusion programme is a huge part of this process. There have been cuts because, as we know, the country found itself in a bailout having lost its financial sovereignty. However, we are now out of the bailout programme and will certainly do everything in our power to protect the school completion programme. However, Government expenditure in this area is not limited to that programme. Nearly €49 million has been spent on various youth services programmes to offer support to young people all around the country. There is no doubt but that we could not do without these youth organisations and the tens of thousands of volunteers who work in this area supporting children and programmes, not to mention the tens of thousands of volunteers in the sports organisations who help to keep children occupied and engaged in healthy and physical activity that is to their benefit. We certainly have not targeted this area for cuts, but it has been one that has had to endure cuts. It is an area in which I firmly believe it is worth investing. Money spent on prevention reduces expenditure on treatment in a general sense, but nowhere is the gain greater than with children. Certainly, from our point of view and in our budget negotiations, this has been to the fore in our minds. We want to continue to support children to get the best out of the education system and support them when they are getting into trouble. There are many programmes in addition to the one in question, including Garda diversion programmes, which help to achieve that end.

Maternity Services

Deputy Clare Daly: Information on Clare Daly Zoom on Clare Daly This issue arises on the back of the tragic and unnecessary death of Dhara Kivlehan which really saddened people throughout the country. She was a young woman in her prime and had just given birth to her first baby. The real tragedy is that this was not an isolated incident. Unfortunately, Dhara was the latest in a long list of others, including Savita Halappanavar, Nora Hyland, Bimbo Onanuga and Tanya McCabe. There have been inquests in Sligo and investigations in Portlaoise, in the middle of which are women hoping their giving birth to their children will be a joyous occasion.

All of the occurrences in question happened under the watch of the HSE. There is a systemic crisis in maternity care, for two reasons. First, the cutbacks have meant that not a single maternity hospital is operating to safe ratios. Critically, however, our policies are wrong. We have an outdated antenatal policy that has not been changed for years. We should be seeking to develop a country-wide strategy involving midwifery-led units; instead, the HSE is actively pursuing midwives. I find it sickening that on the same day that the verdict of death by medical misadventure was given against Sligo hospital, where a midwife said she could not tell a patient had jaundice because she was Indian, an independent midwife with 31 years of stalwart experience, Ms Philomena Canning, had her State indemnity insurance withdrawn consequent to a decision handed down in the courts.

All afternoon I have been receiving e-mails from people who worked with Ms Canning and women for whom she acted or has been acting as midwife. Her crime was not killing somebody or doing something which led to somebody's death; rather, it was that, while observing all procedures and protocols, she transferred a woman to hospital after a home birth when that woman felt dizzy. That woman was discharged ten hours later and she and her baby were fine. Owing to the actions of the HSE, there are ten women – many of whom are about to give birth imminently – who do not have a midwife. This is really serious, particularly when one notes the list of fatalities in hospitals under the direction of the HSE. Nobody was suspended, let alone fired. Ms Canning has devoted her life to women and proper birthing in which women have a choice. The policy is completely wrong and the Minister must consider a decent and proper system of maternity care.

Deputy Billy Kelleher: Information on Billy Kelleher Zoom on Billy Kelleher I extend my deepest sympathies to Mr. Michael Kivlehan and his family on their tragic loss. Mr. Kivlehan's perseverance in having the hearing held in the Republic did the State a great service in the sense that it has brought to light some of the issues regarding the death of his wife, Dhara. It was unacceptable in first instance that efforts were made not to have an inquest. It was said the inquest should be held in Belfast because that was where Dhara had died, but, thankfully, through the perseverance of Michael, his family and legal representatives, an inquest was held here. The information that has emerged on the care offered to Dhara in Sligo leaves a lot of questions unanswered on the longer term issues concerning maternity services, not only in Sligo but also across the country.

  Ms Eilish O'Regan wrote an article in the Irish Independent today on the lack of information emerging from maternity services. We have raised this issue before on foot of the cases of Tanya McCabe, Savita Halappanavar and others who died while giving birth or just thereafter. Ms O'Regan states:

The blunt statement was made by Phelim Quinn, who is now acting head of the Health Information and Quality Authority (HIQA), when he was launching its report on the death of Savita Halappanavar in University Hospital Galway. He revealed that some maternity units have not even provided annual reports to give basic statistics and reveal how and why any babies or mothers died in their care. Maternity services have existed largely under the radar until the case of Savita and earlier this year revelations of four similar baby deaths in Portlaoise hospital since 2006. The full details of the tragic case of Dhara Kivlehan, who died in Sligo General Hospital, would probably never have come to light had it not been for her brave husband Michael.

In general, we have very safe maternity services in this country, but there is still a problem regarding the collation of data on incidents and ensuring monitoring and proper oversight. We cannot continually blame staff when there are huge pressures on the system. There are systemic failures in the system regarding intensive care beds. A lack of such beds was identified during the inquest. We do not yet have a centralised system for intensive care bed allocation such that patients can be transferred to the place where the most appropriate care is available. We owe it to Dhara and the other women who have, unfortunately, died tragically to put in place safe services. Most important, we owe it to those women who are pregnant and the young women who intend to have a child at some stage in our maternity services. We also owe it to the staff.

Minister for Health (Deputy Leo Varadkar): Information on Leo Varadkar Zoom on Leo Varadkar I thank the Deputies for raising this important issue and allowing me to address the House on the matter.

I offer my deepest condolences to Mr. Michael Kivlehan, his son, Dior, and their families on the sad and tragic loss of Dhara Kivlehan. I understand the HSE has offered sincere condolences and apologised to both families for the shortcomings in the management and care of Mrs. Kivlehan at Sligo Regional Hospital.

While cases of medical misadventure do occur in the health service, it is very important to reassure women and their families that maternal and perinatal health statistics indicate that Ireland continues to be a very safe country in which to give birth. Our safety record and maternal mortality rates compare favourably with those of other developed countries. It is important that we reassure people of these facts.

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