Parents warned on hospitals’ lack of paediatric cover

SERIOUSLY ILL children who need emergency care, and women in labour, should not be sent to many of the country’s general hospitals, a report has warned.

Parents should be aware that the general hospitals at Navan, Dundalk, Monaghan, Naas, Nenagh, Mallow, Bantry, Ennis, Roscommon, Tullamore and Cashel don’t have paediatric cover, it says.

There was outrage in late 2002 when newborn, Bronagh Livingstone died en route to Cavan General Hospital. Her mother had been turned away from Monaghan General Hospital due to its lack of maternity cover and she was forced to give birth on the side of the road.

The study, completed by paediatricians at the Royal College of Physicians and the Association of Anaesthetists, recommends that steps are taken by hospital management to deter maternity services and the care of newborns at these 11 locations due to their lack of specialist expertise.

Its authors say parents should be informed which hospitals in their region have the necessary skills to deal best with these emergencies.

Many newborns are sent to these hospitals, the report said, and “on occasion, these infants, as a result of prematurity or other problems, may require more significant interventions such as airways management and IV fluids.”

“Many general anaesthetists are worried that the expectations might be too great of the service they can provide to critically ill children,” it adds.

According to the report, all anaesthetists do a course in paediatrics, but because of the small number of cases they may have experienced, many anaesthetists worry about having lost these specialist skills.

According to Irish Medical News, the report is due to be sent to Health Minister Mary Harney and will be launched next month.

Its comments on paediatrics were not limited to smaller hospitals and it warned that many paediatric units at the bigger hospitals are not staffed properly.

“A number of paediatric units are not adequately staffed to provide onsite middle-grade or registrar level cover at night. This is not a satisfactory situation,” it says.

Despite calling for mothers-to-be to be re-routed from the 11 hospitals, it recommends that protocols should be agreed at general hospitals to help guide staff when such emergencies occur.

The report also calls for a 24-hour ambulance service for children so they can be transferred to bigger hospitals quickly and safely.

Consultant paediatrician at Holles St, Dr John Murphy said many parents don’t realise bigger hospitals like the Mater and St Vincents are not the best place for their children either.

“Like every other area of medicine, this area is getting increasingly specialised and in Dublin, children should attend Tallaght, Crumlin and Temple Street for the best care,” he said.