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As Catherine Reilly reported, the implementation plan for the Strategy remains undeveloped, despite a promise to publish it within six months of the Strategy launch in January 2016. Substantive work on the plan has not yet begun and the HSE provided no timeline as to when it will be published. A chair for the Maternity Guideline Development Group, a key recommendation of the Strategy, has also not yet been appointed.
Online reaction to these revelations was quick and sharp, particularly from those working within maternity care – services are understaffed, overburdened, and morale is low, with many patients not receiving the standard of care they deserve.
Many commentators asked did we expect anything else? Ireland is a leader in publishing excellent national strategies and policies for various health conditions/services, but most are left to gather dust on the shelf, or are slowly, poorly, or only partly implemented.
But this time was supposed to be different; we were assured back in January at the launch of the Strategy. It was first national maternity document of its kind and came on the back of a number of high profile tragedies and scandals in our maternity services. The HIQA Report into the death of Savita Halappanavar recommended that a strategy be developed to implement standard, consistent models for the delivery of a national maternity service that reflects best available evidence, to ensure that all pregnant women have appropriate and informed choices and access to the right level of care and support.
The vision for maternity services, articulated in this Strategy, is for an Ireland where: “Women and babies have access to safe, high quality care in a setting that is most appropriate to their needs; women and families are placed at the centre of all services, and are treated with dignity, respect and compassion; and parents are supported before, during, and after pregnancy to allow them give their child the best possible start in life.” It all sounds great – but its recommendations remain aspirations.
The Budget later this month will hopefully contain more funding for the Strategy, but again it is all very well announcing that new staff and services will be funded when they frequently get bogged down in red tape and delays.
Plans to replace each of Dublin’s three maternity hospitals have also hit significant delays and it now seems there is a lack of urgency and indeed political will attached to these issues, despite strong public statements from Minister for Health Simon Harris. Last week the Minister again acknowledged the poor treatment of families who experience traumatic outcomes in maternity services, and the need for change.
Yes, some changes have occurred, such as the roll-out of various protocols and the welcome publication of bereavement standards by the HSE, but a much more co-ordinated and dedicated approach with an agreed implementation plan and – crucially – deadlines are needed.
The HSE and the Department of Health need to sit down and agree the way forward and make someone accountable for the implementation of the vital changes outlined in the Maternity Strategy.
Our maternity patients and staff deserve better than broken promises.