Dáil Éireann debate -
Wednesday, 20 Feb 2002

Vol. 549 No. 1

Written Answers. - Birth Statistics.

Ivor Callely

Question:

84 Mr. Callely asked the Minister for Health and Children the total number of babies born here in 2001; the percentage of such births delivered in the Dublin maternity hospitals; the percentage of non-national births; the comparative figures for 1996 and 1991; if the Dublin maternity hospitals have expressed views on their capacity to accommodate demands; and if he will make a statement on the matter. [5692/02]

Minister for Health and Children (Mr. Martin)

There were 52,718 births in Ireland in 1991 and 50,655 in 1996. Some 36.7% of the total number of births in Ireland in 1991 and 38.6% of all births in 1996 were delivered in the three Dublin maternity hospitals. Data in respect of 2001 are not yet available in my Department and will be forwarded to the Deputy as soon as it becomes available.

The information requested by the Deputy in respect of the percentage of non-national births is not routinely collected by my Department. However, I have asked the regional chief executive of the Eastern Regional Health Authority and the chief executive officers of the health boards to examine the matter and to reply directly to the Deputy.

I accept that obstetric services at the Dublin Maternity Hospitals are experiencing service pressures. A number of factors have been identified by the Eastern Regional Health Authority, ERHA, as contributing to this pressure.

The number of births in the eastern region has increased from 20,646 births in 1996 to 22,813 in the 2000 with a further increase expected in 2001. A further contributory factor to the current pressures is the level of referrals from outside the regions. The ERHA advises that 10% of the workload in the Dublin hospitals relates to women from outside the region. The ERHA has recommended to the Dublin maternity hospitals that, in general, referrals from outside the region should be based on an assessment by a consultant in the woman's own region that such a referral is warranted on clinical grounds. The ERHA is also contacting other health boards with a view to facilitating women to access maternity services in their local areas in keeping with a policy of regional self-sufficiency. However, services will continue to be provided to patients living outside the region who require access to specialised obstetric services. The ERHA has also set up a working group with the three maternity hospitals to develop proposals for immediate, medium and long-term solutions to the current difficulties.

The Deputy will be aware that I established a special forum in October last to examine the difficulties experienced by the three Dublin maternity hospitals in recruiting and retaining midwives. The forum made a number of recommendations aimed at improving the relative attractiveness of working in these hospitals through introduction of better career opportunities and significantly enhanced support for those who take up appointment. These recommendations have been considered by my Department, having regard to the pressures on the hospitals and the cost and other implications of the measures proposed.

My Department is prepared to sanction the proposed upgradings and new clinical support posts as follows: introduction of shift leaders in each of the larger in-patient clinical areas within the hospitals; upgrading of experienced clinical midwife managers 2 in the labour-delivery suite in each of the three hospitals to clinical midwife manager 3 level; and the introduction of a midwifery practice development co-ordinator, assistant matron level, and clinical skills facilitator, CMM2 level, posts at each of the three hospitals in order to provide additional support to student midwives and newly qualified midwives.

In addition, I wrote to the National Council for the Professional Development of Nursing and Midwifery requesting that a review of the criteria for the establishment of clinical midwife specialist positions be carried out. It is my intention to make the council's report in the matter available to all interested parties, as recommended by the forum.

However, my Department is not in a position to sanction the recommendation that full salary be paid to general nurses undertaking midwifery education. At present, a nurse is paid on the first point of the staff nurse scale for the two year duration of the midwifery education programme. Under the forum's proposal, the nurse would retain her existing pay and receive an increment during the second year of training. This is because this measure cannot be confined to the three Dublin maternity hospitals. It should be noted that the present position is a substantial improvement on the situation which existed before the academic year 2000 to 2001 when I increased the student midwife rate by 9.75%. At the same time, I made provision for the refund of fees to student midwives. My officials will be in contact with the Eastern Regional Health Authority shortly to confirm the position in relation to these recommendations.

I have also been advised by the ERHA that a study was commissioned in 2001 to project the number of births over the period 2000 to 2016 for the greater Dublin area, which includes Counties Dublin, Wicklow, Kildare and Meath. The findings of the report, which will form an important part of the planning process for the future development of maternity services in the eastern region, indicate that a short-term rise in birth numbers was predicted up to 2004 with a subsequent decline for future years.

I would like to take this opportunity to inform the Deputy that capital developments have been planned for the three Dublin maternity hospitals with some funding set out in the national development plan for each hospital. I have been advised by the ERHA that a €10 million development plan is currently under construction at the Rotunda Hospital. These works include the amalgamation of the paediatric unit with the neonatal intensive care unit and the refurbishment of post-natal accommodation. The National Maternity Hospital, Holles Street has developed proposals for a major hospital development. In the short-term, the hospital has proposed an expansion of 12 beds which is under consideration by the ERHA. With regard to the Coombe Women's Hospital, I have been advised by the ERHA that approval is imminent to establish a design team to enhance the facilities at the hospital. Some 15 extra beds will be provided in the upgraded and expanded services planned in this development.

Based on the workload projections, planned enhancement of the facilities together with the range of initiatives already outlined, it is expected that the three Dublin maternity hospitals will be in a position to cope with anticipated demand. I can assure the Deputy that the provision of a comprehensive, safe and high-quality obstetric service for the eastern region will continue to be of the utmost priority.