I congratulate my constituency colleague, the Minister for Health, Deputy Howlin, on his new position and wish him every success.
Since Monday last women in labour in Wexford General Hospital have been refused epidurals due to lack of insurance cover for the three consultant anaesthetists. Their malpractice insurers have insisted that under the present staffing arrangements it is unsafe for the anaesthetists to continue the 24-hour, seven day a week service they have been giving for some years at the hospital.
The epidural service at Wexford General Hospital has been superb, epidurals were available to pregnant women on demand, seven days a week, 52 weeks of the year. However, because of the lack of a resident anaesthetist and the necessity for more NCHDs under the guidelines of the Association of Anaesthetists, the Medical Defence Union and the present three consultants' malpractice insurers have asked them to cease this round-the-clock service because of the risks they perceive.
Apart from pregnant women who have been denied the service and have expressed their concern vociferously in Wexford. The lack of this service will affect other areas of the hospital. The extra NCHDs are required so that a complete cardiac arrest team is available around the clock in the cardiac unit at Wexford General Hospital. An augmented service is also needed for patients on life support machines. Effectively, an anaesthetist is contracted to such a patient once the patient is put on a life support machine, and without a round-the-clock service that support is not available. Anaesthetists are required also to accompany a patient on a life support machine to another hospital or, to accompany any critically ill patient. Therefore, although this issue is of concern to expectant mothers in Wexford — particularly mothers expecting their first babies who have been comforted by the availability of this service — many other sections of the hospital are affected by the lack of sufficient staff in this area.
I understand that a meeting was held yesterday between two consultant anaesthetists and health board personnel — one consultant was absent through ill health — and I hope the proposals put to the consultants resolve the problem. When that consultant has an opportunity to discuss the proposals with his two colleagues it is our hope that by Monday at the very latest a full official epidural service will be available 24 hours a day in Wexford General Hospital. The position at present does not affect 9 a.m. to 5 p.m. elective surgery, caesarean operations — 95 per cent of which are done under epidural — because most of these operations can be scheduled between 9 a.m. and 5 p.m. unless an emergency arises.
Given the superb service provided by Wexford General Hospital and the consultants employed there over the last few years, I would ask the Minister to ensure that everything is done to meet their staffing requirements. It was indicated that the anaesthetists would be unable to continue their 24 hour service from July if their staffing requirements, particularly the provision of a resident anaesthetist, were not met by the South-Eastern Health Board. The hospital has requested four extra staff, but I imagine there has been a compromise in the interim. However, we must bear in mind that the Medical Defence Union, under the Association of Anaesthetists, will be watching carefully to ensure that the staffing arrangements meet the necessary safety guidelines for patients and protect existing consultants from unnecessary claims.
