Vol. 522 No. 3
7 Mr. Shatter asked the Minister for Health and Children if his attention has been drawn to the fact that in two hospitals (details supplied) epidurals are only available every second day to mothers giving birth; if he regards this service as adequate; and the action he will take to ensure that an epidural service is available seven days a week to mothers giving birth in all of our maternity hospitals. [18807/00]
The provision of hospital services in this instance is the statutory responsibility of the health boards concerned. My Department is committed to working with the health boards to ensure that comprehensive pain relief is made available for those women who wish to avail of such relief in labour, as set out in the Plan for Women's Health.
In line with this objective, the North Western Health Board has provided a 24 hour epidural service at Sligo General Hospital since July 1997. At present, there are five consultant anaesthetists at Sligo General Hospital who have responsibility for the provision of the epidural service. The board is currently in the process of filling a sixth post and a further consultant anaesthetist post has recently been approved by my Department.
Notwithstanding the ongoing development of anaesthetist services at the hospital, I am aware from the North Western Health Board that recent difficulties have arisen in relation to an epidural service at Sligo General Hospital. The board has experienced particular short-term difficulties with regard to the availability of non-consultant anaesthetists which has affected the availability of an epidural service on a number of occasions since May of this year. However, I am advised by the board that it anticipates that these short-term difficulties will be resolved with the July NCHD intake. I understand from the board that it is satisfied that all anaesthetist posts will be filled at Sligo General Hospital with effect from 1 July next. This will enable a full epidural service to be restored at the hospital.
In relation to St. Luke's Hospital, I understand from the South Eastern Health Board that it is the board's policy to provide a full epidural service to all women who wish to avail of the service. However, as a qualified midwife must always be present to observe a patient who has received an epidural, there may, on occasion, be a slight reduction in service depending on the activity within the maternity unit at the hospital. However, the South Eastern Health Board has advised that with the occasional exception of such circumstances, a full epidural service is currently being provided at St. Luke's Hospital.
The medical staffing of hospitals, including issues in relation to non-consultant hospital doctors, is currently being addressed by the Medical Manpower Forum. With regard to non-consultant hospital doctors, the forum is seeking to redress the imbalance between career posts and training posts, the need to improve postgraduate medical training to keep more Irish medical graduates in the country and the need to look at the position of women in medicine in Ireland with a view to redressing the number who leave medicine. I mentioned these points already and also mentioned the measures which are being taken in regard to the filling of vacancies by NCHDs from 1 July.
Additional Information.The Medical Manpower Forum is due to publish its first report shortly. Health service employers and the Health Service Employers Agency are continuing to monitor the take-up of employment offers made to NCHDs for 1 July 2000. The situation is likely to remain fluid until then as an NCHD may have an offer of employment from more than one hospital. Hospitals are exploring all options in an effort to ensure that essential posts are filled. In the event that some posts remain unfilled, hospitals will be asked to ensure that essential and critical services are not affected.
While the primary responsibility for the staffing of hospitals rests with hospital management, I am seeking the co-operation of the Opposition in amending the Medical Practitioners Act, 1978 to extend the period of temporary registration for NCHDs from five years to seven years. This will remove an obstacle for some NCHDs and allow them to remain and work in Ireland.
In line with the Plan for Women's Health, I am committed to the provision of an appropriate pain relief service to women in labour who seek such a service. I will continue to work with the health boards to further develop services and to constructively address current manpower challenges to ensure that this and other services are provided in line with the needs of those who require hospital services.
Will the Minister acknowledge that women giving birth who wish to avail of epidural services and who have booked those services have a right to expect them to be available within the maternity hospitals? Will the Minister acknowledge that Sligo General Hospital has not provided an adequate, 24 hour, seven day a week service and that St. Luke's Hospital in Kilkenny is not currently providing an adequate 24 hour, seven day a week service? It is completely unsatisfactory that people are engaged in a game of epidural roulette; if a person's baby is born on the right day, the epidural facility will be available to her in the named hospitals but it will not be available if the baby is born on the wrong day. Will the Minister accept that the situation which pertains in these hospitals mirrors that in other hospitals such as Tralee General Hospital and Cavan General Hospital? Will he guarantee that as and from 1 July, a 24 hour, seven day a week epidural service will be available in Sligo General Hospital and the other three hospitals to which I referred in order that the worries of the many pregnant women serviced by these hospitals who have booked epidurals can be allayed?
I was up-front in acknowledging the difficulties experienced in these hospitals.
Will the Minister guarantee that these difficulties will not be experienced after 1 July?
The Deputy is aware that difficulties have been experienced in terms of NCHDs which were not of my making or of the making of this House. I already stated that the North Western Health Board is satisfied that all anaesthetist posts at Sligo General Hospital will be filled with effect from 1 July and this will enable a full epidural service to be restored at the hospital. That is the black and white position outlined by the board and I must take the board at face value. Likewise in St. Luke's Hospital a full epidural service is being provided. We have been in touch with the South Eastern Health Board.
There are gaps in the service. It is not always available.
I acknowledge in my reply that there have been difficulties. I agree with the Deputy that the objective is to provide a full 24 hour epidural service and to ensure women have this service available. We will do everything we can to ensure that becomes a reality but difficulties occur from time to time. I have put on the record the position as it currently obtains in the hospitals mentioned in the note attached to the question tabled by the Deputy.
Is it not ultimately the Minister's responsibility to ensure that our health services are properly managed, patients are put first and mothers are provided with the service to which they are entitled when giving birth to their bab ies? The Minister and his predecessor failed to do that over the past 12 months. Does it not remain the position that there is no guarantee in St. Luke's in Kilkenny, in Tralee or in Cavan General Hospital that these services will be provided fully and comprehensively in the coming 12 months and will the Minister acknowledge that should not be the position?
With respect, my predecessor did much more than any of the Deputy's predecessors in this office in providing additional resources for the health services, additional funding for consultants to be appointed and anaesthetic—
Tell that to mothers giving birth who are deprived of epidurals.
That is the reality. Deputy Shatter may wish to exploit certain matters for political advantage but it is not acceptable, given the Deputy's record and that of his colleagues—
I am concerned about mothers giving birth, not political point scoring.
—in the health portfolio, to criticise my predecessor, the Minister, Deputy Cowen, who had a very good record in securing additional resources for our health services.
