I raise this matter in response to a number of complaints I have received from concerned constituents. One such letter I received from an expectant woman on 23 January states:
Dear Jimmy,
As one of your local constituents I am writing to voice my horror at the lack of an epidural service in Tralee General Hospital.
I am a first-time expectant woman with a baby due this month. Based on this my husband and I were faced with the choice – do we travel to Limerick or Cork where this basic service is available in January or do we opt for the choice of a 17 mile journey where the epidural may or may not be available depending on the day of the week. Surely in this day and age these choices should not be put to any woman. The thoughts of childbirth are daunting enough without adding this unnecessary worry to any expectant woman.
I am asking you to do whatever you can to make this service available as it should be on a full-time basis in Tralee General Hospital.
Yours sincerely,
In the discussion document on developing a policy for women's health published in June 1995 the State's inadequate maternity service was highlighted as follows:
The maternity services have been criticised for a number of reasons. Concern has been expressed about the lack of respect for the experience of giving birth, the poor continuity in medical and midwifery care for public patients, the absence of appointment systems in out-patients departments of maternity hospitals, the lack of choice for women as regards accommodation, birthing positions, pain control, unnecessary procedures, visiting times and the choice of companion during labour: As women have fewer children, they attach greater importance to the unique experience of childbirth for themselves and their partners. The vast majority of births are normal and without the complications which require medical intervention. There is a clear need for maternity hospitals to respect the unique experience of childbirth for each mother and father by giving parents as much choice as possible and by simulating a domestic environment for those with a normal labour and delivery.
This choice is not available at all times in Tralee General Hospital for expectant women. On 27 January, in response to an oral question I put on this matter, the Minister stated that he was advised by the Southern Health Board that there were ongoing discussions between hospital management, the consultant anaesthetists and the consultant gynaecologists regarding the further development of the epidural service in Tralee General Hospital and that he looked forward to the conclusion of these discussions. Is there a time limit for these discussions and when will they be concluded? If discussions are not fruitful, is the Minister prepared to outline the stumbling blocks?
The Minister also said he had provided an additional £1.487 million in 1999 to meet the cost of service developments, including improved midwifery staffing costs at Tralee General Hospital. My information is that extra staff for midwifery cover have not been provided recently because of midwife shortages in the hospital.
One in three Kerry women go elsewhere for maternity care, including Cork, Limerick and Dublin in some cases. In an article in The Kerryman recently a local general practitioner, commenting on the services in Kerry, stated that a child was delivered on the road to Cork because the mother could not have this service in Kerry. That is unacceptable. There is also the cost factor for families who have to travel to clinics in Cork, Limerick and elsewhere for pre-natal care and childbirth. It is also an emotional time for many women who must leave the comfort of their families.
I appeal to the Minister to take an interest in this matter. If there are problems with providing a proper epidural service in Tralee General Hospital, they should be addressed.
