Covid-19 blamed for delay to national maternity strategy rollout
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An update on the rollout of the national maternity strategy has been delayed, and HSE officials leading the plan say it is unclear when this will be published due to pressures of the pandemic.
This follows controversy last year over significantly reduced funding for the programme.
The strategy was published in 2016 in the wake of a series of tragic incidents and spiralling waiting lists in maternity services. In February this year, Hiqa published a critical report calling for more transparency around the rollout.
This week, clinical director with the National Women and Infants Health Programme, Peter McKenna, and programme director Killian McGrane told the that work continued during the pandemic, but details are not yet fully collected.
“We are at 88% completed or ongoing, 11% not started or delayed,” Mr McGrane said. "There is no doubt that without money, it is difficult to bring any part of this to the table."
He said regular online meetings were held with hospitals, but lack of physical access during Covid-19 and redeployment of key staff caused road bumps.
A key target was improving relationships between smaller HSE hospitals and larger voluntary hospitals. Dr McKenna said this has been challenging.
“Not every hospital took kindly to being overlooked by a bigger brother, not every big brother took kindly for having to take responsibility for their younger brothers," he said.
Crucial training in using CTG traces for reading foetal heartbeats is going well for midwives, he said, but added: “On the medical side, it is more difficult to get consultants to have formalised training, they would say this is something we have known this for years.”
Sub-standard reading of a CTG trace was cited when Cork boy Iarlaith Ó Cinnéide secured a payment in the High Court last year of €3.6m for birth injuries.
Increasing midwifery numbers is another key aim.
The team's latest data shows funding was made available for 30 clinical midwifery specialists and a smaller number of advanced midwifery practitioners. But that there are still maternity units lacking these senior staff on the ground.
The programme has funded about 23 consultant roles, but they are not all filled by permanent staff.
He said it is common for consultant roles to be re-advertised without attracting enough candidates.
They hope to continue reducing gynaecology services waiting lists in 2021. CUMH reduced large waiting lists by 75% using a walk-in-walk-out clinic.
“Cork did have huge waiting lists,” Dr McKenna said, “but through their introduction of the ambulatory clinic, they have managed to address that. They would be an example of what can be done with a relatively small investment.”
Similar clinics are now at the Rotunda and Galway hospitals, with four more planned.
Krysia Lynch from maternity advocacy group Aims Ireland said: “The core purpose of the strategy was to re-align the services. Until now it was dominated by clinical approaches, but the evidence shows people are better served by services which are less medicalised.
“I should say, the rollout of perinatal mental health supports has been well-received by families.”
This year the health budget, under minister Stephen Donnelly, included €12m funding for maternity, gynaecology, and fertility services.