I thank the Ceann Comhairle for allowing me to raise this matter on the Adjournment. I am convinced of the urgent need to appoint a paediatrician to St. Joseph's Hospital, Clonmel, where 1,100 babies are delivered in its maternity-gynaecology department each year. It also deals with approximately 150 miscarriages each year while the caesarean section rate is approximately 10 per cent.
A consultant obstetrician-gynaecologist was appointed 12 years ago and a second consultant was appointed six years ago. This shows that the level of services was improving. As far back as 1986, Comhairle na n-Ospidéal specified the need for neonatal back-up services for the maternity unit. In 1979 it recommended that a locally based consultant should be available for populations of 75,000 people. My constituency has over 80,000 people at present.
In May 1989 the joint committee of the Faculty of Anaesthesia of Great Britain and Ireland stated that a significant maternity unit which handled 1,000 births or more should also have a consultant paediatrician. The local consultant anaesthetists have pointed out the danger of leaving anaesthetised women on operating tables for emergencies during caesarean operations to resuscitate new born infants. This happens reasonably often and exposes the danger to the mothers and children.
In November 1992 the Royal College of Obstetricians and Gynaecologists recommended that a consultant paediatrician should be appointed as soon as possible. In June 1993 the inspection committee of the Institute of Obstetricians and Gynaecologists of the Royal College of Physicians of Ireland reported that its main critical finding was the absence of residential paediatric cover. All these professionals agree an appointment is necessary and on 16 May 1996 the Minister sanctioned the South-Eastern Health Board to fill such a vacancy. However, Comhairle na n-Ospidéal has failed to give full consideration or consent to the appointment. The people of south Tipperary deserve everything which Dublin 4, Cork, Limerick and elsewhere receive and they will not be treated differently by anybody.
The politics of Comhairle na n-Ospidéal and the consultants is the main problem. At present, there are 13,000 school going children in the Clonmel catchment area and 5,000 pre-school children but there is no paediatrician in the area. If Thurles and parts of the north Tipperary constituency and Mid-Western Health Board region, which is a natural hinterland to Clonmel because of easier access, are included, many more people are affected.
In Waterford there is a paediatrician for every 20,000 population but in south Tipperary there is no paediatrician for 75,000 people. An editorial in The Irish Medical News on 17 June 1996 stated that if a community is sufficiently large to warrant the presence of a consultant obstetric service, the paediatric service should be developed in tandem. There is no fail safe method of ensuring antenatal transfer of infants who develop possible postnatal problems.
This danger exists in south Tipperary and I ask the Minister to ensure it is resolved. The only way it can be avoided is the immediate appointment of a paediatrician. The Minister has sanctioned the appointment and provided the funds for it, but Comhairle na n-Ospidéal has not given time to the matter. Since the Minister made that decision on 16 May last, approximately 500 children were born in St. Joseph's Hospital in Clonmel. It is not good enough that the fullest protection was not provided to the children who were born in the last couple of months but, more importantly, it must be provided to the children who will be born in the coming months. I urge the Minister to use his influence to ensure that Comhairle na n-Ospidéal gives the go ahead to the appointment of a consultant paediatrician on 22 November so that all the women, unborn children and fathers in the region may delight in a healthy and proper delivery in full service conditions.
