Rhona’s not alone – our hospitals leave all of us feeling exhausted

MATERNITY chief Rhona Mahony has said she is “exhausted” – and I can well believe it. She is exhausted, she says, by the “toxic” working conditions of doctors in the State’s healthcare system, which is riddled by infrastructure problems, bureaucracy and “chronic” underinvestment. I can well believe that too.

I am observing our National Maternity Hospital Master’s exhaustion from Perth, Western Australia, in the late antipodean winter, where I have been privileged to have been present at the birth of my first grandchild, Emilee, who arrived last month to my daughter Carla and her partner Paddy.

Now a resident of Australia, Carla, who has lived here since 2011, does not have private health insurance and so availed of the GP shared care system, where all her prenatal visits were with her GP until she reached her 24th week of pregnancy, when she transferred to the care of her local hospital, Osborne Park.

Osborne Park is a low-rise, general hospital campus with lots of outdoor space and garden areas. It does not operate an accident and emergency service. Therefore, the atmosphere is reasonably relaxed and informal with little of the bustle and simmering chaos to which I have become accustomed in Dublin hospitals.

The maternity service is midwifeled; Carla was assigned a midwife when her labour started, and she stayed with her until Emilee arrived, even though her shift had ended some three hours earlier. Instead of delivery rooms, there are birthing suites. These L-shaped suites consist of a large lounge-like area with circular sofa and coffee table, a bathroom (with a bath where women can spend some of their labour), an outdoor terrace with bistro table and chairs and the delivery area with large lamps and built-in, wooden units housing the necessary equipment. The only real clue to the room’s purpose is the heated unit for newborns to be weighed and checked.

Doctors came and went through the labour, just checking in, and all introduced themselves by first name. After the birth, mum and baby are transferred to the ‘ward’ (a three-bedded room) for a night or two. Before discharge, Carla was visited by the physiotherapist, the pharmacist, the paediatrician and a midwife, all of whom spent 20 minutes going through all aspects of their area of care.

Once home, a hospital midwife visits every day, until five days after the birth, to check on baby and the new mother.

This, in case you have forgotten, is the public service, that is available to everyone. And it is five star.

The hospital is a calm, nurturing environment, easy to negotiate, without huge, bustling corridors and large atriums. Car parking is free and close to the building.

Another outstanding element of

the service at Osborne Park was the level of communication. Not that I think this is something we are not good at in Ireland but, in my experience, our hospital staff are often under so much pressure, they don’t have the time to sit on the side of the bed encouraging patients to ask as many questions as they like.

When my youngest was a few months old, we had an urgent health issue that necessitated a trip to Tallaght Hospital. I was completely overwhelmed by the size of the place. It felt like an airport terminal. The distances staff cover in a day must be huge.

‘Co-location’ and ‘centres of excellence’ are terms that we hear regularly in relation to our hospitals. In Perth, there is a high-tech general hospital in the city, to which babies are transferred if they have a serious issue. But most babies, thankfully, are born quite healthy.

If I had to choose, be it for maternity or ‘routine’ elective surgery, between a huge, shiny, brand new, high-rise, state-of-theart hospital, several hours’ drive from my home and shoehorned into a tiny site to facilitate co-location with a teaching hospital, or a small, community hospital, where I could get out to the garden and my visitors could park easily and for free, and where staff have time to enjoy their job, and where the food is reasonable and varied, I know which I would choose.

But most of us – exhausted or otherwise – no longer have that choice.