The HSE said “in practice, there is no guarantee that a woman in the public system will see the same consultant obstetrician or the same individual midwife at every appointment”. Alamy Stock Photo
Analysis
Before the government quickly moves on, let’s have a look at what is offered in the public system today and start a conversation about what the goal is for public maternity services.
Christina Finn
CONTRACTS, INSURANCE, EMPLOYMENT law. All of these matters were discussed in the last two weeks during the stand-off between the government and the Rotunda Hospital.
In the end, there was much praise for Health Minister Jennifer Carroll MacNeill who won out, with the hospital conceding that consultants on public-only contracts will not treat private patients.
The health minister isn’t stopping there. In an interview with The Sunday Times today, the minister said she now has a laser focus on ensuring that consultants on the public-only contracts are fulfilling their roster obligations by working later into the evenings and over the weekend.
While the government and the consultants fought over who was right and who was wrong and whose legal advice trumped whose in the Rotunda debate, the crux of the issue, women’s voices, and what they wanted from Ireland’s maternity care, went largely ignored.
When this controversy first erupted, The Journal asked women to get in touch to share their stories about the Ireland’s maternity care, in the public, semi-private and private system.
Continuity of care
There were lots of responses. Many women spoke about having a very good experience in the public system and spoke about the hard-working midwives and doctors.
Others opened up about some very difficult experiences, and how at times in the maternity system they felt they weren’t listened to. Other women spoke about the kind of service they wanted or expected, with some stating that to get that, they chose to pay.
What came out from all the responses was that women, in one of their most vulnerable times of their lives, just want the best standard of care, whether that is in the public or private systems.
Not only that, they want continuity of care.
Women who have gone through a particularly traumatic experience in the past or have worries about the future want a system that supports them when they call on it.
Many women say they have got that care and support in the public system, while others say they have not.
It is not that women fear the public system – as some commentators have said in the last week – it is that they want the best offered to them in the public system.
Many women want the same options, offers of support and reassurances that some women say are on offer to them in the private model. And women are right to demand that for the public system.
What do we want from maternity care?
As the Rotunda controversy dies down, we run the risk now of quickly moving on without questioning: What kind of maternity care do we want under Sláintecare?
During her interview with RTÉ’s David McCullagh last week, the health minister said women in the public system should be able to choose if they want consultant-led care or midwifery-led care if they are having a baby in the public system.
Who can disagree with that?
The ambition of Sláintecare and the public-only contract is to ensure that one day, there is equality across the entire healthcare system, including maternity care.
What women care about is that when they are in the maternity care system, can they see their doctor or midwife, preferably the same one, throughout their pregnancy, just like, as the minister points out, occurs in cancer treatment.
To that degree, The Journal asked the HSE and the Department of Health to outline what the current state of play is when it comes to public maternity services.
A statement from the HSE and the Department of Health to The Journal regarding what is offered to women in the public system stated that continuity of care is a key objective of the National Maternity Strategy.
‘No guarantees’
However, the HSE said “in practice, there is no guarantee that a woman in the public system will see the same consultant obstetrician or the same individual midwife at every appointment”.
It said in most instances, women are cared for appropriately by a multidisciplinary team and may see different members of that team over the course of their pregnancy, labour, and postnatal care.
“For women receiving care through midwifery-led services, continuity is typically provided by a team of midwives rather than by a single named midwife. Similarly, women may request to be under the care of a particular consultant, and maternity services will seek to accommodate such requests where possible, particularly where there has been an established clinical relationship in a previous pregnancy.
“However, this cannot always be guaranteed and is subject to service availability and clinical requirements,” said the HSE.
Anot…
Read the full article at TheJournal.ie →
Ireland