Tag Archives: Philomena Canning Midwife

Philomena Canning

The Philomena Canning case a year on.

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Philomena Canning

This day last year; 12th September 2015 Self Employed Community Midwife Philomena had not long delivered a baby and had some 29 women in her care. Some of those women were about to give birth, some had simply booked her for their births that were over six months away and others were receiving postnatal care for themselves and their babies.

At 5pm on the 12th September 2014 Philomena Canning  was instructed by the HSE that she was no longer to continue care of her clients as her state clinical indemnity had been revoked and she was to hand over all of their files immediately to the HSE. Initially Philomena assumed there had been a misunderstanding and she would be reunited with her clients within the week, but this didnt happen.

Court appearances

On the 24th September and then on the 29th September she went to the High Court to seek an injunction against the revoking of her indemnity, but she was unsuccessful. In return for the indemnity the HSE wanted her to be supervised and work with a second midwife. Philomena rejected this offer and the suspension of her indemnity continued until she lodged an appeal. The appeal was heard at the High Court on the 27th February and and on the basis of testimonies of expert witnesses provided both by the HSE’s and Philomena s legal team the injunction was granted with full costs.

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Placards on the gates of the Four Couts

Everyone  thought this would mean that Philomena would return to practice. But this was not the case. The HSE  were running a second investigation in parallel with the one that had just been discredited.

Many women and midwives came to support Philomena at the court acourt appearances and they were understandably frustrated and angry, A lot of questions were left unanswered also. Women wrote to th TDs to Leo Varadkar and to their local councillors. and yet the situation remains that Philomena has still not returned to practice.

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Student midwives supporting Philomena

Philomena remains keen to return to work. However,  despite being reinstated by the HSE back in February 2015, she continues to be unable to return to practice as long as the second  HSE report (promised in March 2015, relating to the “incidents” at the centre of her suspension), remains unforthcoming. Even though independent expert witnesses have  fully supported every aspect of Philomena s practice in both cases,  the HSE are persisting with this report. It would be professionally compromising for her to return to work. until the HSE’s systems analysis report is complete.

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Shame on the HSE

In July The Philomena Canning campaign made the following statement “We are concerned at this report delay, most especially given the very real impact for clients seeking a home birth that her absence creates, with particular concern for women seeking it through the public health system.”

The Philomena Canning Campaign continued  “We urge supporters to now contact their local TDs requesting they place parliamentary questions to Minister Varadkar when the Dáil resumes, as to the cause of the delay in the HSE investigation report. We’d also encourage those seeking home births to request information from their DMOs and to email HSE investigation head joseph.ruane@hse.ie to seek information on when the report publication is expected, as this is the single obstacle in the way of Philomena’s return. She can not be in as position that leaves her clients open to further compromise after the immense difficulties faced in the aftermath of her suspension in finding replacement midwives, not least due to the HSE’s handling of it for the clients affected.”

 What did Philomena’s removal from practice mean for women booked with her?

One woman was due to give birth over that first weekend when Philomena was suspended.. No carer was put in place for her. Others were due to give birth over the next couple of weeks and no carers were made available for them either. The women were anxious frightened and apprehensive. Mostly they were also without antenatal care, which is not best practice, especially at term.

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Mothers and babies abandoned by the HSE

Some of the women were able to find other midwives to take them on within the national home birth scheme, others had to birth in a hospital setting, some were able to birth with the NMH home birth scheme and some were fortunate enough to be able to access private midwifery care. The last of the 29 women booked in with Philomena gave birth with the Community Midwives at the NMH in April this year.

The manner in which women had their carer removed from them without any alternative care being provided still remains an appallingly dangerous and callous act on behalf of the HSE.

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Some of the women who Philomena would have cared for and their babies

What did this mean for other women seeking home birth in the areas that Philomena  served?

Since Philomena’s removal from practice women in the areas of South County Dublin, Wicklow, parts of Wexford, Kildare, Meath and Louth have been without a free homebirth service with full continuity of care. Women in these areas have been able to access a private home birth service, but this is not an option for all women. In particular women on a medical card who fall outside the administrative catchment area of the NMH’s home birth service have been particularly badly affected. Philomena’s suspension has further served to highlighted the inequity of care in term of maternity choices and service provision in Ireland today.

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Philomena and her legal team

 

Have any of the questions surrounding Philomena’s case been answered?

No answers have been forthcoming, and meanwhile the HSE’s continued refusal to produce the systems analysis report further delays the process and continues to cost the taxpayer a ridiculous amount of money in legal fees. Only the Minister and the Department of Health and Children can reign the HSE in on this one, When we think of the lack of services  available in our maternity system and the desperate shortages of capital and staff, squandering public money by dragging out this case any further is particularly abhorrent.

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Philomena answering questions about her case

 Read more about the Philomena Canning case here

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Home Birth Mums at the Annual La Leche League Conference

Glanbia and breastfeeding in Ireland

Glanbia announced that their new €235 million nutritional ingredients plant in Belview, Co Kilkenny will be opened by Enda Kenny today. This is the largest dairy investment in the history of the State. The purpose of the plant is to focus on exports. Ireland currently supplies 10% of the global infant milk formula. Yes our tiny little country manages to feed 10% of  the children of the world with artificial milk. Targeted marketing has been focused on mainland China in the last year resulting in the volume of these exports to mainland China doubling. Glanbia anticipates huge growth in the area. I am sure they do, given the support they are getting from the agriculture lobby in the Dail.

Meanwhile, in January we heard from robust research that Ireland has the lowest breastfeeding rate in the world. Yes you read that right, not in Europe, not in comparison with other OECD countries, but in the WORLD. (Growing Up in Ireland: Maternal Health Behaviours and Child Growth in Infancy , Layte, Richard / McCrory, Cathal (TCD)  Infant Cohort Report No. 4, Chapter 4)

Not only do we have the lowest rate after discharge (primarily measured as discharge from hospital), but we also have a worrying early weaning rate, with half of Irish born babies being put onto solid food and follow on milks at four months. Evidence based best practice, and the official HSE and Dept of Health guideline is that  exclusive breastfeeding should continue until 6 months, and then continue as part of a mixed diet until two years or beyond. Our rates at 6 months are only 6%. This type of early weaning can result in rapid weight gain which Co – Author of the ESRI Report, Prof Layte  warned can lead to “metabolic disorders later in life.”

Understaffed postnatal units do their best to follow baby friendly guidelines and to give mothers  information on the normality of breastfeeding and the important role it plays in early nutrition, early development, bonding and immunology not to mention life long immunity it naturally offers to certain diseases.

The national breastfeeding coordinator, the fabulous Siobhan Hourigan, who does a fantastic job in promoting the normality and health benefits of breastfeeding has a minimalistic budget.

It is estimated that the total spend on promoting breastfeeding  by the government is less than €100,000, whilst the annual cost invested by the HSE and Department of Health in treating  acute infections in infants nationally stands at around €12m to €15m each year; conditions which can be limited by breastfeeding .

Unpaid and voluntary groups such as la Leche League, Friends of Breastfeeding and Cuidiu do their utmost to encourage breastfeeding in the community and to support mothers in their local areas with a local network of support and information.

Yes, midwives, mothers, babies, volunteers, health promotion officers and researchers all work incredibly hard to support the health of our future nation by encouraging the normal process of breastfeeding, but how can they ever be successful and have access to much needed funding when agricultural lobby groups hold such sway?

There are obvious conflicting agendas in Leinster House; agriculture and exports vs health. and at the moment the favour appears to rest with agriculture at the expense of everything else.

Tomorrow marks the start of the annual La Leche League Conference, which would normally offer an annual opportunity to promote breastfeeding in Ireland in the media. I doubt that Enda Kenny will be opening the conference, and I wonder at the timing of the grand opening of the Glanbia plant.

Home birth breastfeeding rates on discharge are 96%

On the day of discharge from the care of the SECM, 96% of mothers who birthed at home were breastfeeding exclusively. These mothers were twice as likely to be breastfeeding exclusively as on day of discharge compared to all women who gave birth (96% versus 47%). (NPEC, 2012).

Home birth midwives support breastfeeding 100% and many are trained lactation consultants. Independent home birth midwife Philomena Canning was awarded Midwife of the Year in 2012 by the Maternity and Infant Awards; an award she refused to accept on ethical grounds as the awards were sponsored by SMA infant nutrition.

LINKS

La Leche League Annual COnference 7-8th March 2015

https://www.lalecheleagueireland.com/event/la-leche-league-of-ireland-conference-2015/

NPEC Audit on Planned Home Births 2012

http://www.ucc.ie/en/media/research/nationalperinatalepidemiologycentre/NPECHomeBirths261113AnnualReportWebReady.pdf

Growing Up in Ireland: Maternal Health Behaviours and Child Growth in Infancy , Layte, Richard / McCrory, Cathal (TCD) Infant Cohort Report No. 4, Chapter 4

https://www.esri.ie/UserFiles/publications/BKMNEXT286/BKMNEXT286.pdf

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Questions re the Philomena Canning case

Philomena Canning’s clinical indemnity is re instated.

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Philomena Canning after her re instatement outside the High Court 27th Feb 2015

I am delighted. But now I want my questions answered. Why was her indemnity removed in the first place? Why were certain factions within the HSE effectively enabled to extend what appears to be their personal opinions of Ms Canning and her practice into a public destruction of her livelihood and her good name? Why did the Minister of Health insist that there had been “serious concerns” in PQs to Clare Daly TD, when the evidence now shows that there was none? I noted at the time that he did not use the term “alleged specific and serious concerns”, but opted for the more convincing “specific and serious concerns” He is of course protected from defamation proceedings by Dail privilege, but surely this privilege brings with it an extra responsibility not to reiterate potentially defamatory statements that might be made by others?

Minister Varadkar : ‘With regard to this case, I understand from the HSE that her indemnity has been suspended temporarily due to specific and serious concerns expressed by other clinical staff about patient safety. When the HSE suspends an individual as precautionary measure subject to a review/investigation, it does not do so lightly.’

The only way for Philomena to fully regain her exemplary reputation back is for Minister Varadkar to issue a public apology. I would like to know when the Minister plans to issue such an apology?

The HSE removed Philomena from practice  without providing  immediate substitute care for the women on her books.

Pholomena with some of the women who were at term or near term when she lost her indemnity

She was phoned on a Friday evening and no substitute care was available all weekend. Why was the HSE allowed to leave these 29 women without care? This was surely not best practice and might have endangered the lives of both mothers and babies. Two of the women were at term and they were left with no home birth care provider to turn to if they went into labour. As time went on, the HSE found substitute home birth care for a few women, but others were effectively abandoned or forced to engage private services from their own savings. Why was the burden of finding care not fully shouldered by the HSE? Why were women abandoned? Why were some of the 29 women never contacted by the HSE at all? Why did Minister Varadkar not intervene?

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Philomena s clients demand justice, an independent inquiry and answers

The removal of Philomena from her home birth practice left vast swaths of the Greater Dublin area without a National Home Birth Service, as only Philomena covered these areas. For medical card holders living outside the NMH’s catchment area this left them with no home birth option at all. Why, if the HSE are committed to a National Home Birth Service was a substitute midwife not put in place before the suspension to ensure continuity of service? Furthermore, why were the majority of the 29 women never found any substitute care? Why did many of them, whilst heavily pregnant have to try and seek basic antenatal care for themselves and their unborn babies?

The manner in which the suspension of Philomena was carried out left other home birth midwives in the Greater Dublin area unwilling to take on clients who lived in the area presided over by the Designated Midwifery Officer who had been involved in Philomena’s suspension. The National Home Birth Service in South County Dublin, Kildare, Wexford and Wicklow came under serious threat and still is under threat  How could the HSE allow  the National Home Birth Service be de constructed in this way?

And last but not least, why did all this come to light just as Philomena was about to open her to free standing birth centres?

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I am going to hand out some counting blocks now and you can start putting two and two together.

Unlike pretty much every other country in Europe, or OECD countries, there are no free standing birth centres in Ireland. The recent Birthplace Study in the UK showed that free standing birth centres were a safer place for mother and baby than a hospital setting as mothers were subjected to fewer interventions there. Many women in Ireland do not want to avail of obstetric care and neither do they feel comfortable with home birth. They are looking for something in the middle; they are looking for free standing birth centres. The initial results of AIMSI s WMTY 2014 survey of nearly 3,000 women and their maternity care experiences indicate that this is the missing link in our maternity services. Why is there such opposition to free standing birth centres in Ireland? Who are the vested interests that are most vocal in that opposition, and what sway do they hold over the HSE?

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The HSE are never going to answer any of these questions, only an independent inquiry can do that, and if we are ever to find out the answers to these questions that is what is required.

© February 2015

Links

https://www.kildarestreet.com/debates/?id=2014-09-30a.414

http://www.hse.ie/eng/services/list/3/maternity/homebirth.html

https://www.npeu.ox.ac.uk/birthplace/results

http://aimsireland.ie/what-matters-to-you-survey-2015/

www.philomenacanningcampaign.com

https://www.facebook.com/philomenacanningcampaign

Follow the Philomena Canning campaign on Twitter #isupportphilomenacanning