The hospital at the centre of the centre of a damning investigation into avoidable deaths of newborn babies may see its services cut or significantly downgraded in light of the life-threatening care standards revelations.
Health Minister Leo Varadkar confirmed that the move is being considered after long-term safety concerns were identified by State watchdog the Health Information Quality Authority (Hiqa).
The 208-page report, which was published yesterday despite a recent HSE threat to take a High Court injunction to prevent its release, was set up after a January 2014 RTÉ expose uncovered the deaths of five newborn babies at the hospital from a lack of oxygen between 2006 and 2012 because staff failed to properly monitor signs of foetal distress.
It found that serious issues were known by HSE managers at local, regional and national level for “more than a decade”, but were not acted on by a service “beset with indecision” and which Hiqa claims has consistently ignored reform recommendations — putting more patients’ safety at risk.
The officials behind the report yesterday said they are “unable to definitively conclude services at the hospital are safe” for women giving birth today due to ongoing staff shortages and a low level of patients being seen at the facility.
Despite the fact that the issue is partly the fault of the current Government, which has not acted on its plans to reduce services at smaller hospitals such as Portlaoise because not enough patients are attending for surgery and other matters to keep standards high, Mr Varadkar said services will now be reviewed and cut if they “are not viable”.
“The situation is that Portlaoise as a hospital was allowed to drift a long time, problems they face go back probably as far as the [pre-HSE establishment in late 2004] Midland Health Board,” Mr Vardkar said at the Irish Nurses and Midwives Organisation’s annual conference in Trim, Co Meath.
“A new action plan for Portlaoise will ensure all services are safe and properly resourced, and if services are not viable in that they do not have enough patients to support them, well then those services will have to be discontinued.”
Speaking on RTÉ News last night, Mr Varadkar clarified the issue relates to emergency and complex surgeries, and may also involve pregnancies where there is a greater risk to safety and intensive care issues.
He said a review of the situation will be completed within weeks and that “what you really see is more than a decade of missed opportunities to put things right. I want to make sure this report is not another missed opportunity.”
However, when pressed on whether individual managers will be held personally responsible for what happened, he said he cannot “act as judge, jury, and executioner at this stage”.
Meanwhile, Hiqa officials are due to attend a specially organised meeting with the Oireachtas health committee on Wednesday to explain what actions need to be taken.
One of the committee’s members, Fianna Fáil health spokesman Billy Kelleher, said the key priority must be for all of the “shocking” report’s recommendations to be acted on “swiftly” as they “expose the chronically weak levels of oversight and inaction by the HSE nationally, regionally and locally”.
“It is scandalous to think that the HSE failed in its duty to exercise any meaningful oversight of services despite repeated warnings,” said Mr Kelleher.
Hiqa report slates hospital and HSE
by Joe Leogue
The HSE has come in for scathing criticism in the conclusion of a Health Information and Quality Authority report on the investigation into safety, quality, and standards at Portlaoise.
The investigating team found: “Portlaoise Hospital and the Health Service Executive at local, regional and national level were aware for many years of numerous patient safety risks in the hospital but failed to act decisively to reduce these risks.
“It is regrettable and unacceptable that a number of the issues identified by this investigation have previously been examined in detail as part of the previous six investigations carried out by Hiqa over the last seven years.
“These recurring findings indicate a basic and worrying deficit in the Irish health services: namely the capacity and capability to reflect on the findings of all reports, reviews and investigations and apply system-wide learning from these findings for the benefit of all service users.
“It is therefore vitally important that the HSE respond [to this investigation]... to ensure that these findings do not constitute yet another lost opportunity for service improvement .
“In recent years, a number of local and national reviews and investigations into serious adverse events... conducted by the HSE as well as Hiqa, have made numerous recommendations, which if acted on may have addressed many of these risks.
“However, many recommendations were not implemented in a full or timely manner, despite clear risks for patients.
“Portlaoise Hospital lacked formal systems to ensure close clinical cooperation, communication and integrated systems of clinical governance between it and a larger training hospital. At the time of this report, the hospital continues to operate as a stand-alone hospital, providing a model of care for which the Investigation Team believes it is neither resourced nor equipped to safely deliver.”
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