Gynaecology service ‘biggest risk’ in South

A new report on maternity services in the South/South West (SSW) Hospital Group has identified gynaecology services in Cork as its “biggest clinical risk”.

The stark warning, from UCC Prof John Higgins, consultant obstetrician gynaecologist, is contained in the Maternity Services Annual Report 2015, just published.

There were calls in the Seanad yesterday for Health Minister Simon Harris to participate in a debate in the upper house on the crisis that has beset gynaecology services at Cork University Maternity Hospital (CUMH), where almost 4,200 women are awaiting outpatient appointments. Close to 800 women are waiting more than a year and a half.

Independent senator Colette Kelleher, who raised the matter in the Seanad, said the situation had moved “beyond acceptable to dangerous”. She said the minister needed to “answer how this life and death matter for women in Cork and surrounding areas is to be addressed”.

Earlier this week, the Irish Examiner revealed that up to 20 consultants at CUMH had taken the unprecedented step of writing to the hospital’s CEO, Tony McNamara, warning they would no longer take responsibility for women who suffered adverse outcomes as a result of excessive time on gynaecological waiting lists.

The consultants have repeatedly warned hospital management of the need to invest in the service and have called for the opening of a second theatre to tackle surgery lists and for the appointment of four additional consultant gynaecologists.

Fine Gael senator Jerry Buttimer said that if progress was not made at hospital level in tackling the crisis, there was a case for “outside intervention”.

“There is a need for all sides to come together to build a safe service for women,” he said. “If we need an independent facilitator, so be it.”

Peter Boylan, chair of the Institute of Obstetricians and Gynaecologists has called for CUMH to have its own governance framework and ring-fenced budget along the lines of the Mastership system that operates in the three Dublin maternity hospitals, where the master is a doctor responsible for running the hospital.

In today’s Irish Examiner, Dr Boylan says a CEO of a maternity hospital who is not a doctor “can never have as good an understanding of the core business”.

“The advantage of having a doctor as ‘captain of the ship’ is that they are at the coal-face of obstetrics and gynaecology,” he writes.

“They understand the core business of the hospital and can respond effectively to the clinical needs of pregnant women and women with gynaecological problems.

“A CEO who is not a doctor, no matter how well-intentioned, can never have as good an understanding of the core business.”

Dr Boylan also warns that “failures at management level now pose potentially very serious risks to the health of the women served by the hospital”.

“There is a real possibility of cancers going undiagnosed as a result,” he writes. “This is unacceptable in 2016.”

The SSW Maternity Services report says a new regional directorate for maternity services is due to commence in February 2017. This it says “will accelerate the strengthening of clinical governance, resource management and risk reduction”.

Last night, a spokesman for the department said Mr Harris had asked the HSE to update him on the situation at CUMH.

He said “the National Maternity Strategy provides that one individual in the maternity network be identified as charged with responsibility for a safe, quality service... that person may or may not be a clinician”.

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