Guest Blog by Jo Murphy Lawless: National Healthcare Charter for Maternity Care - "An 'opportunity to contribute' ?????

 Guest Blog post by Jo Murphy Lawless, Trinity College Dublin:

National Healthcare Charter for Maternity Care -  "An 'opportunity to contribute' ?????

  'The National Women’s Council of Ireland (NWCI) and the HSE are running workshops on gender and health this month, in Letterkenny (March 4th), Waterford (March 11th) and Mullingar (March 20th). Participants at the workshops will have an opportunity to contribute to the draft HSE National Healthcare Charter for Maternity Care. ' Irish Times, 2 March, 2015

 

Sounds useful doesn't  it?

 

The reality is this:

 

 1. We have had a so-called 'Patients Charter' in this godforsaken jurisdiction since 1992, published then by the Department of Health, and it made not a jot of difference to the long-suffering Irish public (one of the clauses in that original 1992 Charter is that everyone  is entitled to a specified individual appointment time in all outpatients  sections of all our hospitals.; so that was a great success as a policy, wasn't it? Ask women in our antenatal clinics around the conutry, let alone women in breast clinics and so on how long they wait in cattle mart conditions?

 

 2. The whole notion of 'patients  charters' was a very suspect emollient to broken health services from the late 1980s in the UK, when the first steps were taken in the NHS and elsewhere  to privatise. Its focus was  the individual  as a 'consumer' concerned only with her own needs and not with the needs of the community as a whole. They were designed to limit patient dissatisfaction to a menu of complaints and not to investigating how and why

 

 3. That 1992 Department of Health Charter here drew on what was already a politically bankrupt approach to the problems of health services.

 

 4. What women wanted for their maternity services was thoroughly  canvassed in the run up to the publication of the 1997 A Plan for Women's Health; workshops were held round  the country. to no avail. Nothing changed.  Women's voices in that kind of empty exercise decorated with the word' consultation'   were all too readily sidestepped.

 

 5. And the HSE is reviving this tattered and useless set of approaches now?

 

 And the NWCI is signing up to this paper exercise??

 

Such disheartening news for International Women's Day, given all we have endured of scandals which have cost women their lives, their babies’ lives, and families’ well-being  since Tania McCabe’s tragic death in 2007.

 

We need much tougher and realistic engagements, at the very least the setting up of a maternity services committee, integrated directly into local policymaking and chaired by women who have used our maternity  services. One such is now in place in Saolta  University Healthcare Group in the west, where policies can be interrogated by women users of the maternity services, using a solid evidence base, and then getting those policies reformed, monitoring that reform process.

 

The scope needs to be much wider.  Human rights in patients care is a far more appropriate frame of reference  - see http://www.hhrjournal.org/2013/12/10/human-rights-in-patient-care-a-theoretical-and-practical-framework/

 

 

 Jo Murphy-Lawless, TCD, 8 March 2015,

Guest Blog by Jo Murphy Lawless: National Healthcare Charter for Maternity Care - "An 'opportunity to contribute' ?????

National Healthcare Charter for Maternity Care -  "An 'opportunity to contribute' ?????

 'The National Women’s Council of Ireland (NWCI) and the HSE are running workshops on gender and health this month, in Letterkenny (March 4th), Waterford (March 11th) and Mullingar (March 20th). Participants at the workshops will have an opportunity to contribute to the draft HSE National Healthcare Charter for Maternity Care. ' Irish Times, 2 March, 2015

Sounds useful doesn't  it?

The reality is this:

 1. We have had a so-called 'Patients Charter' in this godforsaken jurisdiction since 1992, published then by the Department of Health, and it made not a jot of difference to the long-suffering Irish public (one of the clauses in that original 1992 Charter is that everyone  is entitled to a specified individual appointment time in all outpatients  sections of all our hospitals.; so that was a great success as a policy, wasn't it? Ask women in our antenatal clinics around the conutry, let alone women in breast clinics and so on how long they wait in cattle mart conditions?

 2. The whole notion of 'patients  charters' was a very suspect emollient to broken health services from the late 1980s in the UK, when the first steps were taken in the NHS and elsewhere  to privatise. Its focus was  the individual  as a 'consumer' concerned only with her own needs and not with the needs of the community as a whole. They were designed to limit patient dissatisfaction to a menu of complaints and not to investigating how and why

 3. That 1992 Department of Health Charter here drew on what was already a politically bankrupt approach to the problems of health services.

 4. What women wanted for their maternity services was thoroughly  canvassed in the run up to the publication of the 1997 A Plan for Women's Health; workshops were held round  the country. to no avail. Nothing changed.  Women's voices in that kind of empty exercise decorated with the word' consultation'   were all too readily sidestepped.

 5. And the HSE is reviving this tattered and useless set of approaches now?

 And the NWCI is signing up to this paper exercise??

Such disheartening news for International Women's Day, given all we have endured of scandals which have cost women their lives, their babies’ lives, and families’ well-being  since Tania McCabe’s tragic death in 2007.

We need much tougher and realistic engagements, at the very least the setting up of a maternity services committee, integrated directly into local policymaking and chaired by women who have used our maternity  services. One such is now in place in Saolta  University Healthcare Group in the west, where policies can be interrogated by women users of the maternity services, using a solid evidence base, and then getting those policies reformed, monitoring that reform process.

The scope needs to be much wider.  Human rights in patients care is a far more appropriate frame of reference  - see http://www.hhrjournal.org/2013/12/10/human-rights-in-patient-care-a-theoretical-and-practical-framework/


 Jo Murphy-Lawless, TCD, 8 March 2015,

PRESS STATEMENT FROM THE ASSOCIATION OF IMPROVEMENTS IN THE MATERNITY SERVICES IRELAND (AIMSI) – CHOICES IN MATERNITY SERVICES; WOMEN GIVE UNPRECEDENTED THUMBS UP TO FREE STANDING BIRTH CENTRES

PRESS STATEMENT FROM THE ASSOCIATION OF IMPROVEMENTS IN THE MATERNITY SERVICES IRELAND (AIMSI) – CHOICES IN MATERNITY SERVICES; WOMEN GIVE UNPRECEDENTED THUMBS UP TO FREE STANDING BIRTH CENTRES

MARCH 12TH 2015
For immediate release 12th March 2015

Press statement from The Association of Improvements in the Maternity Services Ireland (AIMSI)

 

Contact Krysia Lynch 087 7543751

email chair@aimsireland.ie In 2014, AMSi undertook the largest consumer based survey of the Maternity Services in Ireland and the initial set of  results on care pathways are being released this Saturday. The Survey; What Matters To You was completed by 2835 women who had used the Irish Maternity Services in the last four years. Respondents used all maternity units, as well as domiciliary care, and the majority of women (75%) were not first time mothers. The survey uncovered a broad range of issues in relation to maternity services and women’s experiences of them. A key finding was that over 90% of respondents stated that women should have the choice of freestanding birth centres. Currently there are NO free standing birth centres in Ireland and very little in terms of midwifery led care per se.

Krysia Lynch, AIMSI Co Chair says “One of the critical decisions in engaging with the maternity services for a woman is the choice of care provider. Recent maternity events in Ireland have highlighted that Ireland is unusual in comparison to other OECD countries in that women are given very limited choices in terms of care pathways and care providers. Our maternity services are overwhelmingly medicalised and obstetric led, when all the available evidence points to midwifery led care being the most suitable option for the majority of women. In midwifery led birth options women are subject to the fewest unnecessary routine interventions and therefore have the lowest risk of morbidity whilst still having excellent perinatal outcomes. Our current system does not provide women with the appropriate range of care options and as a result, all women suffer.  Implementing a full range of care options, from hospital based midwife led care options, homebirth, birth centres, in addition to hospital based obstetric care, not only ensures evidence based care is available to women, but also takes pressure off obstetric led units for women who need this type of specialised care. Choice benefits all.”

Not only are we lagging far behind in terms birth centre provision  but it would appear that any moves to address this discrepancy have been actively stonewalled by the HSE and Department of Health.Ciara Consodine of the Philomena Canning Campaign says “Given the unprecedented demand for birth centres here, combined with the fact that leading independent midwife Philomena Canning has been pursuing them for years, it begs the question as to why the HSE systematically refuses to support them. We are pursuing this with the Minister for Health and hope to bring this issue — along with the highly questionable circumstances surrounding Ms Canning’s unlawful suspension — before an Oireachtas health committee hearing in the near future.”
Further results of the What Matters to You 2014 Survey will be presented by Dr. Krysia Lynch at the AIMSI AGM on Saturday 14th March The Outhouse, Capel St, Dublin 1at 1.30pm and Philomena Canning will speak on “Outcomes of a midwife’s practice under the HSE Home Birth Scheme, October 2008 – September 2014″ at 2.30pm
More details on

http://aimsireland.ie/aims-ireland-agm-march-14th-presentations-of-further-results-from-what-matters-to-you-2014-survey-and-special-guest-speaker-philomena-canning/

ENDS

Boilerplate

For more information on AIMSI

www.aimsireland.ie

For more information on midwifery led care

Birth place study in the UK, https://www.npeu.ox.ac.uk/birthplace/results

NICE guidelines in the UK, https://www.nice.org.uk/news/article/midwife-led-units-safest-for-straightforward-births

The Cochrane review on continuity of care http://www.cochrane.org/CD004667/PREG_midwife-led-continuity-models-versus-other-models-of-care-for-childbearing-women

For more information on the Philomena Canning Campaign

#isupportphilomenacanning

www.philomenacanningcampaign.com

AIMS Ireland AGM - March 14th - Presentation of further #WMTY2014 survey results & special guest speaker, Philomena Canning

 

Come to our AGM! 14th March, 11:30am - 4pm at Outhouse, Capel Street, Dublin 1.

Exclusive first look at next tranche of What Matters to You survey results

AND

Special guest speaker Philomena Canning SECM - "Outcomes of a midwife's practice under the HSE Home Birth Scheme, October 2008 - September 2014"
...

https://www.facebook.com/events/720013498112017/

 

 

 

 

 

AIMS Ireland Statement regarding Philomena Canning being reinstated to practice by HSE

Feb 27, 2015: AIMS Ireland Statement regarding Philomena Canning being reinstated to practice by HSE

Once again, AIMSI would like to highlight the stark inconsistencies with which the HSE will shut down an independent midwife's practice with 'no foundation' while continuing to ignore the grave concerns arising in some hospital maternity services.

While AIMS Ireland are delighted that Philomena Canning can now return to caring for women and babies, many questions remain on how the HSE were supported to illegally purse a midwife who followed protocol and appropriate practice guidelines set out by the HSE themselves in the first place.

A faction within the HSE were allowed to break precedent in removing a midwife from her practice, with no adverse outcome or foundation, while other clinicians continue to practice without suspension following adverse outcomes in maternity hospitals during the same period. This action not only undermines the national home birth service and clinical practice of Philomena Canning, but left 29 women and their babies at risk without care options.

AIMS Ireland note that the timing of this action against Philomena Canning occurred following announcements that she was setting up Ireland's first birth centre and statements of concern regarding the HSE criteria for homebirth and conditions within the MOU which undermine women's rights. It is clear to AIMS Ireland that this case was a 'warning shot' by the HSE.

The HSE need to answer the many questions arising from this injustice and the many others like it. AIMS Ireland are in full support of an independent inquiry into events contributing to the action against Philomena Canning.

AIMS Ireland expects to see the HSE act to swiftly withdraw cover from any clinician involved in future incidents with adverse outcomes in all maternity settings. We expect the HSE to apply this new high bar for all health care providers. Women giving birth in hospital deserve the same protections afforded to homebirth mothers.

Ireland's Maternal Death Rate - Depends on who you are asking.

In Today's Irish Times, John Fitzgerald shares a piece on CSO statistics for Ireland called, ‘Vital Statistics’ sheds light on inequalities in life expectancy”. The articles states, "While the death rate also fell in the Republic, it was not till the late 1970s that it reached the UK level. Today, in spite of recent tragedies that have received significant media attention, the maternal death rate is very low, at about three per 100,000 births, marginally lower than that in Northern Ireland, England and Wales."

Once again AIMS Ireland need to highlight that CSO figures for maternal death of 3 per 100,000 are inaccurate and under-reported. More accurate figures, using a more appropriate, broader classification system on par with other EU countries, show a very different story.

 One of these stats is not like the other

The recent United Nations Population Fund (UNFPA) report put Ireland's maternal death rate at 9 per 100,000. (Irish Independent)

 

The Maternal Death Enquiry (MDE) Ireland has reported a rate of 8 per 100,000 in their recent report with specific mention to issues in the classification and collection of data, with general hospitals and the Irish coroner system both cited as areas which lead to under-reporting. As described here in the most recent MDE Ireland report (2009-2011):

 

"In Ireland, the Medical Death Notification Form completed by a medical practitioner contains

a question “If the deceased was female, was she known to have been pregnant at the time of

death, or within the previous 42 days?” (Answer “yes” or “no” in all cases)13. The Coroner’s
certificate does not contain this question.

 

In the case of Death Notification Forms, a review of MDE cases to date has shown that the
question on pregnancy status has been not being correctly completed in some cases. Review
of death certificates issued by the GRO office, following receipt of a Coroner’s certificate,dentified information on current or recent pregnancy was absent in many cases of indirect
maternal deaths. These issues clearly impact on ascertainment of reliable maternal mortality
data."

 

From MDE Ireland's 2009-2011 report regarding CSO figures:

 

"Comparative available data for the years 2009 and 2010 showed that all but one maternal

direct death was identified by the CSO. However, none of the thirteen indirect or six

coincidental maternal deaths were identified by the CSO."

Despite these noted inaccuracies, flaws and numerous reports of Ireland's true maternal death rate, it is the CSO figures which are regularly quoted by Government and Political representatives. We've all heard the 'Ireland is the safest place to have a baby' speeches, however, what most of us don't realise is that that with a maternal death rate of 8 per 100,000 we are on par with many of our EU counterparts and actually ranks worse than others. For example:

France 8 per 100,000
UK 10 per 100,000
Germany 7 per 100,000
Belgium 5 per 100,000

AIMS Ireland's position:

 

Calculations for a Nation's Maternal Death rate is an international standard for measuring safety in maternal health services, however, AIMS Ireland feel this statistic alone does not provide full insight into safety of care provided to mothers and babies. As a developed Western nation, with access to ante-natal care, nutrition, hygiene, and technology, it is more appropriate to measure safety not only in terms of death but also the 'near misses' and serious health implications to mothers and babies as a result of a pregnancy/birth (morbidity) - both physical and psychological.

 

From the Irish Times, 13/1/2015 regarding CSO figures:

  http://www.irishtimes.com/business/economy/vital-statistics-sheds-light-on-inequalities-in-life-expectancy-1.2063185

 

 

UNFPA rates - Irish Independent 19/11/2014

 

Ireland scores poorly for rates of maternal death: http://www.independent.ie/irish-news/health/ireland-scores-poorly-for-rates-of-maternal-death-30756530.html

 

Maternal Death Enquiry Ireland (MDE Ireland) 2009-2011 report:

http://www.ucc.ie/en/media/research/maternaldeathenquiryireland/MDEReportForTheTriennium2009-2011.pdf

A Year in Review of Irish Maternity Services - 2014 AIMS Ireland (video) #MadAsHell #AIMSIreland

AIMS Ireland look back over 2014 with this short video. Thank you to everyone who marched with us, shared our information, and supported us over the year.  We would especially like to thank our members and those who made donations to AIMS Ireland – in time as volunteers and financially – AIMS Ireland could not exist without your help!

To view click here: 2014 AIMS Ireland