Canterbury board report suggests extra maternity beds

Press, 1 June 1989, Page 24

Canterbury board report suggests extra maternity beds

By SARAH SANDS Retaining country maternity hospitals and increasing the number of maternity beds at Christchurch Women’s Hospital should relieve the pressure on maternity services in Canterbury, according to a Canterbury Hospital Board report. The draft service development plan for obstetrics and gynaecology, which has been accepted by the board, updates and finalises a proposed plan presented to the public in June, 1987. Many key recommendations of the first plan have been changed in line with concerns expressed in submissions and at a public meeting attended by more than 175 people, mainly women. As many people were opposed to a proposal that obstetrics be centralised at Christchurch Women’s Hospital, the revised report recommends that rural maternity hospitals be retained and rural

practitioners encouraged to use them.

It also recommends that Burwood Hospital be retained in its present capacity but be refurbished to improve the physical environment and amenities. To relieve the pressure at Christchurch Women’s Hospital, the report recommends rationalising the gynaecology wards to provide more maternity

beds at the hospital. The new service development plan is the result of 18 months work by a 10-member working party comprising board staff and community representatives. The plan outlines proposals for optimum services for obstetrics and gynaecology but warns that the board may not have adequate resources for the proposals to be implemented. “The extent to which proposals can be implemented will depend on cost constraints placed on the board in the future. However, in a climate of financial constraint, it is even more important that priorities for the use of scarce resources be set clearly.” The report notes concerns about pre-natal care, particularly the big sizes of the parent education classes and the lack of continuity of care. In response the report recommends: • That parent education classes be limited to 10 couples a class. • The board set up a pilot project in conjunction with general practitioners and health workers to hold ante-natal care and parent education classes in suburban locations. ® The board establish, as a pilot project, a con-tinuing-care midwife team

which would care for a defined group of patients through to post-natal period. For post-natal care, the report recommends:

• That women have the option of transferring to a local hospital after delivery at the base hospital.

• An urgent increase in the numbers of midwives in hospitals and in the district service.

Increases in gynaecology admissions in the last 10 years have put pressure on the number of beds at Christchurch Women’s Hospital and the report expresses concern at the waiting time for some gynaecology procedures such as sterilisation.

The expected increased demand for colposcopy services, as a result of the Cartwright report, was also of concern, said the report.

“Some consideration must be given to the provision of colposcopy services at sites other than Christchurch Women’s Hospital. For example, the clientele of the Sexually Transmitted Diseases clinic, a particularly atrisk group, could be more easily examined at that point of contact. “However, the limited resources likely to be available might be used most effectively and flexibly if concentrated at one site.” •

The report notes the increasing death rates from cancer of the cervix of women aged under 35, and the increasing incidence of ectopic pregnancy and pelvic inflammatory disease. “Studies have suggested that these three conditions may be linked to an increased incidence of sexually transmitted diseases.” The report recommends: • No reduction in gynaecology services. • An urgent extension of colposcopy services by training more colposcopists and providing more equipment and support services. • Providing separate, expanded facilities and a

more comfortable environment for colposcopy services. • That the board review the priority given to sterilisation. (The report acknowledges that some action has already been taken on the recommendations to improve colposcopy services). The acting general manager of the Canterbury Hospital Board, Mr Ron Parker, said the service development plan would be referred to one of the standing committees of the new Canterbury Area Health Board for discussion on how the recommendations could be implemented.