Citta' piu' sicura dove far nascere figli

Dublino e' la citta' piu' sicura al mondo dove far nascere bambini.

Mi scoccia dilungarmi in battaglie del tipo "Sono due anni che lo dico"......
Se la sanita' Irlandese sa fare una sola cosa, quella cosa e' far nascere i bambini.
Molte cose pero', lasciano a desiderare non poco.

Ecco la fonte

Chi ha qualcosa da ridire a riguardo, libero di farlo. Pero' ricordate che sono molto attento, visto che e' un argomento a cui tengo molto.
A tal proposito vi invito ad analisi serie e comprovate da dati.
Altrimenti, vista 'importanza dell'argomento, vi chiedo di tacere.

Per "par condicio", vediamo cosa accade a Catania

Bacco1977

Articolo:

‘Dublin now safest city in world for births’

By Niall Hunter-Editor

A major drop in the number of non-national mothers from outside the EU giving birth here has been recorded since the ‘yes’ vote in the citizenship referendum last year, according to the National Maternity Hospital in Holles Street.

Former Holles Street Master Dr Declan Keane told irishhealth.com that prior to the referendum, 16% of the deliveries at the hospital were to non-EU women and five per cent were to women from other EU countries.

He said that since the referendum, this figure had been reversed, with 16% of births now accounted for by mothers from other EU countries and five per cent to mothers from outside the EU.

"The citizenship issue has changed things around dramatically-it has been a complete turnaround, with many of the EU mothers coming from the new accession states and fewer Nigerians now giving birth." The hospital delivered about 8,400 infants in 2004.

Dr Keane, who finished his seven-year term as Master on December 31,said Holles Street was set to record its lowest ever infant mortality rate in 2004,with a corrected rate discounting congenital abnormalities of only four per 1,000 births.

Including congenital abnormalities, the perinatal mortality rate at Holles Street this year was 5.6 per 1,000.

He said a UK expert who had recently reviewed the latest clinical reports for the three Dublin maternity hospitals concluded that Dublin is the safest city in the world for a mother to have her baby, thanks to the high standards of care here.

Dr Keane admitted that this was in contrast to the high level of malpractice litigation in obstetrics in Ireland.

However, he said this was due to the legal climate here and the and the adversarial way in which settlements are reached. "A doctor in Ireland is four times more likely to be sued than his UK counterpart and the average size of awards here are three times the UK rate. These rates have nothing to do with the standards of care, which are extremely high."

Dr Keane said there was an urgent need to reform the medical litigation system in Ireland, and consideration should be given to setting up a structure similar to the personal injuries board to deal with medical malpractice cases and to take them out of the adversarial courts system.

He said recent research from the United States indicated that between 85% and 90% of cerebral palsy cases are not related to events in the hospital around the time of birth and the vast majority are due to events during pregnancy or after birth, yet there was still a very high level of litigation here in relation to cerebral palsy cases.

Dr Keane pointed out that obstetricians in Sweden and Denmark paid very little in medical insurance because the state in these countries looked after families where children developed brain damage and parents did not need to sue hospitals to look for compensation.

"The current situation is that parents in Ireland feel they have to get the money to look after their children from somewhere and at present the only way to do this is to sue doctors and hospitals."

He felt the tide was beginning to turn as regards the high rate of medical litigation; Holles Street had successfully defended four negligence cases in the High Court over the past four years, whereas the previous policy had tended to be that the hospital would try to settle these cases at an early stage. Two of the four cases successfully defended by Holles Street were cerebral palsy cases.

Dr Keane said with the state now taking over negligence insurance for hospitals and doctors, medical negligence cases were likely to be defended more aggressively, as taxpayers' money was involved. However, he stressed that a more equitable compensation system, on the lines of the Personal Injuries Assessment Board, should be established to deal with claims.

"It is true that patients are getting to be more demanding and arguably that is a good thing. Since the advent of the Celtic Tiger, people do not accept second best in restaurants and the same goes for maternity hospitals."

Dr Keane said the great frustration from the hospital’s point of view was that it was not always able to meet all patients' expectations because of financial or infrastructural restraints.

"While we always strive our best to provide optimal care, I sometimes believe patients’ expectations can be too high. We do not live in a perfect world. People now have their children later, have fewer children and they often want every single thing to go perfectly. However, obstetrics is not always an exact science and the reality is that things cannot always go perfectly."

Dr Keane said one third of infant deaths at the hospital, which were now at a record low, were due to congenital abnormalities, one third due to prematurity and one third due to other factors.

"The real challenge for us going forward will be to continue to try to prevent pre-term births and the complications that ensue from these deliveries. There is a lot we can now do, however for premature babies-60% of babies born at 23 weeks now survive, although a high proportion of those would have problems."

Dr Keane says that over his seven years as Master, the most stressful issue Holles Street has had to deal with was the organ retention issue. He said it was a 'no-win' situation for either the parents or the doctors and hospitals. "I can understand why the parents feel aggrieved. It was extremely stressful here for people manning phone lines and for doctors meeting with the parents."

Dr Keane said all hospitals had learned lessons from the organ retention issue but he does not think the Dunne inquiry is going to provide the answer to the problem. "It will be very unsatisfactory for both the parents and the hospitals if satisfactory recommendations and conclusions do not emerge from the Dunne inquiry. Unfortunately, I think this will be the case."

He said the issue was a 'no-win' situation and they were dealing with a previous era when doctors at the time believed what they were doing was right.

Dr Keane said the drop in the rate of post-mortems at Holles Street following the organs controversy, from 90% to under 60%, is 'extremely regrettable'.

"The reason for doing post-mortems is to try to find out why a baby died. If we cannot do post-mortems we cannot give answers on those deaths to parents."

Last year, Holles Street announced that due to space and staff shortages, it would be imposing a limit on the number of patients it will admit this summer.

Dr Keane says that while discussions are taking place about moving Holles Street to a new and bigger unit at St Vincent’s Hospital, this, if it gets the go-ahead could take up to seven years and Holles Street may have to continue to impose some patient restrictions in the meantime.

He said the ERHA and the Central Statistics Office recently made a presentation to the maternity hospitals at which a dramatic increase in the number of patients at the Coombe and Holles Street was predicted up to 2011.

Dr Keane said that if the projected figures come in at the lower end of the scale, Holles Street would be looking after 9,500 women by 2011. "If we are to look after these numbers we need a new hospital and if we got the unit at St Vincent’s we could look after in excess of 10,000."

He said that although Holles Street would be getting an interim development on its site to provide some additional space, he believed the restrictions in admissions may continue for the next few years.

Dr Keane said St Vincent’s was agreeable to Holles Street moving to its site-it was just a question of the funding being provided.

He felt it was unlikely that a fourth public maternity unit would be built in Dublin, but that the existing three hospitals would be expanded.

Dr Michael Robson took over as Master of Holles Street from Dr Keane on January 1.