Consultant calls for ‘honest conversation’ about lack of beds in intensive care

Consultant obstetrician and former master of Holles Street Dr Peter Boylan has criticised a deficit in staffing levels and the lack of an adequate number of intensive-care beds in Irish hospitals.

Dr Boylan was an expert witness at the inquest into the death of Dhara Kivlehan, who died from multi-organ failure a week after giving birth in Sligo Regional Hospital.

Speaking on RTÉ radio yesterday he called for an “honest conversation” to take place. “We have a lower bed capacity than we need for the population and we need to have an honest conversation about this,” he said.

“And if we as a State are willing to put up with infrastructural deficits then we do have to accept that there are going to be tragedies like Dhara Kivlehan happening again,” he said, “or we can reorganise and invest correctly on a par with other OECD countries. Accidents will happen but they will be less likely.”

Continuity

Dr Boylan said if there had been more consultants in Sligo who were able to give better continuity of care, Mrs Kivlehan might have been transferred earlier.

But he said in order for a transfer to take place, beds must be available.

“We have a deficit in this country of intensive care beds, which is well known and has been well known for many years now, so when they tried to transfer Mrs Kivlehan they were unable to because there were no beds available in the Republic, and that’s why she was transferred eventually to Belfast. This happens on a regular basis.”

Dr Boylan said Mrs Kivlehan’s care in Sligo had been excellent right up until after she was delivered.

‘Deficiencies’

“Then I identified some deficiencies in care which I related to a certain extent to a lack of continuity,” he said, “which is a consequence of not having enough consultants on the ground in Sligo. And also then, when they tried to transfer her, as I said, there weren’t intensive care beds available in places.

“Irish hospitals generally run at very high bed-occupancy levels, which are well above the international recommended standard of 80 per cent, and you need to have less than 100 per cent bed occupancy and clean beds in order to have space to accept people when there are emergencies and there are surges in activity. And this is a regular sort of problem.”

Dr Boylan acknowledged a degree of specialisation could not be offered in every centre around the country but said: “We do need to have centres of excellence which are well staffed, well looked after in terms of infrastructure, and our regional hospitals need to be beefed up in terms of staffing . . . at consultant level in particular.”