I thank you, a Cheann Comhairle, for the opportunity to raise this extremely urgent matter on the Adjournment. I am unhappy with the accommodation provided in Southern Health Board hospitals for women who suffer a miscarriage. There are approximately 700 such admissions annually.
We are all well aware of the trauma, depression and sense of loss experienced by women who miscarry. My understanding is that the trauma is exacerbated when the woman is placed in a bed beside a woman who has experienced the great joy of giving birth to a healthy child. In that situation the joy being felt by the exultant mother is tempered while the sense of loss experienced by the woman who has miscarried or who has experienced a stillbirth is heightened. To my knowledge these procedures are not in use in any other health board area. It is vitally important that we address this problem as soon as possible. At a public health board meeting recently, the programme manager stated that he cannot do this under the existing arrangements.
The Minister is aware that the Southern Health Board has submitted a proposal to the Department of Health for the provision of an integrated obstetrics unit. That proposal awaits clarification from the Department of Health on the next stage of planning for this unit at the Cork University Hospital. This has been approved by the board for some considerable time.
The absolute necessity for this unit is becoming apparent. There are glaring gaps in obstetric services in the Cork area and it is well known that there is widespread dissatisfaction among the consultants working there. Inadequate staffing levels, particularly at registrar level, and the fragmentation of the service is placing both mothers and their babies at risk. There have been repeated warnings from consultants about the danger of having one paediatric registrar providing cross cover during on-call periods to four units scattered across the city.
The risks involved are disturbing in the extreme. For instance, if a mother presents with a prolapsed ubilical cord, it is unlikely that there will be an experienced anaesthetist or obstetrical registrar on site to perform the essential emergency caesarean section that would protect the baby's life and prevent brain damage. When a baby needs expert resuscitation following birth, a few minutes without such support can mean the difference between life and death or the difference between being developmentally normal or severely brain damaged.
Approximately one-third of all mothers who present at these units require the presence of an anaesthetist. This service is accepted as an important factor in the continuing decrease in both maternal and perinatal mortality and morbidity. New arrangements must be put in place immediately to rectify what is an intolerable situation for mothers who miscarry and to establish an obstetrics unit in Cork University Hospital.
Medical insurance costs for consultants have quadrupled and a medical insurance company has advised one consultant to pass his file on the inadequacies of the service to the chief executive officer of the Southern Health Board; the file is on the Minister's desk. By taking such action the health board is saying that it is not accepting responsibility for an inadequate service or for claims resulting from that service.
Faculty examiners no longer accept these theatres as suitable for the training of obstetricians. How can women feel confident about having babies in hospitals that have been deemed to be unsafe by the very people who are delivering the service? The Minister has a heavy responsibility and must act immediately to provide a service that is acceptable to everybody.
