Number of maternity posts ‘must double’

A MAJOR report outlining a blueprint for reform of maternity services warns that the number of consultant obstetricians and gynaecologists must double by 2016 to improve patient safety.

The Future of Maternity and Gynaecology Services in Ireland 2006-2016 report found:

At least 200 full-time consultant obstetrician gynaecologists will be required in 10 years’ time. Currently there are 104.

There should be at least one consultant per 350 births in a maternity unit. In 2004, there were more than 60,000 births — an average of 600 births per consultant. By 2016, the CSO projects 70,000-plus births a year.

A shortage of nurses and midwives in gynaecology, especially in larger hospitals.

Most units had no dedicated gynaecology beds.

It says there is a need for:

24-hour epidural cover in all 22 maternity units and 24-hour on-call obstetric cover in labour wards of hospitals handling 6,000- plus deliveries per annum.

Ultrasound to be provided under the direction of obstetricians and gynaecologists who have undergone compulsory training in basic ultrasound techniques. Currently ultrasounds can be carried out by people without specific training.

Publicly-funded assisted-reproduction services.

An adequately resourced Domino service to deal with home-births.

A national perinatal transport system to cover the movement of critically ill mothers and babies to major referral centres 24 hours a day.

An agreed national staffing model for midwifery and nursing.

There are also considerable variations in consultant staffing. Mount Carmel private maternity hospital in Dublin has five consultants to deliver 1,400 babies per annum. University College Hospital Galway has just four to handle 3,200 births.

The Institute of Obstetrics and Gynaecology, authors of the report, said the implementation of its recommendations is necessary to “improve the safety and well-being of women and babies and the life-long gynaecological health of women in Ireland”.

A number of recommendations mirror those of the report of the Lourdes Inquiry — chaired by Judge Maureen Harding Clark — which examined the high rate at which Caesarean hysterectomies were carried out by Dr Michael Neary at Our Lady of Lourdes Hospital, Drogheda. That report and the institute’s report — currently with the Government — stress the need for regular clinical audits.

The Department of Health said the institute’s report “will help to inform the Health Service Executive’s policy in relation to the delivery of maternity services nationally”.

It said a joint Department of Health/HSE group had tendered for consultants to carry out an independent review of maternity and gynaecology services in the Greater Dublin area.

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