Call for review of governance structures for maternity units

A major report into the death of Savita Halappanavar has said some of Ireland’s 19 maternity units may need to be scrapped to ensure patient care.

The possibility is detailed in the Health Information Quality Authority’s (Hiqa) 257-page probe into what happened last October at University Hospital Galway.

The report, which can be read at www.irishexaminer. com, states that Hiqa is “concerned” about a total lack of evidence of any national review, or national population-based needs assessment, to show why current service structures should are in place.

It said there is a “wide variation in the availability of obstetric beds to the number of births within hospitals”, and that there are “many areas where maternity service needs were not being fully met at the time of the investigation”.

As such, it said questions should be raised “as to the sustainability of the provision of maternity services in some areas”.

Hiqa found that at a local level, public maternity services at each of the 19 units are being provided “through a myriad of governance structures and arrangements”.

“The authority is of the opinion that, where such inconsistencies in governance structures exist, and given the authority’s concerns in relation to the lack of accessible, consistent and reproducible data relating to the quality of the service covered later in this report, it is impossible to assess the performance and quality of the maternity service nationally,” Hiqa said.

It did concede that the establishment of hospital groups, as a step to creating independent hospital trusts, “proposes a reorganisation of maternity services in the context of the integration of services and the supporting governance arrangements”.

“Notwithstanding these plans, it is imperative that the HSE immediately conducts a review of the current governance arrangements for the provision of maternity services at local level.

“This review should be led by a named accountable person to ensure that any corporate and clinical risks are identified, mitigated and managed in the context of current services and the proposed changes.”