The National Maternity Hospital sought the appointment of 27 additional staff before providing abortion services, according to its former master Dr Peter Boylan.
Dr Boylan says his " jaw dropped" when then master of the NMH, Dr Rhona Mahony, and colleagues told him they would need the additional staff, as well as MRI funding and operating theatre space, to provide termination of pregnancy services.
This was in October 2018, three months before the planned introduction of the service. Dr Boylan had been appointed by Minister for Health Simon Harris to oversee implementation of the service from the start of this year.
"I advised Dr Mahony and her team that it would do their relationship with the Department of Health no good to submit a request for 27 new staff members for a likely maximum extra workload of 10 patients each week," he says, in a memoir, In the Shadow of the Eighth, which was launched on Thursday.
The NMH has since advertised for two new consultant positions to help provide termination services, he notes.
The possibility of doing surgical abortions at weekends was also considered with the hospital, but was scotched when staff pointed out that nurses would only be paid at additional €6 for working on a Saturday, “and there was therefore unlikely to be great enthusiasm for this particular solution”.
“This was understandable and another illustration of the difficulties of running a health service seven days a week, which some commentators simplistically suggest as a solution to waiting lists.”
The number of terminations being carried out is likely to be about 5,000 a year - half the original estimate, he writes. About 90 per cent of women are presenting at less than nine weeks, which means their terminations can be performed in the community rather than in hospital. The three Dublin maternity hospitals are seeing just five cases a week, half as many as expected.
Dr Boylan recounts the various teething troubles faced by the new service after it began.
“There was a lack of suitable space to hold clinics, a scarcity of inpatient beds and problems with access to operating theatres, which, in some hospitals, were either closed for some days during the week or simply not available to be used because of lack of staff or funding. Ultrasound services were overloaded. There were shortages of staff in every unit.”
In Limerick, entry to the operating theatre was through the labour ward, “a highly unsatisfactory situation both for women who have had miscarriages and for those having terminations”.
In Galway, one gynaecologist had a three-year waiting list, while in Drogheda, staff were concerned about a possible influx of women from Northern Ireland.
Dr Boylan says the fears of some doctors that clinics and operating lists would be swamped have not materialised.
In the book, he restates his opposition to the planned move of the NMH to St Vincent’s University Hospital until ownership issues at the site are resolved. The site, he says, remains under religious control, as the Sisters of Charity still have to get permission from the Vatican to transfer ownership of the land into a secular structure.
Because of the delays in progressing the project, the final cost is likely to exceed €500 million, he estimates - over three times the original estimate.
