First-time mother Siobhán Singleton had her first and only visit from a public health nurse just three days after arriving home with her bundle of joy – that was two years ago.
Ms Singleton, the mother of daughter Molly, was delighted to welcome the nurse into her home, safe in the knowledge that she would see her soon again.
But for Ms Singleton the security bubble of knowing frequent calls by a public health nurse to monitor her baby’s developmental stages burst when she was told she “might not” have another such visit.
The service was pulled due to a lack of nurses.
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“We were left on our own after that, to be honest. I kept thinking we could get more visits, but we didn’t,” said the 33-year-old, who lives in the Drimnagh, Dublin 12, and is on a sabbatical from her career in paediatrics.
“When I needed to weigh my daughter for some medicine when she was almost one-years-old, it became apparent that she was not meeting milestones when it came to her weight.
“I contacted the local public health centre where Molly was seen and I was told she needed a referral to see a dietitian, but that they did not have a dietitian and that maybe someday she would be seen.
“There were no resources made available to the centre. So we had no other option but to see a dietitian privately, which cost around €170, but we were lucky we could afford to do so.” Thankfully Molly gained weight when her calorie intake was increased.
Ms Singleton said that “it’s well known that intervention if it’s needed in a child’s early months and years” was vital.
“I’m totally gobsmacked by this. The service provided by public health nurses should not be allowed to be pulled like this. The safety nets are completely gone,” she said.
Julie Blakeney (38), whose son Walter McEvoy Blakeney is now almost two, was delighted to have a visit from her public health nurse two days after they had left hospital.
“I was so appreciative of her help and guidance, but when she was leaving I was also informed that I might not see her again. And she was right, I haven’t,” she said. “This is such a basic need that should be in place everywhere. I’ve been left to research whether Walter is meeting his milestones on my own.”
But what “really annoyed” Ms Blakeney, who runs her own communications business, was a leaflet that came through her door telling her and others, also in Drimnagh, that for public health nursing services they should “scan the QR code” provided to check to see if developmental guidelines were being met.
“There seems to be a real disparity of care in areas of Dublin and in the parts that really need them. Areas such as Clontarf, Glasnevin, Fairview, Blackrock or Terenure don’t seem to be affected by the lack of public health nurses. There certainly seems to be levels of inequality.”
Dr Tadhg Crowley, who chairs the Irish Medical Organisation’s GP committee, said “replacing primary health nurses with non-specialist nurses or services” was not a solution and was “worrying for parents” and GPs.
“At a human level, a primary healthcare nurse enters a home and sees exactly what is happening. They are another set of eyes. By stopping such a service my fear is that it will not come back to what that level was before. It is like kicking a person when they need the help of the primary health nurse the most,” he said.
A HSE Dublin and Midlands spokesperson said it was “experiencing challenges in relation to the recruitment and retention” of public health nurses (PHNs) within the Greater Dublin Area.
Staff shortages mean that some areas are operating what is called a “Priority 1 (P1) service as per the National Caseload Prioritisation Procedure for the PHN service”. What this means to parents and children is the HSE is now “prioritising essential services in line with immediate clinical needs and national guidelines” and “unfortunately” some services will not be provided.
The HSE said those overseeing the Dublin and Midlands region were working to address service provision and said this included the development of partnerships between acute hospitals and community partners to provide graduate nurses with opportunity for a clinical rotation to the community and to initiate a similar opportunity for experienced registered nurses working within hospitals.
In addition, the Department of Health has allocated 26.7 such posts with priority allocation to the three areas where there are high pressures, which include Dublin south city, Dublin west and Dublin southwest. The department said efforts were under way to fill the positions as quickly as possible.
