Dáil Éireann díospóireacht -
Thursday, 22 Jun 2000

Vol. 521 No. 6

Adjournment Debate. - Hospital Services.

Mr. Shatter

I wish to share my time with Deputy Perry.

If men rather than women gave birth, I would not have to raise this issue this evening. If men gave birth there would not be a problem. If men gave birth, male medical personnel, male administrators and bureaucrats and male politicians would ensure the whole process of labour and delivery was as pain free and stress free as possible.

Women give birth and their needs in relation to pain relief are not being met in many maternity units in this country, particularly in Sligo General Hospital. While the birth of a new baby is normally a joyous occasion, it can be stressful, traumatic and painful for the mother during the birth period. Giving birth is not an elective procedure. Women cannot order the day of labour or delivery. By and large, the date on which a baby is born is decided by natural processes outside of the remit of hospital administration. Given that fact, one would assume that pregnant women would be able to rely on a 24 hours a day, 7 days a week service for the administration of epidural anaesthesia for those who chose an epidural. That is not the case for women in Sligo and Leitrim. The epidural service in Sligo General Hospital is only available on five days out of seven. The days in which the epidural service is available varies depending on the rotas for non-consultant hospital doctors. Women who go into labour and arrive at the hospital expecting epidural may draw the short straw in the epidural lottery and find they are unlucky enough to be delivering on a day when a service is not available to them.

There were on average 1,283 births in Sligo General Hospital in the past two years. That is an average of 106 births per month. Between January and May 2000, there were 521 babies born in Sligo General Hospital. How many of their mothers who wished to do so were able to avail of an epidural? What percentage of the average 106 mothers who will give birth in Sligo General Hospital this month will have no choice but to give birth without the aid of an epidural? Can the Minister stand over such shoddy treatment of pregnant women? Sligo General Hospital is one non-consultant hospital doctor short for the past six months. It is only with the goodwill of the already over-worked NCHD that some of the 520 women who gave birth in Sligo this year were able to have an epidural.

I understand it is hoped to supply a full seven days service in July when the new NCHD contracts are signed. That is not good enough. There are no guarantees. We are likely to be short nationally of 142 non-consultant hospital doctors from 1 July onwards. What are women supposed to do in the meantime and what will they do in Sligo if there are no appointments in July? The Minister is responsible for this situation. He and his predecessor have presided over the rapid deterioration in our health services and it is time he put patients first. It is time for action and for the restoration of the best possible care. Pregnant women should not have to worry about whether there will be a doctor available to give them an epidural. It is a scandal that matters have reached this stage.

I hope to hear tonight that the Minister of State has an immediate and comprehensive solution to this dreadful problem. I hope she will acknowledge that women are entitled to full and proper care at all our maternity hospitals and to services they seek when giving birth. I hope to hear that pregnant women will have one less matter to worry about when they go into labour in Sligo General Hospital in the weeks to come. I fear, however, that they will be disappointed.

Mr. Perry

I thank Deputy Shatter for allowing me to contribute to this very important debate and I compliment him for raising the issue. It is outrageous at a time of such prosperity that the epidural service at Sligo General Hospital is available only at random during the week. Given the 106 births per month, it is unbelievable that expectant mothers are not assured of an epidural service. This is very alarming and I would say to the Minister of State that a promise of a July appointment is not good enough. We need a guarantee as to when a consultant will be appointed. This is no reassurance for people in areas of the north west such as Donegal and Sligo which Sligo General Hospital serves. I appeal to the Minister of State to give a clear indication of when this appointment will take place because expectant parents from Sligo and Leitrim need such reassurance. Given the present situation, some expectant parents are making arrangements to have their babies delivered outside the region which is causing undue stress to expectant mothers.

Minister of State at the Department of Health and Children (Ms Hanafin)

I thank Deputies Shatter and Perry for raising this important issue. I assure both Deputies that the Minister for Health and Children and the two Ministers of State are committed to improvements in the health service in maintaining the best aspects of it and ensuring investment is made.

The provision of services at Sligo General Hospital is a matter for the North Western Health Board in the first instance. This Government has displayed a strong commitment to the development of services in Sligo General Hospital in line with the priorities identified by the North Western Health Board. In this regard, there are a number of ongoing developments at Sligo General Hospital. These include a day service unit and pathology services. In addition, obstetrics-gynaecology services and cancer services have been enhanced by the appointment of a consultant obstetrician-gynaecologist and a consultant oncologist, respectively. Approval was also granted for the appointment of a consultant histopathologist and a third general surgeon.

The North Western Health Board introduced a 24 hour epidural service in July 1997 at Sligo General Hospital and the demand for this service has grown in recent years. There are at present five consultant anaesthetists at Sligo General Hospital and the board is in the process of filling a sixth post. In addition, a further consultant post has recently been approved by the 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 advised that the epidural service is dependent on the availability of non-consultant hospital doctor anaesthetists. The board has experienced short-term difficulties in this regard which have impacted on this 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. Notwithstanding the current national issues in the recruitment of NCHD posts from July, I understand from the board that it is satisfied that all anaesthetist posts will be filled at Sligo General Hospital. This will enable a comprehensive epidural service to be restored at the hospital. The overall objective of the significant ongoing development of service that is under way at Sligo General Hospital is to ensure that the services available to the people in the region are responsive to their needs. Clearly, the early restoration of a full epidural service is essential to that. In this regard, the Minister is encouraged by the fact that the North Western Health Board is taking the necessary steps to achieve this.