asked the Minister for Health the basis on which he reduced the number of maternity beds in the North Eastern Health Board region from 182, as approved at the March 1983 meetings of the Health Board, to 165.
Ceisteanna—Questions. Oral Answers. - Health Board Maternity Beds.
1.
The main difference between the North Eastern Health Board's calculation of the future maternity bed requirement for their area and the figure used by my Department arises from the recognition, in the latter, of the net outflow of mothers resident in the board's area who have their babies delivered elsewhere, especially in the Dublin hospitals. No account was taken of this important factor in the calculation which was the basis of the board's decision in March 1983. Ignoring this significant aspect of the overall situation would eventually lead to an over-provision of maternity beds. My Department, therefore, quite rightly took account of this and concluded from the evidence available that a total of 165 beds would be adequate to cater for births delivered within the board's area by the nineties.
Is the Minister aware that only about one-third of the mothers within the region go to the regional hospitals for the delivery of their babies? Is he also aware that the policy of health board members like myself is to ensure that the greatest possible use is made of our regional facilities? Instead of encouraging that, the Minister is reducing the number of maternity beds in the region. This is a policy matter and I would ask the Minister to examine it very closely.
The main factor concerned here is that when the health board came to their conclusion that 182 beds would be required, they did not take into account that the planning of the James Connolly Memorial Hospital at Blanchardstown catered for a projected population of 20,000 from south Meath for maternity purposes.
I cannot agree with that assessment. I was a member of the committee which drew up that report——
A question, please, Deputy.
——and is the Minister aware that we, as members of the health board concerned, were satisfied that there was a need for 182 beds? The management team of the health board are still so satisfied. I am asking the Minister two fundamental questions — firstly, is he going to disregard the views of that health board and secondly, is his policy geared towards use for maternity services of hospitals outside the control of that health board?
The health board gave an estimate of 7,271 births. On the other hand, my Department's figure, using a slight revision of the birth rate projected, was 7,030. We then deducted births expected to be delivered in the Dublin area — about 1,000. We added to the result the north Dublin births to be delivered in Drogheda — 480. That left a net figure of births to be catered for in the north eastern region of 6,510. The number of maternity beds needed to cater for this number, on the basis of the planning guideline providing for 39.5 births per bed, is 165. I might state that the health board in its calculation did not take into account even the number of mothers from Balbriggan who would have their babies delivered in Drogheda.
We did take that into account and, in addition, the projection of figures——
A question, Deputy, please.
Excuse me, a Cheann Comhairle. This is an important question — as important as many which we are discussing here for 20 minutes on some days.
I am sure that it is, but it still does not bear a debate.
This is not a debate. Is the Minister aware that we took into account the projection from the National Economic and Social Council's study to the year 1991 for births, which showed a substantial increase in that area, an increase in respect of some of the hospitals in that area of up to 20 per cent?
The 1982 July Report on Population and Labour Force Projections published by the NESC has also been availed of by my Department. That is the general source of the calculations. In 1981 a total of 354 live births to mothers resident outside the area was delivered in the North Eastern Health Board area, mostly from north Dublin. We have projected an increase to 480 per annum, taking into account that there is a growing population in north Dublin and that there is a new unit in Drogheda. I have checked the calculations quite thoroughly. There is no statement from the health board as to how they got the figure of 182. They do not take into account the outflow and inflow into the area.
The Minister stated he revised the plans put forward by the North Eastern Health Board because of the number of births in Dublin from outside the region. Can the Minister give us details of the counties in the North Eastern Health Board region in which the mothers were resident?
I do not have that information. I have no doubt quite a number of mothers come to Dublin. For example, it is not unknown for the Deputy's obstetrician colleague in Cavan to send quite a number to the Coombe. I can get the details for the Deputy. The number is quite substantial.
Will the Minister accept that the vast majority are from County Meath where there is no obstetrics service since Trim hospital was closed? The Minister and his Department have agreed that a new unit will be set up in Navan. Further, will he accept that a number of women from the Dundalk area go to Newry for their deliveries? With the appointment of an obstetrician in Dundalk — there is not one at the moment — and with the building of a new maternity unit at Navan the trend will be reversed and fewer births will take place in Dublin from outside the North Eastern Health Board region. Will the Minister accept that the North Eastern Health Board were quite correct in deciding on the number of beds for the region?
I do not share entirely the views of the Deputy in that regard. For example, a substantial number of women who go to Newry are from the North and they prefer to go back to Newry to have their children where they will be near their own families. I do not think the development of the consultant unit in Dundalk will have any dramatic impact. A substantial number of mothers from south Meath will come to Dublin. We have assigned to Blanchardstown hospital about 20,000 of the population from south Meath. In the North Eastern Health Board area in a population of about 315,000 there is a new unit in Drogheda and there will be a major maternity unit in Navan and also in Cavan.
Is the Minister aware that when an obstetrician was appointed in his own town the number of deliveries increased from 600 to 1,000 births? Is the Minister suggesting that when he opens a new maternity unit in Navan the women from Meath will continue to come to Dublin?
A substantial number of women from Cavan, Meath, Louth and from Monaghan will tend to come to Dublin. A substantial number from the general Leinster region still gravitate to Dublin. I cannot dictate to the mothers of Ireland where they wish to have their children. The situation in the health board area will improve substantially with the major development in Dundalk. For the first time we are giving consultant cover in Dundalk. I do not know what else we can do. The Deputies can hardly expect me to deliver the babies myself.
I am calling Question No. 2.