Tuesday, 19 March 2013

If in doubt, blame it on 'safety'; HSE closures in the Northeast

The past month there have been whispers of HSE plans to closure ante-natal clincs in Navan and Dundalk. In true HSE style, these closures look set to be implemented under the radar, without informing women, they will just suddenly cease to exist.

In an interview on LMFM radio, Alan Finan, clinical director for women and children's services in the Northeast has confirmed closures of clinics citing reasons for "ultimately about patient safety" LINK

Patient Safety?! That old reliable.

Of course, closures of clinics will have the direct opposite effect as an extra 60+ women will be booked into already full to capacity clinics in OLOL Drogheda. Women will be required to travel long distances for care, heavily pregnant on public transport, or will decide to forgo ante-natal care due to logistical problems.

Please see our letter to local TDs on this issue:

I wish to express the shock and anger of AIMSI's and Families for Safe Maternity Services in OLOL members regarding the closure of antenatal clinics in Dundalk and Navan. Members are well aware of the potential negative impact of these closures on all current and future pregnant women throughout Co Louth and Meath and we wish to ask a Parliamentary question on this matter. We wish to know why this decision was made in the first place and when will this decision be reversed, knowing the negative effect these closures will have on the growing numbers of women who are not in a position to travel to Drogheda for basic antenatal check-ups. These clinics were set up so that pregnant women could attend local antenatal clinics as lack of transport and caring for other children prevent many women from attending these essential medical check-ups during pregnancy.

 While all pregnant women in the Dundalk and Navan areas will be affected, disadvantaged women in particular will be more affected as attendance may not be a priority for these women and particularly when attending clinics involves bus journeys, financial costs and many hours away from home. Disadvantaged women are at higher risk of adverse birth outcomes for themselves and their children. However, disadvantaged women are an easy target as most will be unaware that antenatal services are no longer available until it directly affects them. These women are less likely to read local papers, listen to local radio and are also less likely to attend antenatal services, even when they are available locally. When services become difficult to access for these women, I fear that their attendance at antenatal clinics will decline even further. Closing local antenatal clinics will disproportionately affect disadvantaged women who are already at greater risk of complications and adverse outcomes. If the health service exists to protect health, what is the rationale for closing local basic antenatal clinics?

 While disadvantaged women will be most affected, many of our members are aware of the growing numbers of middle class women who are struggling financially. Recently some women have said that they were unable to bring their children to school as they did not have enough money for petrol and it was too far to walk. How are these women who are already struggling going to be able to afford transport to centralised antenatal clinics?

 Lack of local access to essential antenatal services breaches the HSE’s own service plans and all the Health Service research on women’s services over the past decade. We are aware of this because some of our members are also members of “Birth Matters”,a consumer group set up for parents to work with staff to improve local maternity services. Maternity services consumer groups were part of the Kinder recommendations for the on-going improvement of maternity services in response to parents needs. Parents identified their needs and some progress was made in developing local support structures for women. The Kinder report recommended community based and midwifery led services and recognised the importance of providing antenatal and postnatal services locally so that more women could attend. The HSEs own research also highlights that women need local access to services in recognition that potential barriers like childcare, lack of transport, cost of transport, work commitments are factored in when planning services. In this context, it beggars belief that decisions were made to stop these services and ask all pregnant women in County Louth and County Meath to attend Drogheda Hospital which is already experiencing very busy antenatal clinics. Closing antenatal clinics has huge implications for many women who don’t have transport and I fear that many women will not attend clinics in Drogheda. Closure of antenatal clinics contradicts all the Kinder recommendations aimed at improving health outcomes.

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