asked the Minister for Health the date on which the maternity unit at Bantry Hospital, County Cork, closed; and the reason consultant out-patient maternity services have not yet been provided.
19.
Ceisteanna — Questions. Oral Answers. - Bantry (Cork) Hospital Maternity Unit.
18.
asked the Minister for Health the progress he has made to alleviate the hardship caused to the people of the south-west by the closure of the maternity unit at the County Hospital, Bantry, County Cork; and if he will make a statement on the matter.
20.
asked the Minister for Health if following the recent decision of the Supreme Court he will now ensure the continuation of maternity services at Bantry Hospital, County Cork; and if he will make a statement on the matter.
I propose to take Questions Nos. 18, 19 and 20 together. The maternity unit at Bantry General Hospital closed on 16 April 1983. The question of the provision of out-patient maternity services at the hospital is a present the subject of discussion between the Southern Health Board and the Irish-Medical Organisation. I am keeping the matter under review.
With regard to the recent decision of the Surpeme Court, I am at present examining its implications and would not propose commenting on it in relation to Bantry Hospital until I have completed that examination.
The Minister said that the maternity unit in Bantry closed in April 1983. Not alone are the people of west Cork deprived of a maternity unit but they are also without an ante-natal out-patient service. Does the Minister now accept that it was wrong to close the maternity unit in Bantry and to leave the people of south west Cork, particularly those in Castletownbere, 100 miles from their nearest maternity unit?
No. Up to the end of 1982, there were 13 maternity beds in the hospital and the number was reduced to seven beds as part of the drive by the Southern Health Board to control expenditure. In 1982 there were 191 births, three or four per week, and seven beds were quite sufficient to cope with the workload. Contrary to popular belief, there has never been a consultant obstetrician gynaecologist at the hospital in Bantry. They used to employ a consultant physician who did maternity work but, when he became ill in February 1983, he was unable to provide a service and the Southern Health Board decided not to seek the appointment of a consultant obstetrician gynaecologist. Indeed, Comhairle na nOspidéal or I would not have given approval for such an appointment because he would not have enough work in the delivery of three or four births a week. He would spend most of his time playing golf and enjoying the excellent boating facilities of west Cork. Since 1983 there has been no maternity service in the hospital, apart from emergency cases which are admitted there. Since then, I have been endeavouring to get the agreement of the Irish Medical Organisation to provide an effective maternity out-patient clinic in the hospital with consultants from other hospitals attending. I am still hopeful that I will get the agreement of the consultants to do this.
Surely the Minister accepts that Comhairle na nOspidéal would sanction the appointment of a consultant to Bantry hospital? They always made the case that Bantry was an exception and would need an obstetrician as there are so many people in the area who are isolated from hospital services generally. Even the old Fitzgerald report made an exception of Bantry because the people are so far removed from essential services. Would the Minister accept that if he appointed an obstetrician to this hospital, the number of deliveries there would increase because more women would opt to have their babies at that hospital? This has been the case in every other instance in which an obstetrician was appointed to a local hospital. Would the Minister accept also that there are up to 700 births each year in the south west Cork area, some of these in Cork city, some in Skibbereen and some in Tralee and that if Bantry hospital were given the opportunity to prove that they could operate a viable maternity unit, the Minister by appointing an obstetrician to the hospital would be providing an essential service for the people of south west Cork? It is highly unlikely, for many good and legitimate reasons, that there will not be a consultant-based out-patient maternity facility in Bantry hospital because a consultant obstetrician would not be prepared to travel the 50 miles journey to provide that type of out-patient facility.
The consultants generally in the Cork city area maintain that there is no reason medically for the provision of out-patient clinics at Bantry. They maintain also that it is not in accordance with their common contract that they should be obliged to travel to Bantry from Cork. The matter is currently the subject of dispute and interpretation but I am hopeful that it will be resolved in a suitable way. However, I make the point strongly to the people of west Cork that babies should be delivered in a fully staffed unit where there is a consultant obstetrician-gynaecologist present and preferably where there is a paediatric consultant available close by. It is not possible to have that type of unit unless there are between 1,500 and 2,000 children born in a hospital each year. There never has been a consultant obstetrician at Bantry hospital. Children born there were delivered by the physician but when he became ill he was unable to continue with that aspect of the work. The position is that the women of Dunmanway, Bandon and further up towards Cork city go to the city for the delivery of their babies just as people from Arklow, for instance, which is 40 miles from here, come to the general hospitals in Dublin. Likewise people from Athy in south Kildare travel to hospitals in Dublin. Admittedly there is a question of distance but I am anxious that through the health boards we provide facilities for emergencies and for out-patient use. I am continuing that work. Deputies from south west Cork from both parties have been in touch with me regularly in connection with facilities at Bantry. The Leader of the Opposition has promised that, if returned to office, he would establish a full scale unit at Bantry. In other words, he would be prepared to spend up to £750,000 on a facility that would not be of benefit to the women of west Cork, a facility that would be limited in scope and for which the search for a consultant gynaecologist-obstetrician would hardly be successful because of there not being sufficient work. I doubt if we would succeed in finding someone to take the job.
Would it not be well for the Minister to come clean on this matter, to say that he has no intention of re-opening a maternity unit at Bantry, and that it would be impossible to provide out-patient facilities there? Is the Minister not proceeding with all haste to close more surgical wards at Bantry hospital? It will be only a matter of time before the entire staff of the hospital are out playing golf at Glengarriff.
This matter must be put in perspective. When I assumed office, there were seven maternity beds at that hospital. In addition there were 37 medical beds there. I have not made any decision in regard to those and neither have I made any decision in regard to the 63 surgical beds there. A reduction in the number of beds, in accordance with the requirements of the area, would be a matter for the Southern Health Board. There are also 16 children's beds in the hospital. All I am saying is that on the basis of the best professional advice available to me in the Department of Health, I cannot agree to the provision of in-patient maternity services of a consultant nature at Bantry hospital. The hospital never had such a service and would not have a sufficient number of patients to enable the provision of such facility. The average number of births in the area is from 150 to 190 per year. It would not be possible to provide a maternity unit with qualified maternity nursing staff and a consultant obstetrician for a unit in which there would be only two or three births per week.
Would the Minister not accept that there are at least 800 births annually in the south-west Cork area, that the area has never had an obstetrician but that if one were appointed, most of the women would opt to have their babies at Bantry hospital? I would agree that the ideal is that a woman have her baby in a fully staffed unit, but what the Minister is asking women from towns such as Castletownbere to do in order to be delivered of their babies is to travel a distance comparable with the distance from Belfast to Dublin or from Nenagh to Dublin. A woman from Belfast would hardly be asked to go to Dublin to have her baby on the basis that in Dublin there was a unit with three consultant obstetricians.
On analysis, the figure of 800 is very false.
The Chair would point out that there are more than 90 further questions on health to be dealt with.
I know the area in question very well and I cannot accept that the women of Bandon and Dunmanway would be prepared to begin going back to Bantry to have their babies in the event of an obstetrician being appointed to Bantry hospital. In that catchment area the likely highest number of births in a year would be 250 and it would not be feasible to operate a maternity unit on that basis. Despite the enormous level of playing of politics locally we must be honest on this issue.