A comprehensive review of maternity and gynaecology services in the greater Dublin area was completed in 2008. The KPMG Independent Review of Maternity and Gynaecology Services in the Greater Dublin area identified the need to increase consultant and midwife staffing levels and recommended the recruitment of additional staff across the three Dublin sites. The staff numbers required, as outlined in the KPMG report, were based on the current model of service provision, the report noted that this would need to be reconsidered and a detailed manpower plan developed as and when the future service model is implemented, taking into account workforce needs, demand, configuration with other obstetric/gynaecology units and related acute services staffing (eg anaesthetics) and primary care services (eg community midwifery). The report also noted that Dublin’s model of stand alone maternity hospitals is not the norm internationally and recommended that the Dublin maternity hospitals should be co-located with adult acute services and that one of the three new Dublin maternity facilities should be built on the site of the new national paediatric hospital. Maternity and paediatric service co-location has advantages for infants with congenital malformations, for foetal medicine or complications which require neonatal surgery. Maternity and adult service co-location has advantages for mothers in providing on-campus rapid and ready access to non-obstetric specialist expertise, and to specialist surgery and intensive care in the case of major obstetric emergency.
In this context the proposal in 2008 was that the National Maternity Hospital be relocated to St Vincent's, the Coombe to Tallaght and the Rotunda to the Mater, and the maternity hospitals have been working with the relevant adult sites to progress this. There will be early discussions with the maternity hospitals regarding their maternity /adult co-location plans in the context of the recent Government decision to build the new children’s hospital on the St James's campus. Notwithstanding this, I am committed to the intent of the report - that the Dublin maternity hospitals be located alongside adult acute services - while also bearing in mind the need to plan for the provision of tri-located paediatric, adult and maternity services, as is the intention in relation to the new children’s hospital.
In 2009 the HSE received an additional service development funding, including additional funding for the three Dublin maternity hospitals, to address priority needs associated with demographic pressures for maternity services. That funding was allocated to hospitals primarily to support the provision of additional staff in priority areas as follows:
- Consultant Obstetric & Gynaecologist posts;
- Midwifery Teams to initiate/extend Early Transfer Home/ DOMINO/antenatal/postnatal community outreach schemes;
- Hospital midwives/neonatal nurses;
- Anaesthetics.
Management and delivery of maternity services is the responsibility of the Health Service Executive. In relation to the query on staff shortages, I have forwarded the question to the HSE who will respond directly to the Deputy regarding the progress made in recent years in addressing the staffing requirements of the Dublin maternity services.
