Minister still awaiting report on Midwifery-led Unit

Cllrs support retention of MLU

The Minister for Health Simon Harris and his department are awaiting a report examining operations within Cavan General Hospital's Midwifery Led Unit with particular focus on the future of the service.

The report, being undertaken by the National Women & Infants Health Programme (NWIHP) and commissioned by the Minister himself, was due on his desk last week.

However, a spokesperson for the Department confirmed that, while the report has been requested, it is still awaited.

“The [NWIHP] has advised that a review is underway within the RCSI Hospital Group, led by the Group Clinical Director for Maternity Services in conjunction with the Directors of Midwifery from Our Lady of Lourdes, Drogheda and the Rotunda Hospitals. The Department has sought assurances that any proposals, emanating from the RCSI review, will serve to ensure the future of the MLU in Cavan and that it will operate in line with the National Maternity Strategy.”

The report was ordered after the MLU at Cavan General was merged with local consultant-run maternity services earlier this month.

No new cases were being admitted from June 1. But, within a matter of days and following public outcry at the decision, not to mention a petition of over 11,000 signatures, the proposal to merge services was put on 'pause'.

It's understood the decision blind-sided the Department, which was then forced to emphasise the Government's commitment to the 2016 National Maternity Strategy, which advocates the expansion of midwifery-led services at maternity hospitals nationally.

The NWIHP, in conjunction with Acute Operations, is to report to the Minister on the steps now being taken to ensure the long-term sustainability of the MLU service in Cavan.

There is no confirmation yet whether the report will be made public or if the terms of reference include an investigation into the decision making processes that led to the merger of services.

RCSI, which takes in Cavan General Hospital, last week responded to two local Oireachtas members - Niamh Smyth TD and Senator Robbie Gallagher - stating that the local MLU continues to be “fully operational”.

They add that RCSI Hospital Group continues to work closely with the consultant obstetricians and midwives in Cavan and Monaghan with regards to “strengthening the clinical governance framework” of the service.

The Department for Health spokesperson concluded by stating, once the full report has been received, it will work with the NWIHP to ensure any “additional supports” required to secure the future of community midwifery services in Cavan “will be put in place”.

“This will ensure that the choice of the Supported Care pathway remains available to women attending CGH for maternity services. The question of publication will be considered when the report has been received.”

Council support

Meanwhile, the issue was to the fore at the June monthly meeting of Cavan County Council with several motions tabled.

Fianna Fáil's Aiden Fitzpatrick said the news when it first emerged had “caused shock”, and continued that there should be no question raised as to its “future”- being one of only two such units in the country. He pointed out that those attending the MLU in Cavan, but living in neighbouring Monaghan, could attend a clinic on the HSE's Davnet's campus. “What was the rationale for downgrading the service?” asked Cllr Fitzpatrick, while welcoming the news the decision is being reviewed.

He suggested that the Council write to the Minister on the subject. Fine Gael's TP O'Reilly agreed with his council counterpart. He said the Government fully supported “this type of unit” and further welcomed the commitment of funding for an additional Advanced Midwifery Practitioner at Cavan General.

The Fianna Fail Group also tabled a motion to discuss the recent development, with Fianna Fail's John Paul Feeley questioning the RCSI's role in recommending the move. Fine Gael's Madeleine Argue added to the debate, stating that to merge maternity services at CGH was “never a plan”, and that the MLU was “never going to close”.

But Cllr Feeley responded, noting how the unit had stopped taking new referrals from the beginning of June, and only restarted the process after the Minister's intervention. He said too that the RCSI had seemingly taken “definite approach” and that it had to be “called on for want of a better word".