Ireland's two-tier maternity system under fire as reform stalls

The author, expecting a baby at Dublin's Rotunda hospital, highlights the unfairness of Ireland's two-tier maternity care, where paying patients get private consultants and rooms. A long-delayed reform plan aims to ensure equal access but faces opposition from consultants. The author argues that safety in childbirth should not depend on wealth.

Ireland’s Rotunda hospital, the world’s oldest continuously operating maternity facility, is nearing its millionth birth amid a dispute over private care within public wards. Private patients pay up to €4,500 for consultant continuity, scans, and private rooms, while public patients face crowded conditions. The Sláintecare reform, launched nearly a decade ago, aims to end this two-tier system, but only about half of obstetrics consultants have accepted new public-only contracts—the lowest uptake of any specialty. Recent revelations show some public-contract consultants still billed insurers for private work, and alleged cash gifts of €1,500 were offered to colleagues for weekend deliveries. Ireland’s consultant-to-patient ratio remains among the lowest in the EU, with many graduates emigrating.