Maternity “choice” must be backed by properly resourced public maternity services

• Rotunda dispute highlights serious gaps in maternity care and the operation of the Public Only Consultant Contract
• Threatening to withdraw funding from the Rotunda over a board decision is over the top and would ultimately hurt the women the HSE says it wants to protect.
• The HSE and the Rotunda Board must engage constructively to address issues arising from the operation of the Public Only Consultant Contract (POCC).
• Maternity choice cannot be reduced to purchasing power. It must be about ensuring women can access the care they want and need, regardless of their income.

Labour health spokesperson and Dublin Central TD Marie Sherlock was responding to the HSE’s threat to the Rotunda over its decision to permit consultants on the Public Only Consultant Contract to undertake private practice.

Deputy Sherlock said:

“This threat from the HSE is totally disproportionate. Withdrawing funding from the Rotunda would damage the public maternity services provided there, the very services the HSE says it wants to protect and expand.

“It is a fundamental principle of Sláintecare that publicly funded hospital facilities should move towards providing public healthcare only and should not subsidise private healthcare. In that context, the Rotunda must now provide clarity that consultants on the Public Only Consultant Contract are undertaking public work only within the hospital.

“However, it would be a serious mistake if this controversy were allowed to obscure the practical challenges arising from the operation of the POCC in hospitals across the country. The contract provides for a specified number of public hours while permitting private practice outside those hours. In some hospitals, management have raised concerns that this can result in reduced consultant availability compared with what services require.

“It is also vital that this debate does not lose sight of the chronic staffing shortages and resource pressures facing our maternity services. By issuing this threat, the HSE and the Department of Health risk deflecting attention from their own failures. The fact remains that there were fewer whole-time equivalent midwives employed at the end of 2025 than in 2019, despite increasing complexity in maternity care and rising demand.

“Finally, the discussion around maternity choice must not be reduced to a question of who can afford to pay for additional services or who can navigate an overstretched public system. Real choice means ensuring women have access to a full range of high-quality maternity options.

“The restrictions placed on home births, the failure to fully roll out midwife-led alongside birth centres, and the limited availability of the Domino and Early Transfer schemes across much of the country are all examples of where Government has failed to provide meaningful choice. These service gaps must be addressed if women are to have genuine choice in maternity care.”