Wednesday, 27 May 2015

Strategic review of the maternity services: the importance of service user representation

On Saturday 23rd May 2015, the Irish Times printed an article which highlighted a letter sent from the Institute of Obstetricians and Gynaecologists of Ireland to the Minister for Health Leo Varadkar about the Membership of the Strategy Review Steering Group.

AIMSI Ireland through their Chair Krysia Lynch has a place on the committee representing the views of service users. Also on the committee are two service users whose babies died in Portlaoise Hospital.

In the letter, Prof Robert Harrison, said his members were "dismayed about the make-up of the group". He stated that the presence of three obstetricians and no anaesthetists or critical care specialists, compared to nine people from a midwifery background and three lay people, “does not reflect a fair balance of those who work in maternity services today”.

The letter implies that those who work in the maternity services should dominate how future maternity services are delivered and planned. It  discusses ratios of those that work in the maternity services today and assumes wrongly, as it turns out, that obstetricians should have the majority of seats. There are many more midwives working in the maternity services than obstetricians; it is logical that the majority view around the table should be from midwives. Perhaps what the statement really means to imply is that obstetricians have grown accustomed to dominating discussions surrounding maternity services, and suddenly finding themselves not in a majority is unfamiliar and unwelcome territory.

The reporting of the letter in the Irish Times implies that the querying of the service users by Prof Harrison was insensitive and inappropriate given the way these women had been treated by the members of his own profession.

Whilst the comments re service users made in the letter received a lot of publicity, little commentary was made on the demands from the Institute of Obstetricians and Gynaecologists of Ireland for the inclusion of a critical care representative and  the inclusion of an anaesthetist representative; both of which were duly appointed following the request from the Institute. 

An interesting question that the letter does not address is whether the inclusion of two service users and one advocacy organisation is sufficient. AIMSI would argue (along with the other service users representatives) that 70,000 maternity care service users might deserve even more than two service users representing them. To this end AIMSI also wrote to the Strategic Review Committee suggesting the inclusion of a further consumer representative who had perhaps experienced a different model of care and a different outcome to those already included. AIMSI were told no further representatives could be added.

On Tuesday 25th May 2015 AIMSI issued the following statement:

"The recent comments in the Irish Times questioning the inclusion of two service users was unhelpful. This group might not be sitting if it were not for the experience of the service users on the committee. Their bravery in coming forward  and the support they received from advocacy groups is an important aspect of improving maternity services for women in Ireland, and AIMSI would if anything be advocating for more service user inclusion on the group"

The full article can be read here

The second article following Prof Harrison s resignation can be read here

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