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Maternity hospital chiefs warn of 'unique exodus' of doctors and midwives

Published 24/09/2015

Sam Coulter-Smith said Ireland has the highest birth rate in Europe yet the third lowest number of consultant obstetricians among leading western countries
Sam Coulter-Smith said Ireland has the highest birth rate in Europe yet the third lowest number of consultant obstetricians among leading western countries

Ireland is now training the best doctors in the world for export overseas, two of the country's top maternity chiefs have said.

Masters at both the Rotunda and Coombe hospitals in Dublin warned of a "unique exodus" of medics, who for the first time in living memory have no intention of coming home.

A "pigeon homing" mechanism inside generations of Irish doctors moving abroad to get experience has been "switched off" along with any desire to repay the system that trained them, a parliamentary watchdog heard.

Sam Coulter-Smith, master of the Rotunda Hospital in the capital's northside, said: "We have some of the best doctors in the world coming out of Ireland, but unfortunately they are not coming back anymore."

Sharon Sheehan, master of the Coombe on the city's southside, added: "We are now training to export and we need to ask ourselves why is that."

The senior medics, who head two of the country's largest and busiest maternity hospitals, were appearing before the Oireachtas joint committee on Health and Children about the state of the nation's child-birth services.

Dr Coulter-Smith said Ireland has the highest birth rate in Europe yet the third lowest number of consultant obstetricians among leading western countries.

Despite 10 years of official reports urging more consultants, funding has been cut back under austerity measures while an "exodus" of doctors and midwives to more attractive packages overseas continues, he told the hearing.

Health chiefs have to rely on temporary locum and agency staff to cope with the work-load.

"This drives costs up and quality down and is no way to run our health service," he added.

Dr Coulter-Smith said it wasn't just better pay luring medics away from Ireland.

"It boils down to the packages that we can offer, the facilities to come back to, the infrastructure, the staffing levels, the funding and the possibilities of performing the world-class research that we can do in Ireland," he said.

"But we can't do this currently because we are not getting the people back to do it."

Dr Sheehan said like many medics, including her Rotunda counterpart, she trained abroad, but a strong trend among Irish exiles in wanting to return home has now bucked.

"What is quite unique now is that many of our staff who leave to train abroad have absolutely no intention of coming back to Ireland - that is new," she told the committee.

"We always referred to ourselves as having a homing pigeon beacon, something inside our brains that always wanted us to come home.

"That seems to have been switched off in the staff that are qualifying now and training."

Dr Sheehan said she recently asked a class of obstetrics and gynaecology students at University College Dublin (UCD) for a show of hands on who saw themselves with careers back in Ireland eventually.

"Less than half of the class raised their hand. That is unique," she said.

"In my own class in UCD, all of us wanted to come back here, all of us aspired to work in Ireland and put back into the system what the system has given us in our training.

"We are now training to export and we need to ask ourselves why is that."

A recent report suggested Ireland needs another 100 consultant obstetricians to bring numbers into line relative with the UK figure. There are currently between 120 and 140.

Both top doctors stressed that maternity care and hospitals in Ireland are good compared to international standards.

Dr Coulter-Smith said services had been in the headlines over the past three years for all the wrong reasons, to a point where "the confidence of the public is severely shaken".

He criticised some "sensationalist" accounts of high-profile tragedies in recent years.

As well as dealing with record numbers against the backdrop of cutbacks, medics were also having to deal with new challenges, he said.

These included more resistant infections, more complex medical problems, as well new diseases and communication issues with a more diverse population.

Some 30% of mothers-to-be are now obese, he cited as an example.

Dr Sheehan said "poor social circumstances and homelessness" are also adding to the complexity of patient care.

The Coombe chief also hit out a lack of funding for forcing bereaved mothers or women in the middle of a miscarriage having to share rooms and wards with newborn babies and buggies.

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