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.