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Care for the few, not the many?

A recent piece in The Irish Times on the emergence of a new private antenatal clinic caught my eye. The birth child (no pun intended!) of Prof Sean Daly, Consultant Obstetrician and Gynaecologist in the Coombe Hospital, the Evie Clinic, based in Sandyford, aims to be a ‘one-stop-shop’ for expectant mothers and adopts a holistic approach to delivering antenatal care. It is offering standard medical management with access to prenatal and high-end scanning in tandem with advice on mindfulness, Pilates, lactation consultants and dieticians, etc. The interview sought to elicit the differences between the care and services that the Evie Clinic provides and the standard of antenatal care offered to women and their babies in the public system.

Prof Daly acknowledged in the article that a failing of the current public service is the lack of universal foetal anomaly scan provision, which is considered as routine in Dublin maternity hospitals, but is still not offered routinely to women in other parts of the country. He noted, as have other prominent obstetricians, the stark geographical variation in anomaly scan provision when he spoke at the Joint Oireachtas Committee for Health in May and that “the lack of a foetal anomaly scan was a tragedy, which can result in tragic consequences for the baby, if it is born with a significant abnormality and born in the wrong place”. The Evie Clinic offers three antenatal scans as part of its treatment package – an early scan, an anomaly and a growth scan.

Women attending the service will still need to register with a Dublin maternity hospital to which their consultant is attached and attend there for a booking visit. The article did not outline the costs involved but pointed out that fees would not exceed those of private consultant fees in the other maternity hospitals, which range from €3,000-3,900 and are for the most part not covered by any health insurance plans. The women who can afford to attend this clinic will undoubtedly receive top-level care from their attending consultant and midwife and benefit from a holistic approach to managing a healthy pregnancy.

Isn’t this what all women deserve, irrespective of their financial means? The founders of this clinic can hardly be faulted for spotting an opportunity to provide a level of care that they feel women are not being offered in the public system. Prof Daly, when asked whether he believes the private care on offer at the Evie Clinic provides a higher chance of having a healthy baby, answered ‘yes’ and I would take this to be a possible reflection on the constraints of the public maternity system that he himself works in, which is obviously a damning indictment of where we are at in 2017.

The recent controversy over the location of the planned new National Maternity Hospital highlighted just how far we are falling behind in terms of our ability to be able to deliver modern healthcare to women and their babies in quality, purpose-built facilities, so is it any wonder that women may be looking for private models of care that they perceive to be more attuned to their needs and that of their babies?

Having recently had my first child, a daughter, in Holles Street, I can attest to the dedication and professionalism of the world-class midwives and doctors who, despite working in cramped conditions, and in a building that would make a charming museum, versus an actual maternity hospital, ensured that we came home together, happy, healthy and safe. I received an anomaly scan. I didn’t have to shout or put my hand in my pocket for it. As the weeks progressed, I patiently waited for my daughter to be born, reassured that we were both in safe hands. This shouldn’t be a luxury or for the few. This was my right, and that of my daughter, and should be the right of every pregnant woman in Ireland today. It’s nothing short of a disgrace that women are not being offered this fundamental aspect of antenatal care dependent on their address or their ability to pay and it’s an issue that appears to be falling on deaf ears to those in Government who have the ability to be able to resource our health professionals to deliver the care they were trained to provide. The prospect that health outcomes for women and babies could be even partially determined by what’s in a patient’s purse is devastating. As another writer for this paper called it, it’d be enough to turn you into a raging socialist. They say you can’t buy peace of mind, but it appears in some cases, if you have the means, you may be able to do just that.

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