Yesterday there was an announcement that the HSE's review of maternity services in the west/north west hospitals group was being shelved and would be subsumed into the national maternity services review. The report into the group's maternity services was near finalisation and it was exposed recently as containing alarming recommendations for the downgrading and potential closure of maternity services across the region.

There was no public consultation on the report and public procurement rules were circumvented. Owing to the good work of Senator Marc MacSharry and others, the issue was disclosed and exposed and it contained revelations about proposals concerning maternity services at Portiuncula, about which there are very grave concerns.

Services in the north west will be included in the national examination of maternity services. There are approximately 19 public maternity units in Ireland. What is the agenda for the strategy and the review? Will the Government publish the terms of reference and ensure there will be public consultation? Will the Taoiseach confirm that the agenda is not to reduce the number of maternity units to 14, 12, ten or fewer? People consider such a reduction is within the remit of the maternity services strategy. There are key issues regarding the recruitment of obstetricians and midwives. The Government's policy on obstetricians has backfired and we are short of obstetricians throughout the country. There is a need to end the anxiety in places such as south Tipperary, Portlaoise, Portiuncula, Castlebar and Sligo. If the trend is to locate maternity services in acute tertiary centres, where does that leave existing maternity hospitals? It is important that the Taoiseach indicate to the House the terms of reference.

The national examination of maternity services arose from a number of high profile, tragic cases. The Minister was in order in saying we needed to see the highest standards applied in maternity units throughout the country in order to maintain Ireland's reputation as one of the safest countries in the world in which to give birth. For that reason, it is very important that mothers-to-be understand medical care, facilities and safety are of the highest order. Before the recent elections, one would have assumed, according to what I was hearing, that we planned to close maternity services in Letterkenny, Sligo, Mayo and at Portiuncula, leaving the entire west and north west with one centre for the provision of maternity services, Galway hospital.

Was the Taoiseach listening?

Obviously, this is not the case. It is in order that there be a national examination of standards in maternity units. There should be public consultation and the terms of reference should be published and they will be. Our intention is to raise standards to the highest quality in order that those giving birth will be comfortable in the knowledge that whatever maternity unit they are in is of the highest standard and integrity. That is the policy and intention.

In February the Minister for Health, Deputy James Reilly, announced the national maternity care strategy, but we have still not seen the terms of reference. At this stage, we are entitled to see them because this is a very important issue. Some people working in maternity services argue that they need immediate intervention by the Government to upgrade staffing levels to provide an obstetrician-led service, more midwives and better conditions. Not long ago, leading practitioners in the field of obstetrics said our maternity hospitals were not safe and did not have safe staffing levels and that those responsible for delivering a safe service were at the end of their tether because of the difficulty in recruiting obstetricians. There are clear issues regarding terms and conditions which have resulted in shortages and great difficulty in recruiting obstetricians and midwives. We need to see the terms of reference and I ask the Taoiseach to come back to me on their publication. Although the strategy which began in February is meant to be complete by October, we have not seen the terms of reference. The Taoiseach has shoved the west and north west into the process because it was too hot a potato for him to deal with.

It is important that the terms of reference be published and they will be. Although people with experience in child health said it would be very dangerous in maternity units during the changeover when staff were taking early retirement from the service, nothing of the kind happened. It is everybody's interests that there be an examination of the standards that apply and that where they are inadequate, they be raised, by whatever means necessary. It is very important, as the Deputy can understand, that women and families be comfortable in the knowledge that they are going to one of the safest places on the planet in which to give birth. It is right and proper, following a number of high profile and tragic cases, that there be an analysis and examination of the standards, efficiencies, staffing and criteria that apply in order that we can keep and be seen to keep Ireland's reputation as one of the safest places in the world in which to give birth.