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The decision to engage a private consultant is made for a variety of reasons, all of which should be respected
Rotunda’s defiance of public policy shows us how some are born more equal ,” Opinion, June 2nd). While I readily agree with his assertion that all babies should be born equal, there was a glaring omission from his analysis: the women whose care and wellbeing are central to every pregnancy and birth.
When Prof Sean Daly spoke about choice and safety as key components of private maternity care, he was explicitly referring to women. The decision to engage a private consultant is made for a variety of reasons, including continuity of care throughout pregnancy and the opportunity to establish trust with a single doctor in advance of what is often the most significant medical event in a woman’s life.
For some women, the reasons are even more compelling, encompassing complex fertility journeys, previous pregnancy losses, traumatic birth experiences or a history of sexual assault. As the article itself acknowledges, there is no alternative private hospital to turn to for this model of care. I suspect that, like many people, Fintan O’Toole may appreciate the additional choice and sense of security that private healthcare can provide.
If so, he should recognise that women may reasonably make similar choices regarding pregnancy and childbirth. – Yours, etc,Ciarán Murphy: A sight to behold as the Ghosts of AFL Past and Future saved their countiesfor standing firm in preserving choice for women in maternity care. It is difficult to understand why maternity care should be treated differently from any other area of medical practice in Ireland, where tiered access exists without similar scrutiny or objection.
Rather than removing options available to women, the focus should instead be on addressing the well-documented shortcomings within the public system and directing resources accordingly. Consultants – the most experienced voices in this field – have been clear about what is required to improve services. The elimination of private practice has not been among their recommendations.
It is therefore concerning that policy efforts appear to be directed towards curtailing choice in what is, in reality, a relatively small segment of care. The directive for consultants to immediately cease seeing private patients reflects a troubling disregard for women and their babies, reminiscent of the lack of consideration shown when partners were excluded from maternity settings during the In 2026, it is extraordinary that women’s autonomy in maternity care is under question.
This feels like yet another paternalistic response to an issue that fundamentally concerns women’s lived experiences and choices. I speak from personal experience. I received exceptional private care at the Rotunda during my pregnancies, resulting in the safe arrival of my children. My elective Caesarean sections were my choice, made in consultation with a trusted and supportive consultant obstetrician.
Sir, – Fintan O’Toole once observed that Irish people possess “an extraordinary capacity for cognitive disjunction . . . a genius for knowing and not knowing at the same time”. O’Toole was referring to our well-honed collective ability to distinguish the things we talk about from those we’d prefer not to.
But some things need to be talked about. Ireland’s two-tiered model of healthcare casts us as an outlier among developed nations. In our maternity hospitals, we provide materially different levels of care to different women and babies, in publicly-funded facilities, based not on clinical circumstances but on whether or not the patient is paying their consultant a few grand extra to be there.
I have worked in three maternity hospitals now – including the Rotunda – and from my experience, people prefer not to acknowledge this out loud. This is because we know it is wrong. The status quo is justified using the language of women’s choice. This is problematic for several reasons.
Firstly, it’s not about choice if it costs five grand. It’s about class and ability to pay.
Moreover, if a consumer’s “choice” to buy something is distorted by fear that they or their unborn child might be harmed by not doing so, then that is a warped form of choice indeed. Secondly, there is a brazen conflict of interest at play in this debate. The most vocal proponents of the status quo are those who financially benefit most from it. This needs to be called out.
And thirdly, this is simply the wrong way to treat something as important as healthcare for women and babies. Markets don’t only allocate goods; they also express and promote certain attitudes and values towards the goods being exchanged. At an airport, we can pay extra to skip the boarding queue or for extra legroom on the plane. Healthcare is fundamentally different from this.
Our two-tiered model of care undermines and corrupts the notion of healthcare as a human right, not a market good to be bought and sold like any other.offers us a big opportunity to move away from this discriminatory dynamic and towards a universal system in which everybody has access to the care they need, no matter who they are. Many doctors support this. So, let’s talk about it.
– Yours, etc,Wife of jailed Ballyseedy Garden Centre owner summonsed over drug-drivingIreland’s data centre strain a ‘cautionary tale’ for rest of world, UN saysFiachna Ó Braonáin’s Leaving Cert: ‘I stayed up very late at night, drinking coffee and cramming’ The Leaving Cert according to a guidance counsellor: ‘Their brains have been working so hard ... they need to get fresh air’
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