Minister Jung Eun-kyeong of the Ministry of Health and Welfare has launched work to improve the overall medical system for high-risk mothers and newborns following a recent string of so-called "emergency delivery pinball" incidents. However, voices in the field say that simple support measures alone are unlikely to revive the already collapsing regional delivery infrastructure.
On the 14th, the Minister visited a senior-physician operating institution and a regional maternal and child medical center in Suncheon, South Jeolla, to review the status of essential care and high-risk delivery systems, saying, "We will swiftly prepare improvement measures so that pregnant women can give birth with peace of mind and safety," and, "We will strengthen the safety net for medical accidents and establish an appropriate compensation system so that medical professionals dedicated to essential care can focus on treatment."
That day, the Minister visited Suncheon Medical Center, the public base hospital for eastern South Jeolla, to check the operation of the senior-physician support program, and then went to Hyundai Women and Children's Hospital, the only regional maternal and child medical center in South Jeolla, to review the care system for high-risk mothers and newborns and the emergency response system.
The on-site visit was arranged after a series of so-called "emergency delivery pinball" incidents in Daegu and Cheongju, North Chungcheong, in which high-risk pregnant women could not find hospitals to accept them and were transported for long hours. The ministry is preparing a "maternal and child safe delivery improvement plan" that includes enhancing the maternal and child care delivery system, improving transfer and transport systems, and strengthening the medical accident safety net.
Recently, it also announced plans to promote a program to subsidize liability insurance premiums to reduce the legal burden on essential-care medical staff. The aim is to allow obstetrics and gynecology and pediatrics medical staff to focus on care without the burden of medical accidents.
But voices in the field say that subsidizing liability insurance premiums or providing short-term staffing alone will not solve the problem. High-risk deliveries must be organically linked not only to obstetrics and gynecology but also to pediatrics and neonatal intensive care units (NICUs), but in regional areas the related infrastructure has already entered a de facto collapse phase.
In fact, according to the Korean Society of Obstetrics and Gynecology's "nationwide status survey of obstetrics and gynecology fellows," as of March there were only 17 obstetrics and gynecology fellows at some 40 university hospitals nationwide. Of these, only five were obstetrics fellows. Work locations were concentrated in the Seoul metropolitan area, including CHA Gangnam Medical Center, Gachon University Gil Medical Center, Konkuk University Medical Center, Korea University Ansan Hospital, and Samsung Medical Center.
The shortage of pediatrics personnel is also severe. The Jeonju Jesus Hospital pediatric emergency center, the only pediatric emergency medical center in the Honam region, is struggling to operate due to a lack of medical staff. Meanwhile, the two pediatric emergency medical centers newly designated by the ministry that day—Seoul St. Mary's Hospital and St. Vincent's Hospital—are both located in the Seoul metropolitan area, prompting concerns that regional disparities could widen.
The shortage of beds also persists. According to data titled "status of NICU resources by city and province" received by Rep. Kim Sun-min's office of the Rebuilding Korea Party from the Health Insurance Review & Assessment Service (HIRA), the number of NICU beds nationwide stood at 1,953 as of March this year.
By region, shortages were pronounced in North Chungcheong, South Jeolla, and North Gyeongsang. The actual number of NICU beds was 30 in North Chungcheong, 26 in South Jeolla, and 18 in North Gyeongsang, but the number of beds deemed necessary by the Ministry of Health and Welfare was 32, 35, and 44, respectively. That means North Chungcheong is short by 2 beds, South Jeolla by 9, and North Gyeongsang by 26.
In a recent case in Cheongju, North Chungcheong, where a high-risk pregnant woman could not find a hospital capable of emergency delivery and was transported all the way to Busan, the reasons cited for refusal by hospitals in the Chungcheong region included the absence of obstetrics specialists and a shortage of NICU beds.
The Korean Intern Resident Association (KIRA) also expressed concern in a report that day about the government's reorganization of the emergency patient transport system. KIRA stressed, "Although the Ministry of Health and Welfare and the National Fire Agency have been conducting a pilot project since March to overhaul the emergency patient transport system based on a metropolitan situation room in the Honam region, concerns continue in the actual medical field about emergency room overcrowding, care gaps in backup departments, and increased transports without prior notice."