Robert Troy (Longford-Westmeath, Fianna Fail)
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28. To ask the Minister for Health when anomaly scans will be available in the Midland Regional Hospital Mullingar. [47978/17]

Mick Barry (Cork North Central, Solidarity)
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39. To ask the Minister for Health if the provision of anomaly scanning for all pregnancies will be expedited; and if he will make a statement on the matter. [48181/17]

Robert Troy (Longford-Westmeath, Fianna Fail)
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When does the Minister envisage anomaly scans will be available in the Midland Regional Hospital Mullingar?

Simon Harris (Wicklow, Fine Gael)
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Is this question being grouped with Question No. 39?

Pat Gallagher (Donegal, Fianna Fail)
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Yes, Nos. 28 and 30 are being taken together.

Simon Harris (Wicklow, Fine Gael)
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I propose to take Questions Nos. 28 and 39 together.

I thank Deputies Tory and Barry for their questions. I accept that the provision of anomaly scanning is not uniform throughout the country. However, we are working to address this. I want to assure Deputy Troy of that. The national maternity strategy is very clear that all women must have equal access to standardised ultrasound services. The strategy will be implemented on a phased basis over the coming years - I have just published the first implementation plan - and this work will be led by the HSE national women and infants health programme. This is a specific programme office within the HSE very similar to the way we delivered improvements in cancer services in the past. Last month, I was pleased to launch the programme’s detailed implementation plan.

I am advised that anomaly scans are available in each hospital group, as distinct from each hospital. I am also advised that those maternity hospitals and units which currently provide anomaly scans accept referrals from other maternity units. This occurs where the medical team in the referring maternity unit considers that such a scan is clinically indicated. I am informed that the Midland Regional Hospital Mullingar provides anomaly scans to women when clinically indicated to do so.

One of the current challenges to increasing access to anomaly scans is the recruitment of ultrasonographers. In this context, it is expected that the establishment of maternity networks across hospital groups will assist in the development of a sustainable model that ensures all women can have access to anomaly scans routinely. They are already happening where clinically indicated. I think what the Deputy is asking me is when they will be available routinely for all women. I am assured that the programme will continue to work with the maternity networks to assist in increasing access to anomaly scans for those maternity units that currently have limited availability. The additional funding that will be provided for anomaly scanning in 2018 will be set out in detail in the national service plan, which I hope to publish in the coming weeks. I assure the Deputy in the interests of clarity that specific funding will be provided for the recruitment of additional ultrasonographers in 2018. The exact details will be outlined. I expect, and the national women and infants health programme expects, that we will have more sonographers working in our health service next year. That should enable us to further increase provision beyond just where clinically indicated and to offer anomaly scans on a routine basis. I will keep in touch with the Deputy as the service plan details become apparent.

Robert Troy (Longford-Westmeath, Fianna Fail)
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I thank the Minister. He is right that the national maternity strategy states there must be equal access to standardised ultrasound services for every pregnant woman, not just where there is a potential risk to the child or the mother. That followed the identification of a geographic inequity in the availability of 20-week foetal anomaly scans. The Midland Regional Hospital, Mullingar does not just serve Mullingar. It serves all of Westmeath and Longford, and parts of Offaly, Meath, Louth and Roscommon. It actually services quite a large geographical area. I know this matter is a priority as part of the hospital business case for 2018. I stand to be corrected but I am led to believe that the hospital has the highest rate of births outside Dublin. That is an indication of the large number of people it serves and shows how urgent it is for it to be in a position to offer anomaly scans to all pregnant women from 2018 onwards.

Simon Harris (Wicklow, Fine Gael)
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I thank the Deputy. He is entirely correct. The national maternity strategy is clear that it wants to make detailed routine scans available for 100% of women within the public health system. It wants to make them available on the basis of a woman's choice rather than on the basis of specific clinical indications. That is where we need to get to. I think it is right and proper that we start with clinical indications, in the interest of women's health and wellbeing, and that we make sure the scans are available in every hospital group, which is the current situation. The regional hospital in Mullingar is doing an excellent job in that regard and I thank its staff for that.

We will be looking at how we can deploy the extra ultrasonographers we will be hiring in 2018 to best ensure geographic equity. Mullingar will be considered in that context as well. It is estimated that for everybody to have absolutely routine access to such an anomaly scan, we would need an additional 52 ultrasonographers - 35 for anomaly scans and a further 17 for dating scans. It is important to note that the benefit of this planned recruitment will be released incrementally because, let us be very honest, the likelihood of finding all of that cohort in one go is slim. We will be increasing the number of ultrasonographers in 2018. I will talk to the HSE about the point the Deputy makes about Mullingar and the fact that it is very much a regional hospital.

Robert Troy (Longford-Westmeath, Fianna Fail)
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I appreciate that the Minister has undertaken to look at Mullingar hospital given its location, the number of counties it serves and the high level of births that take place there, as I said at the outset. On the recruitment of the additional 52 sonographers, obviously that will not happen in one year. Has the process of recruiting the additional staff commenced? Quite often what happens with the HSE is that it makes an allocation for a particular calendar year, for example, 2018, but does not commence the recruitment process until well into that year. The full benefit of the services is therefore not realised in the calendar year. How long is the recruitment process going to take? Has the Minister identified exactly how many additional staff are going to be hired in 2018?

Simon Harris (Wicklow, Fine Gael)
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No, we have not because that will be a matter for the HSE service plan, which is the subject of ongoing discussions within the HSE. It is due to be presented to me and published by the HSE in the coming weeks, and one would hope this will be the case. That will provide the more granular detail of how many and in what year. It is the very clear aim of the programme and the national maternity strategy to ensure that all women have access to routine anomaly scans by 2019. That is where we want to get to. We want to make progress in 2018.

The Deputy's point is well made in respect of the recruitment process. There is no point in the HSE saying it is going to do something in 2018 and starting in the middle of that year. I will give the Deputy my assurance that once the service plan is finalised, I will ask the HSE to prioritise the recruitment process. It should start immediately once the service plan is signed off on so that we can have actual ultrasonographers in place in our hospitals in 2018. I expect that will happen.