HP, Would he be open to doing the grocery shopping with you and the kids? Not a very romantic thing, but doing little stuff like that together can help to take the edge off. While MrsGGB and I don't go out on dates much, we do frequently leave S16 in charge while we run out the the grocery for a while. Not sure the dynamic would be quite the same with 3 kids in tow, but at the very least it might help to have a change in scenery.
As for the babysitting, I know all about the not wanting to leave the kids. We didn't go out for close to 10 years after S16 was born, mostly because MrsGGB wasn't comfortable with leaving the kids with anyone. Even when we did start to go out (which was once in a blue moon), she'd call home every half hour to check up on them, and insist we get home quickly regardless of our plans. It will take a lot of effort on his part to get comfortable with having a babysitter. Might help if you find a babysitter with red cross certification. S16 and S13 both completed the red cross course for babysitters and are certified. At least then, you know the babysitter has had basic first aid training and has learned about basic child care. I'm not sure where to get a list of certified babysitters though. Ask around.
Anyway, you gotta get him to loosen up a little. The health of your R is at stake. You two need to get out.