PRETERM AND NEWBORN babies could become the “latest casualties of Ireland’s acute hospital capacity pressures”, consultants have warned.
The Irish Hospital Consultants Association (IHCA) has today raised concerns that a lack of consultants and capacity in Ireland’s neonatal services threaten to impact hospitals’ ability to provide specialist care for preterm and newborn babies.
The group said the situation has been made worse due to the backlog created by the Covid-19 pandemic, noting staff shortages and that many neonatal units have no isolation facilities to deal with coronavirus patients.
According a report by Health Information and Quality Authority (Hiqa) published in February 2020, approximately 10% of newborns are admitted to neonatal units in Ireland every year, the majority of which are struggling to deliver the required levels of care.
The report showed that four neonatal units did not have adequate isolation facilities, and that neonatal cots were being placed too close together, increasing the risk of cross-infection between infants in these units.
The IHCA has said these isolation facilities are now critical for managing care for infants and parents in a Covid-19 environment in line with international guidelines.
Children of mothers who have or are suspected to have Covid-19 should initially be isolated if they require admission to a neonatal unit. However, without adequate investment to create the additional space, consultants have warned “the risk of transmission of infection will remain dangerously high”.
Consultant shortages
The IHCA said capacity issues in Ireland’s neonatal services are further compounded by severe consultant shortages.
Hiqa found that none of the specialist maternity hospitals – the National Maternity Hospital (Holles Street), Rotunda Hospital, Coombe Women & Infants University Hospital, and Cork University Maternity Hospital – had achieved the recommended levels of staffing, meaning that the nation’s specialist facilities are falling below the required levels.
“Difficulties and delays in recruitment is a key issue that Department of Health confirms is impacting the implementation of Maternity Policy in Ireland.
“The medical staffing requirements are also at odds with HSE figures, which suggest that only 37 of the approved 41 permanent consultant neonatology posts in public hospitals are filled on a permanent basis,” the IHCA said in a statement today.
Ireland has a lower number of consultant paediatricians on a population basis (5.4 per 100,000) than England, Scotland, Australia, and New Zealand, according to a HSE report.
The report also projects a 78% increase in the demand for consultant paediatricians and neonatologists by 2028, meaning an extra 199 consultants will need to be added to the current headcount of 255 in less than eight years.
Speaking in a video interview released by the IHCA today as part of its #CareCantWait campaign, consultant neonatologist Dr Michael Boyle of the Rotunda Hospital said: “Having a baby is one of the most momentous experiences of anybody’s life, and if you add a huge stressor like giving birth at 25 weeks into that, it’s full of uncertainty and worry.
“There are significant challenges as I would see it from my perspective such as access to intensive care beds. We would occasionally find that we are unable to accept a referral from another hospital because we don’t have the space or the staff to care for them and that is an awful position to be in.
“We are firefighting, we’re dealing with the issues as they present on the day. It’s a challenge to improve a service when you can’t focus on the longer-term elements that you’d like to develop.”
TheJournal.ie has contacted the HSE and Department of Health for comment.
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