The Master of the National Maternity Hospital has expressed concern at the continuing rise in the rate at which Caesarean sections are being carried out.
Dr Declan Keane said the rate at his hospital in Holles Street rose slightly to 16 per cent last year, but while this was still low by national and international standards, one had to "remain concerned".
The rate in the Coombe Women's Hospital was approaching 20 per cent and in the Rotunda it was approaching 30 per cent, he said. He expressed particular concern at the number of women electing for Caesarean sections.
His comments are contained in the hospital's annual report for 2003, which has just been published. It says 8,255 women gave birth to 8,378 infants at the hospital last year, up 3 per cent on 2002. The number of non-nationals delivering at the hospital increased by 17.9 per cent last year on 2002 figures.
Despite the increase in deliveries, there had been no increase in consultant numbers at the hospital. "This now remains a grave cause of concern ... the reality of the situation is that based on these numbers of 8,000 deliveries, this hospital requires 16 obstetrical consultants," he wrote.
The hospital has 11 consultant obstetricians. While two more will join the staff shortly, Dr Keane said the Royal College of Obstetricians in London suggested there should be one consultant obstetrician for every 500 babies delivered. This means we will still be sub-optimal even when we get the two additional obstetricians."
Meanwhile, the hospital's secretary/manager, Mr Michael Lenihan, expressed concern in the report that capital funds "continue to be unavailable for the replacement of medical and non-medical equipment and urgent maintenance works".
"The non-availability of such funding has the potential to undermine seriously the capacity of the hospital to maintain key services at agreed levels," he wrote.
He is already on record as saying the hospital may have to reduce its activity levels later this year if interim development works, including an extension to the pathology department, are not urgently approved by the Department of Health.
The report says that "lack of facilities in the post-mortem room reached such a level of concern during the year that a decision was made in September to cease conducting post-mortems there". Facilities at St Vincent's Hospital have been used instead.