Sir, – It seems a serious indictment of current practice in maternity care if choice and continuity of obstetrical care, particularly for those with “complex medical needs”, can only be provided if women continue to pay up to €5,000 to see the obstetrician of their choice (in addition to paying medical insurance, from which the obstetrician also gets paid), and that removing private care from our public maternity hospitals “will also impact on neonates”, and be “chilling” (“Masters of maternity hospitals criticise move to end private care of pregnant women”, News, December 19th).
The medical arguments made by the masters of two Dublin maternity hospitals for an exception to be made to allow private maternity care to continue in public maternity hospitals and units under Sláintecare seem to me to be precisely the reasons why the current two-tier system needs to end.
Choice and continuity of care for mothers and babies in public hospitals should not be about the ability to pay – particularly given the relationship between socio-economic deprivation and pregnancy outcomes. It is of note that no reference is made by the two masters to midwives or neonatal nurses who provide one-tier care to all.
As for the argument that the State needs to allow private maternity practice to continue in public hospitals because exorbitant medical insurance costs prohibit the development of private maternity hospitals, surely this may be one reason why the current system of medical litigation and compensation needs to be reformed; a more pressing reason for medico-legal reform is the financial impact this is having on the sustainability of public maternity services. – Yours, etc,
CHRIS FITZPATRICK,
(Retired consultant
obstetrician and
gynaecologist, and
former master of
the Coombe Hospital),
Dublin 6.
A chara, – As someone currently pregnant and paying privately for consultant-led maternity care, the right to choose healthcare based on your ability to pay is not a choice but a privilege that undermines the entire system.
I know I’d rather that the model of care I choose to access be available to everyone regardless of means. Surely this is more in keeping with the objectives of the National Maternity Strategy than maintaining the “choice” to pay to access your preferred care model? – Is mise,
KATE MOLONEY,
Ennis,
Co Clare.