Mothers and babies 'at risk' in ward crisis
Pregnant women forced to queue in maternity hospitals
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WOMEN and their babies face "significant" risks at some of the country's main maternity hospitals which are desperately struggling to cope with the soaring birth rate.
Pregnant women are even being forced to queue to get into the labour ward in some overcrowded and underfunded maternity hospitals, an Irish Independent investigation has revealed.
The ongoing crisis faced by Dublin's three maternity hospitals is revealed in confidential correspondence from doctors and managers to the Health Service Executive (HSE), including pleas for funding to protect mothers and babies as overcrowding escalates.
The letters show frantic, persistent and often futile attempts by doctors and managers to persuade the HSE of the need to improve and make facilities safe now and not just wait until the promised move to modern buildings in the middle of the next decade.
In response to questions from the Irish Independent, the HSE said in a statement that the "system operates in an environment which inherently contains risk" and that no decision had yet been taken on whether the major Dublin maternity hospitals would be given any extra funding.
Last year, 75,332 babies were born nationally -- the highest figure since 1896, and although the rise in the birth rate is slowing, 2009's figures are expected to show another increase.
The three main maternity hospitals -- the Rotunda, the National Maternity Hospital and the Coombe Women's Hospital -- delivered more than 26,200 of these babies last year.
The correspondence revealed:
- Backlogs of women in the labour ward in the Rotunda hospital who cannot be moved after giving birth.
- Urgent building work needs to be carried out in the Coombe Women's Hospital to reduce fire deaths and risks to premature babies.
- Long delays for first appointments for pregnant women.
- Fears at the National Maternity Hospital over its financial viability.
The letters show that last July, Master of the Rotunda Sam Coulter-Smith wrote to the HSE warning of delays in getting patients into the labour ward.
"This results in the unacceptable situation (where) women in early labour are on the ante-natal ward where staffing levels are not sufficient to monitor these cases," he said.
He added: "Again, because of increased activity when women are delivered they often have to spend longer than necessary waiting in the labour ward for post-natal patients to be discharged. This further adds to the backlog of women in the labour ward."
He said because of the "high level of emergency activity, the operating theatres are extraordinarily busy and routine operating lists are regularly overrun, requiring elective (non-emergency) Caesarean-sections to be done into the evening time and sometimes quite late at night". He warned: "Clearly it is unacceptable to have a pregnant woman fasting for such a long time."
The proposal to move the Rotunda to the campus of the Mater Hospital in Dublin will not now happen for at least five or six years.
Investment
"There needs to be investment on the part of the HSE into providing the facilities and the staff necessary to deal with the very significant capacity and risk issues we presently face," Dr Coulter-Smith wrote.
Other internal documents from the hospital express concern about the delays in giving pregnant women their first appointment.
And they also reveal that seven women gave birth in 2008 outside the delivery room because rooms were full.
Questioned on its response to the concerns highlighted by the hospitals, the HSE told the Irish Independent that it was aware of the pressures caused by the growth in births but the "latest indications show a stabilising of the rate of increase".
Asked if any additional funds would be allocated to relieve the pressures, the spokesman said "all efforts are being made to ensure adequate funding is available to all hospitals".
A final decision will be made when the HSE works out its service plan for 2010.
Questioned about whether it felt any patient was being put at risk, the HSE said the "system operates in an environment which inherently contains risk" but that both the hospitals and HSE worked to manage that risk using best international practice.
- Eilish O'Regan Health Correspondent
Irish Independent
