Rotunda master says private maternity care row raises issues that must be explored

Health minister Jennifer Carroll MacNeill speaks to the media outside Government Buildings in Dublin about the row with the Rotunda Hospital over the provision of private maternity care on public-only contracts. Picture: Grainne Ni Aodha/PA Wire

The master of the Rotunda Hospital has said he does not want to draw a line under the controversy surrounding access to private maternity care following a very public disagreement with the health minister.

The hospital opted in 2024 to allow consultants on new public-only contracts to continue providing private care if they chose to do so. However, this arrangement is not provided for under the Sláintecare agreement.

While it has emerged that the numbers involved were very low among the more than 8,000 babies delivered at the hospital last year, the situation caused significant tension with the HSE and Department of Health, which largely fund the voluntary hospital.

Professor Sean Daly was speaking on RTÉ Radio 1 on Tuesday following the board’s decision on Monday evening to remove those additional permissions.

“I don’t really want to draw a line under it, I think there have been many issues raised during the last few weeks that need to be explored further,” he said.

“And in the Board’s statement they did say they would welcome dialogue. Is this decision unanimous, it is and I believe it was taken for the right reasons and that was we were not go to do anything to jeopardise patient safety.” 

Health minister Jennifer Carroll MacNeill had indicated that the hospital’s funding could be reassessed, and Minister for Public Expenditure Jack Chambers publicly backed her position on Monday.

Prof Daly insisted throughout the interview that continuing to offer private obstetric care is about choice for women.

“It isn’t a legal issue,” he said. “At the end of the day the Rotunda has always stood for women and babies. We had a fairly significant threat that our funding would be cut.” 

When asked why it was not a legal issue when the hospital had acted on legal advice from the firm Arthur Cox, Prof Daly said: “Legally, the board felt it had made a reasonable decision.”

When it was pointed out that this choice is only available to women who can afford it, he said: “If we have sufficient midwives to ensure continuity of care, I would love to be able to offer that service.

“It’s very interesting when you look at midwifery numbers. We have unbelievably good midwives in the Rotunda but we don’t have enough of them.” 

He said: “We don’t have enough of them for the 8,600 babies that we delivered last year.” 

Women can still hire a private midwife, he said, although he did not mention that Private Midwives Ireland closed down last year.

He also noted that women can hire a doula to assist them during pregnancy and birth.

Doulas are non-medical maternity workers who provide support to women who choose to hire them. They typically work independently.

Prof Daly raised concerns about staffing and workforce numbers, noting that most babies are delivered at night but that it is very challenging to staff wards using the limited number of obstetricians and midwives available.

He also said Ms Carroll MacNeill was “incredibly supportive” of the hospital during issues relating to planning for the new critical care wing.

Prof Daly also acknowledged his grief following the death of his father at the weekend, saying he had received "incredible care" in a hospice and at Tallaght University Hospital.