THE master of the largest maternity hospital in the country has warned the lives and health of patients will be put at risk if staff cuts keep on coming.
Dr Rhona Mahony, master of the National Maternity Hospital in Holles Street in Dublin, said they are dealing with growing numbers of complex cases because women are having babies at an older age, more are obese and increasingly they have underlying disorders making their care more difficult.
"If you cut things enough", maternal lives and health will be affected, she warned.
But despite the reduction in staff and budgets so far, the hospital, which has around 9,000 births a year, has a very low mortality rate for infants, which is a "phenomenal" result.
On April 5 this year, the hospital had 50 deliveries, compared with its normal 25 to 30 per day – one of its unpredictable "super-peaks", she said.
"It is really a question of staff. That is where we fall down – Ireland has the lowest number of obstetricians in the OECD.
"This is a real challenge when you look at the volume of people coming through the door. Our infrastructure and space is also a problem."
Dr Mahony acknowledged that having to put extra beds on wards has been "difficult for patients in terms of privacy, and very difficult for staff", who are managing in excess of the normal complement.
"Our clinics' numbers are very large indeed and doctors and midwives are working very hard to get through the volume that makes up our clinics day on day."
Referring to the ongoing adversarial system of litigation, where patients seek compensation for alleged negligence, she said it was driving some clinical staff to illness, depression and early retirement.
"We actually now have a medical disorder called 'medical malpractice syndrome' suffered by clinical staff. The symptoms include anxiety, loss of appetite, depression etc," she said in an interview with irishhealth.com.
"The courts are overwhelmed and the medical services are struggling to keep up with the volume of work. The current legal system is one of tort, that relies on finding fault in order to compensate.
"So if you like, the 'pillars' of medical negligence are blame, litigation and punishment.
"Not all adverse outcomes are the result of a person being negligent or careless, so it is very difficult for staff to be faced with the accusations and the personal questions raised about them when they go through a litigation case," she added.
"What we see in some cases... is people changing their practice following a major case. They may either stop practising or avoid high-risk situations, or take early retirement."
Parents whose child is born with cerebral palsy often have no choice but to litigate in order to get the necessary services and income.
"Our first priority must be to care for these children and their families. What you don't want to see is some children and families having no compensation, some not getting enough, and others... getting in excess of what is required."