Τρίτη, 23 Ιουλίου 2013

Question at the Greek Parliament by MP M.Yannakaki: "Home birth and delivery of placenta material to private enterprises"

On Monday 22nd of July 1013, the following question was posed before the Greek Parliament by Ms Maria Yannakakis, MP (B Pireaus) of the Democratic Left. It needs to be noted that Ms Yannakakis has already posed two questions in the past (on March and April 1013) which to this day remain unanswered by the respective Ministers they were addressed to.

To
The Esteemed Ministers for the Environment, Energy and Climate Change
Health

Subject: Home birth and delivery of placenta material to private enterprises

Recently, the private data concerning parents, children, and health care practicioners participating in home births which took place in the city of Thessaloniki during the year 2009, have fallen prey to the discretion of sectors and services of (affiliated with) the Ministry of Health, such the Midwife Association of Thessaloniki, the Medical Association of Thessaloniki, the Ministry of Health and Social Solidarity (Department of Public Health, Department of Sanitary Health & Sanitary Regulations for the Environment, Minister's office, Vice Minister's Office, General Secretariat of Health Office) …....... and the Inspector General of Public Governance, while the Body of Inspectors of Health Services’ Providers – “SEYYP”(Regional Office Thrace – Macedonia) conducted an investigation with all aforementioned private data, in addition to further data collected (without notifying the subjects of the investigation that they were being investigated) regarding the „“legality of adherence to the prescribed management of genetic material produced during a home delivery“
Following this, all parents who opted for a home birth in the region of Thessaloniki during the period covered by the investigation of the Ministry subsequently found themselves accused for „ environmental pollution“ because, following the birth, they failed to deliver the placenta to private companies specializing in „waste management“ (companies which operate possibly without any tangible form of outside control), but instead chose to handle the afterbirth material themselves, with adequate respect to the bonding between mother and child.
Additionally, instances have been observed when public sector officials have offered advice to those interested in a home birth regarding the „legality of the process of home delivery“ and all issues related to this decision, such as the delivery of after birth material to private dangerous, toxic and medical waste management companies, for a monetary price, if they do not wish to find themselves before the judge.
The SEYYP has taken the issue a notch further, even suggesting that the invoice – proof of payment made to the waste management company be a necessary prerequisite for the registration of the newborn, if the child's birth took place outside medical facilities. The suggestion was lodged even though its survey showed that only 21 home deliveries had taken place outside the premises of accredited medical facilities during the time of auditing, which makes the allegedly dangerous and toxic medical waste in question virtually a non issue.
On the other hand it is certainly doubtful that such accredited biological waste management companies are subjected to adequate quality controls regarding the disposal of the placenta material, a fact that seems insignificant enough in comparison to the arguably bigger issues of the usual (bulky in quantity and potentially genuinely dangerous) medical waste produced on average in the medical facilities, but that acquires nonetheless significance if one is to consider that what is in this case branded as „dangerous medical waste“ is in fact priceless on black market terms and widely used both in the production of cosmetics and for unofficial pioneering medical research. That fact alone places the issue on the core of bioethics’ questions.
Women find themselves intimidated by the potential law suits, the detailed emphasis placed upon the „lagality conditions“ of a home birth and all additional actions that need to occur surrounding this type of birth and express their need to protest being essentially forced by law to surrender a part of their physical body (and to have to pay for this) to privately owned companies. At the same time they need to deal with the fear that they may somehow find themselves as defendants in criminal proceedings for other “materials”, that may be considered medical waste in the eyes of the law. The legislation itself does not specify with regards to the quantity and the type of medical infectious waste. The law clarifies that “any material which comes into contact with human blood and human bodily fluids“ should obligatorily be surrendered to licensed enterprises for it to be handled properly.
It should be dully noted that women who choose a home delivery are closely monitored by specializing physicians during their pregnancy, undergo all necessary prenatal care tests and are not carriers of sexually transmitted or otherwise infectuous diseases.
Therefore, in the light of the above, the competent Ministers are being asked:
1.      What types of internal and external control measures are enforced in order to ensure that after birth material is in fact destroyed safely instead of being further exploited in the black market against lucrative monetary incentives (cosmetics industry/medical research)? In which precise manner are these private companies being controlled in their everyday operations and which are the criteria for their accreditation and the renewal of their licence?
2.      Would the Ministry be prepared to issue a Bulletin (“circular” giving direction for the enforcement of the relative law), clarifying that women who so choose should be allowed to handle their own placenta material according to their beliefs and traditions, in conformity with Art. 9 and 3 of the ECHR, even if certain restrictions are to apply?
3.      Would the Ministry be prepared to issue clarifications regarding the application of the law on medical waste management produced daily and habitually in each and every Greek household which comes into contact with bodily fluids and/or blood, so that the average citizen may not run the risk of finding themselves before the criminal courts?
4.      What monetary sanctions are there imposed by the Greek State for non compliance with the regulations concerning medical waste management against hospitals and private medical clinics yearly?
5.      Has the Ministry of Health (SEYYP) ever conducted a serious investigation regarding medical waste management by the „major pollutors“ such as hospitals and private medical clinics? What sanctions have been imposed against „major pollutors“ , sectors and organs falling within the scope of the SEYYP's jurisdiction, which led the country to convictions and the tax payers to contributions?
6.      Could SEYYP's controls extend to include other issues not directly relevant to provision of health care per se to the public, such as adherence to urban planning, environmental, tax/fiscal regulations etc. for the private sphere (as a home birth can be considered) or are they strictly limited to issues regarding the provision of health care to the public at large exclusively?
7.   Given that in the relevant Report of Controls by the SEYYP it is proposed that (page 12): „The Health Directorate of the Prefectural Governance of Thessaloniki is to demand from the Birth Registration Services to provide it permanently with the registration details for every home birth within the Prefecture so that that compliance with relevant legislation regarding biological/medical waste can be assured „ We are therefore asking: has the Health Department of the Prefecture continued to collect data regarding home birth participants and if that is the case have the subjects of the database been informed about the process? If so, in what way?

Questions posed by Member of the Parliament
Maria Yannakakis

Special thanks to Faye Karavasili for the translation of the MP's Question in English.
Questions are one of the means for Parliamentary Control, according to the Greek Constitution and the Rules of the Parliament.