Rotunda hospitals confirms 49 private deliveries covered by public-only consultants

Rotunda consultants on public-only contracts delivered 49 private births over three years. File picture

Consultants on public-only contracts delivered 49 babies for private patients at the Rotunda Hospital over a three-year period when the women's private consultants were unavailable.

Women who sign up for private obstetric care in hospitals expect their chosen consultant to attend the birth. However, in some emergency cases, that doctor may not be available.

It emerged in recent weeks that, at both the Rotunda Hospital and Cork University Maternity Hospital (CUMH), consultants were paid up to €1,500 by their private colleagues to provide cover in such circumstances.

Speaking to the Oireachtas Health Committee on Wednesday, Dr Vicky Dwyer. Rotunda clinical director, confirmed the numbers involved.

She told Sinn Féin TD Sorcha Clarke: "There was only one consultant on the public contract providing private antenatal care" last year.

She also said: "In terms of the unscheduled emergency care at the weekend, there were eight." 

This was "similar" for 2023 and 2024, she said, meaning that across the three years there were a total of 49 deliveries.

Jim Hussey, the hospital's secretary and general manager, said these arrangements were not processed through the hospital payroll and have now ceased.

He said payments to external legal firms to advise the board on the issue were funded using income generated from leases with the Gate and Ambassador theatres.

Dr Máiread O'Riordan, clinical director at Cork University Maternity Hospital, also attended the committee.

Padraig Rice, committee chair, asked her about any potential tax liability for the hospital arising from the practice.

“This has been a long-standing arrangement in the service, so more than 20 years before the hospital even opened, there’s been a long-standing arrangement,” she said.

She said she was not aware of individual doctors' tax arrangements and added that, when she undertook private practice earlier in her career, she was billed and paid tax on that income.

The payment practice has also now ceased at CUMH, with a new roster in place, HSE South West has previously said.

Professor Sean Daly, Rotunda chief executive, said he withdrew comments made at a previous committee session implying public care is not as safe as private care.

However, he told Fianna Fáil TD Padraig O'Sullivan that the public-only contract on its own is not enough to improve services.

He indicated there was a concern that "perhaps Sláintecare wasn't ideal for maternity services" because of the urgent nature of births.

He said Ireland has 3.85 obstetricians per 100,000 women, compared with between five and 6.5 in other English-speaking countries. Midwifery numbers are also "well below international standards".

In his statement, he said: “What occurred over the past few weeks, where women were made feel guilty or privileged for having made certain choices was unconscionable.” 

Dr Colm Henry, HSE chief clinical officer, said the HSE remains committed to the public-only contract.

He said it has received responses from 75% of consultants as part of its ongoing assessment of the contract.

Prof Daly told Labour health spokeswoman Marie Sherlock that a planning application for redevelopment at the hospital will be resubmitted, and he expects this to happen within the next three to four weeks.

Michael O'Leary, principal officer at the Department of Health, indicated to Ms Sherlock that a new 10-year maternity strategy is unlikely to be in place before the end of next year.

The current strategy expires in December 2026.