Hospitals suffer 'dumbing down' in the quality of doctors for hire
Irish hospitals are suffering a "dumbing down" in the quality of doctors available to hire for specialist and trainee jobs, a leading obstetrician has warned.
Dr Sam Coulter-Smith, outgoing master of the Rotunda maternity hospital in Dublin, said the shortage of high-calibre candidates for consultant posts here has worsened further.
"When you advertise a post it is nice to have a range of people applying," said Dr Coulter-Smith. "Obviously, you want people to have the appropriate qualifications.
"But what we are seeing to some extent has been a dumbing down.
"We still see good quality people but they are not coming back to Ireland in the same numbers. There is not the same competition."
Dr Coulter-Smith, who steps down from his seven-year term at the helm of the Rotunda in December, said it is a problem faced by all hospitals across the country and is not confined to obstetrics.
"We have been very lucky in the Rotunda," he said. "In the past couple of years we have seen some world-class people coming back into the system."
Reflecting on his term as Master, he said the rise in the birth rate coincided with the worst recession in living memory and health cuts which created the "perfect storm".
It meant maternity services were struggling with less staff and resources.
On one day in 2012 the hospital delivered 45 babies in 24 hours.
A variety of factors, including a lack of investment and problems in securing staff, means that the status of maternity care as the 'flagship' of the Irish health service is at risk, he warned.
He said the perinatal mortality rate - deaths of babies at and around the time of birth - is good but not as good as it should be. "But they could be better and that is what we should be striving for," said Dr Coulter-Smith.
"If you want to have consultants available in the labour ward 24 hours a day you need a significant increase in numbers.
"But if someone said to us tomorrow to go out and employ another 10 obstetricians for each of the Dublin maternity hospitals, we would not be able to get those people," he added.
In the bigger maternity hospitals there should be one consultant for every 350 deliveries. In the Rotunda it is one for every 1,000 deliveries.
Although the birth rate peaked in 2012, the hospital will deliver 8,500 babies this year, making it 20pc busier than a decade ago.
Pregnant women who are very overweight or obese are presenting a greater level of risk to hospitals.
Referring to maternity services across the country, Dr Coulter-Smith said he did not see any of them closing.
But some of the smaller ones could be midwifery-led units with high-risk women going to larger hospitals, he added.
The Rotunda has seen a reduction in waiting times for its outpatient gynaecology clinic due to outsourcing.
The delay used to be two years but it is now under 18 months, added Dr Coulter-Smith.