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IHCA expresses concern at findings from HIQA maternity services report

The IHCA has expressed concerned about the commitment to funding women’s health services following the publication of a new report from HIQA into Ireland’s 19 maternity units and hospitals.

While HIQA found good practice in how maternity services detect and respond to obstetric emergencies, it also identified opportunities for improvement to ensure that maternity services remain safe and effective into the future. 

HIQA’s Director of Regulation Ms Mary Dunnion said: “Overall, our findings provide assurance that improvements have been made in maternity services since HIQA’s investigation into maternal care in Portlaoise Hospital. However, we found a lack of clarity and national leadership within the HSE regarding the responsibility for implementing the National Maternity Strategy. This Strategy provides a framework for a new and better maternity service that improves choice for women, and ensures that smaller maternity units, in particular, are better supported to provide sustainably high-quality and safe care.”

Ms Dunnion said it was of concern to HIQA that the HSE had made only limited progress in advancing this Strategy since it was approved by Government in 2016, and a more comprehensive, time-bound and costed implementation plan is required. 

“While more formalised governance structures were introduced by the HSE at the end of 2019 to improve national leadership in this area, the HSE must now implement the Strategy and establish maternity networks to ensure that pregnant women, mothers and newborns across the country have access to the same level of care and support regardless of where they live,” Ms Dunnion said.

Responding to the report, IHCA President Dr Donal O’Hanlon said the delay in implementing the national maternity strategy is “a failing many, many women”.

“The strategy committed to recruiting 100 more consultants in obstetrics and gynaecology over the ten-year period to bring Ireland up to UK standards,” Dr O’Hanlon said.

“With approximately 20 additional consultants hired since 2016, the HSE has already missed its target of appointing 10 additional consultants a year by 50 per cent and would have to hire an additional 20 consultants this year alone to reach the level recommended in the strategy.

“Promised specialist perinatal mental health services were due to be established in maternity network hubs to treat women directly and provide expert advice to other maternity units in the country. It is extremely disappointing that the €370,000 required for the operation of the Galway University Hospital Specialist Perinatal Mental Health Service, for example, has been diverted.

“At the same time, the HSE is failing to adequately fund the Strategy. An €80 million increased investment was foreseen in 2018, providing an additional €8 million on average for each of the 10 years. However, the total funds spent was around half that amount (€4.55 million) in 2018; there was no development funding in 2019; and of greater concern, the HSE Service Plan for 2020 has allocated just €1.5 million this year and a further €1.5 million in 2021.”

Dr O’Hanlon said it was important “a clear and consistent commitment” from Government that it will restore and ringfence the additional €80 million in funding required to implement the maternity Strategy

Read the overview report of HIQA’s monitoring programme against the National Standards for Safer Better Maternity Services, with a focus on obstetric emergencies, and all 19 inspection reports, at www.hiqa.ie.

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