Vol. 481 No. 3
6 Mr. Callely asked the Minister for Health and Children the number of new-born babies suffering from drug-related symptoms born to date in 1997 in maternity hospitals; if he will give a monthly breakdown in this regard; the total number in 1996; and if he will give comparative figures for 1986 and 1976. [15789/97]
47 Mr. Callely asked the Minister for Health and Children if he will list the maternity hospitals which have noticed a dramatic increase in the number of new-born babies suffering from drug-related symptoms; the procedures which are put in place in such circumstances; the follow-up and support services available; and if he will make a statement on the matter. [15788/97]
118 Mr. Callely asked the Minister for Health and Children the particular issues, if any, which have been drawn to his attention regarding developing trends in births and, in particular, babies suffering from drug-related symptoms; the mechanisms, if any, put in place to address this issue; and if he will make a statement on the matter. [16036/97]
I propose to take Questions Nos. 6, 47 and 118 together.
In the time available it has not been possible to obtain the detailed information requested by the Deputy. I am, however, arranging to have as much information as possible collected and will forward it to him at an early date. Information for 1996, however, indicates that there were 60 babies born to drug misusers in the Rotunda Hospital, 50 at the Coombe Hospital and 30 at the National Maternity Hospital at Holles Street, a total of 140 babies.
While the Dublin maternity hospitals catered for approximately 38 per cent of total births in 1996 it would be expected that they would in fact cater for the vast majority of the babies born with a drug addiction because of the concentration of heroin addiction in the Dublin area. According to information published by the Central Statistics Office, the number of births registered here has increased annually since 1994. In 1994 the number of births registered was 47,929; in 1995 it was 48,530; and in 1996 it were 50,390. The annual birth rate per thousand of the population has also increased since 1994. In 1994 the number of live births per thousand was 13.4; in 1995 it was 13.5; and in 1996 it was 13.9. Maternity hospitals are reporting a continuing increase in the number of births in 1997 and no evidence of a reduction in this trend.
The Eastern Health Board is conscious of the need for the collection of better information on the issue of pregnant mothers who are misusing drugs. The board has been in contact with the three main Dublin maternity hospitals and is working on the development during 1997 of routine data collection from these sources as part of a broader data base on drug misuse. This will enable the health board to target its services more effectively at areas of greatest need.
The board, as part of its overall development plan to significantly progress the development of treatment services has identified a number of key areas where resources are needed. One such area is the care of pregnant drug misusers, and the board has been in discussion with the maternity hospitals concerning the provision of back-up services to babies born with drug-related symptoms and their mothers. Following these consultations the board is now in the process of appointing drug liaison midwives to operate between the three maternity hospitals and drug treatment services. These nurse-midwives will be responsible for all pregnant drug misusers from the initial point of contact with the treatment services. The midwives will work between ante-natal and post-natal clinics as well as in hospital wards and will also liaise between drug treatment clinics and public health nurses as part of a follow-up process. The midwives will be involved in assisting patients to attend gynaecological clinics for follow-up, family planning and post-delivery care and will work closely with social services around child care issues in the early postnatal period and up to six months post-delivery. This service will be overseen by a consultant psychiatrist.
The board also plans to set up a special gynaecological clinic at a drug treatment clinic to provide family planning services to those women wishing to avail of this service. The board has also put in place an in-patient stabilisation programme for pregnant drug misusers at Cherry Orchard Hospital.
The Eastern Health Board in expanding its drug treatment services is conscious of the needs of the various groups of misusers and will continue to improve its service provision in all areas to ensure that adequate facilities are put in place for those who need them.
The number of babies born to drug misusers in the greater Dublin area where few services are available for drug addicts appears to be on the increase. This is a worrying development. Has an assessment been carried out to identify the needs of the professional support services and to ensure there are sufficient staff available? What mechanisms have been put in place to address any problems identified? This matter merits priority.
There has been a worrying rise in the number of babies born to drug misusers in the Eastern Health Board area in recent years. This has placed an increased burden on maternity hospitals as the babies require special attention and need to be kept in hospital longer, usually in intensive care units, to be detoxified. The Eastern Health Board is to appoint drug liaison midwives to assist pregnant drug misusers throughout their pregnancy to minimise the effects on their babies. This will help to reduce the strain on hospital resources at the time of birth. The Department is in consultation with the hospitals concerned to identify the other resources they require. This is continuing.
It is extremely serious that such a large number of babies are being born to drug misusers. I am surprised the Minister has not mentioned the role general practitioners can play. I would have thought the general practitioner is the person closest to the pregnant mother. I welcome the fact that at hospital level services are being developed in a targeted way but the Minister must be aware that general practitioners are experiencing difficulties in providing treatment services to drug addicts who are their patients. For example, in relation to the drug budgeting scheme the prescribing of methadone has an impact on general practitioners' budgets. Why is the Minister not considering developing further the services that can be provided by general practitioners who are already closely involved in providing ante-natal and post-natal services?
The question relates to the services available in maternity hospitals and the resources that need to be provided but I take the Deputy's point that the general practitioner is an important link in the chain in providing an adequate service to pregnant drug misusers. I do not have the information the Deputy sought but I will contact her directly on the role health boards see general practitioners playing in this matter.
Will this matter be central to the work of the interdepartmental committee to which the Minister referred? How does the Department plan to counter heavy cigarette smoking among young women and pregnant mothers in particular on whom it has a negative impact?
We have to consider whether the health promotion unit's targeted prevention programmes are meeting with the required success. I would like it to produce anti-addiction programmes which will have the required impact. We should seek to involve in this process those who have suffered from an addiction, to warn school-going children and communities of the dangers to which the Deputy referred. On the interdepartmental committee, Deputy Flood is the Minister of State directly responsible. The arrangements being made in maternity hospitals form part of his brief. He is aware of the work being done at health board level.
I appreciate the Minister is primarily responsible for treatment services. Given the low success rate in treating addiction and the increased emphasis on the importance of prevention and rehabilitation programmes, is the Minister liaising with the Minister of State, Deputy Flood, to ensure sufficient funding is allocated to the area task forces?
I can assure the Deputy on that point. The Cabinet subcommittee on social exclusion, of which the Minister of State, Deputy Flood, is a member, is meeting as we speak under the chairmanship of the Taoiseach. Its function is to ensure policies are co-ordinated so that they have the required impact in the areas where drug addiction is most prevalent and social exclusion is a factor. Despite the availability of increased resources the emphasis has been on treatment services to the detriment of good health promotion and illness prevention programmes. We have to be vigilant and try to boost budgets in health promotion areas so that not all our money is spent on the illness aspect. We must have an impact on people's responsibility to live a healthy lifestyle.
Regarding children born in maternity hospitals or at home to mothers who are addicted to drugs, is the Minister satisfied that the necessary co-ordinated services are operating between maternity hospitals, health board social workers and those who deliver babies at home to ensure that the children of such mothers are not at risk? Is the Minister satisfied that services are co-ordinated in so far as is possible to enable children to be taken temporarily into care or to obtain orders to supervise the care given by mothers to babies at home?
That is outside the scope of the question, which was technical and sought various details. If a detailed question is submitted I can give a more comprehensive reply to the Deputy's query; it is an issue that deserves attention.
I acknowledge the appointment of midwives in the Eastern Health Board region, where the shortage of such staff is very serious. The Minister referred to other resources and supports that are required. Will he communicate to me what resources and supports have been identified as being required by each hospital and when they will be put in place? Due to the impact this has on the services of the maternity hospitals, the Minister should ensure that an appropriate budget is allocated in l998 to deal with this and the issue of drugs in the greater Dublin area.
I will communicate with the Deputy. Consultation is continuing between the hospitals and the health boards as to what other resources are required arising from this increasing phenomenon. I hope the Eastern Health Board will give this the priority it deserves as it is becoming increasingly problematic in its region. The overall allocation is my responsibility and I hope the board takes cognisance of the trend so that adequate resources are provided for these vulnerable people.
I would like that information also.
