A review of maternity and gynaecology services in the greater Dublin area has recommended many services are moved to different hospitals.
Read the report in full.
It recommended that services at the Rotunda Hospital be moved to the Mater Hospital site, that the Coombe Women's Hospital transfer to Tallaght Hospital and services at Holles Street be moved to St Vincent's Hospital.
It also warned that the current pressure of demand on maternity services is leading to a significant increase in 'the risk of serious untoward incidents'.
The review by consultants KPMG, published on the HSE's website, says that Dublin's model of stand-alone maternity hospitals is not the norm internationally and that maternity services should be located with adult acute services, allowing the mother access to a full range of medical and support services should the need arise.
It concluded that the three maternity hospitals are currently understaffed and need an extra 20 obstetricians, 221 midwives, 20 neonatal nurses and 35 theatre staff to meet existing demand.
The number of delivery suites and theatres is below what is required now and planned operations often get interrupted for emergency deliveries.
The report says that the changes will require substantial capital investment but that the existing hospital land may help towards the funding needs.
KPMG says that the three maternity hospitals are under considerable pressure due to the growth in demand in recent years and each hospital now delivers over 8,000 babies a year, accounting for 40% of all babies born in Ireland.
It projects that the growth in births will continue until 2016 when it will level off.
To allow greater choice for women, the review recommends the introduction of midwife led units (MLUs,) adjacent to hospital based obstetric units, as well as the option to have a home birth.
The HSE said that while the issue of how the changes are funded arises, it is confident that the 'ultimate goal' of developing maternity services at the three main hospitals will deliver significant savings and will represent better services.
