Referendum campaign: The Rotunda Hospital in Dublin asked the Government last year to give urgent attention to an "alarming" increase in the number of non-national patients who were HIV positive, it has emerged.
In its case for the referendum, the Government has cited pressure on maternity hospitals due to the automatic entitlement to an Irish passport of children born to non-nationals.
However, the Rotunda said an expectation among HIV patients that they would not be turned away was a factor behind the increase in non-national pregnant women with HIV seeking care.
The master of the hospital, Dr Michael Geary, said in a private letter to the Minister for Health, Mr Martin, that the trend was having a major impact on the delivery of care in the hospital and was causing a major drain on resources.
Seen by The Irish Times, the letter drew attention to a "considerable increase" in the number of women from sub-Saharan Africa who were arriving at the Rotunda and revealing that they were HIV-positive. The trend was "worrying and alarming", it said. The hospital dealt with 23 cases of HIV-positive pregnant women in 2001, 18 of whom were non-nationals. This rose to 50 cases in 2002, of whom 44 were non-national. The hospital did not not have the required number of clinical staff to deal with such numbers, the letter said.
Writing on February 23rd last year, Dr Geary said the problem had become "acute" as 18 HIV-positive pregnant women had presented for treatment in the first number of weeks in the year. In a post scriptum, he said the busiest unit in the US was in Miami, "and they have between two and three new cases of HIV in pregnancy per month".
However, Dr Geary said last night that the rate increase early in the year was disproportionate. The hospital ultimately treated 65-70 HIV-positive pregnant women last year, he said.
He said the breakdown between Irish patients with HIV and non-national HIV patients was roughly the same as in the two previous years.
"We expect 60-70 cases this year if the trend continues," he said. His biggest concern remained the number of women presenting late in their pregnancies or in labour.
The letter said it had been "suggested in some quarters that women who present themselves with HIV-positive (sic) will not be turned away from these shores and that we will feel obliged to provide the appropriate medical care during pregnancy and on an on-going basis into the future".
Dr Geary said staff were very concerned about the situation. "While we, as healthcare workers, will take the appropriate cautions to avoid transmission of HIV, it is obvious to all that the more cases of HIV that one is exposed to, in theory, there is a greater risk of transmission of the virus.
"Although precautions are taken, I would not like to be in the position to have a member of my staff needing to change their career because of contracting HIV through an occupational incident."
The development follows publication in the Irish Examiner yesterday of a letter from the master of the National Maternity Hospital, Holles Street, Dublin, Dr Declan Keane, in which he drew attention to a faxed letter from a Ukrainian man in which he sought care for his pregnant wife.
While Mr Victor Tkachenko told RTÉ he knew of two people who had come to Ireland to give birth so their children would have Irish passports, he said "for me it was not a critical question".