‘Maternity hospital problems ignored for years’
Dr Chris Fitzpatrick, former master at the Coombe Women and Infants University Hospital in Dublin, said maternity staff felt abandoned by the political system.
Dr Fitzpatrick, who has worked as a consultant at the Coombe for almost 20 years, seven as master, said hospitals were often run into the ground because of chronic under-investment.
He said politicians, particularly those in government, had a key responsibility for the planning, resourcing, provision, and regulation of effective health services on a national basis.
He said it was important to examine why a service for “our most precious and most vulnerable resource — mothers and babies” never became a political priority until a series of adverse clinical outcomes hit the headlines recently.
During the boom years there was little, if any, investment in maternity services, he said. So when the bust happened they were exposed to systematic cutbacks at a time when they were dealing with unprecedented levels of clinical activity, complexity, and demographic change.
Dr Fitzpatrick said the warning signs were there for a long time and were raised by many within the system. Unfortunately they were, in the main, ignored, or became the subject of reviews and reports, often costing considerable amounts of money, and, when completed, were, for the most part, not implemented in any meaningful sense.
In 2011 Dr Fitzpatrick chaired a multidisciplinary team of clinicians and health managers which highlighted a number of significant clinical risks across a network of hospitals. A strategy was developed to deal with the issues but, he said, there was no response,
“It is also of concern that many of the risks highlighted in the 2011 tri-hospital submission are still present throughout the country.”
Dr Fitzpatrick said the maternity strategy had to be more than a “cut-and-paste” exercise of generalisa-tions, as many previous reports had been. “Most importantly, it must be a political priority with a life expectancy beyond the next election.”
Dr Fitzpatrick pointed to the National Cancer Control Programme as an example of how political prioritisation improved clinical outcomes.
He believes Health Minister Leo Varadkar should establish a National Women and Infants Programme to drive change and clinical excellence. “The minister must act decisively to restore confidence in this service, otherwise there will be more critical incidents, more traumatised mothers, fathers, babies, and families — and ever fewer school-leavers and graduates will choose to become midwives or obstetricians in this country.”
Senator John Crown, a consultant oncologist, said Ireland did not have any excellent obstetric centre.
While staff were well trained and do a heroic job, the circumstances in which they are forced to work and the back-up they had was far from ideal, he claimed. “Maybe there is going to be a ‘Road to Damascus’ moment with the health service. I don’t see it coming.”
