Premature babies 'at risk' in Mullingar

Report highlights 'huge problem' with transfer of babies from Longford/Westmeath General Hospital to specialist units

Report highlights 'huge problem' with transfer of babies from Longford/Westmeath General Hospital to specialist units

Premature babies born at the Longford/Westmeath General Hospital in Mullingar are being put at risk because of the "absence of cohesion" between the hospital and specialist maternity units, a report has revealed.

The report, drawn up by the Institute of Obstetricians and Gynaecologists of the Royal College of Physicians of Ireland, has said the problem should be addressed.

A team from the institute visited the hospital last autumn and its report on maternity services there, released to The Irish Times under the Freedom of Information Act, said there was "a huge problem" with regard to the transfer of babies to specialist maternity hospitals.

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These are known as level III hospitals, and include the Rotunda, the Coombe and the National Maternity Hospital in Dublin.

It said this was obvious from discussions with consultants and junior doctors. "Since there is no integrated scheme for neonatal and in utero transfers between level II and level III hospitals, the organisation of these transfers is frequently chaotic," the report said.

"A registrar told us that she spent seven hours one day on the telephone trying to organise an in utero transfer," it added.

Furthermore, it said there was "no formal structure or protocol" governing the level II type maternity services provided by the Midland Health Board at its two maternity hospitals in Mullingar and Portlaoise.

There were 1,791 births at Mullingar Hospital and 1,260 at Portlaoise General Hospital last year.

"While the two maternity hospitals in the Midland Health Board area are operating as level II units, there is no formal structure or protocol governing this type of service. Furthermore, there is no cohesion between level II and level III units. This poses considerable risk for patients and particularly premature neonates," the report said.

"We recommend that the institute take up this issue with the Department of Health and with the respective health boards."

The report describes as "poor" the organisation of acute hospital services in the Midland Health Board area. This was, it said, because all the hospitals were operating at a similar level.

The institute's visit to the Mullingar hospital was for the purposes of its accreditation for postgraduate training of junior doctors. It noted that such training was "severely hampered" by the lack of a third consultant obstetrician/gynaecologist. The hospital had two such consultants at the time of inspection, and these also covered other hospitals in the region.

The institute considered their workload excessive "both in terms of the number of fixed sessions and the on call rota".

However, it noted this was likely to improve with the appointment of a third consultant.

The health board confirmed yesterday that a candidate had been selected for the third post and a locum consultant was in place in the meantime.

The health board spokeswoman also said maternity service protocols were in place at the time of inspection but were not to the institute's standards. "We are now in the process of putting together a written protocol," she said.

Despite the institute's concerns it said that trainee doctors, all of whom were non-nationals, in the Longford/Westmeath Hospital were happy with the facilities at the hospital, with their training and with their level of supervision.

However, they were concerned that their opportunities for further training in a specialist unit were limited.

The provision of a service was dependent on these doctors, the report said, but the posts they occupied were not suitable for long-term training.

"This issue needed to be addressed", it said.