Appropriate Maternity Care could save Exchequer 18.6 million per annum.
The Association for Improvements in the Maternity Services Ireland (AIMS Ireland) are demanding an immediate response from the Government in budget 2015 on calls for a review into patient safety and appropriate care models in Irish maternity services.
AIMS Ireland's calls follow fresh reports following the judgment of medical misadventure into the death of Dhara Kivlehan, the approaching inquest into the death of Sally Rowlette, investigations into the death of a baby in Mullingar, and failures by the HSE to provide appropriate care solutions and clinical care to 25 women following the removal of indemnity of Philomena Canning.
Krysia Lynch of AIMS Ireland "We are not using our Budget effectively in our maternity services. Our insistence of an obstetric care model has had profound effects on costs and patient safety. Ninety percent of women have no option than to book into obstetric led care, which is more expensive and is shown to have greater rates of intervention. These interventions are very costly in human and financial measures."
She Adds, "We are not getting value for money. We are not getting widespread access to full service provision. Most importantly, we are not reaching the bar in terms of offering safe maternity services."
Ireland's obstetric-led model of care is outdated and is of very little benefit to the majority of women. While there may be an estimated 10% to 15% of women and babies who are in need of obstetric-led care, this care model is not recommended for the majority of women and babies, is shown to increase risk factors and adverse events to mothers and babies, and costs significantly more than hospital and community based midwife-led care options.
Austerity budget measures have increased these risks to patient safety in recent years. Irish obstetric led units are significantly understaffed to unsafe levels. Safe Childbirth recommends midwife to woman ratios of 1:28 for high risk case loads and 1:25 for low risk case loads; the majority of Irish units do not meet these standards of care with some units exceeding midwife to woman ratios of 1:50. Midwives express their concerns to AIMS Ireland, describing clinical care under these extreme pressures as 'fire-fighting'.
The HSE’s Mid-U study found that the same birth, for the same woman, costs over €300 MORE for women in hospital based Obstetric led care options compared to Midwife-Led care. Midwife led care options use less interventions, are safe, and have high satisfaction ratings from women. Ireland has the highest birth rate in the OECD with roughly 73,000 births per annum. Subtracting the 15% of births where obstetric led care may be warranted, this leaves just over 62,000 births where midwife-led continuity of care would be best practice and safest for mothers and babies. This adds up to a potential cost savings of over 18.6 million euros.
Krysia Lynch ends, "Why is the Government failing to address these issues? This is the question we should all be asking. Why is our Government insisting on continuing with a care model which is not evidenced, is consistently struggling to provide safe clinical care to women and babies, and puts severe pressure on the public purse with no added benefit?"