A Strategy for Maternity Care in Northern Ireland 2012-2018

DHSSPS has carried out a review of policy on maternity service provision in Northern Ireland. The review focused on the best available evidence for the care and treatment of mothers-to-be; quality, safety and service sustainability; wider workforce issues; and professional roles and responsibilities. As a result, a draft strategy was developed, which was the subject of a public consultation from 28 September 2011 to 23 January 2012. Following an analysis of the responses to the consultation, the final strategy, A Strategy for Maternity Care in Northern Ireland 2012-2018, was published on 2 July 2012. The Strategy is outcomes focused. The six outcomes are:- give every baby and family the best start in life; effective communication and high-quality maternity care; healthier women at the start of pregnancy (preconception care); effective, locally accessible, antenatal care and a positive experience for prospective parents; safe labour and birth (intrapartum) care with improved experiences for mothers and babies; and appropriate advice, and support for parents and baby after birth The strategy aims to provide women and their partners, HSC staff, commissioners and policy makers with a clear pathway for maternity care in Northern Ireland from pre conceptual care through to postnatal care. Within the document, twenty two objectives have been identified which link to the six outcomes identified above. The HSC Board and Public Health Agency will co-lead on implementation. An action plan will be developed to take account of the outcomes and objectives listed in the document. The Department will receive an annual report on progress towards implementation.

Child Health Care in Ireland

The Irish health care system is based on a complex and costly mix of private, statutory, and voluntary provisions. The majority of health care expenditure comes from the state, with a significant proportion of acute hospital care funded from private insurance, but there are relatively high out-of-pocket costs for most service users. There is free access to acute hospital care, but not for primary care, for all children. About 40% of the population have free access to primary care. Universal preventive public health services, including vaccination and immunization, newborn blood spot screening, and universal neonatal hearing screening are free. Major health challenges include poverty, obesity, drug and alcohol use, and mental health. The health care system has been dominated for the last 5 years by the impact of the current recession, which has led to very sharp cuts in health care expenditure. It is unclear if the necessary substantial reform of the system will happen. Government policy calls for a move toward a patient-centered, primary care-led system, but without very substantial transfers of resources and investment in Information and Communication Technology, this is unlikely to occur. The paper has been published as part of an overall report of Child Health in Europe: Diversity of Child Health Care in Europe: A Study of the European Paediatric Association/Union of National European Paediatric Societies and Associations http://www.jpeds.com/issue/S0022-3476(16)X0010-8 . (J Pediatr 2016;177S:S87-106).