More senior medics needed on labour wards 'to cut cases of cerebral palsy'
Published 13/09/2013 | 05:00
MORE senior doctors should be on maternity labour wards if we are to reduce the numbers of babies born with cerebral palsy, a leading consultant has warned.
Dr Sam Coulter-Smith, master of the Rotunda Hospital in Dublin, said the incidence of babies with cerebral palsy had not reduced in the past 20 years despite the increase in foetal monitoring and caesarean sections.
Around six to 10 babies a year are born with cerebral palsy in Ireland each year and about 10pc of these are a result of some mistakes by a hospital which could have been prevented.
Dr Coulter-Smith was speaking at a major conference yesterday organised by the Rotunda Hospital to hear from doctors, midwives, the legal profession and families on how these preventable injuries to babies can be reduced.
He told the gathering that "junior doctors and other staff lacking the necessary experience and seniority are being asked to make decisions surrounding the birth and the healthcare of the mother and baby. There needs to be 24/7 cover of labour wards by senior consultants to address this problem".
However, under the current consultant contracts, the senior doctors are only required to work 8am-8pm and for the remainder of the time they can be on call at home to come into the hospital for an emergency.
"In the Rotunda, we only have 10 whole-time equivalent obstetricians and those are contracted to work during the day. They are on call at home at night and are available to come into the hospital but they are not required to be here around the clock."
The hospital has tried to alleviate this by setting up a second tier of experienced junior doctors at registrar level who are available in the wards outside normal working hours because it is so busy due to the baby boom.
"But that flies in the face of the advice from the Health Service Executive (HSE) who told us to reduce our staff head count," Dr Coulter-Smith said.
It is a hugely expensive problem – not just in the human cost – but also because of the compensation payouts for the State which reach around €45m a year, the equivalent of the Rotunda's annual budget.
"Someone at some point has to stand back and look at the problem. We hope the HSE and the Department of Health will listen to what is said here today and then sit down with us to try to create a solution," he added.
Earlier, Michael Boylan, a leading personal injuries lawyer with Augustus Cullen Law Solicitors, who has acted for many families seeking compensation for negligence, said there were a number of recurring mistakes which contribute to preventable birth injury. They include missing subtle changes in CTG monitoring of the foetal heartbeat; the use of oxytocin given to women to induce labour which may be the wrong dosage and make foetal distress worse; and midwives who may be slow in calling for obstetric assistance.
In smaller maternity units around the country where there may be only two obstetricians employed and if they are called in from home, it may be too late for the baby.
He criticised the continued legal battles which parents have to fight to secure compensation for their injured children.