Locums now fill one in 10 obstetrician positions
One in 10 of the posts for obstetricians in maternity units and hospitals is filled by a temporary doctor - and some are vacant, new figures reveal.
There are 134 public obstetricians and gynaecologist posts across the country but 13 are reliant on a stand-in doctor and three are unfilled.
The figures supplied to Senator John Crown at the Joint Oireachtas Committee on Health and Children raise new concerns and come amid ongoing anxiety about standards of care in maternity services in the wake of the Hiqa report on Portlaoise Hospital.
Failure to attract permanent doctors leaves pregnant women with less continuity of care. Senator Crown, who is a cancer specialist, told the committee that there are fine doctors standing in as locums, but "no matter how well-trained they are" it is not as good as having somebody there permanently providing continuity of care.
The findings of the Portlaoise report - which laid the blame for lapses in patient care at national, regional and local level - will be put to top management in the Health Service Executive (HSE) at a special committee meeting next week.
Earlier, Health Minister Leo Varadkar confirmed that a team from the Department of Health, rather than the HSE, will take charge of implementing its recommendations - including the setting up a a patient advocacy agency to help patients and families seeking answers about injury or death. It will include a patient representative.
He said he had a better insight into the issues following a five-hour meeting on Wednesday night with over 100 families in Portlaoise.
Mr Varadkar added: "I expect the HSE to implement an action plan to address the findings of the report without delay, certainly by the end of the year."
Questioned by Sinn Fein TD Caoimhghín Ó Caoláin, he agreed it was premature to talk about the closure of some maternity units - but he insisted it has not been ruled out.
The issue will be looked at in the maternity strategy to be completed before the end of 2015, he added.
There are inherent risks for mothers in smaller centres where complicated births may not be picked up on time.
Meanwhile, a spokewoman for the maternity unit in Cavan Hospital, where a baby died while being delivered by caesarean section on Tuesday, said a post mortem to find the cause of death is a matter for the coroner.
It is the fourth baby death in 30 months at the unit. Three other cases are under review.
She said several safeguards have been put in place since 2012.
Chief medical officer Dr Tony Holohan said smaller maternity units cannot rely on their perinatal mortality rate (deaths of babies at or around the time of birth) for reassurance.
He said it is essential each unit carries out a monthly audit of matters such as adverse events or staff shortages to ensure that any risks to patient safety are identified and acted on as early as possible.