Concerns over obstetrical care. Why is there no adult intensive care unit in any of our maternity hospitals?

[Speaking in the Seanad during Order of Business]

I propose that the Minister for Health or the Minister of State at the Department of Health should come to the House to brief us urgently on what is happening with obstetrical care.

It is now more than two years since the tragic death of Savita Halappanavar in Galway. Since then we have highlighted many other occasions where there have been concerns about the adequacy of the resourcing of obstetrical care. We have had one entire inquiry about another episode in a hospital in another part of the country. A common theme across all of these is a desperate, unbelievable shortage of obstetricians per head of population, placing an inappropriate burden of responsibility on trainee doctors. Trainee doctors are there exclusively to train; that is why they are here. Our service should not depend on the labour of trainee doctors; we should be educating trainee doctors. Unfortunately we have a shortage of fully trained specialists and it is much easier to have departures from the high-quality care we would have.

Much phraseology was tossed around over recent years about the superlative quality of maternal care in Ireland and that it was the safest country to have a baby. We now know that is not the case. It is a very safe country and we have wonderful doctors and midwives but just do not have enough of them.

In the past 24 hours Sam Coulter Smith has highlighted another glaring problem. None of the three maternity hospitals in Dublin, which are among the three largest delivery units for babies in Europe, has an adult intensive-care unit. This means that anyone who develops a serious medical complication must be transferred from the campus of the maternity hospital to another hospital. Once there is that kind of blockage in the care of a patient, be it transferring them to a neurosurgery centre to a cardiac centre or to an intensive-care unit, there will inevitably be delays. A degree of triage starts to creep in and occasionally, sadly, there will be an outcome that is inferior. I acknowledge that not every hospital can have every facility. However, there is clearly something wrong when three of the largest maternity hospitals in Europe are in one city and not one of them can have an intensive-care unit. That is wrong.

I ask for the Minister to come in to us today because I am not one bit happy. I have raised the issue of obstetrical care on a number of occasions in a number of contexts and we still have not had a clear answer. There has been huge debate over whether it is suitable to locate a children’s hospital some place because of car parking, bus stops and such things. There has been a totally inadequate debate on the issue of where our young women – in some cases slightly older women – go to have babies and the level of support for them.

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