Offshore and on call: healthcare on Irish islands
Although much has improved, healthcare services on offshore islands are facing cutbacks in cover
Rhoda Twombly: ‘It is vital that the level of healthcare on the islands is not only maintained but, in cases where there have been reductions in the numbre there have been reductions in the number of nurses employed and the hours that they work, restored to previous levels.’
Sarah and Mike Walsh and their daughter Saidbh: ‘Saidbh was a January baby and you couldn’t guarantee ferry sailings wouldn’t be affected.’
Dr Marion Broderick covers the three Aran islands, where she is on 24/7 duty, as her nurse is on fewer than 40 hours a week, with holiday nursing cover of only two days a week. Photograph: Joe O’Shaughnessy
When Sarah Walsh prepares her bag for maternity hospital in a few days’ time, she won’t be as obsessed with weather forecasts as she was when approaching her due date with Saidbh, her first child, who is two.
“Saidbh was a January baby and you couldn’t guarantee ferry sailings wouldn’t be affected,” says Walsh, who lives on Clare island, Co Mayo.
“To be honest, my parents were more worried than I was, whereas I kept saying I would be fine.”
Like most island women, Sarah’s mother, Mary McCabe, a school teacher, and grandmother, May McCabe, a postmistress, travelled out to the mainland several weeks before each delivery.
“That could be hard if you didn’t have family to stay with and if you had small children already at home,” Walsh says.
“I was lucky in that I had my in-laws in Westport and I stayed with my granny in Louisburg for a week after Saidbh’s birth. Many women had to, and sometimes still have to, book in to guest houses for that time. A summer birth is different,” Walsh adds.
Still, there are no guarantees; last month, the RNLI Achill lifeboat was called to Clare island when a young pregnant woman went into labour.
Medical corpsAs with rescue agency staff and volunteers, Ireland’s small but highly effective offshore medical corps of doctors and nurses are trained for such close calls. In 1996, Mairéad Uí Fhlatharta gave birth to a daughter, Sorcha, in an Irish Coast Guard helicopter that was flying her from the Aran island of Inis Oírr to hospital in Galway.
In July 2013, paramedics Gary Robertson and John McCartney delivered a baby boy in mid-air as the Irish Coast Guard’s Sligo-based helicopter flew from Arranmore island, Co Donegal, to Letterkenny General Hospital.
The establishment of what was originally called the Irish Marine Emergency Service in 1990, and consequent expansion of air/sea rescue and lifeboat cover, has transformed life for some 3,000 residents on islands and in more remote coastal communities.
Improved and more regularly subsidised ferry services have had a positive impact. Growth in tourism and technological change has also made island living more economically viable for young families with particular skills.
“In some ways, we are often in a better position here than Glencolumbille or some other isolated community on the mainland,” says Dr Kevin Quinn, who has been the resident GP on Donegal’s Arranmore island for the past 30 years. “When there is a real emergency, we can always call the helicopter.”
Changed protocolsThe problem now is that changed protocols and a more centralised HSE-led management system has resulted in cutbacks in less headline-making preventative and primary care, and overexpenditure in other instances.
For example, last month HSE West defended a decision to deploy two successive Irish Coast Guard helicopters to Inis Mór for an injured tourist who could have been transported to hospital on a regular Aer Arann commuter flight at a fraction of the cost.